1. © 2007 McGraw-Hill Higher Education. All rights reserved. Chapter Twelve Drugs and Addictive Behavior: Use, Abuse, and Control

2. © 2007 McGraw-Hill Higher Education. All rights reserved. What is a Drug? Drug: a substance other than food that affects the structure or function of the body through its chemical action Drug: a substance other than food that affects the structure or function of the body through its chemical action Psychoactive drugs: substances that cause changes in brain chemistry and alter consciousness, perception, mood, and thought Psychoactive drugs: substances that cause changes in brain chemistry and alter consciousness, perception, mood, and thought Drug of abuse: medical drugs used for non-medical purposes or a drug that has no medical uses Drug of abuse: medical drugs used for non-medical purposes or a drug that has no medical uses All drugs have the potential to be toxic, poisonous, dangerous, or deadly All drugs have the potential to be toxic, poisonous, dangerous, or deadly

3. © 2007 McGraw-Hill Higher Education. All rights reserved. Types of Drugs Drugs are classified in several different ways Drugs are classified in several different ways Legal drugs include: Legal drugs include: Medication prescribed by physicians Medication prescribed by physicians Over the counter (OTC) medications Over the counter (OTC) medications Herbal remedies Herbal remedies Illicit drugs are unlawful to possess, manufacture, sell, or use Illicit drugs are unlawful to possess, manufacture, sell, or use Table 12.2 summarizes the controlled substance schedules

4. © 2007 McGraw-Hill Higher Education. All rights reserved. Drug Use, Misuse, and Abuse Drug use can refer to something as common taking two aspirin for a headache Drug use can refer to something as common taking two aspirin for a headache Drug misuse: use of prescription drugs for purposes other than those for which they were prescribed or in greater amounts than prescribed Drug misuse: use of prescription drugs for purposes other than those for which they were prescribed or in greater amounts than prescribed Drug abuse: the use of a substance in amounts, situations, or a manner such that it causes problems, or greatly increases the risk of problems, for the user or for others Drug abuse: the use of a substance in amounts, situations, or a manner such that it causes problems, or greatly increases the risk of problems, for the user or for others

5. © 2007 McGraw-Hill Higher Education. All rights reserved. Routes of Administration Orally Orally Injection Injection Usually involves a hypodermic needle delivered into the bloodstream by: Usually involves a hypodermic needle delivered into the bloodstream by: Intravenous injection Intravenous injection Intramuscular injection Intramuscular injection Subcutaneous injection Subcutaneous injection Inhalation Inhalation Application to skin or mucous membranes Application to skin or mucous membranes Dermal absorption Dermal absorption Transdermal absorption Transdermal absorption

6. © 2007 McGraw-Hill Higher Education. All rights reserved. Factors Influencing the Effects of Drugs Characteristics of the drug Characteristics of the drug Chemical properties of the drug and its actions Chemical properties of the drug and its actions Characteristics of the person Characteristics of the person Age Age Gender Gender Body weight and mass Body weight and mass Physical condition Physical condition Mood Mood Experience with the drug Experience with the drug Expectations Expectations Characteristics of the situation Characteristics of the situation Environmental experience Environmental experience

7. © 2007 McGraw-Hill Higher Education. All rights reserved. Drug Dependence A condition characterized by a strong craving for a drug and by compulsive use of the drug despite serious negative consequences A condition characterized by a strong craving for a drug and by compulsive use of the drug despite serious negative consequences Dependence usually means that physiological changes have taken place in the brain and body chemistry Dependence usually means that physiological changes have taken place in the brain and body chemistry Tolerance usually occurs because the body seeks to compensate for the chemical imbalance caused by the drug and achieves a ‘new normal’ Tolerance usually occurs because the body seeks to compensate for the chemical imbalance caused by the drug and achieves a ‘new normal’ Withdrawal symptoms are different for different drugs and lead to unpleasant feelings Withdrawal symptoms are different for different drugs and lead to unpleasant feelings

8. © 2007 McGraw-Hill Higher Education. All rights reserved. Effects of Drugs on the Brain Many addictive drugs act on neurons in three brain structures: Many addictive drugs act on neurons in three brain structures: The ventral tegmental area (VTA) in the midbrain The ventral tegmental area (VTA) in the midbrain Nucleus accumbens Nucleus accumbens Prefrontal cortex Prefrontal cortex These neurons form a pathway called the Pleasure and Reward Circuit (see Figure 12.2) These neurons form a pathway called the Pleasure and Reward Circuit (see Figure 12.2) Once drugs reach this area, productions of dopamine increase Once drugs reach this area, productions of dopamine increase All or nearly all addictive drugs operate via this pleasure and reward circuit All or nearly all addictive drugs operate via this pleasure and reward circuit

9. © 2007 McGraw-Hill Higher Education. All rights reserved. Addictive Behaviors Many experts now extend the concept of addiction to other areas in which behavior can be compulsive Many experts now extend the concept of addiction to other areas in which behavior can be compulsive Such as gambling, exercise, and sex Such as gambling, exercise, and sex These behaviors may follow the same pleasure pathway as drugs do in the brain These behaviors may follow the same pleasure pathway as drugs do in the brain These behaviors produce a ‘high’, and the brain adjusts in such a way that the person experiences a strong desire to repeat the behavior as well as a craving for the behavior when it stops These behaviors produce a ‘high’, and the brain adjusts in such a way that the person experiences a strong desire to repeat the behavior as well as a craving for the behavior when it stops

10. © 2007 McGraw-Hill Higher Education. All rights reserved. Drugs of Abuse Stimulants Stimulants Depressants Depressants Opioids Opioids Hallucinogens Hallucinogens Inhalants Inhalants Marijuana Marijuana

11. © 2007 McGraw-Hill Higher Education. All rights reserved. Central Nervous System Stimulants Drugs that speed up activity in the brain and sympathetic nervous system Drugs that speed up activity in the brain and sympathetic nervous system Effects evoke a ‘fight or flight’ response Effects evoke a ‘fight or flight’ response May produce intense feelings of euphoria and create a sense of well-being May produce intense feelings of euphoria and create a sense of well-being Examples are: Examples are: Caffeine Caffeine Amphetamines Amphetamines Cocaine Cocaine MDMA (ecstasy) MDMA (ecstasy)

12. © 2007 McGraw-Hill Higher Education. All rights reserved. CNS Depressants Slow down activity in the brain and sympathetic nervous system Slow down activity in the brain and sympathetic nervous system Can be deadly if misused, especially when mixed with alcohol Can be deadly if misused, especially when mixed with alcohol CNS depressants carry a high risk of dependence CNS depressants carry a high risk of dependence Examples include: Examples include: Barbiturates and Hypnotics Barbiturates and Hypnotics Anti-anxiety drugs (benzodiazepines) Anti-anxiety drugs (benzodiazepines) Rohypnol Rohypnol GHB (Gamma hydroxbutyrate) GHB (Gamma hydroxbutyrate)

13. © 2007 McGraw-Hill Higher Education. All rights reserved. Opioids Natural and synthetic derivatives of opium Natural and synthetic derivatives of opium Have a long history of medical use for pain relief and treatment of dehydration Have a long history of medical use for pain relief and treatment of dehydration Prescribed as pain relievers, anesthetics, antidiarrheal agents, and cough suppressants Prescribed as pain relievers, anesthetics, antidiarrheal agents, and cough suppressants Examples include: Examples include: Morphine Morphine Heroin Heroin Codeine Codeine Oxycodone Oxycodone Produce feelings of pleasure and block sensation of pain Produce feelings of pleasure and block sensation of pain

14. © 2007 McGraw-Hill Higher Education. All rights reserved. Hallucinogens Also known as psychedelics Also known as psychedelics Alter perceptions and thinking in characteristic ways Alter perceptions and thinking in characteristic ways They produce intensification and distortion of visual and auditory perceptions as well as hallucinations They produce intensification and distortion of visual and auditory perceptions as well as hallucinations Schedule I drugs with no current medical uses Schedule I drugs with no current medical uses Examples are: Examples are: LSD (Lysergic acid diethylamide) LSD (Lysergic acid diethylamide) Psilocybin Psilocybin Mescaline Mescaline PCP (Phencylclidine) PCP (Phencylclidine)

15. © 2007 McGraw-Hill Higher Education. All rights reserved. Inhalants Breathable chemical vapors that alter consciousness, typically producing a state of intoxication that resembles drunkenness Breathable chemical vapors that alter consciousness, typically producing a state of intoxication that resembles drunkenness Commonly classified into 4 categories: Commonly classified into 4 categories: Volatile solvents Volatile solvents Aerosols Aerosols Gases Gases Nitrates Nitrates The most significant negative effect for chronic users is widespread and long-lasting brain damage The most significant negative effect for chronic users is widespread and long-lasting brain damage

16. © 2007 McGraw-Hill Higher Education. All rights reserved. Marijuana The most widely used illicit drug in the United States The most widely used illicit drug in the United States Marijuana is derived from the hemp plant, Cannabis sativa Marijuana is derived from the hemp plant, Cannabis sativa The active ingredient is delta-9-tetrahydrocannabinol (THC) The active ingredient is delta-9-tetrahydrocannabinol (THC) Marijuana produces mild euphoria, sedation, lethargy, short- term memory, impairment, distorted sensory perceptions, and impaired coordination Marijuana produces mild euphoria, sedation, lethargy, short- term memory, impairment, distorted sensory perceptions, and impaired coordination Researchers have found that THC has a variety of effects on the brain, creating decision-making problems Researchers have found that THC has a variety of effects on the brain, creating decision-making problems

17. © 2007 McGraw-Hill Higher Education. All rights reserved. Demand Reduction Strategies Incarceration for Drug-related Crimes Incarceration for Drug-related Crimes Prevention Strategies through Education Prevention Strategies through Education Primary Prevention Primary Prevention Secondary Prevention Secondary Prevention Tertiary Prevention Tertiary Prevention Drug Treatment Programs Drug Treatment Programs Narcotics Anonymous (NA) Narcotics Anonymous (NA)

18. © 2007 McGraw-Hill Higher Education. All rights reserved. Chapter Twelve Drugs and Addictive Behavior: Use, Abuse, and Control