1. Addictive Behaviors, Licit and Illicit Drugs: Use, Misuse, and Abuse

2. Defining Addiction
Use substance or continue behavior despite negative consequence
Must have the potential to produce positive mood change

3. Defining Addiction Physiological dependence/psychological dependence
Inextricably tied together
Addiction traditionally based on four criteria:
1) Relief of withdrawal symptoms
2) Continued use despite harm to self and others
3) Unsuccessful efforts to cease using or cut down on use, including relapse
4) Tolerance
Increasingly recognized that these four criteria do not characterize all addictive behavior

4. Signs of Addiction Addictions characterized by four common symptoms
1) compulsion (can include obsession)
2) loss of control
3) negative consequences
4) denial

5. Compulsive or Pathological Gambling
Facts
Cravings or highs similar to those experienced by drug users
Often seek the excitement more than the money
Men are more likely than women to have gambling problems
Incidence higher in lower-income individuals, those who are divorced, African Americans, older adults, those living within 50 miles of a casino

6. Compulsive or Pathological Gambling
College students
Increasingly involved in gambling due to ease of participation
More casinos
Internet gambling
Often has a detrimental affect on health
38% have cardiovascular problems
Suicide rate 20 times higher than that of general population

7. Compulsive Shopping and Borrowing
Facts
Money often spent to meet emotional needs not being fulfilled elsewhere
College students often open to spending problems due to targeting by advertisers and credit card companies
On average, compulsive spenders $23,000 in debt
Compulsive spending often leads to compulsive borrowing to help support addiction

8. ABC News: Addictions and Addictive Behavior
Play
Video
| Addictions and Addictive Behavior
Discussion Questions
What are some of the other types of addiction beyond drug, alcohol and nicotine addictions?
Do you think that compulsive shoplifting should be considered a disease? Why or why not?

9. How Addiction Affects Family and Friends
Codependence
Pattern of behavior
Person becomes “addicted to the addict”
Subsume personal needs in order to meet needs or desires of addict
Enabling
Knowingly or unknowingly protects addict from consequences of behavior
Rarely conscious and generally unintentional

10. Drug Abuse in the United States
Facts
Drug and alcohol abuse contributes to more than 120,000 deaths a year
Costs $294 billion in preventable healthcare expenses
Across the U.S. overall use has fallen
Adolescent use has risen in certain drug use

11. Drugs Abuse in the United States
Types of drugs
1) Prescription
2) Over-the-counter
3) Recreational – alcohol, tobacco, coffee
4) Herbal preparations – products of plant origin
5) Illicit (illegal) – all are psychoactive
6) Commercial preparations – household cleaners, pesticides

12. Drug Dynamics Routes of administration Oral Injection
1) Intravenous- into bloodstream
2) Intramuscular- into muscle
3) Subcutaneous- just under the skin
Inhalation
Inunction – through the skin
Suppositories

13. How the Body Metabolizes Drugs
Figure 7.1

14. Using, Misusing, and Abusing Drugs
Abuse often associated with illegal drugs, but many people abuse and misuse legal drugs
Drug misuse – use for purpose not intended
Drug abuse – excessive use
Misuse and abuse may lead to addiction
Evaluation of risks and benefits of use of chemical substances is necessary

15. Prescription Drugs Types of prescription drugs
Antibiotics – fight bacteria
Central nervous system depressants- sedative or hypnotic
Antidepressants
Generic drugs
Less expensive
Many brand name drugs have generic counterparts

16. Over-The-Counter (OTC)
Facts
Nonprescription medicine
More than 1/3 of the time people self-treat
How a prescription drug becomes an OTC drug
1) At least three years of sales
2) Use has been relatively high
3) Adverse drug reactions are not alarming

17. Over-The-Counter (OTC)
Types of OTC drugs
Analgesics – pain relief
GRAS (Generally Recognized as Safe) GRAE (Generally Recognized as Effective)
Cold, cough, allergy, and asthma relievers
Sleeping aids
Dieting Aids

19. Over-The-Counter (OTC)
Rules for proper OTC drug use
1) Know what you are taking
2) Know the effects
3) Reading warnings and cautions
4) Don’t use anything for more than 1 or 2 weeks
5) Be careful if you also take prescriptions
6) Ask your pharmacist if you have questions
7) If you don’t need it, don’t take it!

20. The Over-the-Counter Drug Label
Figure 7.2

21. Drug Interactions Polydrug use
Taking several substances simultaneously
Synergism
Effects are multiplied
Expressed as 2+2=10
Example: Alcohol and barbiturates
Antagonism
Work at same receptor
One drug blocks the other
Example: Alcohol and antibiotics

22. Drug Interactions Intolerance
When drugs combine to produce extremely uncomfortable reactions
Example: Antabuse and alcohol
Cross-tolerance
Tolerance for one drug creates a similar reaction to another drug
Example: Alcohol and barbiturates

23. Illicit Drugs Users of illicit drugs
In 2003, estimated 19.2 million Americans used illicit drugs
College use (tried any illicit drug) was 52%
Why might use in the college population be high?
What do you think would be a successful anti-drug campaign?

26. Controlled Substances: Stimulants
Cocaine
White crystalline powder
Derived from the leaves of the South American coca shrub
Cocaine rapidly enters bloodstream
Exposed fetus is likely to suffer
Methods of use vary
Freebase cocaine
Crack
Cocaine addiction and society
Annual cost of addiction in USA: $3.8 billion

27. The Ups and Downs of a Typical Dose of Cocaine
Figure 7.3

28. Controlled Substances: Amphetamines
Synthetic agents that stimulate the central nervous system
Some are used for medicinal purposes
Ritalin, Adderall for attention deficit hyperactivity disorder
High potential for abuse

29. Controlled Substances: Amphetamines
Methamphetamine
Effects brain and central nervous system
Euphoria lasts 6-8 hours
Methods of use varied: snorted, injected, smoked, ingested
Increasingly more common in rural America
Ice is a potent methamphetamine

30. ABC News: Illicit Drugs
Play
Video
| Illicit Drugs
Discussion Questions
Do you think that the young man and woman had a history of using meth?
How did the crystal meth interfere with the young man attempting to get help?

31. Effects of Amphetamines on the Body and Mind
Figure 7.4

32. Controlled Substances: Marijuana and Derivatives
Use goes back 6,000 years
Derived from Cannabis sativa or Cannabis indica (hemp)
Tetrahydrocannabinol, or THC, is the active ingredient
Hashish – derived from the resin of the plant
Long-term studies have not been done in the U.S.
Studies have indicated that the inhalation from smoking is harmful

33. Controlled Substances: Marijuana and Derivatives
Effects of marijuana use
Carbon monoxide to blood-heart works harder
Contains high levels of carcinogens
Suppression of the immune system
Pregnant women at higher risk for stillbirth or miscarriage
Driving ability impaired

34. Controlled Substances: Marijuana and Derivatives
Marijuana and medicine
Helps with severe nausea and vomiting during chemotherapy
Improves appetite of AIDS related wasting syndrome
Aids those with multiple sclerosis by reducing pain and spasticity
Reduces eye pressure of glaucoma

35. Controlled Substances: Marijuana and Derivatives
Marijuana and driving
Reduces reaction time
6-11% of fatal accident victims had THC in their bloodstream
Why do you think marijuana is the most popular illicit drug on colleges campuses?

36. Controlled Substances: Opiates
Cause drowsiness, relieve pain, and induce euphoria
Called narcotics
Derived from opium – from poppy
Include morphine, codeine, heroin, and black tar heroin
Depress CNS
Lower heart rate, respiration, and blood pressure
Decreases sex drive

37. Controlled Substances: Opiates
Black tar heroin
Pure, inexpensive, sticky, dark brown form
Relatively pure and inexpensive
Heroin addiction
Heroin withdrawal is distinct
3.7 million people have used heroin in their lives

38. Controlled Substances: Opiates
Treatment of opiates
Methadone
Blocks effects of opiates
Potentially addictive; trade one substance for another?
Naltrexone
Opiate antagonist
Lose compulsion to use heroin
Buprenorphine
Blocks cravings for heroin
Non-addictive

39. Controlled Substances: Hallucinogens (Psychedelics)
Hallucinogen facts
Known as psychedelics
Scramble messages coming to reticular formation
Synesthesia – mixing of the message
May “hear colors” and “smell tastes”

40. Controlled Substances: Hallucinogens (Psychedelics)
LSD (lysergic acid diethylamide)
Common hallucinogen used to unlock mind
Used to “turn on” and “tune out” world
1970’s – placed on controlled substances list
Over 11 million Americans have tried acid
Commonly sold as a “blotter” on paper

41. Reticular Formation
Figure 7.5

42. Controlled Substances: Hallucinogens (Psychedelics)
Mescaline
From peyote cactus
Native Americans still use
Typically swallow dried peyote buttons
Generally induce immediate vomiting
Psilocybin or “magic mushrooms”
Effects generally wear off in 4-6 hours
Cultivated from spores or harvested wild
Similar to LSD in effect

43. Controlled Substances: Hallucinogens (Psychedelics)
PCP (Phencyclidine)
Originally used as a dissociative anesthetic
Side effects like amnesia led doctors to abandon use Interrupt neurotransmitter glutamate in the brain
May cause euphoria or dysphoria
Known to cause hallucinations, delusions and overall delirium

44. Controlled Substances: Designer Drugs (Club Drugs)
Ecstasy (MDMA) most common club drug
Hallucinations
Paranoia
Amnesia
Death in some cases, especially when combined with alcohol
Chronic use can damage the brain
GHB, Ketamine (Special K), and Rohypnol
Includes “date rape” drug

45. Inhalants Facts Inhale chemicals Legal to purchase
Includes: glue, paint thinner, rubber cement
Amyl nitrate – “poppers” or “rush”
Abused to enhance sexual function
Nitrous oxide
Dental anesthesia
Pain relief
“Silly feeling”

46. Controlled Substances: Steroids
Ergogenic drugs
Used to increase strength, power, bulk, speed, performance
17-20% of college athletes once estimated to use them
Now estimated at 1.1%
Recent survey shows increased usage in high schools since 1991

47. Controlled Substances: Steroids
Anabolic steroids
Ergogenic drugs
Available as pill or injectable
Adverse effects occur
1990 Anabolic Steroids Control Act (ASCA)
“Performance-enhancing” steroid alternatives
Gamma-hydroxybutyrate (GHB)
Clenbuterol
Androstenedione (andro)
Who is commonly associated with steroid use and why?

48. Illegal Drug Use in the United States
Facts
Costly habits: estimated $180.9 billion
Half of crime expenditure
Solutions to the problem
Often “scare tactics” unsuccessful
Drug abuse has been around for thousands of years
It is unlikely to change in the near future
Must target at-risk groups
Stricter border control
Need for better educational programs
Do you think employers should do random drug testing?