1. 9/5/20151 Graded Discussion (Out of 5) 1 person at a time (Facilitator?) -1 Point Everyone speaks once (1 Freebies) -1 Point (At least) 5 subtopics related to addiction -1 Point Time (At least 20 minutes) & No lapse in speaking >15 seconds -1 Point Side chatter (nada) -1 Point

2. 9/5/20152 Graded Discussion Hints: Utilize your guided notes from the Movie, “Help Me, I Can’t Help Myself” as arguments. There is no wrong answer! Feel free to disagree w/ somebody. Start simple-Is addiction a choice or a disease?

3. 9/5/20153 Graded Discussion Comments Sub Topics

4. 9/5/20154 Now or never..

5. 9/5/20155 Essential Questions What are the 3 best arguments for/against addiction as a disease? What are the 3 best arguments for/against addiction as a disease? What does labeling it as a disease do to the accountability of the individual? Right/Wrong? Describe this debate as it relates to the circle of control? How does someone become an addict?

6. 9/5/20156 This Week in Health Monday: Feedback on Pres, Grade Update, Questions Regarding Drug Fair Intro to Drugs Tuesday: Finish Intro to Drugs Wednesday: Tobacco Thursday: Finish Tobacco / Marijuana? Friday: Drug Fair

7. 9/5/20157 Overview of Drugs in Our Society

8. Page 1-Where it says at the very least I want to know before this unit is over….  Provide at least two things you’d like to learn about regarding drugs Page 1-Where it says Give 1, Get 1….Drugs Role in Society.  Provide at least 6 ways drugs impact society either negatively or positively….it helps to think of certain drugs like alcohol or tobacco. Page 1-Bottom, Rank in Order  Rank both-pay attention to directions on the second one (% not rank). 9/5/20158

9. 9 The least you need to know…(TSWBAT) ---------------------------------day 1----------------------------------------- Discuss the role drugs play in our society Distinguish among perceived and actual drug use statistics. Examine pertinent questions when discussing the drug problem in the U.S. ---------------------------------day 2----------------------------------------- Identify the 4 principles of psychoactive drugs Differentiate among the reasons ‘we’ use drugs Define a psychoactive substance State the 3 classifications of psychoactive substances and provide examples of each Distinguish between the various routes of administration and hazards of each

10. 9/5/201510 Drugs Role in Society

11. 9/5/201511 What Role Do Drugs Play in Our Society?

12. 9/5/201512 Damaging Statistics The cost of drug abuse to the United States was $180.9 billion.($2,446 per American Family). Roughly ¼ Million US adults contract HIV from IV drug use 8.5 percent of new mothers report having used illicit drugs 90 % of identity theft cases are generated by drug users Over 6 million children live with at least one parent who abused or was dependent upon alcohol or illegal drugs. Americans spend $64 billion to buy illegal drugs every year Second only to alcohol, marijuana is the drug most detected in impaired drivers, fatally injured drivers and motor crash victims. States spent $42.89 billion on Corrections in 2005 alone Roughly ½ of all ER Visits, suicides, homicides, rapes, and traffic fatalities

13. 9/5/201513 Is there a ‘Drug Problem?’

14. 9/5/201514 Place in Order by Perceived Use Alcohol Ecstasy LSD Cigarettes Marijuana OTC Steroids Inhalants Prescription Drugs Abuse vs. Use / Regular vs. Experiment

15. 9/5/201515 Social Acceptance Continuum?

16. 9/5/201516 29% in vehicle w/ driver had been drinking (<30) 10% driven vehicle after drinking (<30) 20% smoked cigarettes <30 (10% frequent daily-1/2 try to quit) 44% drink 1 or more drinks < 30 (26% binge drink) 19% smoked marijuana <30 3% used any form of cocaine <30 Lifetime Use  8% Hallucinogens  13% huffed  2 % heroin  4 % methamphetamines  4% steroids  6% ecstasy

17. 9/5/201517 Risk-Taking BehaviorTOTAL SAMPLE GenderGrade CategoryDefinitionMF9101112 Alcohol Used Alcohol once or more in the last 30 days. Got drunk once or more in the last two weeks. (2000)45(2003)46 ( (2006)39 (2009)34(2000)31(2003)30(2006)24(2009)23474640353234272542453833282622222938241923231414404533312528182152534541363728266550584543364133 Tobacco Smoked cigarettes once or more in the last 30 days. Used smokeless tobacco once or more in the last 12 months. (2000)30(2003)27(2006)18(2009)15(2000)8(2003)6(2006)5(2009)5272819171411910322516132211212012765112227121395543731201698664529292597911 Inhalants Sniffed of inhaled substances to get high once or more in the last 12 months. (2000)9(2003)9(2006)6(2009)69977896591377986679679566 Marijuana Used marijuana once or more in the last 12 months. (2000)29(2003)31(2006)22(2009)27303526322726182214221311283217213435273646383442 Other Drug Use Used other illicit drugs once or more in the last 12 months.* (2000)15(2003)13(2006)7(2009)7161587131256101043101444191610724151011 Driving and Alcohol Drove after drinking once or more in the last 12 months. Rode (once or more in the last 12 months) with a driver who had been drinking. (2000)16(2003)15(2006)12(2009)9(2000)35(2003)33(2006)32(2009)34171614103532313116149936343237564227313132109343432293721241511353430323425272120343837 *Includes cocaine, LSD, PCP or angel dust, heroin, and amphetamines.

18. 9/5/201518 Defining the Drug Problem… Who is taking the drug? What drug are they taking? When and where the drug is being used. Why a person takes a drug? How the drug is taken? How much?

19. 9/5/201519

20. 9/5/201520 4 Principles of Psychoactive Drugs Every drug has multiple effects (virtually every drug that acts in the brain also has effects of the rest of the body) Both the size and quality of a drug’s effect depend on the amount the individual has taken The effect of any psychoactive drug depends on the individual’s history and expectations…

21. 9/5/201521 4 Principles Continued Drugs, per se, are not good or bad.

22. 9/5/201522 “I don’t think that a drug is evil in and of itself, but just as drugs can be used to help heal a person, they can result in destroying a life as they did to me. So it really depends on the individual-what and how he chooses, and how wisely he uses or chooses not to use medication and drugs.” -28 year-old recovering sedative-hypnotic abuser

23. 9/5/201523 Why do people use drugs? Curiosity and Availability To Get High Self-medication Confidence Energy Pain Relief Anxiety Control Internal/External Peer Pressure Social Confidence Boredom Relief Deal w/ Isolation Competitive Edge

24. 9/5/201524 The worst reason….. How are Depression and Drug Use Related?

25. 9/5/201525 Why use? VS. Why continue to use?

26. 9/5/201526 Withdrawal When an addictive behavior is stopped or an addictive substance is withdrawn from use, withdrawal symptoms almost always follow. Depending on the behavior or substance:  sweating and fever  restless behavior and anxiety  abdominal and muscle cramps (even convulsions)  nausea and vomiting  diarrhea.

27. 9/5/201527 Tolerance Tolerance can develop with regular use. This occurs when the person becomes used to taking drugs of abuse and the drug no longer provides the same effect as it did when first taken. Tolerance can occur with regular use of most drugs of abuse. Tolerance  Physiological Tolerance Vs. Psychological Tolerance

28. 9/5/201528 What is the most dangerous or harmful drug?

29. 9/5/201529 Harm to the individual and Society Drugs could be classified or rank ordered according to their hazard potential to the individual and/or society. Harm to the individual would include - significant organ or tissue damage potential for tolerance physiological or psychological addiction harm to an unborn child increased death rate from use or abuse of the substance Harm to the society would include -increased rates of death of others (i.e. drunk driving) increased insurance rates loss of working days crimes of violence disability payments family breakdown and mental, physical, or sexual abuse from the use or abuse of the substance

30. 9/5/201530 Current research has led to the formulation of the following rank ordering of drugs, in terms of degree of harm to the individual and to society: 1 and 2. Tobacco and Alcohol 3. Sedative-hypnotics 4. Cocaine 5. Heroin 6. Tranquilizers 7. Narcotic-analgesics other than heroin 8. Amphetamines 9. PCP 10. Volatile Substances 11. Hallucinogens 12. Marijuana (Cannabis sativa) 13. Antihistamines 14. Xanthines

31. 9/5/201531 Table 3 Drug misuse and abuse in ED visits in the U.S., by type of drug involvement: 2004 Drug involvement 1 Estimate visits Percent All types of drug misuse/abuse1,254,078100% Illicit drugs only379,60930% Alcohol only (age < 21)98,1748% Pharmaceuticals only313,12525% Combinations Illicit drugs with alcohol 4 190,74715% Illicit drugs with pharmaceuticals99,5358% Alcohol with pharmaceuticals125,37410% Illicit drugs with alcohol and pharmaceuticals47,515

32. 9/5/201532 Drug Abuse Warning Network (DAWN) Other illicit drugs appeared at much lower frequencies. For 2007, DAWN estimates: MDMA (Ecstasy) in 8,621 (CI: 5,985 to 11,257) ED visits, GHB in 2,340 (CI: 125 to 4,555) ED visits, Ketamine in 227 (CI: 109 to 345) ED visits, LSD in 1,953 (CI: 1,179 to 2,727) ED visits, PCP in 8,928 (CI: 4,920 to 12,936) ED visits, and Miscellaneous hallucinogens in 3,445 (CI: 2,202 to 4,688) ED visits.

33. 9/5/201533 What is a Psychoactive Drug? : Any substance that directly alters the normal functioning of the CNS The major classifications of drugs are uppers (stimulants), downers (depressants), and “all-arounders” (psychedelics or hallucinogens).

34. 9/5/201534 Uppers or Stimulants All-Arounders or Hallucinogens Downers or Depressants Class of DrugsEffect on the Brain

35. 9/5/201535 Uppers or Stimulants Ex. Cocaine, amphetamines, diet pills, caffeine, tobacco. Major effects: ^ neural activity in the brain = ^ sensory experience ( ^ energy, feelings of confidence, ^ HR & BP) Overuse: Jitteriness (tremor test), anger, insomnia, depletion of energy, paranoia, damage to heart, lungs, and BV’s

36. 9/5/201536 These two images of the brain are positron emission tomography (PET) scans of a normal The PET scan shows brain function by seeing how the brain uses glucose, the energy source for neurons. In these scans, the red color shows high use of glucose, yellow shows medium use and blue shows the least use of glucose. Notice that many areas of the brain of the cocaine user do not use glucose as effectively as the brain of the normal person.

37. 9/5/201537 Downers or Depressants Ex: Opiates (heroin, morphine), barbituates, and alcohol. Major effects: Depressants work by depressing the central nervous system. They can therefore induce a state of relaxation or sedation as well as reducing the intensity of pain and of emotions such as fear, anger or anxiety. (Depress circulatory, respiratory, & muscular systems). Prolonged use: Numerous health problems and dependence. Reducing intellectual ability, concentrate, retain information, motivation and energy, manual dexterity (ie. the ability to operate machinery, drive, climb or swim).

38. 9/5/201538 Adam Drewnowski at the University of Michigan researched whether chocolate increases the production of opioids (endorphins). Opioids are chemicals, such as those found in opium,that produce a feeling of well-being (euphoria). Drewnowski found that eating chocolate causes the brain to produce natural opiates, which dull pain and increase a feeling of well-being. This may be a reason why we like to eat chocolate! And dark chocolate contains more of these compounds than milk chocolate. Why We Love Chocolate

39. 9/5/201539 All-Arounders or Hallucinogens Ex: Marijuana, LSD, PCP, psilocybin mushrooms, and peyote. Major effects: These drugs enhance sensory perceptions - sight, sound, smell and touch. = Illusions, hallucinations, & confused sensations. Bad “Trip” vs. Good “Trip”

40. 9/5/201540 How Drugs Get to the Brain By definition, psychoactive drugs are substances that affect the central nervous system to cause physical and mental changes. Factors that determine the effects: Methods of ingestion Speed of transit Affinity of the drug for nerve cells, neurotransmitters, and other brain chemicals

41. 9/5/201541 Routes of Administration Inhaling Injecting Mucosal absorption Oral ingestion Contact absorption

42. 9/5/201542 Inhaling Ex. Smoking a “joint,” freebase cocaine, “huffing” Vaporized drug enters the lungs and is rapidly absorbed through capillaries-veins-heart-brain-body Most addictive route of administration because it hits the brain so quickly *Because it is inhaled, the nicotine in cigarettes takes seven to 10 seconds to reach the brain — twice as fast as intravenous drugs and three times faster than alcohol.

43. 9/5/201543 Snorting & Mucosal Absorption Ex. Snorting heroin or cocaine, chewing tobacco Absorbed by capillaries in the mucous membranes lining nasal passages

44. 9/5/201544 Oral Ingestion Ex. Swallowing alcohol, pills, etc. Onset of effect is slower…(Alcohol Poisoning..) Absorbed through capillaries lining digestive tract-stomach & S.I.

45. 9/5/201545 Contact & Transdermal Absorption Ex. LSD, skin creams, nicotine patches. ? Speed ? Digestive system ? Dose regulation

46. 9/5/201546 Injection Ex. Heroin, cocaine, methamphetaminees, by way of needles Extremely rapid Initial absorption step is by-passed The Lancet has found that the proportion of IV drug users that are HIV positive may exceed 40 percent in at least nine countries around the world  Needle Exchange Programs???

47. 9/5/201547 Controversial Issue? Injection drug users typically share needles and syringes, which frequently transmits HIV or hepatitis C. Needle exchange programs are a strategy to reduce harm in injection drug. In an attempt to reduce sharing of contaminated equipment, needle-exchange programs provide sterile needles and syringes to individuals in exchange for used equipment.

48. 9/5/201548 Harm Reduction -right or wrong- It is a philosophy or way of thinking on drugs and many other topics. “Individuals are going to engage in risky behaviors regardless, as a society we might as well lessen the harm associated with the behaviors.” Do you agree or disagree?

49. 9/5/201549 Essential Questions Can you identify:  All 3 classes of drugs?  Examples of each?  Consequences of each?  Tolerance vs. Withdrawal  Routes of administration? What is the worst drug? Why? What are the three worst effects of drugs on society? Explain harm reduction in your own words (give 3 examples we discussed).