ECON 546 Lecture Notes - Lecture 24: Metabotropic Glutamate Receptor 2, Brain-Derived Neurotrophic Factor, Brainstem
27 Jun 2018
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Lecture 24: Substance Abuse I Wednesday, April 11, 2018
Dr. Emmanuel Darcq
Socioeconomic Burden
In USA:
- 8-10% of people of 12 years of age or older are addicted to alcohol or other drugs (20 to
22 million people)
- The abuse of tobacco, alcohol, and illicit drugs in the US exacts more than $700 billion
annually in costs related to crime, lost work productivity, and health care
In the world:
- 230 million people, or 1 in 20 adults are estimated to have used an illicit drug at least
once in 2010
- 1.3 billion smokers
- 2 billion alcohol users
- 185 million illicit drug users
- 99 000 – 253 000 drug related deaths per million aged 15-64
In North America:
- 45 000 drug related deaths per million aged 15-64
DALY: Disability Adjusted Life Years
- Alcohol use and drug use account for a total 6.5 years
- Second and fourth most impactful psychiatric disorders
Abuse of Prescription Drugs
- Begins with prescription opioids, and then transitions to illicit drugs like heroin or
fentanyl
Definitions
- Substance use disorders: the essential features of a substance use disorder is a cluster of
cognitive, behavioural, and physiological symptoms indicating that the individual
continues using the substance despite significant substance-related problems
- Addiction: a term used to indicate the most severe, chronic stage of substance-use
disorder, in which there is a substantial loss of self-control, as indicated by compulsive
drug taking despite the desire to stop taking the drug. In the DSM-V, the term addiction
is synonymous with the classification of severe substance-use disorder.
- Substance-induced disorder: includes intoxication, withdrawal, and other
substance/medication-induced mental disorders (eg. substance-induced psychotic
disorder, substance-induced depressive disorder)
- Tolerance: phenomenon in which, after repeated administration, a given dose of drug
produces decreased effect or increasingly larger doses must be administered to obtain
the effect observed with the original dose
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2
- Withdrawal: a syndrome that occurs when blood or tissue concentrations of a substance
decline in an individual who had maintained prolonged heavy use of the substance
- In the DSM-V, there are 12 symptom criteria that must be present within the past 12
months
- 2-3 criteria: mild disorder, 4-5: moderate disorder, 6+: severe disorder
- Examples of criteria:
oPatients continue using despite persistent or recurring social or interpersonal
problems caused or exacerbated by the effects of the drug
oImportant social, occupational, or recreational activities given up
oRecurrent use in situations in which it is physically hazardous
oTolerance or withdrawal develops
oSpending significant amount of time on activities necessary to obtain the drug,
use it, or recover from its effects
- Addiction is often related with other neuropsychiatric disorders, such as depression,
anxiety, or sleep disorders
Types of Substance Abuse
Alcohol
Opioids
- Heroin, hydrocodone, oxycodone, fentanyl
- Drug derived from opium
- Originally developed as an analgesic
- Side effect: euphoria, high sensation of pleasure
- Act on the mu-opioid receptor, GPCR
oDecreases excitability, produces high euphoria
Stimulants
- Cocaine, amphetamine
- Cocaine inhibits the DAT and increases DA level
- Amphetamine increases the release of DA
Others
- Cannabinoids: act on GPCR, decrease excitability and increase euphoric effect
- Nicotine
Reward Systems
- Promotes survival activated when you eat, drink, engage in social interaction, etc.
- Increase in dopamine when an animal eats or has sex engages in survival-promoting
activity
- Ventral tegmental area: produces dopamine, sends it to the NAc and cortex
oCauses the animal to repeat the action necessary for survival
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find more resources at oneclass.com
Document Summary
8-10% of people of 12 years of age or older are addicted to alcohol or other drugs (20 to. The abuse of tobacco, alcohol, and illicit drugs in the us exacts more than billion annually in costs related to crime, lost work productivity, and health care. 230 million people, or 1 in 20 adults are estimated to have used an illicit drug at least once in 2010. 99 000 253 000 drug related deaths per million aged 15-64. 45 000 drug related deaths per million aged 15-64. Alcohol use and drug use account for a total 6. 5 years. Begins with prescription opioids, and then transitions to illicit drugs like heroin or fentanyl. Substance use disorders: the essential features of a substance use disorder is a cluster of cognitive, behavioural, and physiological symptoms indicating that the individual continues using the substance despite significant substance-related problems.
