Summary Pages.docx

Summary Pages Lecture #1- An Introduction to the Study of Drug and Alcohol Problems Harm reduction= understanding the risks before choosing to use a substance and taking all necessary precautions to reduce those risks - Started in injection community (methadone treatment) - Social norm- acknowledge that people will take part in harmful behaviours - As humans we naturally self-regulate: We use substances to regulate our emotions Continuum for harm reduction has a boundary line - Behaviours become habitual and they become part of who you are - Brain changes as more molecules are introduced into the bloodstream; temporary changes can be reversed to the norm as long as the norm doesnt change - If the norm changes brain needs to keep that same amount of stimulation o Endogenous opioids- pleasure chemicals - Drugs can change who you are and what substances you need o Addicted to not only the substance but also the behaviour/ritual associated with it Addiction is person dependent and culturally dependent - Social policy: can increase/decrease harm from illicit substances - Insight- Vancouver clinic for addicts to have a safe haven for nurses, clean needles, etc. o Social progress: supreme court decision allowed Insight to stay open - Addiction moral problem vs. medical condition - Nicotine and alcohol cause the most harm and yet we are most accepting of them because they are legal - Social patterns: we are a product of our environment; we dont choose where were born. - Critical brain development- 0-4 years and adolescence Plants - Opium pod, marijuana plant, mushrooms - Modern wars are centered around controlling the plant market (not just drugs, but spices too) - All used at different times for different purposes People - In time and in culture - the norm of the time; i.e. smoking and working as a child - The way substances are used (ritualistic, pleasure, medicinal) - Religious influences and spiritual purposes o Traditional medicines of indigenous cultures used to benefit modern societies in different ways The Brain - Our mind and consciousness - What is consciousness? Theatre of thought, feeling, aspiration, fears, etc. o Premised on your physical body; our experience of the neurochemicals - Addicts chase the feeling of the first hit. Once habituated it no longer fires the way you need it to - Marijuana is the opposite of most drugs, the more you smoke the more you can get out of it, youre not increasing your tolerance you are increasing your pleasure o THC heightens short term memory and appetite o Medicinal uses Society - i.e. Amsterdam- legal marijuana for sale in coffee shops; positive influence on society - the right to choose model o Acceptable legality lowers the rate of use o Being given the right to explore drugs lowers the use of the heavier drugs in turn - Crime - Poverty and marginalization SYNAPSE NEURON On Intoxication - Excitement, euphoria, elation, exhilaration, infatuation, delirium, exaltation - History shows us we have always used drugs: people have pursued intoxication with plant drugs, alcohol and other mind-altering substances - Our brains give us an affinity for plant compounds: we evolved the ability to extract the plant compounds, synthesize their chemical relatives, and develop ways to introduce highly concentrated forms directly into our bodies. Drug Use Ecologies - Interaction between people, places, and things determines whether the substance is harmful or helpful - Social values, natural environment, parents, society - Natural interaction with drugs and the body, ingestion effect excretion - Difference between when someone injects with the substance or when you choose to ingest one yourself o Particular experience/purpose in mind when we use a substance Drug Choices - Drug is physically available - Drug is psychologically available - Choice and temperament - Liking the effect of the drug - Personal image and peer group approbation - Drugs have in common the capacity to be rewarding Siegels Patterns of Drug Use - Experimental - Social-recreational - Circumstantial/situational - Intensified - Compulsive - Addiction/dependence Opponent-Process Theory - According to this model, proposed by psychologist Richard Solomon, most organisms behave in a direction of restoring bodily functions to a normal state - The brains of all mammals are organized to oppose or suppress many types of emotional arousals or hedonic processes, whether they have been generated by positive or negative reinforcers - Alcohol and drug use is an assertion of choice, an expression of free will, intending to regulate or modify the perceptions, emotions, thoughts and sensations that comprise our experience, in an environment in which we acknowledge we have limited control - Border of need and want Addiction is - A condition whereby lifes possibilities become telescoped, reduced to a self-limiting fixation on one manner of coping and of self-mastery - A loss of control, in which choice is overcome by need - We aspire to great feelings for elation but they eventually catch up with us - Reward = both the onset of pleasurable effect and the amelioration of the withdrawal effect - Dissociation = daydreaming, creativity and response to trauma o Ease the pain of consciousness 4 Dimensions - Biological, psychological, sociological, spiritual Lecture #2- Drugs, Drug Actions, and Incidence of Use - As costs keep increasing the demand keeps increasing for more resources (i.e. dental, pharmaceuticals, etc.) o Inequitable access o Health care is the centre of the Canadian reputation; what is our social responsibility towards someone else? o Health policy distinction: who deserves the support and who doesnt? - Distribution of health as a resource o Health is associated with an absence of disease; illness is associated with doctors and having a disease o Health is more complicated- its a resource we use every day to succeed in day-to-day life o Disability= we tend to have empathy, requires a social responsibility o Health equity= those who have health for everyday life and those who dont. The distribution shows the deprivation (dont have enough income) by clustering in certain neighbours. Comparing health distribution to this income distribution; lower income families spend more time in the emergency rooms and stay longer statistically, EXCEPT for injuries (due to expensive sports) o Illness is a part of human life and yet those who are ill are looked at differently o Assessed psychologically for what they wouldve done to deserve it o Addiction is a problem we dont understand so we judge the behaviour - The way we perceive the world is a lens, which is the product of our upbringing o Always a construct with a time and place o Drugs change the lens; short term and can affect the reprogram the brain long-term o Drugs show us that we arent that separated from our world; we are far more integrated then we like to admit - We make an association between the behaviour and the drug o We tend to look at it as a choice someone has made o Setting is the leading theory of why you CHOOSE to use a drug o Another important one is genetic influence; impulsive behaviours, not necessarily addiction - Zinberg- role of setting; during Vietnam war men were sent over there and had access to heroine (85%), 54% tried it, 35% of those who tried it became addicted. Come home to the U.S.A. to huge conflict and lack of health care. After a year only 12% were addicted. Canadian Addiction Survey - Purpose: need for timely and relevant data to assist in health planning Alcohol - Most are moderate drinkers - 79.3% report drinking in past year o 44% drink weekly - Highest among males 18-24 - Heavy drinking o 5 or more if male and 4 or more if female o 6.2% o Males, 18-24 most likely - Low Risk Drinking Guidelines o Weekly intake should not exceed 14 drinks for males and 9 for females, daily consumption shouldnt be more than 2 o 22.6% of past year drinkers exceed this - High Risk Drinking o AUDIT scale indicates hazards and harms due to drinking o 17% of drinkers are considered high risk: correlated with young males - Provincial Comparisons o Low rates in PEI, New Brunswick, Newfoundland and Labrador o High rates in Quebec Cannabis - 44.5% of Canadians use cannabis at least once in their lifetime; 14.1% in past year - Males > females and Young > old - Beyond age 45, less than 10% have past year use - More likely to have never been married - High SES > low SES - Provincial Comparisons o Lifetime use higher in B.C. and Alberta o Lower use in Ontario, Newfoundland, and PEI Other Illicit Drugs - Hallucinog