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Chapter 14

Chapter 14: Psychoactive Drugs

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Health Sciences
Health Sciences 1001A/B
Shauna Burke

Chapter 14: Use & Abuse of Psychoactive Drugs1 • Drug: any chemical other than food intended to affect structure/function of body • Psychoactive drug: chemical that can alter person’s consciousness/experience • Intoxication: state of being mentally affected by chemical (state of being poisoned) Addictive Behaviour: • Addiction: 1. compulsive desire for drug, 2. need to increase dosage associated w/ psychological & physical dependance, 3. harmful effects to individual, 4. harm to society • Habituation: similar to addiction; involving routine use of substance, w/o level of compulsion or increasing need that characterizes addiction; psychological but not physical dependence Characteristics of Addictive Behaviour: • Reinforcement: pleasurable physical/emotional states, relieves negative ones • Compulsion/craving: obsessive planning for next opportunity • Loss of control: cannot block impulse • Escalation: more of behaviour is needed to produce desired effects • Negative Consequences: academic/job performance, personal relationships, health, legal/financial troubles Development: • behaviour becomes necessary to avoid pain, no longer for pleasure • addiction depends on combinations w/: personality, lifestyle, heredity, social/physical environment, nature of substance • ex. nicotine (psychoactive drug in tobacco) Characteristics of People w/Addictions: • substitute for healthier coping strategy • genetic predisposition • problems w/ impulse control, self-regulation, risk takers Examples of Addictive Behaviour Chapter 14: Use & Abuse of Psychoactive Drugs2 Compulsive or Pathological Gambling: • even in face of financial/personal ruin; increasingly larger bets, lie/steal to pay off debts • deaths/year: 200; 1%=compulsive, 5%=gambling-related problems • behaviours: preoccupation, unsuccessful efforts to cut back/quit, escape problems, lying to family members Compulsive Exercising: • associated w/ anorexia, bulimia nervosa • traits: excessive preoccupation/dissatisfaction w/ body image, use of laxatives/vomiting to lose weight, development of other obsessive-compulsive symptoms • ex. body builders: harmful weight-lifting practices WorkAddiction: • intense work schedule; inability to limit work schedule; inability to relax even when away from work; failed attempts at curtailing intensity of work • neglect other areas of life; ex. stay away from family/society, exercise less • risk factor for cardiovascular disease- typeApersonality: traits- competitiveness, ambition, drive, time, urgency, restlessness, hyper-alertness • culture bound disorder: arise from workplace Sex & LoveAddiction: • initial rush/arousal & erotic/romantic chemistry=taking amphetamines, morphine • brain becomes desensitized, must seek new partner • traits: extreme preoccupation w/ sex; compulsion to have sex within short time period; spending great time looking for partners/having sex; relieving painful feelings; suffering negative emotional, personal, professional consequences Compulsive Buying/Shopping: • more than needed/can afford; luxury items rather than necessities link w/ neglect/abuse during childhood, eating disorders, depression, bipolar disorder • InternetAddiction: • skip important school, social, recreational activities Chapter 14: Use & Abuse of Psychoactive Drugs3 • alleviate stress, avoid painful emotions • 5-10%; 38 hours/week Drug Use,Abuse & Dependence • prescription meds (antibiotics, antidepressants), nonprescription/OTC (alcohol, tobacco, caffeine), illegal substances (LSD, heroin) Drug Tradition: • Pharmacy: art of compounding drugs from various substances; ex. plants • Pharmacology: science/study of drugs • earlier: sales=not regulated; ex. cocaine in Coca-Cola • increasingly associated w/ criminal subcultures • expanded (1960-70s); declined (mid 90s); 2008: 4x weed, 9x other illicit drugs * APA’s Diagnostic & Statistical Manual of Mental Disorders - don’t use word “addiction” instead abuse & dependence Abuse: • recurrent drug use - > failure to fulfill major responsibilities at work, school, home • during physically hazardous situations; ex. driving • legal problems • continuous despite persistent social/interpersonal problems Physical dependance: response to frequent presence of drug; associated w/ tolerance & • withdrawal Dependance: Chapter 14: Use & Abuse of Psychoactive Drugs4 • Substance dependance: cognitive, behavioural & physiological symptoms that occur in someone who continues to use substance despite suffering significant substance-related problems, leading to considerable impairment/distress • first 2=physical dependence, last 5=compulsive use 1. tolerance to substance: lower sensitivity to drug so given dose no longer exerts usual effect, larger dosages needed 2. experiencing withdrawal: physical/psychological symptoms that follow interrupted use of drug on which user is physically dependent; mild or life threatening; ex. nausea, vomiting, tremors 3. taking substance in larger amounts/over longer period that originally intended 4. persistent desire to cut down/regulate use 5. spending great time obtaining, using, recovering from use 6. giving up/reducing important social, school, work, recreational activities 7. continuous use despite knowledge of psychological/physical problem Who Uses Drugs? • being young • being male • being troubled adolescent • being thrill-seeker being in dysfunctional family • • being in peer group that accepts drug use • being poor • dating young • lower rates: self-control, social competence, optimism, academic achievement, regular church attendance; family life (open communication w/ parents) Why Do People Use Drugs? • allure of exciting & illegal; vulnerability • factors: peer pressure, models (social media) • desire to alter mood, seeking spiritual experience Chapter 14: Use & Abuse of Psychoactive Drugs5 • escape boredom, anxiety, depression, feelings of worthlessness • buying/selling: alternative economy Risk Factors for Dependence • genetic: brain chemistry, metabolism, exposed to drugs while in womb • psychological: difficulty controlling impulses, strong need for excitement, stimulation, gratification • mental health: 1/3 associated w/ drugs • dual (co-occurring) disorder: presence of 2+ mental disorders (i.e. drug dependence, depression) in same individual at same time • social: family history, living in poverty, peer pressure Intoxication: • act in uncharacteristic/unsafe ways • injury: falls, drowning, automobile crashes, unsafe sex, risk for STIs, unintended pregnancy, incidents of aggression (inc. sexual assault) Unexpected Side Effects: • nausea, constipation, paranoia, depression, heart failure fatal overdose • Unknown Drug Constituents: • street: unsafe dosages, mixed w/ other drugs to boost effects • careless manufacturing Injections: • share/re-use needles, syringes - > contaminated w/ user’s blood, survive in needle for 1 month+ • carry HIV, hepatitis C (HCV) • 19% new HIV/AIDS cases • skin/soft tissue infections - > gangrene, endocarditis (heart valves), tuberculosis, tetanus • syringe exchange programs (SEP): trade used for new syringe; controversial; offerAIDS counselling Legal Consequences: • large fines/inprisonment Chapter 14: Use & Abuse of Psychoactive Drugs6 • factors: police policies, charging practices, available resources • 305/100,000 (2007)- 30% increase How DrugsAffect Body Changes in Brain Chemistry: • molecules of drug carried to brain via bloodstream mouth: dissolve in stomach, absorbed into blood stream through lining of small intestine, pass • through liver, heart, lungs before returning to heart to be carried via arteries to brain • injected/inhaled=much faster (more dependance) • neurotransmitter: brain chemical th at transmits nerve impulses • concentration- controlled by reuptake/resorption by releasing neuron • dopamine- process of reinforcement; ex. cocaine metabolized by liver, excreted by kidneys in urine; sweat, breast milk, lungs • Drug Factors 1. pharmacological properties: overall effects of drug on person’s behaviour, psychology, chemistry; amount required to exert effects, chemical composition 2. dose-response function: relationship b/w amount of drug taken & intensity, type of resulting effect 3. time-action function: relationship b/w time elapsed since drug was taken & intensity of effect 4. drug use history 5. method of use: injected - > intravenously, intramuscularly, subcataneously Individual Factors • body mass, general health/genetic factors (higher metabolism) • drugs intensify or block effects of other drugs • precaution: pregnancy- greatest during 1st trimester • high: subjectively pleasing effects of drug; usually felt quite soon after drug is taken Chapter 14: Use & Abuse of Psychoactive Drugs7 • placebo effect: response to an inert/innocuous medication given in place of active drug Social Factors • setting: ex. smoking marijuana at home w/ friends vs in lab Opioids:
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