Intro to Healthy Living

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The Basics Health

13th Edition

Chapter 8

Recognizing and Avoiding Addiction and Drug Abuse

What Is Addiction?

Addiction - continued involvement with a substance or activity despite its ongoing negative consequences.

Classified by the American Psychiatric Association (APA) as a mental disorder.

Physiological dependence results in tolerance and withdrawal.

Psychological dependence is the dependency of the mind on a substance or behavior that can lead to psychological withdrawal symptoms, such as anxiety, irritability, or cravings.

The Process of Addiction

Compulsion

obsession with the behavior and an overwhelming need to perform it

Loss of control

the inability to predict reliably whether any isolated occurrence of the behavior will be healthy or damaging

Negative consequences

such as physical damage, legal trouble, financial problems, academic failure, or family dissolution

Denial,

the inability to perceive that the behavior is self-destructive

Inability to abstain,

continuance regardless of outcomes

Cycle of Psychological Addiction

Habit versus Addiction

Addiction involves elements of habit – which is a repeated behavior in which the repetition may be unconscious.

A habit can be broken.

Addiction involves repetition of a behavior that occurs with compulsion, and considerable discomfort occurs if the behavior is not performed.

Addiction Affects Family and Friends

Codependence: a condition in which a person is controlled by an addict's addictive behavior

Defined by lack of ability to set boundaries

Living in a chaotic, crisis-oriented mode

Assuming responsibility for meeting others' needs to the point of subordinating own needs or even being unaware of personal needs

Enablers: people who knowingly or unknowingly protect addicts from the consequences of their behavior

Addictive Behaviors

Drug chemicals are not the only source of addiction. People can become addicted to certain behaviors.

Process addictions are behaviors known to be addictive because they are mood altering.

Gambling, compulsive buying, compulsive exercise, and compulsive Internet or technology use are all process addictions.

Gambling Disorder

More than five million people meet the criteria for having a gambling addiction; still many others ar

There is strong evidence for a biological component.

Compulsive Buying Disorder

Shopping is often used as a way to make people feel better about themselves, but for some people it becomes compulsive buying disorder.

Symptoms include the following:

Preoccupation with shopping and spending

Buying more than one of the same item

Shopping for longer periods than intended

Repeatedly buying more than is needed or can be afforded

Buying to the point that it interferes with social activities or work

Exercise Addiction

Addictive or compulsive exercise results in negative consequences similar to those of other addictions.

Warning signs include working out alone, rigid exercise patterns, exercising for more than two hours daily, exercising when sick or injured or to avoid social events, school, or work.

Technology Addictions

Cell phones, video games, networking sites, and the Internet can all be addictive.

Approximately 9 percent of college students report that Internet use and computer games have interfered with their academic performance.

Symptoms include general disregard for one's health, sleep deprivation, neglecting family and friends, lack of physical activity, euphoria when online, lower grades in school, and poor job performance.

Internet addicts may feel moody or uncomfortable when they are not online.

What Is a Drug?

Drugs are substances other than food that are intended to affect the structure or function of the mind or body through chemical action.

Types of Drugs

Prescription: obtained only with a prescription from a licensed physician

Over-the-counter (OTC): no prescription needed and more than 100,000 available

Recreational: most are legal substances, such as alcohol, tobacco, coffee, and so on

Herbal preparations: products of plant origin

Illicit (illegal): all are psychoactive

Commercial: found in commercially sold products such as household cleaners, pesticides, etc.

How Drugs Affect the Brain

The brain is wired to repeat pleasurable experiences.

One nerve cell set uses dopamine, a neurotransmitter.

This "pleasure circuit" is known as the mesolimbic dopamine system.

All addictive drugs activate the brain's pleasure circuit, and addiction alters the way the pleasure center and other parts of the brain function.

Psychoactive drugs: affect chemical neurotransmission, either enhancing it, suppressing it, or interfering with it

Routes of Administration

Oral ingestion

Inhalation

Through the nose or mouth

Injection

Intravenous—into bloodstream

Intramuscular—into muscle

Subcutaneous—just under the skin

Transdermal

Through the skin

Suppositories

Through the vagina or anus

Drug Use and Misuse

Abuse is 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 cause serious harm

Approximately 27 million people report being current users of illicit drugs.

Drug Misuse and Abuse

Over-the-counter drugs

High doses can cause hallucinations, bizarre sleep patterns, mood changes, and sometimes death.

Those most vulnerable to abusing OTC drugs are teenagers, young adults, and people over the age of 65.

Sleep aids

Excedrin PM, Sominex, Unisom, and Tylenol PM

Can cause problems with the sleep cycle, weaken areas of the body, or induce narcolepsy.

Caffeine pills and energy drinks.

Caffeine in large doses can result in tremors/shaking, restlessness and edginess, insomnia, dehydration, panic attacks, heart irregularities, and other symptoms.

Drug Misuse and Abuse

Cold medicines

Robitussin, Vicks, Coricidin, and NyQuil

Dextromethorphan (DXM) can cause hallucinations, loss of motor control, and "out-of body" sensations.

Diet pills

Contain stimulants such as caffeine or Hoodia gordoni

Marketed as dietary supplements, rather than drugs, manufacturers may make unsubstantiated claims of effectiveness or can use untested or unsafe ingredients.

Drug Misuse and Abuse

Prescription drug abuse:

About 6.4 million Americans aged 12 and older used prescription drugs for nonmedical reasons in the past month.

It is particularly common among teens and young adults.

The problem may be getting worse among the youngest segment of society, with nearly 13 percent of 12th graders reporting prescription drug abuse by the time they graduate.

Risks vary from irregular heart rate to death. Injecting prescription drugs may result in exposure to HIV, hepatitis B and C and other bloodborne viruses.

College Students and Prescription Drug Abuse

A recent survey indicates 12 percent of students reported illegally using prescription drugs in the last year.

Commonly used painkillers (Vicodin, OxyContin, or Percocet) are used to relax or get high.

Student say they abuse Adderall and Ritalin (intended to treat attention-deficit/hyperactivity disorder [ADHD]) for academic gain.

Most commonly reported side effects are sleeping difficulties, irritability, and reduced appetite.

30-Day Drug Use Prevalence, Full-Time College Students vs. Respondents 1 to 4 Years beyond High School

Illicit Drugs

Illicit drug use spans all age groups, genders, ethnicities, occupations, socioeconomic groups.

Marijuana use has risen in recent years.

Close to 50 percent of college-aged students nationwide have tried an illicit drug, most commonly marijuana.

College offices are concerned about the link between substance abuse and poor academic performance.

Drugs of Abuse: Uses and Effects

Drugs of Abuse: Uses and Effects (cont.)

Common Drugs of Abuse

Amphetamines

Synthetic agents that stimulate the central nervous system (CNS)

Some are used for medicinal purposes.

Ritalin and Adderall are used for attention-deficit/hyperactivity disorder (ADHD).

High potential for abuse

Methamphetamine

Affects brain and CNS

Euphoria lasts 6 to 8 hours.

Methods of use: snorted, injected, smoked, and ingested

Short-term effects include increased physical activity, alertness, rapid breathing, increased body temperature, insomnia, tremors, anxiety, confusion, and decreased appetite.

Caffeine

Most popular and widely consumed drug in the United States

Caffeine is derived from the chemical family called xanthines, which are found in plant products such as coffee, tea, and chocolate.

Enhances mental alertness and reduces feelings of fatigue.

Side effects include wakefulness, insomnia, irregular heartbeat, dizziness, nausea, indigestion, mild delirium, and heartburn.

Caffeine meets the requirements for addiction: tolerance, psychological dependence, and withdrawal symptoms.

Caffeine Content Consumption

Marijuana

Tetrahydrocannabinol (THC) is the psychoactive substance in marijuana;

average concentration is 15 percent, but some forms can contain up to 27 percent.

Has many medical purposes

controls nausea and vomiting,

improves appetite,

forestalls loss of lean muscle mass associated with AIDS wasting syndrome,

reduces muscle pain and spasticity caused by multiple sclerosis.

THC - Resin

Smoking THC-rich resin extracts, called dabbing, is becoming much more common among marijuana users.

Extracts contain high levels of THC

Dangers include visits to the emergency room and fires resulting from the extraction process.

Dangers of Marijuana Use

The drug substantially reduces a driver’s ability to react and make quick decisions

Altered perception may linger for hours after use and the “high” has subsided.

Recent research indicates that a person having used marijuana is two and a half times more likely to be involved in a motor vehicle accident. The impairment is enhanced when mixed with alcohol.

In Washington, where it is legal, one in six drivers involved in fatal car crashes had recently used marijuana.

Chronic users are affected by the same toxins and carcinogens as tobacco users.

Synthetic Marijuana

Products contain dried, shredded plant material and one or more synthetic cannabinoids. Commonly known as: K2 (or spice), fake marijuana, Yucatan Fire, Skunk, and Moon Rocks.

K2 or spice:

sold legally as herbal blend incense.

used by nearly one in seven college students,

11.3 percent, of high school seniors are using this drug.

health effects such as hallucinations, severe agitation, extremely elevated heart rate and blood pressure, coma, suicide attempts, and drug dependence are common.

Narcotics and Depressants

Benzodiazepines and barbiturates

Benzodiazepines (tranquilizers)

The most common sedative-hypnotic drugs

Valium, Ativan, and Xanax

Barbiturates

Sedative-hypnotic drugs

Amytal and Seconal

Less safe than benzodiazepines

Synergistic effect, when combined with alcohol, can lead to respiratory failure and death.

Can produce physical and psychological dependence in several weeks.

Cross-tolerance is a complication specific to sedatives

Narcotics and Depressants

Rohypnol

A tranquilizer and "date rape" drug

Produces a sedative effect, amnesia, muscle relaxation, and slowed psychomotor responses.

Has gained notoriety as a growing problem on college campuses as it has been added to punch and other drinks at parties in hopes of incapacitating a woman so she is unable to resist sexual assault.

Gamma-hydroxybutyrate (GHB)

CNS depressant known to have euphoric, sedative, and anabolic (body-building) effects

Another "date rape" drug

Side effects include loss of memory, unconsciousness, amnesia, hallucinations, and death.

Narcotics and Depressants

Opioids

Cause drowsiness, relieve pain, and induce euphoria

Called narcotics

Derived from opium

Include morphine, codeine, heroin, and black tar heroin

Depress CNS and lower heart rate, respiration, and blood pressure

Treating and Reducing Drug Abuse

An estimated 20.8 million Americans aged 12 or older needed treatment for an illicit drug or alcohol use problem in 2015. Of these, only approximately 10 percent received treatment.

Detoxification is an early abstinence period when the addict physically and cognitively adjusts to being free from the addiction's influence.

Treatment Approaches

Outpatient behavioral treatment

Cognitive behavioral therapy

Multidimensional family therapy

Motivational interviewing

Motivational incentives (contingency management)

Residential treatment programs

Therapeutic communities (TCs) are highly structured programs in which addicts remain at a residence, typically for 6 to 12 months.

12-step programs

Nonjudgmental treatment programs that aim to work on personal recovery

Drug Treatment and Recovery for College Students

Early intervention increases the likelihood of successful treatment.

Private therapy, group therapy, cognitive training, nutrition counseling, and health therapies all help with recovery.

Drug Use and Abuse: Costs to Society

Illegal drug use in the United States costs about $193 billion per year.

$11 billion in the cost of health care, $120 billion in lost productivity, and $61 billion in costs to criminal justice system

There are no simple solutions to this complex problem