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Drugs, Society, and Criminal Justice

CHAPTER

Drugs, Society, and Criminal Justice, Fourth Edition Charles F. Levinthal

FOURTH EDITION

Fundamentals of Drug- Taking Behavior

Drugs, Society, and Criminal Justice, Fourth Edition Charles F. Levinthal

Introduction

• Psychoactive drugs affect our behavior and experience through their effects on the functioning of the brain.

continued on next slide

Drugs, Society, and Criminal Justice, Fourth Edition Charles F. Levinthal

Introduction

• Four principal routes drugs enter the body

 Oral

 Injection

 Inhalation

 Absorption through the skin or membranes

Drugs, Society, and Criminal Justice, Fourth Edition Charles F. Levinthal

Oral Administration

• Ingesting a drug by mouth leads to it being digested and absorbed into the bloodstream via the intestine.

• Advantages

 Oldest and easiest way of taking a drug

 Long absorption

• Disadvantages

 Slow absorption time

 No immediate effect continued on next slide

Drugs, Society, and Criminal Justice, Fourth Edition Charles F. Levinthal

Oral Administration

• Natural barriers in the stomach, intestines, and blood-brain barrier require that the dose be elevated to allow for the fact that a portion of the drug will be lost.

Drugs, Society, and Criminal Justice, Fourth Edition Charles F. Levinthal

Injection: Intravenous

• Injecting a drug with syringe and needle, directly into the bloodstream ("mainlining")

• Advantages

 Fastest means of injection

 Large amount of control

• Disadvantages

 Intravenous is irreversible.

 Veins can collapse, develop blood clots

Drugs, Society, and Criminal Justice, Fourth Edition Charles F. Levinthal

Injection: Intramuscular

• Injecting a drug into a large muscle, which is absorbed into the bloodstream

• Advantages

 Slower absorption time

 Administered rapidly in emergency

• Disadvantages

 Slower absorption than intravenous

 Risk of piercing a vein by accident

Drugs, Society, and Criminal Justice, Fourth Edition Charles F. Levinthal

Injection: Subcutaneous

• Injecting a drug into tissue under skin (skin-popping)

• Advantages

 Slowest absorption time of all

 Steady absorption, control

• Disadvantages

 Skin easily irritated

 Risk of irritation

 Only small amounts can be injected.

Drugs, Society, and Criminal Justice, Fourth Edition Charles F. Levinthal

Inhalation

• Breathing in vapors from a drug

• Advantages

 Extremely fast absorption time

 Travels from lungs to brain in five to eight seconds

• Disadvantages

 Effect limited to time drug is inhaled.

 Lung and throat irritation

Drugs, Society, and Criminal Justice, Fourth Edition Charles F. Levinthal

Absorption (Skin or Membranes)

• A drug is sniffed, snorted, chewed, used as a suppository, placed under tongue (sublingual), or used as a transdermal patch.

• Advantages

 Quick absorption time

 Enhances skin penetration

• Disadvantages

 Irritation of skin or membranes

Drugs, Society, and Criminal Justice, Fourth Edition Charles F. Levinthal

How Drugs Exit the Body

• Biotransformation

 Metabolic action in the liver (chemical breakdown) leads to urinary excretion.

• Water-soluble

 Action in the liver and kidneys leads to excretion in the urine.

 Most common

continued on next slide

Drugs, Society, and Criminal Justice, Fourth Edition Charles F. Levinthal

How Drugs Exit the Body

• Less water-soluble

 Action in the intestines leads to excretion through defecation.

Drugs, Society, and Criminal Justice, Fourth Edition Charles F. Levinthal

Factors Affecting Drugs Exiting the Body

• Quantity of the drug

 The larger the quantity of the drug the faster the body tries to get rid of it, except alcohol which is constant.

• Presence of other drugs

• Age of the user

 Over 40 years old, people eliminate drugs slower.

continued on next slide

Drugs, Society, and Criminal Justice, Fourth Edition Charles F. Levinthal

Factors Affecting Drugs Exiting the Body

• Drug's chemical properties lead to different exiting rates.

• Elimination half-life is the amount of time it takes for the drug in the bloodstream to decline to 50 percent of its original equilibrium level.

Drugs, Society, and Criminal Justice, Fourth Edition Charles F. Levinthal

Factors Determining the Behavioral Impact of Drugs

• Type of delivery route can optimize or place constraints on the effect of the drug.

 Timing of administration

 Interaction of two drugs administered close together

 Repeat administration can diminish the effect

 The user himself

Drugs, Society, and Criminal Justice, Fourth Edition Charles F. Levinthal

Timing

• Latency period

 Drug is increasing, yet not yet detected.

• Latency of the drug is related to the absorption time of the drug.

• Effect of the drug will attain maximum strength while the concentration in the blood continues to rise.

 Time release keeps therapeutic dose without toxic effects.

Drugs, Society, and Criminal Justice, Fourth Edition Charles F. Levinthal

Drug Interactions

• Two drugs in combination may produce an acute effect that is greater than the effect if administered separately.

• Additive effect adds the two effects of the drugs together.

• Hyperadditive effect is an acute effect in which the combined effect exceeds the sum of the two drugs is administered separately.

continued on next slide

Drugs, Society, and Criminal Justice, Fourth Edition Charles F. Levinthal

Drug Interactions

• Synergism

 Any hyperadditive effect produced by a combination of two or more drugs

• Potentiation

 The possibility that one drug might have no effect at all unless it is taken simultaneously with another

continued on next slide

Drugs, Society, and Criminal Justice, Fourth Edition Charles F. Levinthal

Drug Interactions

• Antagonistic

 The acute effect of one drug is diminished to some degree when administered with another.

Drugs, Society, and Criminal Justice, Fourth Edition Charles F. Levinthal

Tolerance

• The capacity of a specific dose of a drug to have a gradually diminished effect on the user as the drug is taken repeatedly.

continued on next slide

Drugs, Society, and Criminal Justice, Fourth Edition Charles F. Levinthal

Tolerance

• Behavioral tolerance (conditional tolerance)

 Tolerance is maximized when the drug- taking behavior occurs consistently in the same surroundings or under the same set of circumstances.

 Pavlovian conditioning

Drugs, Society, and Criminal Justice, Fourth Edition Charles F. Levinthal

Quick Concept Check 4.1 Understanding Drug Interactions

Drugs, Society, and Criminal Justice, Fourth Edition Charles F. Levinthal

Cross-Tolerance

• The chronic use of one drug inducing a tolerance effect with regard to a second drug that has never been used before.

• Example

 An alcoholic will already developed a tolerance for a barbiturate, or a barbiturate abuser will need a greater amount of anesthetic when undergoing surgery.

Drugs, Society, and Criminal Justice, Fourth Edition Charles F. Levinthal

Individual Differences

• Some variations in drug effects may be specifically related to the person taking the drug.

 Person's weight

 Gender

• Ratio of fat

• Differences in enzyme levels

 Ethnic background

 Patterns of the drug taking behavior

Drugs, Society, and Criminal Justice, Fourth Edition Charles F. Levinthal

Psychological Factors

• Expectation effects are one of the most uncontrollable factors.

• Placebo

 Inert or inactive substance that produces a psychological or physiological reaction

 Not sure how it works

continued on next slide

Drugs, Society, and Criminal Justice, Fourth Edition Charles F. Levinthal

Psychological Factors

• Double blind

 Neither administrator nor individual knows which substance is a placebo.

Drugs, Society, and Criminal Justice, Fourth Edition Charles F. Levinthal

Dependence

• Drug dependence involves a person having a strong compulsion to continue taking a drug.

• Physical dependence

 Continued use to avoid physical withdrawal

• Psychological dependence

 Drug abuser craves for the pleasurable effects of the drug.

Drugs, Society, and Criminal Justice, Fourth Edition Charles F. Levinthal

Physical Dependence

• Symptoms vary with the drug being withdrawn.

• Physical symptoms suggest that there is a physical need for continued drug use.

• Withdrawal symptoms are often the opposite of the effects the drug had on the body.

Drugs, Society, and Criminal Justice, Fourth Edition Charles F. Levinthal

Psychological Dependence

• Users feel they need to take the drug to function.

• Positive reinforcement for taking a drug

Drugs, Society, and Criminal Justice, Fourth Edition Charles F. Levinthal

Drug-Taking Behavior Health Perspective

• Health perspective for drug-taking behavior requires a system of guidelines to establish a diagnosis and treatment plan.

• Diagnostic and Statistical Manual of Mental Disorders (DSM)

 Substance use disorder

• 11 possible behavioral criteria for diagnosis from mild to severe

continued on next slide

Drugs, Society, and Criminal Justice, Fourth Edition Charles F. Levinthal

Drug-Taking Behavior Health Perspective

• Four points regarding the terminology used in the DSM for Substance Use Disorder

1. Substance use not drug use.

2. Addiction is not used in the diagnostic classification.

3. Separate diagnosis for substance abuse and substance dependence

4. Single drug involved