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FA18_KNH125_11.Addiction.Drug.Abuse.pptx

Addiction & Drug Abuse

Lecture 11

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Overview

Part 1 of 2

Be able to differentiate Addiction vs. Habit when given an example.

Know what is meant by Behavioral Addiction, Substance Addiction, Psychological Dependence, and Physiological Dependence.

Part 2 of 2

Know what is meant by Drug Abuse, Drug Misuse, Prescription Drug, and OTC Drug.

Know details (facts and misconceptions) about Marijuana

Know what is meant by “relapse,” and why it is important in addiction treatment/recovery.

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Introduction

Addiction is a persistent & compulsive dependence on a behavior or substance, despite ongoing negative consequences.

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

Physiological dependence results in tolerance & withdrawal

Addiction is recognized as a form of mental disorder by the APA

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Introduction

Two types of addictions:

Behavior / Process Addictions (e.g., gambling, shopping, eating, and sex)

Substance Addictions (e.g., alcoholism, drug abuse, and smoking)

Don’t confuse two types of addictions with two forms of dependence (psychological & physiological)

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What Happens to Addicts?

Dependence may be psychological and/or physiological

Often see…

Compulsion

Loss of control + tolerance

Negative consequences

Denial

Withdrawl

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Why Care about Addiction? (micro)

Is addiction just a “bad” habit? (NO, not really)

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

But, not all habits are addiction

Habits can be broken.

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

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Why Care about Addiction? (micro)

Effect on (of effect of) Family/Friends

Codependents

Enablers

Knowingly or unknowingly protect addicts from the consequences of their behavior

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Why Care about Addiction? (macro)

In the U.S… (according to the Surgeon General’s Report)

48 million people use illegal drugs or abuse prescription drugs

28 million people drive under the influence of drugs or alcohol

21 million people suffer from addiction

8 million people need treatment for drug addiction

Less than 10% of addicts receive proper treatment

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Behavioral Addiction: Types

Gambling Addiction

Characteristic behaviors include preoccupation with gambling, unsuccessful efforts to quit, and lying to conceal the extent of one’s involvement.

Affects more than two million Americans.

Only behavioral addiction recognized by DSM-V.

Can happen to college students too

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Behavioral Addiction: Types

Technology / Internet Addictions

Exercise Addiction

Work Addiction

Shopping Addiction

Sexual Addiction

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Substance Addiction: Background

Various routes of drug administration

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Substance Addiction: Background

Drug misuse vs. abuse

Drug misuse: using a drug for a purpose for which it was not intended

Drug abuse: excessive use of any drug.

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Substance Addiction: Background

Prescription vs. OTC drugs

Prescription drugs: Only available via a licensed healthcare practitioner; Not readily available

Over-the-Counter (“OTC”) Drugs: Can be purchased without a prescription; Many times, safer and as effective as prescribed drugs

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Substance Addiction: Background

Legal vs. illegal/controlled substance? (DEA)

Federal law vs. state/local law?

Legal infraction vs. misdemeanor vs. felony?

Total prohibition vs. allowing use vs. possession vs. sale vs. transportation vs. cultivation of substance?

De-regulation vs. de-criminalization? (admin efficiency?)

Legalization vs. de-criminalization? (impunity?)

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Substance Abuse/Addiction: Types

Legal Drugs

Can be legally bought and sold in the marketplace

Includes drugs that can be closely regulated, likely regulated, and not regulated at all

Controlled Substances and Illicit Drugs

Those regulated by the Controlled Substances Act of 1970

Cannot be cultivated, manufactured, bought, sold, or used within the confines of the law

Schedule I – high potential for abuse; no accepted medical uses

Schedules II-V – have medical uses; scheduled based on potential for risk of dependence or abuse

Drug Enforcement Agency (DEA) responsible for enforcing Controlled Substances Act

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Substance Abuse/Addiction: Types

Legal Drugs

Can be legally bought and sold in the marketplace

Includes drugs that can be closely regulated, likely regulated, and not regulated at all

Controlled Substances and Illicit Drugs

Those regulated by the Controlled Substances Act of 1970

Cannot be cultivated, manufactured, bought, sold, or used within the confines of the law

Schedule I – high potential for abuse; no accepted medical uses

Schedules II-V – have medical uses; scheduled based on potential for risk of dependence or abuse

Drug Enforcement Agency (DEA) responsible for enforcing Controlled Substances Act

Alcohol, nicotine, nonprescription (OTC) drugs, prescription drugs

Marijuana, narcotics, cocaine and crack cocaine, hallucinogens, stimulants, depressants, club drugs and designer drugs, anabolic drugs, inhalants

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Substance Abuse: Legal Drugs

Alcohol & Nicotine Products

Some of most commonly used & abused substance

Presented in Lecture 12

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Substance Abuse: Legal Drugs

Prescription Drugs

Regulated by the Food and Drug Administration (FDA)

Subject to misuse and abuse

Opioid pain relievers

Risk of dependence and unintentional overdose

Development of drug-resistant strains of pathogens

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Substance Abuse: Legal Drugs

Over-the-Counter Drugs (OTCs)

Most only provide symptomatic relief, not a cure

Regulated by the Food and Drug Administration (FDA)

Subject to misuse and abuse

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Substance Abuse: Illegal Drugs

Marijuana

Products derived from hemp plant (active ingredient = THC)

Most abused illicit drug in the U.S.

Legal status varies by State; Not legal at federal level

Polydrug use common

Not a safer alternative to cigarette/tobacco

Acute effects – reduced concentration, slowed reaction time, impaired short-term memory, impaired judgment

Chronic effects – damage to the respiratory system (if smoked), amotivational syndrome

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Substance Abuse: Illegal Drugs

Opioids (syn. = opiates; narcotics)

Opium and its derivatives, morphine and heroin, come from an oriental poppy plant

Numb the senses and reduce pain

High potential for abuse; recently declared a “national public health emergency” (not all are necessarily illegal)

Opium poppies do not grow in U.S.; drug trafficking problems

Heroin addiction leads to significant community health problems

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Substance Abuse: Illegal Drugs

Depressants

Slow down the central nervous system

May lower anxiety and inhibitions

Tolerance develops; Strong physical dependence

Alcohol, barbiturates, benzodiazepines

(again, not all depressants are illegal)

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Substance Abuse: Illegal Drugs

Stimulants

Increase the activity of the central nervous system

Includes caffeine (legal)

Amphetamines

Schedule II prescription drugs; widely abused

Methamphetamines often made in secret labs

Total of all secret lab incidents involving methamphetamine

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Substance Abuse: Illegal Drugs

Inhalants

Collection of psychoactive breathable chemicals

Paint solvents, motor fuels, glues, aerosol sprays, cleaners (e.g., “liquid gold”)

Easy availability + Low cost

Often drug choice of younger population

Acute and chronic effects

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Prevention/Control of Drug Abuse

Primary prevention aimed at those who have never used drugs (DARE)

Secondary prevention aimed at those who have used, but are not chronic abusers (students)

Tertiary prevention aimed at drug abuse treatment and aftercare, including relapse prevention (AA?)

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Prevention/Control of Drug Abuse

Goals of prevention is to…

Reduce demand for drugs

Education

Treatment

Reduce supply and availability of drugs

Public policy

Law enforcement

NOT EASY!

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Treatment/Recovery

Treatment/recovery is a lifelong process

Recognition of problem first step to before treatment

Persistence is key

Expect relapse

Relapse: an isolated occurrence of or full return to addictive behavior is a defining characteristic of addiction.

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Take-Home Points

Addiction is a serious problem with physiological and psychological consequences

Individuals affected by addiction go through several stages, with external and internal characteristics

Abuse and addiction come in various forms, including use of illicit drugs, prescription medication, uncontrolled behavior, etc.

Substance abuse has acute and chronic effect on person’s physical and mental health

Common drug abuse involves stimulants, marijuana, depressants, hallucinogens, inhalants, etc.

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