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Assignment:

This assignment provides an opportunity to reflect on all that you have learned over the time period of this course and to synthesize and integrate your new learning into your existing knowledge base. Review all course components including the course objectives, readings, discussions, online chats, and major assignments and identify the three most important concepts, strategies, techniques, or perspectives presented during this course. You will provide a rationale for your selection and discuss how to apply this new learning in your current or anticipated professional sphere of influence. Incorporate references to the literature (you may use some of the ones reviewed for your previous assignments and/or find new ones) of the psychopharmacology of illicit and licit drugs that you have studied during this course. Further, you will also describe how the experiences of this course might contribute to your involvement (current or future) in helping individuals that may be at risk of substance use disorder.  Format is a presentation to your classmates and instructor and while students may choose what format to use the most common is PowerPoint Presentation

 Information discussed in class:

Genetic theories 

One of the genetic aging theories studied in the second chapter is the "Limited Gene Usage" theory. Gene usage is repetitive throughout a person's adulthood, and repeated usage of genes results in their eventual deterioration or damage, thereby participating in aging. The theory states that there is an upper limit on the number of times the instructions within genes could be decoded before they become unreadable or damaged (DiGiovanna, 2024). This accumulative reading process results in the alteration or damage of the genes and mistakes by the body in the long run, which leads to aging. With time, this repeated damage results in a weakened body that is unable to recover fully, which, in effect, leads to death. This theory postulates two reasons why genes can only be read several times. The first explanation is the "Somatic Mutation Theory," which proposes that harmful agents like radiation, chemicals, and free radicals can damage the genes during the reading process. These environmental factors are both external and internal, and they worsen the health of the genes over time.

The second explanation is the "Mismatch repair theory, " which argues that genes are permanently damaged in life. Still, cells have mechanisms that repair this as long as the damage is done. Nevertheless, with age, these repair mechanisms become unsuccessful, and in turn, the genetic damage closes, which makes genes unable to direct the body's activities properly (DiGiovanna, 2024). Generally, the Theory of Limited Gene Usage draws our attention to the genetic influence on the aging process by suggesting how the repeated use of genes over the individual's lifetime leads to their eventual deterioration and the onset of age-related changes in the body. This theory calls for a deeper understanding of the molecular mechanisms of gene activity and maintenance so that strategies of prevention for mitigating the impacts of aging and promoting successful aging can be developed.

Expanding Understanding: Substance Use Etiology Beyond Textbook Insights

Reading the NCBI chapter on etiology significantly expanded my understanding of substance use beyond what Chapter 4 of our textbook provided. Even though the textbook covered several variables leading to substance use, the NCBI chapter presented a detailed analysis of genetic, psychosocial, and contextual factors that correspond to addiction. One primary term highlighted in the NCBI section was genetic susceptibility (Institute of Medicine (US) Committee on Opportunities in Drug Abuse Research, 1996). The textbook just had the family study, but the NBIC chapter added the transmission of addiction characteristics from generation to generation. Being familiar with twin and adoption studies made it possible to discover how significant the heritability of substance use disorders is in comparison with that which was not broadly covered in the textbook. Knowing the genetic risk of addiction, along with looking at how biology related to substance use, enhanced my knowledge of the role biology plays in substance abuse.

 Furthermore, the NCBI chapter focused on the multilevel nature of psychosocial mechanisms governing substance use. It provided a close-up view of the interplay between personality types, such as rebellion and antisocial tendencies, and the origin of drug abuse. Investigating the relationship between psychological conditions like depression and substance abuse took my comprehension of the psychological nature of addiction to a level that the textbook failed to achieve. In addition, the NCBI chapter explored contextual elements, including family/friend influence, social class differences, and normative culture (Institute of Medicine (US) Committee on Opportunities in Drug Abuse Research, 1996). It is through the exploration of how family difficulties, peer relationships, and socio-cultural settings influence substance use behaviors that the chapter of the NCBI gave a more complete picture of the environmental determinants of addiction. The multi-faceted interplay between the individual, the family, and society broadened my thoughts about addiction etiology beyond textbook definition. Finally, I gained a deeper understanding of the etiology of addiction by looking at genetic, psychosocial, and contextual aspects that cause addictive behaviors through the NCBI chapter. It gave views and aspects not fully explored in Chapter 4 of our text, widening my knowledge of addiction causality. 

References

DiGiovanna. (2024). 2.7: Biological Aging Theories. In Human Aging: Biological Perspectives. Publisher. https://med.libretexts.org/Bookshelves/Gerontology/Human_Aging%3A_Biological_Perspectives_(DiGiovanna) Links to an external site.

Institute of Medicine (US) Committee on Opportunities in Drug Abuse Research. (1996). Pathways of Addiction: Opportunities in Drug Abuse Research. National Academies Press (US).  https://www.ncbi.nlm.nih.gov/books/NBK232972/ Links to an external site.

Discussion 2

From the textbook "The Effects of Drug Abuse on the Human Nervous System" and the supplementary article, we gain a profound understanding of the staggering impact substance use disorders have on the brain's intricate workings. These insights not only shed light on the complex physiological mechanisms underlying addiction, but also challenge longstanding stigmas surrounding this chronic condition (Madras & Kuhar, 2013).

The readings reveal that the brain's reward circuit, particularly the basal ganglia, plays an utterly pivotal role in the development and maintenance of addictive behaviors. Drugs of abuse hijack this system, causing massive surges of neurotransmitters like dopamine that far exceed even those produced by basic survival rewards like food or social interaction. This intense rush of euphoric pleasure reinforces drug-seeking and consumption, forming immensely powerful neural connections and ingrained habits that become increasingly difficult to break free from over time (Madras & Kuhar, 2013).

Crucially, the extended amygdala and prefrontal cortex are also critically implicated in perpetuating the vicious cycle of addiction. The extended amygdala is intimately linked to the anxiety, irritability, and distress experienced during withdrawal, driving individuals to seek temporary relief through further drug use. Simultaneously, the prefrontal cortex, which governs decision-making abilities and impulse control, becomes profoundly impaired, directly contributing to the compulsive and seemingly irrational behavior patterns observed in those suffering from substance use disorders.

The article by National Institute on Drug Abuse, (2022) uses a particularly compelling analogy to explain how the brain tries to compensate for the fact that receptors in the reward circuit are flooded with drugs – just as we can turn down the volume on a radio that is playing too loud, the brain turns down the production of natural neurotransmitters or the number of receptors in the reward circuit to accommodate the constant drug exposure. This means that, substance use disorder patients have a progressively reduced ability to derive pleasure or satisfaction from activities which were once rewarding; this leads to continued substance use in a futile bid to recapture the familiar euphoria.

These powerful insights robustly challenge the deeply entrenched stigma that addiction merely stems from a personal moral failing or lack of willpower. Instead, the readings acutely highlight the profound, long-lasting neurobiological changes that occur, fundamentally reshaping neural pathways and disrupting the delicate balance of neurotransmitters essential for normal brain function and reasoned behavior. Addiction is reframed not as a personal shortcoming, but as a legitimate chronic brain disease requiring compassionate, evidence-based treatment approaches, rather than judgment or punishment (Madras & Kuhar, 2013).

Moreover, the article offers an emphatic message of hope regarding the prospect of recovery, firmly emphasizing that even after years or decades of drug use, the brain retains a truly remarkable innate capacity for neuronal adaptation and healing. While exposure to specific environmental cues and contexts that have become deeply associated with past drug use can indeed trigger intense cravings, the findings indicate that with appropriate interventions, therapy, and comprehensive support systems, these learned associations can gradually be unlearned and reshaped, allowing the remolding and "re-wiring" of more positive neural pathways over time (National Institute on Drug Abuse, 2022).

In conclusion, the textbook chapter and supplementary article together provide a comprehensive, grounded understanding of the immensely complex physiological mechanisms underpinning substance use disorders. By illuminating the intricate interplay between drugs and the brain's neural circuitry, they overturn deeply rooted stigmas surrounding addiction as a personal failing, underscoring instead the vital importance of a compassionate, evidence-based approach to both treatment and long-term recovery for those affected by this chronic brain disease.

References

Madras, B., & Kuhar, M. (Eds.). (2013). The effects of drug abuse on the human nervous system. Elsevier.

National Institute on Drug Abuse, (2022, March 22). Drugs and the brain..  https://nida.nih.gov/publications/drugs-brains-behavior-science-addiction/drugs-brain Links to an external site.

Discussion 3

Question 1

The distinction between signs and symptoms is a crucial one in the medical field. A sign is an objective, measurable indicator of a health condition that can be observed or detected by a healthcare professional or others. Signs may include physical manifestations such as fever, swelling, rash, or abnormal sounds during examination. In contrast, a symptom is a subjective experience reported by the patient themselves. Symptoms encompass the feelings and sensations experienced by an individual, such as pain, fatigue, nausea, or difficulty concentrating. These are personal and can only be described by the person undergoing them, as they cannot be directly observed or measured by others.

Question 2

Moving to the Drugs of Abuse, let us explore the characteristics of cocaine and methamphetamine and the signs and symptoms that are likely to be observed among users. Cocaine drug signs include: enlarged pupils, high pulse rate and blood pressure, anxiety, aggressiveness, and sweating. Also, when the substance is sniffed, users may experience paranoia, anxiety, insomnia, and often nose bleeding. However, methamphetamine abuse can lead to the following effects: dilated pupils, involuntary rapid eye movement, high body temperature, excessive sweating, teeth chattering or grinding, heightened aggression and or violence, and or psychotic features like hallucinations or paranoia. It is also a fact that many individuals suffering from methamphetamine addiction experience weight loss or even malnutrition (Nassar & Ouanounou, 2020).

 Question 3

When it comes to treatment for Cocaine Use Disorder (CUD), Cognitive Behavioral Therapy (CBT) is known to be helpful to the individuals concerned. CBT is a type of therapy that is designed to change the negative thoughts and behaviors that are associated with substance dependency. In this way, a person gets to know how to avoid situations or thoughts that make him or her develop cravings and how to stay away from drugs or alcohol. CBT sessions also entail the use of the contingency management where the patient is rewarded for not using the substance that requires changing. CBT is used by evaluating and modifying negative thoughts that result in drug use and is collaboration with clients (Nassar & Ouanounou, 2020). In addition, CBT also helps people to understand how one can resist the temptation to use drugs, how one can avoid being influenced by friends to use drugs and how one can deal with situations that may in the future provoke the use of drugs again so that the person can make a better decision for the benefit of his or her health and further recovery.

Question 4

Due to the possibility of developing Methamphetamine Use Disorder (MUD), a multi-faceted prevention plan is needed. The role of education and information campaigns where a wide range of populations such as youth, parents, and communities is concerned is to offer more information on the risks associated with methamphetamine use, its temporary and permanent effects and the likelihood of developing dependence. Their findings explained that through awareness, people may be in a position to change their behavior and actually avoid the influence of peers or any other factor such as drugs (Nassar and Ouanounou, 2020).

After school programs, mentorship programs, and services for needy youth are examples of programs that keep youth engaged in positive activities instead of involving themselves in antisocial behaviors, teach them values, and equip them with skills for future employments. Also, another way through which the quantity of the substance in the community can be regulated is through policy and regulation measures such as increasing the control of precursor chemicals that are used in the manufacture of methamphetamine meaning that the availability and accessibility of the substance may deter potential users.

Substance use cannot be treated in isolation but rather requires intervention on other factors that may lead to substance use such as poverty, lack of job or school and violence or trauma. Public health prevention strategies should involve a coordinated effort of the government, health care workers, teachers, police, and other community-based organizations in addressing the factors that cause the problem and implementing best practices in prevention.

Reference

Nassar, P., & Ouanounou, A. (2020). Cocaine and methamphetamine: Pharmacology and dental implications. Canadian journal of dental hygiene, 54(2), 75.

Discussion 4

MDMA (Ecstasy) and marijuana are worth considering. Dilated pupils, increased heart rate and blood pressure, teeth clenching, and muscular tension are common MDMA symptoms. Users enjoy pleasure, increased energy, and a desire to socialize. Dehydration, nausea, sweating, and teeth chewing are symptoms (Martini et al., 2022). On the other hand, marijuana usage causes bloodshot eyes, a decrease in appetite (called "the munchies"), and poor coordination. Users may experience sleepiness, delayed response times, and changed time perception (Ethan et al., 2020). Dry mouth, paranoia, memory loss, and hallucinations or delusions may occur, particularly at large dosages or in vulnerable people. Understanding these signs and symptoms helps healthcare practitioners diagnose and treat drug use disorders and educate and prevent at-risk populations.

If MDMA (Ecstasy) use disorder (SUD) is not appropriately screened or evaluated, people may be in danger of being misdiagnosed with other mental health illnesses owing to the drug's overlapping symptoms. Bipolar disorder and Major Depressive Disorder (MDD) might be misdiagnosed. MDMA may alleviate depression or imitate bipolar disease by increasing pleasure and empathy. In mood disorder sufferers, this brief euphoria may mask depressed or hypomanic episodes. Serotonin depletion from repeated MDMA usage may worsen depressive symptoms. Another possible mistake is in anxiety disorders. MDMA may initially boost alertness and social confidence, but it may also cause anxiety, agitation, and panic attacks. If the underlying drug use disease is not treated, these symptoms may be misdiagnosed as GAD or panic disorder. Chronic MDMA use may also disturb brain neurotransmitter balance, confounding the clinical picture and perhaps disguising anxiety symptoms (Ornell et al., 2021). Thus, accurate screening and assessment for substance use disorders, including MDMA use, are essential in psychiatric practice to distinguish drug-induced symptoms from primary mental health disorders and ensure optimal treatment and outcomes for affected individuals.

Marijuana usage is commonly linked to mental health illnesses, many of which include CUD. In CUD, problematic marijuana usage causes clinically substantial impairment or suffering. Marijuana users may develop dependency, which causes withdrawal symptoms and an unwillingness to quit despite unpleasant effects. Co-occurring mental health issues with marijuana use include anxiety disorders, especially GAD and SAD. Chronic marijuana use may worsen anxiety symptoms, even if it first calms consumers. Marijuana use changes brain chemistry, affecting neurotransmitter systems involved in controlling anxiety, which may increase anxiety and paranoia, particularly in vulnerable people or at larger dosages. Psychosis risk increases with marijuana usage, especially in people prone to schizophrenia (Kancherla et al., 2021). Marijuana usage may increase psychotic symptoms in sensitive people, although the link is complicated. Thus, professional settings must recognize these co-occurring illnesses to offer comprehensive treatment for drug use and mental health issues.

The correlation between drug usage and suicide is substantial. Substance use disorders (SUDs) increase suicide risk in several ways. Alcohol and drugs impair judgment and cognitive function, which may lead to impulsive or dangerous behavior, including suicide. Intoxication may lower inhibitions and increase hopelessness and despair, leading to suicide. Substance addiction often co-occurs with depression, anxiety, and bipolar disorder, which independently increase suicide risk. Psychiatric and drug addiction may increase, increasing suicide risk. Certain drug withdrawals may induce emotional and physical distress and suicide thoughts or behaviors (Lynch et al., 2020). Substance use may cause social issues such strained relationships, financial issues, and legal issues, leaving users miserable and alone and increasing suicide risk. Effective suicide prevention and intervention programs must address substance use disorders and co-occurring mental health difficulties.

 

 

References

Ethan, X., Logan, A., Liam, M., & Leonard, J. (2020). Impact of marijuana (cannabis) on health, safety and economy. IDOSR JOURNAL of EXPERIMENTAL SCIENCES, 5(1), 43–52. https://idosr.org/wp-content/uploads/2020/04/IDOSR-JES-51-43-52-2020.-P7.pdf

Kancherla, N., Jeyanthi, K. M., Abbas, R., Sathi, T. S. C. R., Upadhyay, A., & Garlapati, S. K. P. (2021). Cannabis Associated Mental Health Effects: A Review. Journal of Pharmacy & Bioallied Sciences, 13(Suppl 2), S943–S946. https://doi.org/10.4103/jpbs.jpbs_388_21

Lynch, F. L., Peterson, E. L., Lu, C. Y., Hu, Y., Rossom, R. C., Waitzfelder, B. E., Owen-Smith, A. A., Hubley, S., Prabhakar, D., Keoki Williams, L., Beck, A., Simon, G. E., & Ahmedani, B. K. (2020). Substance use disorders and risk of suicide in a general US population: a case control study. Addiction Science & Clinical Practice, 15(1). https://doi.org/10.1186/s13722-020-0181-1

Martini, F., Fregna, L., Bosia, M., Perrozzi, G., & Cavallaro, R. (2022). Substance-Related Disorders. Fundamentals of Psychiatry for Health Care Professionals, 263–295. https://doi.org/10.1007/978-3-031-07715-9_9

Ornell, F., Halpern, S., & Lisia von Diemen. (2021). Substance Use Disorders and Psychiatric Comorbidity. Springer EBooks, 23–41. https://doi.org/10.1007/978-3-030-62106-3_2