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Chapter 13 Lecture

Access to Health Thirteenth Edition

Avoiding Drug

Misuse and Abuse

Did you PREPARE and did you LEARN?

• Discuss the six categories of drugs and their

routes of administration.

• Discuss the use of illicit drugs among college

students.

• Review problems relating to the misuse and

abuse of prescription drugs.

Did you PREPARE and did you LEARN?

• Discuss the use and abuse of controlled

substances, including cocaine, amphetamines,

marijuana, opioids, hallucinogens, club drugs,

inhalants, and steroids.

• Profile illicit drug use in the United States,

including who uses illicit drugs, financial impact,

and impact on college campuses and the

workplace.

Drug Dynamics

• Drugs work because they are similar to

chemicals produced naturally in the body.

• According to the receptor site theory, drugs bind

to specific receptors within the body.

– Psychoactive drugs can alter mood or

behavior by acting on neurotransmitters in the

brain.

How Drugs Affect the Brain

• Pleasure, or reward, is a powerful biological

force for survival.

• Life-sustaining activities stimulate specialized

nerve cells devoted to producing and regulating

pleasure.

• A neurotransmitter is one of many chemical

substances that transmit nerve impulses along

nerve fibers.

The Action of Cocaine at Dopamine

Receptors in the Brain, an Example of

Psychoactive Drug Action

Types of Drugs

• Prescription drugs

• Over-the-counter (OTC) drugs

• Recreational drugs

• Herbal preparations

• Illicit (illegal) drugs

• Commercial preparations

Routes of Drug Administration

• Oral ingestion—taken by mouth

• Inhalation—sniffed, smoked, or inhaled

• Injection—administered either intravenously or

subcutaneously

• Transdermal—absorbed through the skin,

vagina, or anus (suppositories)

Routes of Drug Administration

Drug Interactions

• Polydrug use—where several substances are taken simultaneously

• Synergism—(potentiation) where the effects of two or more drugs

are multiplied beyond what is expected if each were taken alone

• Antagonism—where one drug blocks the action of another drug

• Inhibition—where the effects of one drug are eliminated or reduced

by the presence of another drug

• Cross-tolerance—where tolerance to one drug transfers to a second

drug

Using, Misusing, and Abusing Drugs

• Drug misuse involves using a drug for a purpose

other than that for which it was intended.

• Drug abuse, the excessive use of any drug, may

cause serious harm.

• Both misuse and abuse can lead to addiction.

Abuse of Over-the-Counter (OTC) Drugs

• OTC medications can be abused, with resultant

health complications.

• The most likely candidates for abuse are teens,

young adults, and people over aged 65.

• Examples of abused OTC drugs include sleep

aids, cold medicines, and diet pills.

Nonmedical Use or Abuse of Prescription

Drugs

• Only marijuana is more widely abused than

prescription drugs.

• Over 7 million Americans over the age of 12

have used prescription drugs for nonmedical

reasons in the last month.

• The prescription drugs most likely to be abused

include opioids/narcotics, depressants, and

stimulants.

College Students and Prescription Drug

Abuse

• Prescription drugs can be as unsafe or even more unsafe that illegal drugs.

• 15.3 percent of students surveyed in a 2011 study reported illegally using prescription drugs in the last year, compared to 13.5 percent in 2008.

• Stimulant drugs used to treat attention deficit hyperactivity disorder (ADHD) are of particular concern.

Illicit Drugs

• In 2010, an estimated 22.6 million Americans

were users of illicit drugs.

• In 2010, almost 35 percent of college students

had tried an illicit drug; about a third had smoked

marijuana in the previous year.

• Cocaine, heroin, and Ecstasy use increased 52

percent—from 5 percent to 8 percent of all

students—in the past decade.

Why Do Some College Students Use Drugs?

• Positive expectations

• Genetics and family history

• Substance use in high school

• Mental health problems

• Sorority and fraternity membership

• Stress

Reasons College Students Use Illicit Drugs

or Controlled Prescription Drugs

Why Don't Some College Students

Use Drugs?

• Parental attitudes and behavior

• Religion and spirituality

• Student engagement

• College athletics

• Healthy social network

Common Drugs of Abuse

• Stimulants

• Marijuana and other cannabinoids

• Depressants and narcotics

• Hallucinogens

• Inhalants

• Steroids

Stimulants

• Cocaine—one of the most powerful naturally occurring stimulants.

• It can be snorted, smoked, and injected.

• Freebase is obtained by removing the hydrochloride salt from

cocaine powder.

• Cocaine is an anesthetic and a central nervous system (CNS)

stimulant.

• High doses can lead to increased heart rate and blood pressure,

weight loss, convulsions, muscle twitching, and other effects.

Stimulants

• Amphetamines are also called bennies, dex, meth,

speed, cross tops, uppers, and ice.

– Adderall and Ritalin are used for medical purposes.

– Recently, these drugs have become popular on

college campuses (for "all nighters").

• Methamphetamine is powerfully addicting and easily

made using over-the-counter drugs.

– Small doses increase alertness and decrease

appetite.

– Large doses can lead to convulsions, hallucinations,

and death.

Physical Consequences of

Methamphetamine

The physical consequences of methamphetamine use are often

dramatic. The photos to the left show a person before and 1.5 years

after methamphetamine use.

Caffeine

• Caffeine is the most popular and widely

consumed drug in the United States.

• Almost half of Americans use caffeine.

• Made from xanthines, caffeine is a mild CNS

stimulant that enhances mental alertness and

reduces feelings of drowsiness.

• It takes 4 to 6 hours for the body to metabolize

half of the caffeine ingested.

Caffeine Content Comparison

Marijuana

• Active ingredient

– Tetrahydrocannabinol (THC) is the

psychoactive substance in marijuana.

• Physical effects

– Dilation of blood vessels in the eyes, dry

mouth, increased appetite, lowered blood

pressure, and mild muscular weakness

– Severe anxiety, panic, paranoia, and

psychosis

Marijuana and Driving

• Marijuana substantially reduces a driver's ability

to react and make quick decisions. Users often

fail to recognize their impairment. Marijuana is

the most prevalent illegal drug detected in

impaired drivers, fatally injured drivers, and

motor vehicle crash victims.

• Even a moderate dose alone impairs driving; but

when marijuana is combined with alcohol, the

two drugs synergize.

Effects of Chronic Marijuana Use

• Marijuana contains 50 to 70 percent more

carcinogenic hydrocarbons than tobacco smoke,

and because of the way it is smoked, the lungs

have longer exposure to carcinogens.

• Chronic use results in chronic bronchitis,

emphysema, oxygen-depleted blood supply,

higher risk of testicular cancer, higher risk of

mental health problems, and suppressed

immune system.

Marijuana as Medicine

• Reduces severe nausea and vomiting caused by

chemotherapy

• Improves appetite

• Forestalls the loss of muscle mass associated

with the AIDS wasting syndrome

• Reduces muscle pain and spasticity caused by

multiple sclerosis

Synthetic Marijuana

• Also known as K2 or "Spice"

• Mimics marijuana intoxication but with longer duration

and poor detection on urine drug screens.

• K2 is used by nearly 1 in 10 college students and is

more commonly used by males and first- and second-

year college students.

• The most common way of smoking K2 was in a "joint,"

followed by hookah use.

Points of View—Medical Marijuana: Too

Legal or Not Legal Enough?

Depressants: Benzodiazepines and

Barbiturates

• These are sedative drugs that promote mental

calmness and reduce anxiety, while hypnotic

drugs promote sleep or drowsiness.

• Sedatives depress the CNS.

• These drugs are commonly prescribed for

tension, muscular strain, sleep problems,

anxiety, panic attacks, and to treat alcohol

withdrawal.

Depressants: Opiates

• Powerful depressants of the CNS

– Also called narcotics

• Derived from opium, the dark, resinous substance made

from the juice of the opium poppy

– Derivatives: morphine and codeine

– Synthetic opiates: Percodan, Demerol, and Dilaudid

– OxyContin is another powerful opiate.

– Heroin is highly addictive.

• Endorphins (opiate-like substances) are manufactured in

the body and have many receptor sites.

Treatment for Heroin Addiction

• Most treatment programs for heroin addiction are not

very successful.

• Distinct pattern of withdrawal:

– Sleep disturbance, irritability, and muscle tremors

occur 12 hours after the initial dose.

– Nausea, abdominal cramps, vomiting, and diarrhea

occur 24 to 72 hours after the last use in the

withdrawal process.

• Methadone is a synthetic narcotic that blocks the effects

of opiate withdrawal.

Hallucinogens

• Hallucinogens, or psychedelics, are a group of mind-

altering drugs that affect the brain and nervous system

and bring about changes in thought, self-awareness,

emotion, and sensation.

• Major receptor sites are in the reticular formation,

located in the brainstem; when a hallucinogen reaches

this site, messages become scrambled.

• Synesthesia occurs when sensory messages are mixed

(one smells colors or hears tastes).

Hallucinogens

• LSD (lysergic acid diethylamide)

• Mescaline, derived from the peyote cactus

• Psilocybin, also known as the "magic mushroom"

• Phencyclidine (PCP) is a synthetic substance

that was originally developed as an anesthetic.

Hallucinogens: LSD

• LSD is the most notorious hallucinogen.

• Its physiological effects include increased heart

rate, elevated blood pressure and temperature,

muscle tremors, gooseflesh, headaches, and

mild nausea.

• Its psychological effects include euphoria,

dysphoria (sense of foreboding), shortened

attention span, introspection, and distorted

perceptions.

Club Drugs or Designer Drugs

• Ecstasy

• Mescaline

• Psilocybin

• PCP

• Ketamine

• The sources of these drugs and the chemicals in

them can vary, so the drugs may be impure and

their effects unpredictable.

Mescaline

• Mescaline is one of

hundreds of chemicals

derived from the peyote

cactus.

• It is both a powerful

hallucinogen and a

CNS stimulant.

Inhalants

• Inhalants are chemicals that produce vapors

capable of causing hallucinations and creating

intoxicating and euphoric effects.

• Some agents are organic, solvent by-products of

the distillation of petroleum products.

– Rubber cement, model glue, paint thinner,

lighter fluid, varnish, wax, and gasoline are

examples.

Steroids

• Anabolic steroids are artificial forms of the male hormone

testosterone. They include ergogenic drugs, which are

substances that enhance athletic performance.

• There are two forms of anabolic steroids:

– Injectable solutions

– Pills

• Effects of steroids include mood swings, acne, liver

tumors, elevated cholesterol levels, hypertension, and

kidney disease.

• Anabolic Steroids Control Act of 1990

Treatment and Recovery

• In 2010 an estimated 23.5 million Americans

age 12 or older needed treatment for a drug or

alcohol problem.

• The most difficult step in recovery is admitting

that there is a problem. Denial is the hallmark of

addiction.

• Detoxification refers to the early abstinence

period, during which an addict adjusts physically

and cognitively.

Treatment Approaches

• Outpatient behavioral treatment:

– Residential treatment

– Therapeutic communities

• 12-step programs:

– Alcoholics Anonymous

– Cocaine Anonymous

– Crystal Meth Anonymous

– Gambler's Anonymous

– Pills Anonymous

Addressing Drug Misuse and Abuse in the

United States

• Risks associated with drug use extend beyond

the personal. Illegal drug use costs about $193

billion per year.

• Some 50 percent of those who use illicit drugs

are employed either full or part time.

• Reductions in student drug use might require

changing attitudes, identifying high-risk students,

and providing services.

Possible Solutions to the Drug Problem

• Educate young people about drugs.

• Implement stricter border controls.

• Require longer prison sentences for drug dealers.

• Increase spending on prevention and improve the

enforcement of anti-drug laws; also facilitate

greater cooperation among agencies.

• Develop harm-reduction strategies.

Assessing Yourself—A Personal Inventory

• Go online to the Live It! section of www.pearsonhighered.com/donatelle to take the "Learn to Recognize Drug Use and Potential Abuse" assessment.

• Do you think your age impacts how you view illicit drugs and the laws that surround them?

• If you have used or continue to use illicit drugs, do you think your life and the life of those you love is better for this?

• Would you mind if your physician or pharmacist used drugs recreationally the day before you required the services of these people?