Substance Use Survey Results

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3 Psychology 179 Fall 2006 Substance Use Survey Results Alcohol Tried Recently used Weekly beer Weekly wine Weekly mixed Males (n = 95) 87% 86% 62% 50% 55% Females (n = 223) 86% 82% 27% 25% 41% Total (n = 322) 84% 83% 40% 27% 44% Tobacco Cigarettes (daily) Cigar, pipe, clove Chew, snuff Recently used 6% 10% 4% 32% 3% 4% <1% 18% 4% 6% 2% 22% Marijuana Tried Recently used 57% 28% 49% 22% 50% 24% Cocaine Tried Recently used Tried crack 10% 3% 1% 11% 3% 1% 10% 3% 1% Amphetamine Tried Recently used 8% 1% 5% <1% 6% <1% Have tried: LSD Heroin Morphine Amyl Nitrate Barbiturates PCP Darvon Psilocybin MDMA Nitrous Oxide 7% 2% 5% 4% 5% 1% 2% 18% 12% 14% 5% 0% 6% 2% 2% 0% 0% 12% 14% 7% 5% <1% 6% 3% 3% <1% <1% 13% 13% 9% Used within last 30 days: Sleeping Pills Pain relievers minor Tranquilizers Weight control pills 5% 40% 6% 2% 3% 53% 4% 2% 4% 49% 5% 3% Artificial Sweeteners Saccharin Nutrasweet 16% 17% 21% 27% 19% 24% Substance Abuse Problems Problems with abuse 3% 4% 4%

4 Psychology 179 DRUG SURVEY SUMMARY Tobacco (currently smoke) Alcohol (currently drink) Marijuana (recently used) 9% 6% 6% 6% 7% 8% 13% 7% 7% 10% 10% 11% 17% 10% 10% 13% 10% 11% 6% 9% 12% 8% 90% 89% 89% 88% 81% 81% 83% 82% 86% 86% 86% 82% 78% 80% 85% 82% 86% 86% 81% 82% 86% 85% 30% 25% 24% 25% 15% 19% 20% 20% 24% 30% 24% 23% 22% 19% 25% 25% 28% 26% 23% 22% 24% 24% Marijuana (tried) 75% 68% 64% 69% 57% 67% 53% 53% 55% 60% 56% 48% 53% 49% 56% 55% 62% 54% 55% 53% 51% 58% LSD (tried) 9% 14% 13% 15% 15% 17% 12% 14% 14% 16% 13% 14% 14% 12% 12% 17% 15% 8% 8% 2% 5% 6% Mushrooms (tried) 27% 27% 22% 26% 22% 23% 16% 19% 21% 23% 17% 20% 24% 22% 19% 30% 24% 18% 18% 10% 13% 14% Cocaine (tried) 46% 42% 32% 32% 22% 34% 13% 14% 11% 17% 10% 7% 12% 10% 10% 20% 19% 11% 13% 8% 12% 14%

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20 Treatments A. Electroconvulsive therapy (ECT) B. Psychotherapy C. Selective serotonin reuptake inhibitors (SSRIs) D. Tricyclic antidepressants E. Monoamine oxidase inhibitors (MAOIs) F. Lithium G. Valproic acid A. Electroconvulsive Therapy (ECT) 1. Electric current passed through nondominant cranial hemisphere resulting in a seizure which lasts around one minute. 2. Short-acting barbiturate and muscle relaxant given to prevent a total body (tonic-clonic) seizures. 3. Duration: treatments in 2-3 weeks. 4. Side effects: confusion, anterograde amnesia. No permanent significant changes in brain function occur. 5. ECT requires a board-certified psychiatrist, anesthesiologist and consent of the patient (or in extreme cases, a family member). 6. Efficacy 93%, the single, most effective treatment for MDE. B. Psychotherapy 1. Quite effective in moderate cases of depression. 2. Interpersonal: focus on relationships with others. 3. Psychodynamic: classical Freudian psychotherapy, focuses on resolving psychic conflicts. 4. Cognitive: developed by Beck, focuses on correcting negative thoughts which perpetuate helplessness-hopelessness. 5. Combination therapies: All recent studies confirm a combined approach is usually optimal, e.g. medication plus therapy. C. Antidepressants (AD) 1. Selective serotonin reuptake inhibitors (SSRIs) have fewest side-effects of all AD, block reuptake of serotonin, include Prozac, Paxil, Zoloft, Effexor. 2. Tricyclic AD named for their 3-ring chemical structure, block reuptake of norepinephrine, dopamine, and serotonin, include Elavil, Tofranil, Pamelor. a. Efficacy of SSRIs and trycyclics: 60-70%. 3. Monoamine oxidase inhibitors. a. Block monoamine oxidase, used to treat depression;. b. Special diet: avoid smoked meats, aged cheeses, red wine, all of which are high in amino acid tyramine, which is usually metabolized by MAO, high levels lead to hypertensive crisis.

21 4. Lithium (Li) a. Naturally occurring alkali metal. b. Mechanism of action is unclear, may stabilize brain cell membranes. c. Efficacy for mania: 80%, depression: 60%. d. Neurological effects: fatigue and lethargy, tremor, muscle weakness; severe neurological signs: coma and death. e. Other side-effects: frequent urination, thirst, nausea, abdominal discomfort, hypothyroidism. f. Requires frequent monitoring of Li levels, thyroid and kidney function. 5. Valproic adid (Depakote) divalproex a. Proven effective in treating Bipolar Disorder. b. Formerly an anticonvulsant, antiepileptic. c. Side-effects less than Li, some abdominal discomfort, mild tremor, liver function needs to be monitored.

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27 DRUGS DOSE HALF-LIFE DURATION BENZODIAZEPINES 2-3x/day diazepam (Valium) 1 10 mg 3-60 hours long lorazepam (Ativan) 2 6 mg hours medium alprazolam (Xanax) mg hours medium chlordiazepoxide (Librium) mg 5 15 hours short NON-BENZODIAZEPINES buspirone (Buspar) mg 2 3 hours short propanolol (Inderal) mg 4 hours short clomipramine (Anafranil) mg hours long fluoxetine (Prozac) mg hours long

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