Properties of Drugs. 3. Dependence. (From DSM-IV)

Transcription

1 Drugs Drug chemical substance that can alter structure and function of body Psychoactive drugs alters behavior, thought, or perceptions affect nervous system most cross blood brain barrier Properties of Drugs 1. Tolerance 2. Withdrawal 3. Addiction Begin using increase dose to get same effect 1. Tolerance continue with same dose OVERDOSE DEPENDENCE decreased effect with same dose 2. Withdrawal Physical response when not taking drug smokers get edgy and anxious caffeine headaches alcohol WD can be fatal use drug to reduce/prevent (From DSM-IV) 3. Dependence 3 or more in 12 month period: Tolerance Withdrawal symptoms Substance taken in larger amount and for longer period than intended 3. Dependence Ongoing desire or unsuccessful attempts to quit Much time to obtain, use, recover Important activities given up or reduced Use continues despite knowledge of negative consequences 3. Dependence Physical vs. Psychological physical often seen as worse due to withdrawal Not necessarily! Dependence vs. Abuse (From DSM-IV) 1 or more in 12 month period: Repeated use resulting in failure to fulfill major obligations Repeated use in physically hazardous situations Dependence vs. Abuse Repeated substance related legal problems Continued use despite ongoing social problems caused or made worse by substance 1

2 How do drugs affect the brain? Neurons (nerve cells) Drugs change the way neurons communicate Psychoactive Drugs Three effects 1. quicker release of neurotransmitters (NTs) 2. longer effects of NTs 3. copy effects of NTs 2

3 Categories of Psychoactive Drugs Depressants Hallucinogens Psychoactive Drugs 1. Depressants relax and calm a user induce sleep at higher doses depress brain activity examples: alcohol opiates Alcohol Depressants Active ingredient = ethanol Which drink has most alcohol? Each = one standard drink Alcohol s Effects arousal inhibitions reaction time Blood Alcohol Content (BAC) mg alcohol per 100 mg blood.10 =.1% of bloodstream is alcohol Average person eliminates one standard drink per hour Factors Affecting Blood Alcohol Content 1. Body weight and muscle mass 2. Food consumption Slows down, doesn t prevent 3. Gender Women have lower enzyme activity and less muscle mass The Biphasic Effect of Alcohol Effects of alcohol have 2 phases Phase 1: excitement, euphoria Phase 2: depressant effects Most people start to feel negative effects at a BAC of The Biphasic Effect of Alcohol Buzz Sober Drunk Moderate Drinking Levels Women 1 per day; men 2 per day Binge drinking Bringing BAC to 0.08% 5 for men, 4 for women in 2 hours 3

4 Alcohol: Biological Effects Self-control, decision making Vision Memory Balance, coordination Breathing, heartbeat Alcohol: Changes in the Brain Alcohol: Biological Effects Tolerance chronic use more liver enzymes to break it down Effect on BAC? Physical dependence Withdrawal Delirium tremens ( the DTs ) Severe cravings Alcohol: Biological Effects Withdrawal Delirium tremens ( the DTs ) shaking hallucinations seizures Alcohol-Related Diseases Heart disease Cancer: mouth, throat, etc. Liver diseases: cirrhosis, hepatitis Opiates (Narcotics) From opium poppy Healthy liver Cirrhosis Examples Opiates (Narcotics) Natural opium, morphine, codeine Semi-synthetic heroin, OxyContin, Vicodin Opiates In brain, occupy endorphin receptors Chemicals in brain Natural pain relievers When used for addiction pain relief less likely pleasure euphoria tolerance, addiction History of Opium Native to many regions Middle East Laos, Thailand, Afghanistan Mexico & Colombia Use dates back 6000 years to Sumerians Egyptians used it medically 3500 years ago Common in Islamic world for medical & recreational purposes 4

5 Collision of cultures Chinese building railroad San Francisco outlawed opium dens & opium smoking Laws targeted not at opium (laudanum legal), but at Chinese Federal laws prohibiting opium smoking followed 19 th century opium-based medicines 19 th century opium-based medicines Morphine morphine separated from opium development of hypodermic needle Use became widespread Doctors began injecting opium solutions Used during Civil War for injuries (dependence known as soldier s disease ) Heroin Heroin first made sold as cough medicine Why heroin? Heroin Products An asthma medicine Heroin Injected, smoked, snorted Often cut with other substances Heroin Short-term effects Euphoria, flushing of skin Long-term effects Addiction Collapsed veins Organ damage mood alertness blood pressure heart rate fatigue appetite 5

6 Caffeine Found in coffee, tea, soft drinks, chocolate, some nuts, and some medicines Caffeine Found in > 60 plants 90% use every day 6 hour half life Blocks adenosine (drowsiness) Increases dopamine (pleasure) Caffeine mg/day probably OK Excess anxiety, restlessness, palpitations Linked with osteoporosis, miscarriage 2. Nicotine Active ingredient in tobacco In U.S., 20.6% of adults smoke (2009) 29% use tobacco products A tobacco leaf Nicotine Tobacco field in North Carolina 2. Nicotine Tobacco products Dip Chewing tobacco Snus Cigarettes, cigars, pipes Cans of dip Chewing tobacco Snus Chemicals in Cigarettes Chemicals in Cigarettes More than 4000 chemicals in smoke Where do they come from? tobacco plant soil and environment manufacturing process additives burning the tobacco 6

7 Cancer Causing Chemicals Identified in Cigarettes Acetaldehyde Acetamide Acrylamide Acrylonitrile 2-Amino-3,4-dimethyl-3H-imidazo[4,5-f]quinoline (MeIQ) 3-Amino-1,4-dimethyl-5H-pyrido [4,3-b]indole (Trp-P-1) 2-Amino-l-methyl-6-phenyl-1H-imidazo [4,5-b]pyridine (PhlP) 2-Amino-6-methyldipyrido[1,2-a:3',2'-d]imidazole (Glu-P-1) 3-Amino-l-methyl-5H-pyrido {4,3-b]indole (Trp-P-2 2-Amino-3-methyl-9H-pyrido[2,3-b]indole (MeAaC) 2-Amino-9H-pyrido[2,3-b]indole (AaC) 4-Aminobiphenyl 2-Aminodipyrido[1,2-a:3',2'-d]imidazole (Glu-P-2) 0-Anisidine Arsenic Benz[a]anthracene Benzene Benzo[a]pyrene Benzo[b]fluoranthene Benzo[j]fluoranthene Benzo[k]fluoranthene Benzo[b]furan Beryllium 1,3-Butadiene Cadmium Catechol (1,2-benzenediol) p-chloroaniline Chloroform Cobalt p,p'-ddt Dibenz[a,h]acridine Dibenz[a,j]acridine Dibenz(a,h)anthracene 7H-Dibenzo[c,g]carbazole Dibenzo(a,e)pyrene Dibenzo(a,i)pyrene Dibenzo(a,h)pyrene Dibenzo(a,i)pyrene Dibenzo(a,l)pyrene 3,4-Dihydroxycinnamic acid (caffeic acid) Ethylbenzene Ethylene oxide Formaldehyde Furan Glycidol Heptachlor Hydrazine Indeno[1,2,3-cd]pyrene IQ 92-Amino-3-methyl-3H-imidazo[4,5-f]quinoline) Isoprene Lead 5-Methyl-chrysene 2-Naphthylamine Nitrobenzene Nitrogen mustard Nitromethane 2-Nitropropane N-Nitrosodi-n-butylamine (NDBA) N-Nitrosodi-n-propylamine (NDPA) N-Nitrosodiethanolamine (NDELA) N-Nitrosodiethylamine (DEN) N-Nitrosodimethylamine (DMN) N-Nitrosoethylmethylamine (NEMA, MEN) 4-(N-Nitrosomethylamino)-1-(3-pyridinyl)-1- butanone (NNK) N'-Nitrosonornicotine (NNN) N-Nitrosopiperidine (NPIP, NPP) N-Nitrosopyrrolidine (NPYR, NPY) Polonium-210 (Radon 222) Propylene oxide Safrole Styrene Tetrachloroethylene o-toluidine (2-methylaniline) Trichloroethylene Urethane (carbamic acid, ethyl ester) Vinyl acetate Vinyl chloride 4-Vinylcyclohexene 2,6-Xylidine (2,6-dimethylaniline) Smoking: Psychological Effects Increased alertness Feelings of pleasure Teen smokers have higher rates of: anxiety disorders depression Smoking: Health Effects 1 in 5 deaths in U.S. (20%) Pay up to double for life insurance Die average of years earlier than non-smokers Smoking-Related Diseases (A Partial List) Lip Cancer Oral Cavity Cancer Tongue Cancer Pharyngeal Cancer Esophageal Cancer Stomach Cancer Pancreatic Cancer Laryngeal Cancer Tracheal Cancer Lung Cancer Kidney Cancer Urinary Bladder Cancer Cervical Cancer Acute Myeloid Leukemia Peripheral vascular disease Coronary Heart Disease Ischemic Heart Disease Cerebrovascular Disease Atherosclerosis Aortic Aneurysm Invasive Pneumococcal Disease Chronic Obstructive Pulmonary Disease (COPD) Complications of pregnancy Smoking: Health Effects Foreign warning labels Lung Images HEALTHY LUNG CANCER EMPHYSEMA "Quitting smoking is easy I've done it a thousand times." Mark Twain Nicotine: Quitting Smoking Fewer than 1 in 10 trying to quit succeed on first try Hardest = starting before age 21 (80-90% start in teens) Nicotine replacement Gum, lozenge, patch Medication 7

8 Cocaine Coca plant Mid-1800s Used as an anesthetic Common ingredient Cocaine Snorted, smoked, injected Street names: blow, snow, nose candy Cocaine Short-term effects Intense euphoria Very fast-acting Effects short-lived urge to use more Long-term effects Heart disease Damaged septum Amphetamines Benzedrine, Ritalin, Adderall Increases alertness Decreases appetite Dependence & tolerance Altered thoughts Paranoia Similar to schizophrenia Methamphetamine Similar to amphetamines, but stronger Made in home labs Pills, injected, snorted, smoked Street names: speed, ice, meth, crystal meth 3. Hallucinogens A. Psychoactive Drugs Affect mood, thought, memory, judgment, and perception Sometimes called psychedelic drugs Alter perception and produce vivid imagery Their impact varies widely depending on the user and the particular drug Hallucinogens Affect mood, thought, memory, judgment, and perception Sometimes called psychedelic drugs Alter perception and produce vivid imagery Effects vary depending on user and particular drug 3. Hallucinogens a. Marijuana Most widely used illegal drug Reactions vary widely Affects judgment and coordination Possible psychological dependence in some 8

9 3. Psychedelic Drugs b. LSD Lysergic acid diethylamide Produces altered visual and auditory perception Sometimes causes changes in time and distance perception 3. Hallucinogens c. Ecstasy Methylenedioxymethamphetamine (MDMA) Causes massive release of serotonin in the brain May lead to prolonged problems regulating serotonin levels May contribute to depression and memory problems 9