PUBH 3003 Exam 1

Characteristics of the five drug schedules

I: high misuse, no accepted medical use, high addiction (ecstasy, heroin)
II: high misuse, some accepted medical use, high addiction (cocaine)
III: med misuse, accepted medical use, moderate addiction (steroids, ketamine)
IV: moderate misuse, accepted medical use, possible addiction (benzodiazapenes - xanax)
V: low misuse, accepted medical use, possible addiction (cough syrup, pain releivers)

Examples of APE

- agent (drug): potency, purity, dose, administration
- person: internal (age, sex, genetics), external (exercise, food, sleep)
- environment: marketing, availability, etc

Socioecological model

public policy, community, instituition, interpersonal, individual

Public health approach steps

define the problem, risk/protective factors, test prevention strategies, ensure widespread adoption

Three vital functions of central nervous system

circulation, respiratory, reflex

Different routes of administration for drugs

ingesting, skin, mucous membranes, inhaling, iv

How does route of administration affect concentration of drug in brain?

- ingesting is the slowest route to the brain
- inhaling can be just as fast or faster than IV depending on the drug

What does an agonist do?

binds to the receptor and activates it

What does an antagonist do?

binds to the receptor and blocks other molecules from binding to receptor

What is potency?

the amount need to produce effect of given intensity

What is affinity?

the ability to bind to receptor to produce effect

What is efficacy?

the maximum effect produced regardless of dose

How and why do the effects of drugs change over time?

- tolerance: increased concentrations needed to achieve the same effect (frequency, dose --> tolerance)
- withdrawal: body adapts to drug use, body needs to adapt to not having drug

How do drugs influence neuron function?

- produce less neurotransmitter
- more/fewer receptors
- more/fewer receptor blockers

What is the biphasic effect of alcohol?

- low: alcohol activates some nerve cells, buzz and euphoria
- high: alcohol supresses activity, drunk and dysphoria

Standard drinks

12oz beer = 8oz malt = 5oz wine = 1.5oz 80 proof liqour

How does alcohol move through the body?

- in: 20% stomach, 80% small intestine, reaches brain first
- out: liver breaks down alc, constant in adults

Effects of alcohol at BAC 0.05, 0.2, 0.3, 0.4

- 0.05: relaxed, euphoria
- 0.2: dysphoria, slight nausea
- 0.3: loss of consciousness
- 0.4: coma, death due to respiratory arrest

Signs of alcohol overdose

mental confusion, irregular breathing, vomiting while unconscious, hypothermia, seizures

What is teratogen and what is the most critical time in pregnancy for alcohol teratogen?

teratogen: produces physical/functional defects in embryos/fetus
3rd week post conception to develop FAD

What is the spectrum of effects of prenatal alcohol exposure?

- effects: birth defects (ARBD) or neurodevelopmental defects (ARND)
- fetal alcohol syndrome
- death

Public health policies that have worked

- cost: increase taxes and pricing
- access/availability: regulate stores in the area, limits on hours/days for sales, legal minimum drinking age

What are the changes between DSM-IV and DSM-V in relation to substance use?

- changed to substance use disorder from 2 diff disorders
- removed legal reasons as a criterion
- added craving as a criterion

What are the major groupings for substance use disorder?

impaired control, social impairment, risky use, pharmacological issues (tolerance, withdrawal)

What is the qualification of severity for substance use disorder?

- mild (2-3 criterion)
- moderate (4-5 criterion)
- severe (6+)

What are the three reasons for co-occurance of substance abuse and mental health disorders?

- common risk factors
- mental health illness can cause substance misuse
- substance misuse can cause mental illness

3 traditional models to explain addiction

- moral: personal choice
- disease: mental disorder/brain disease, AA
- learning: behavioral/societal factors

Physical dependence vs. addiction

physical dependence is when individual functions normally with drug and can't without drug, can lead to addiction

What is addiction and why is it a brain disease?

- addiction: repetitive and compulsive use of substance
- brain circuits involved

Dopamine and reward/pleasure system in addiction

- constant stimulation leads to expectation of stimulus
- dopamine is involved with reinforcement
- low levels of one of the dopamine receptors bc constant dopamine leads to cell wanting to shut down reception

Why does an addicted person keep taking drugs?

brain changes, wants pleasure, anhedonia, reward anticipation, withdrawal discomfort, environmental/social cues, mental health

What is recovery?

process of change to improve health and wellbeing, live self directed life, reach full potential

What are some treatment program options

- residential: based on AA, initial detox, group therapy, spiritual meditation, 30 days
- outpatient: like residential but don't live there, change-oriented (stop all drug use), adaptive (reduce dependence to function)
- SMART: like AA but not religious

What are the three broad steps of AA?

find god, clean house, help others

Three things that perpetuate alcoholism

- fear and anxiety
- guilt and shame
- resentment and anger