Drugs and Behavior Exam 1

biopsychosocial model

Drug-taking behavior is best accounted for by a combination of biological, psychological, and sociological factors

• ex: genetic predisposition for alcoholism + mental health disorder + pressure from peers = higher risk

drug

• chemical substance that, when taken into the body, alters the structure or functioning of the body in some way EXCLUDING those nutrients considered to be related to normal functioning

  • AND, if the intended purpose is to induce bodily or psychological change

psychoactive drugs

chemical substances that alter our feelings, thoughts, perceptions of the world, and behaviors

• instrumental use vs. recreational use

brand name

drug name given by pharmaceutical manufacturer who has the rights to marketing that drug

• ex: Tylenol, Zoloft, Zyrtec

generic name

name of a drug that does not belong to a specific brand

• ex: acetaminophen, heroin, methampetamine

natural-product name

drug name referring to the plant or chemical from which the drug was derived

• ex: marijuana, morphine

street name

drug name referring to slang terms generated by users of that drug

• ex: speed, coke, weed

sociocultural factors

• what determines whether a drug is legal or illegal?

  • ex: history, culture, and religion

drug misuse

instrumental goal, but used inappropriately

drug abuse

usually recreational goal, used to produce physical, mental, or social impairment

drug dependence

intense cravings, preoccupation with obtaining the drug, high tolerance and withdrawal

drug origins

• shamanism (~10000BC) and priestly healing (~1500 BC)

  • opium

  • cocaine

  • fly agaric

opium

found in poppies, likely consumed or applied to wounds

• part of drug origins

cocaine

• found in coca leaves, consumed for pain relief and energy boosts

  • part of drug origins

fly agaric

• found in mushrooms, ate by vikings before battle, gave them extreme levels of energy

  • part of drug origins

late 1800’s

• medicinal developments

  • morphine prescribed as effective pain reliever

  • cocaine used a stimulant and antidepressant

  • anesthetics discovered

  • vaccine development (rabies, smallpox)

• social developments

  • widespread and uncontrolled access to psychoactive drugs

early 1900’s

• promising medicinal developments and concern over dependency

  • 18th amendment- prohibition

  • eventually overshadowed by negative social changes

1945-1960

• medicinal developments

  • “psychiatric revolution” in the 50’s

• social developments:

  • Post WWII

  • Cocktail parties, smoking rates peak

1960’s-1990’s

• fallout from the Cold War and Vietnam War

  • result- heavy drug experimentation

• war on drugs (Nixon, 1968)

• Controlled Substances Act (1970)

• Neuroscience field established (70s)

Controlled Substances Act

• five schedules for the classification of drugs

  • based on approved medicinal uses, potential for abuse, and potential for dependence

Schedule I

• most potential for abuse and dependence

• no medicinal qualities

  • ex: heroin, LSD, marijuana, ectasy, peytoe

Schedule 2

• high potential for abuse and dependence

• some medicinal qualities

  • ex: Vicodin, cocaine, meth, OxyContin, Adderall

Schedule 3

• Moderate potential for abuse/dependence

• Acceptable medicinal qualities

• doctor’s prescription required

  • Ex: Tylenol with Codeine, Ketamine, Steroids, Testosterone

Schedule 4

• low potential for abuse and dependence

• acceptable medicinal qualities

• prescription required— fewer refill regulations

  • ex: Xanax, Darvon, Vallum, Ativan, Ambien, Tramadol

Schedule 5

• lowest potential for abuse/dependence

• acceptable medicinal qualities

• prescription required—fewest refill regulations

  • ex: Robitussin aC, Lomotil, Motofen, Lyrica

Early 2000’s

• Bush- war on terrorism, increased control over drug trafficking

  • programs for drug abuse + programs for national security

National Survey of Drug Use and Health

• an annual nationwide study that provides up-to-date data on tobacco, alcohol, and illicit drug use, mental health conditions, and substance use or mental health treatment in the United States

• over- and under reporting assumed

Monitoring the Future

• survey is an ongoing, long-term study that tracks substance use, behaviors, and values among American adolescents and adults.

• over-and under reporting assumed

high school students

• drug use peaked in ‘79 and ‘81

• drug use hit lowest point in ‘91 and ‘93

• alcohol use more steady-highest in 70’s (laws)

• overall decrease in cigarette use, slight peak in late in late 90s

college students

• marijuana men use more than women (now changed)

• alcohol- steady has decreased throughout past 30 years (women uses more than men)

• cigarette use- consistent decline

risk factors

circumstances that increase the likelihood of drug-taking behavior

• ex:

  • antisocial behaviors (e.g. getting into fights)

  • having friends who use or believing that they do

  • personal positive views of drug use

  • friends positive views of drug use

  • Low SES

protective factors

circumstances that decrease the likelihood of drug-taking behaviors

• ex:

  • perceived risk of punishment

  • high social support/parental support

  • commitment to school

  • religiosity

  • extracurricular involvement

  • high SES

odds ratio

statistically determining risk and protective factors

= # of “yes” responses/ # of “no” responses

• Ratio > = risk factor

• Ratio < = protective factor

• Ratio = 1 = no factor

DSM-5 Diagnosis

• taking the substance in larger amounts and for longe than intended

• wanting to cut down or quit substance use but not being able to do it

• spending a lot of time obtaining the substance

• craving or having a strong desire to engage in substance use

• repeatedly being unable to carry out major obligations at work, school, or home due to substance use

• continued use despite persistent or recurring social or interpersonal problems caused or made worse by substance use

• stopping or reducing important social, occupational, or interpersonal activities due to substance

• withdrawal

• tolerance

substance use disorder

• 4 categories

  • impaired control

  • social impairment

  • risky sue

  • pharmacological effects

drug-taking behavior

actions and their consequences regarding acquiring a drug, taking a drug, and responding to a drug

Effective dose

the minimal dose of a drug necessary to produce the intended drug effect in a given percentage of the population

• ex: ED50- effective dose for 50% of the population

lethal dose

the minimal dose of a drug that would be lethal to a given percentage of the population

• ex: LD50- lethal dose for 50% of the population

therapeutic index

the ratio of a lethal dose for 50% of the population to the effective dose for 50% of the population (LD50/ED50)

• ex: a drug with an LD50 of 500 mg and an ED50 of 50 would have a TI of 10

• the smaller, the more dangerous it is

margin of safety

the ratio of a lethal dose for 1% of the population to the effective dose fo 99% of the population (LD1/ED99)

• ex: a drug with an LD1 of 400 mg and en ED99 of 100 would have a MS of 4

• the smaller, the more dangerous it is

toxicity

a risk of physical or psychological harm for a drug user

• relative

alcohol

results in the most drug-related ER visits

tolerance

with repeated administrations, you need a higher dose of a drug to achieve the same effect

behavioral tolerance

• tolerance that occurs when drug-taking behavior consistently takes place in the same surroundings or under the same circumstances

Siegel’s study

• results: rats tested in the same room that they were trained in had lower mortality rates (32%) than rats tested in different room than they were trained in (64%)

• conclusion: environmental cues can somewhat compensate for some of the effects of a drug

  • the less similar, the more likely an accidental overdose will occur

physical dependence

avoiding the physical symptoms of withdrawal

• avoiding punishment

psychological dependence

craving the pleasurable effects of the drug

• craving reinforcement

drug-defined crimes

violations of a law that prohibits the possession, distribution, or manufacturing of a drug

• ex: possession of cocaine

drug-related crimes

violations of a law that is not a drug law through an act that involves drug

• ex: physical assault while on drugs

tripartite model

• model for drugs and violence

  • pharmacological violence

  • economically compulsive violence

  • systemic violence

pharmacological violence

violence committed by an individual while under the direct influence of a psychoactive drug

• ex: committing aggravated assault while high on cocaine

• confounds:

  • not all drugs make people aggressive

  • people who are more aggressive might be more likely to do drugs

  • doing drugs and committing crimes have similar risk factors

economically compulsive violence

violence committed for the purpose of securing money to buy drugs or securing drugs without paying

• ex: robbing someone for drug money

• evidence:

  • property crime increases when drug prices are high

  • opioid prices peaked in 2012, pharmacy robberies peaked in 2012

systemic violence

violence that arises from patterns of aggression within an organization involved in illicit drug trafficking and distribution (usually gangs)

• ex: drug trafficking gangs

• evidence:

  • gang member who sell drugs tend to be more violent than member who dont sell drugs and more violent than drug sellers who aren’t in a gang

pure food and drug act

• governmental policy

• required food and drug manufactures to list the amounts of alcohol or “habit-forming” drugs on their product labels

harrison act

• governmental policy

• required anyone importing, manufacturing, selling, or dispensing opium-related drugs (narcotics) or cocaine to register with the Treasury Department, pay a tax, and keep record of all transactions

marijuana tax act

• governmental policty

• required growers, sellers, and buyers of marijuana to pay a tax

anti-drug abuse act

• governmental policies

• penalized money laundering when associated with drug smuggling and sales

current government policy

• supply side approach- reduce drug availability

• demand side approach - reduce inclination to seek out drugs

• Moving from “zero tolerance” to “harm reduction”

money laundering

• smurfing

• offshore bank accounts

• use of retail service establishments (laundromats)

pharmacokinetics

how drugs move throughout the body

• 4 principles

  • absorption

  • distribution

  • metabolism

  • elimination

absorption

• how a drug enters the bloodstream once administered

  • 4 main routes

    • oral

    • injection

      • IV, IM, and SC

    • inhalation

    • through skin or membranes

oral administration

• eating or drinking a substance

  • ex: alcohol, edible marijuana, caffeine

• pros

  • slow absorption (30-60 minutes)

• cons

  • slow absorption

  • natural barriers of digestion

  • highly variable/less predictable

injection

• through hypodermic needle

  • intravenous- (IV) needle in vein (fastest)

    • ex: heroin, cocaine, meth, morphine

  • intramuscular (IM)- needle in muscle

    • ex: vaccines

  • subcutaneous (SC)- needle in tissue just underneath skin

    • ex: heroin, some opioids

• pros

  • fast absorption (~10 seconds)

  • immediate effects

• cons

  • fast absorption (high overdose risk)

  • risk of skin irritation

  • potential blood clots

  • needles must be sterile

inhalation

• breathing smoke-borne particles and gases into lungs

  • ex: nicotine, crack, marijuana, anesthetics

• pros

  • fast absorption (~2-3 seconds)

  • large surface area (lungs)

• cons

  • fast absorption

  • effect only while drug is being inhaled

  • long term risks (lung cancer, asthma)

  • throat/nasal irritation

through skin membranes

• positioning drug against skin or membranes (intranasal, transdermal, etc.)

  • ex: nicotine patches, cocaine, zyn

• pros

  • sustained delivery

  • controllable administration

• cons

  • skin/membrane irritation

  • certain drugs can’t penetrate skin

rates of absorption

1. inhalation (fastest)

2. injection

   1. IV

   2. IM

   3. SC

3. Absorption through skin/membranes

4. Oral (slowest)

distribution

how a drug moves throughout the body

blood-brain barrier

barrier between the brain and bloodstream that restricts the passage of certain drugs and molecules into the brain

• what drugs/molecules can pass

  • fat soluble

    • ex: nicotine, alcohol, cocaine, caffeine

  • very small

    • ex: oxygen, anesthetics

  • has a specialized transporter protein (active transporter)

    • ex: glucose, amino acids, vitamins

metabolism

how the molecular structure of a drug is changed to make excretion easier

biotransformation

• the chemical alteration of a substance within the body

  • typically occurs via liver enzymes

elimination half-life

• the amount of time it takes for a drug to decline to 50$ of its original concentration level in the bloodstream

  • a drug is considered “eliminated” after 4-5 half-lives

underlying factors of drugs

• timing

  • initial latency period, side effects when drug effect peaks

  • solution-time-release drugs

• drug interactions

  • additive effects

  • antagonistic effects

additive effects

• the combined effect of multiple drugs is greater than either drug on its own

  • ex: alcohol with barbiturates

antagonistic effects

the individual effect of a drug is somewhat diminished when administered with another drug

• ex: heroin with Narcan

cross-tolerance

• when the tolerance to one drug induces a tolerance effect to another drug that hasn’t been taken before

  • ex: someone who abuses sedatives may need a higher dose of anesthetics

cross-dependence

when the withdrawal symptoms of one drug are relieved by administering another drug

• ex: quitting alcohol but using a barbiturate instead

peripheral nervous system

• nerves and nerve fibers

  • splits into

    • somatic nervous system (voluntary muscles)

    • autonomic nervous system (involuntary muscles)

sympathetic nervous system

• uses energy; subgroup of autonomic nervous system

• stimulants

  • heart racing

  • fast breathing

  • pupils dilated

  • dry mouth

  • loss of bladder control

  • adrenaline increases

  • no digestion

parasympathetic nervous system

• restores energy; subgroup of autonomic nervous system

• depressants

  • heart slowing

  • slowed breathing

  • pupils constricted

  • increased salivation

  • bladder constriction

  • no adrenaline

  • increased digestion

neurons

cell of the nervous system that receive and transmit information

dendrite

part of neuron that receives information

axon

part of neuron that transmits information

action potential

electrical impulse that can trigger the release of neurotransmitters

synpatic cleft

gap between neurons

vesicles

containers for neurotransmitters in the presynaptic cell

neurotransmitter

chemical compounds used by neurons to communicate (chemical messengers)

7 main

• acetylcholine

• norepinephrine

• dopamine

• serotonin

• GABA

• Glutamate

• Endorphins

receptor

proteins on the membrane of a postsynaptic cell that receive neurotransmitters from presynaptic cells

neurotransmission

1. neurotransmitter release

2. receptor binding (selective; excitatory; inhibitory)

3. reuptake or degradation

acetylcholine

neurotransmitter involved in parasympathetic nervous system regulation, motor functions

• receptors: cholinerergic receptors (muscarinic and nicotininc)

norepinephrine

neurotransmitter involved in sympathetic nervous system regulation, mood regulation

• Receptors: adrenoceptors (alpha-1, alpha-2, beta-1, beta-2)

dopamine

neurotransmitter involved in motor control, emotionality, reward/reinforcement

• Receptors: dopaminergic receptors (D1-D5)

serotonin

neurotransmitter involved in sleep and wakefulness, mood regulation

• Receptor: 5HT receptors (5HT1-7)

GABA

neurotransmitter involved in inhibitory, fear/stress reduction

• receptors: GABAergic receptors (GABA-A and GABA-B)

Glutamate

neurotransmitter involved in excitatory, cravings

• receptors: glutamatergic receptors (NMDA, AMPA, kainate, mGluRs)

endorphins

neurotransmitter involved in natural painkillers

• receptors: opioid receptors (mu, delta, kappa, NOP)

• neuropeptide

amino acids

• Glutamate

• GABA

• Aspartate

• Glycine

monoamines

• catecholamines

  • Dopamine

  • Norepinephrine

  • Epinephrine

• Indolamines

  • Serotonin

soluble gases

• nitric oxide

• carbon monoxide

metabolic tolerance

• increased amount of enzymes that metabolize that drug

  • larger drug dose is needed to reach same blood concentration

pharmacodynamic tolerance

• reduced number of receptors or sensitivity of receptors for that drug

  • same blood concentration, but less effective