Substance Abuse Midterm

What are the four principal factors that affect drug use?

Biological/genetic/pharmacological

Cultural

Social

Contextual

What is a licit drug?

Type of psychoactive drug. It is legal, includes coffee, tea, alcohol, tobacco, over the counter drugs

What is an illicit drug?

Type of psychoactive drug. It is illegal, includes marijuana, cocaine, minors vaping tobacco, LSD

What is a designer/synthetic drug?

They are structural analogs that result from altered chemical structures of current illicit drugs (substances classified under the controlled substances act). Modification of the basic molecular Skeleton of a compound to form a new molecular species. Ex: Ectasy , Demerol and synthetic opioids

What is a gateway drug?

Types of commonly used drugs that lead to the use and abuse of other more powerful mind-altering and addictive drugs such as hallucinogens , meth, crack and heroin. Examples: weed, alcohol, tobacco are the most common

What is drug misuse?

Unintentional or inappropriate use of prescribed or over the counter types of drugs

Ex) taking more then what is recommended in advil or taking melatonin every day

Discontinuing drugs at will or against orders.

Giving prescribed drugs to family or friends without supervision

What is drug abuse?

Also known as chemical or substance abuse. Willful misuse of either licit or illicit drugs for the purpose of recreation, perceived necessity, or convenience. It refers to a more intense drug misuse. Dependency and addiction easily associated

What are Erich Goodes four types of drug use?

Legal instrument use

Legal recreational use

Illegal instrumental use

Illegal recreational use

What is legal instrumental use?

One of Erich Goode four drug use types

Taking prescribed or over the counter drugs to relieve or treat mental/physical symptoms

What is legal recreational use?

one of erich goodes four types of drug use

Using licit drugs such as tobacco, alcohol, and caffeine to achieve a certain mental state

What is illegal instrumental use?

One of Erich goodes four types of drug use

Taking nonprescribed drugs to achieve a task or goal

What is illegal recreational use?

One of Erich goodes four types of drug use

Taking illicit drugs for fun and pleasure

What are the three types of drug users?

Experimenters, compulsive users, and floaters

What are experimenters in terms of drug users?

Begin using drugs largely because of peer pressure and curiosity, and they confine their use to recreational settings

What are compulsive users in terms of drug users?

They devote considerable time and energy into getting high, talk incessantly about drug use, and become connoisseurs of street drugs

What are floaters in terms of drug users?

Focus in on using other people’s drugs and is often a light drug user

What are the five stages of drug dependence?

Relief: satisfaction from negative feelings in using the drug

Increased use: involves taking greater quantities of the drug

Preoccupation: consists of constant concern with the substance

Dependency: synonym for addiction when more of the drug is sought despite the presence of physical symptoms

Withdrawal: the physical and/or psychological effects from not using the drug

What does it mean by drug use is an equal opportunity affliction?

Drug users are found in all occupations and professions, at all income and social class levels , and age. No one is immune to drug use

What are some notable trends across groups that use drugs?

Drug users are more likely to commit crimes

Highest rate of users in workplace between ages 18 to 64 goes accommodations and food services (19.1%), construction, arts and entertainment/recreation . Lowest rates mining (5), educational services (4.8), public administration

What are some of the reasons why people take drugs?

Search for pleasure, relieve stress, peer pressure, enhance religious or mystical experiences, enhance social experiences, enhance work performance, athletic performance, relieve pain or illness

What are some of the physical and mental factors for drug use?

Body size (smaller or thinner persons can experience effects more intensely)

Gender (lower tolerance associated with woman due to higher fat, less water)

Poly drug use

Fatigue and illness increases affects

An empty stomach can increase effects

Mindset

What is addiction?

Refers to process of binding to things. Chronic adherence to drugs

“A state of periodic or chronic intoxication detrimental to the individual and society, which is characterized by an overwhelming desire to continue taking the drug and to obtain it by any means”

A complex Brain disease characterized by drug seeking and use, despite harmful consequences

What is psychological dependence?

Refers to the self-felt psychological inability to stop using the drug or drugs

What is physical dependence?

Refers to the body’s need to constantly have the drug or drugs

What is the moral model?

Belief that addicts lack morality and character compared to those that are not addicted

What is the disease model?

Belief that addiction is a chronic disease and is progressive. It’s treatable and there is a hope for recovery but it can kill you. This is where the attention should be directed.

What is the personality (character) model?

Theory of predispositioned personality that leads to addiction. Ideology of personality disorders (antisocial) -not caring about society, laws, and consequences .”selfish”

Associated with double wall of encapsulation, the deeper concern in which peopel addicted are harder to reach

What is the career path for addiction?

Experimentation, escalation (increased use), maintenance (optimistic belief that the drug fits in well with day to day goals and activities), dysfunction (problems with use interfering with day to day goals -grades, lungs hurting, working out), recovery, ex addict

What are the major risk factors for drug use and abuse ?

teenage risk taking , belief of being invulnerable to effects

Drug use viewed as a rite of passage into adulthood

Drug use perceived as glamorous, fun, facilitating, and intimate

Loss of meaningful role or occupational identity due to pending retirement

Loss, grief, or isolation due to divorce, loss of parents, or departure of children

Loss of positive body image

Dealing with newly diagnosed illness

Disappointment when life’s expectations are clearly

What is the biological theory?

Due to genetics, brain dysfunction, and biochemical patterns (ex: explanation of drugs on the CNS)

Reward centers being more sensitive, drugs interfering with neurotransmitters

Principal theories: positive reinforcers, psychiatric disorders (drug use and abuse can be used to self medicate mental disorders) , and genetic explanations

What are examples of positive enforcers?

Accustomed to presence of dopamine and crave when not present

Enhance pleasure centers by causing neurotransmitter ex) dopamine release.

Cocaine, amphetamines . Any drug that has abuse potential belief

What is the psychological theory?

Focus on mental or emotional states of drug users, possible motivation of unconscious motivations within all of us, and social and environmental factors

APA classifies severe drug dependence as a psychiatric disorder

Drugs abused cause mental conditions that mimic psychiatric illnesses

Factors include more escape from reality, self medicating, boredom, destructive self indulgence , blindly using , inability to cope

What are learning theories?

Theory that humans acquire drug use behavior by the close association of pairing of one significant reinforcing stimulus (friendship or intimacy) with another less significant of neutral stimulus (initial use of alcohol, marijuana, ectasy, cocaine).

What is conditioning in learning theory?

close association of significant reinforcing stimulus with another Less significant or neutral stimulus

What is habituation of learning theory?

Repeating certain patterns of behavior until they become established

What is the addiction to pleasure Theory?

Assumes it is biologically normal to continue a pleasure stimulus when once begun

What is social influence theories?

A persons day to day relations are the primary influence on drug use. Includes Social learning theory (role of significant others or others in close contact with, form of learned behavior, intimate interaction-primary group uses drugs)

Includes labeling theory and subculture theory (Peer pressure)

What is labelling theory?

Says people whose opinions we value have a determining influence over self image. Primary deviance (others giving label), secondary deviance (giving self recognition) , master status (reputation focus), retrospective interpretation (moment you realize reputation has change and behavior)

What is structural influence theories?

Focuses on how organization of a society, group, or subculture largely responsible for drug abuse by its members

Social disorganization and social strain theories, control theories (if people are left without attachments to other groups they have a tendency to deviate from expected cultural values)

What are patent medicines?

Signifies secret ingredients , shows problems of insufficient regulation of the drug industry

What was the 1906 Pure Food and Drug Act?

Required manufacturers to include on labels the amounts of alcohol, morphine, opium, cocaine, heroin, or marijuana extract in each product

Did not prohibit distribution of dangerous preparations

What was said in the Sherley amendment in 1912?

Passed to strengthen existing laws and required that labels should not contain “any statement…. Regarding the curative or therapeutic effect…. which is false and fraudulent”

Controlled accuracy of claims (therapeutic claims) controlled by the pure food and drug act

What does the food, drug, and cosmetic act do? What started it?

Started after the sale of elixir sulfanilamide led to a tragic accident that killed over 100 people. Companies were required to file applications with the government showing that new drugs were safe. Act required safe tolerances be set for unavoidable poisonous substances, requires authorized establishment of identity and quality for foods

Amended version from Kefauver-Harris requires that all drugs be registered and approved by FDA

What is the Durham-Humphrey amendment?

Made the formal distinction between prescription and no prescription drugs. It established drug classification categories : habit forming, not safe for self medicationC new drug and not shown to be completely safe

What were the Kefauver-Harris Amendments?

Passed in consequence to the thalidomide tragedy

Drug manufacturers had to demonstrate efficacy and safety of drugs, FDA was empowered to withdraw approval that has already been marketed and permitted to regulate and evaluate drug testing by pharmaceutical companies

What was the Harrison act of 1914?

Marked the first legitimate effort by the federal government to regulate and control the production and importation of addicting substances

What did the comprehensive drug abuse prevention and control act of 1970 do?

Divided substances with abuse potential into categories based on the degree of their abuse potential and clinical usefulness (schedules I, II/IIN….)

What are schedule I substances?

Substances have high abuse potential and no currently approved medicinal uses

Heroin, weed, LSD, marijuana, peyote

What are substance II substances?

Substances that have high abuse potential but are approved for medical uses and can be prescribed

Vicodin, adderall, cocaine, meth

What are schedule II to V substances?

Reflect the likelihood of abuse and clinical usefulness

3 is less of a abuse potential then 1 or 2, 4 is less then 3, 4 is less then 4. All have current accepted medical use

3-codeine, anabolic steroids

4-Xanax

5-OTC

What are the strategies for preventing drug abuse?

Supply reduction (curtail supply of illegal drugs and or precursors and have more control over therapeutic drugs. Interdiction, cutting off or destroying supplies of illicit drugs)

Inoculation- aims to protect drug users by teaching responsibility and explaining drug effects on body and Brain

Demand reduction (reduce actual drug demand)

Drug courts (putting drug defendants into judicially supervised rehab programs)

What is decriminalization?

Is a compromise between legalization and current criminalization of illicit drug use

Removes prosecutions but act still remains illegal

What was the drug addiction treatment act of 2000?

Allows physicians to prescribe opioids to treat opioid addiction in their offices (maintenance)

How does homestasis work? What is the definition?

Internal and external changes in the system environment occur (cold air, worry, shock, fear, someone chasing you, exercise, getting sick), body self revisited using endocrine system and nervous system until it reaches equilibrium. The body is always trying to get back to an equilibrium

Maintenance of internal stability or equilibrium of the body and it’s functions

What type of drugs act on dopamine?

Amphetamines and cocaine , bath salts activate dopamine

What drugs act on GABA?

Alcohol, Valium-type, barbiturates activate

What drugs work on serotonin?

LSD (activates)

What drugs work on acetylcholine?

Tobacco/nicotine

What drugs work on endorphins?

Narcotics

What drugs work on anandamide?

THC

How do drug receptors work?

Neurotransmitters exert effects by interaction, can interact only with specific configurations.

What are agonists?

Substances or drugs that activate receptors

What are antagonists?

Substances or drugs they attach to receptors but do not activate them and therefore prevent activation

What are the two major divisions of the nervous system?

Central (Brain and spinal cord) and peripheral (extremities)

What is the function of the CNS?

Evaluates status of all organs and general status of the body, receives and processes info and reacts by regulating muscle and organ activity through the PNS

What is the reticular activating system?

Area of the Brain that receives input from all sensory systems as well from cerebral cortex. Found at junction of spinal cord and the brain. Main function is to control brains state of arousal aka the sleep wake system

It is highly susceptible to effects of Drugs . ACh drugs suppress RAS activity causing sleepiness

What is the basal ganglia?

Includes the caudate nucleus. Primary Center for involuntary and fine tuned motor functions (posture and muscle tone), additionally involved in establishing and maintaining behaviors

What is the Limbic system?

Includes hypothalamus, thalamus, medial forebrain bundle, nucleolus accumbens and frontal portion of cerebral cortex. Inseparably linked with basal ganglia

Roles include regulating emotional activities , memory, modulation of endocrine functions, mating, caring for young, reward centers

What is the cerebral cortex?

Layer of gray matter right under skull responsible for receiving sensory input, interpreting info, and initiating voluntary motor behavior. Contains over 80% of neurons in central nervous system

What is the autonomic nervous system?

Axons project out of CNS to involuntary muscles, organs and glands. Part of the PNS . Does not require concious control. Divided into sympathetic and parasympathetic

What does the sympathetic nervous system do?

Increase heart rate, breathing rate. Reduces motility of stomach, constricts blood vessels, pupils dilate

Fight response

What does the parasympathetic system do?

Decrease heart rate, slow breathing rate, increase stomach motility, dilates blood vessels, constricts pupils

What neurotransmitter is involved with Parasympathetic system? Sympathetic?

ACH

Norepinephrine

What does it mean for a drug to be cholinergic?

Drugs that affect AcH release and impacts parasympathetic system

What does it mean for drugs to be sympathomimetics?

Activates sympathetic nervous system

What is the role of the endocrine system?

Consists of glands that secrete hormones into bloodstream. Hormones regulate a variety of functions with more generalized targets . Major sources of hormones include pituitary gland, adrenal glands and sex glands

What is the master gland?

Pituitary

What does the adrenal cortex produce? Adrenal medulla?

Steroids (corticosteroids)

Epinephrine (involved in sympathetic)

What are adrogens?

Male sex hormones released by adrenal cortex. Produces anabolic effects that increases retention and synthesis of proteins, causing growth in muscle and bones

These hormones are responsible for maintenance of secondary sex characteristics. Influence emotional states, affecting limbic system

What is the difference between intended and unintended?

Intended responses are the reason for using the drug, unintended responses include side effects . Depends on therapeutic objective

What is potency?

The amount of drug necessary to cause an effect

What is toxicity?

The capacity of a drug to do damage or cause adverse effects in the body

How does the margin of safety work?

The more potent and the more toxic, the lower margin of safety

What are the pharmacokinetic effects of drugs?

Administration (how drug is taken), absorption, distribution (oral is slowest , injections fastest), inactivation, biotransformation and elimination

What is the effective dose?

Quantity needed to relieve symptoms in 50% of the population

What is the lethal dose?

The amount of a substance that kills half the test group

What is the therapeutic index?

LD50/ED50

Relative safety of a drug regard to overdose

What is a threshold dose?

The minimum amount of a drug necessary to have an effect

What is additive effects?

1+1 =2

(Summation)

What is antagonistic effects?

1+1=0

Inhibitory one drug cancels of blocks effects of another

What is potentiative effects?

Synergy (a+b=B)

Effect of drug is enhanced by another drug or substance (methadone+ xanex)

What is the plateau effect?

The maximum effect a drug can have regardless of dose

What is cumulative effect?

The buildup of drug concentration in the body due to multiple doses taken within short intervals

What are time-response factors?

The closer a drug is placed to a target area, the faster the onset of action. Acute (immediate) and chronic response (long term effects after a single dose)

What are the physiological factors that affect drug affects?

Age, gender, and pregnancy

What are the adaptive processes of drug use?

Tolerance (decreased response to a set dose of a drug), dependence (physiological and psychological), withdrawal

What are the psychological factors that affect drug effects?

Individuals mental set and placebo effects

What is reverse tolerance?

Reversal of side effects to a drug after tolerance has been established, enhanced response to a given drug dose. After liver damage

What is the history of CNS depressants?

1800s: bromides

1900: barbiturates

1950: benodiazipines

1973 to present continued use of benzodiazepines