Drugs, Deviance, and Social Control Exam 2

Sedative effect

mild depression and relaxation

Hypnotic effect

includes drowsiness and encourage sleep

Benzodiazepine medical utility

Most commonly prescribed medication for anxiety

Benzodiazepine methods for treatment

First goal = detoxification, if you don't slowly detox, can cause dangerous seizures

Dose reduction, temporary substitution with dose reduction, may need supervised by doctor, treatment must be tailored to the individual

Anesthetic effect

Knocks you out

Benzodiazepine abuse behaviors

Take medications orally, reduces negative effects of other drugs of abuse and increases pleasurable effects

Benzodiazepine addiction trends

- Age of 1st use: 15-17 y/o

- Rare to only find someone addicted to benzos

- Use pretty equal for males and females, with males a bit higher

- Whites over-represented (access to drug, etc.)

Alcohol: Nature and History

Fermentation, ingested for more than 10,000 years - began with ingesting fermented fruit, technology increases and allows us to make alcohol taste better

Pleasure + euphoria + relaxation = purposeful ingestion

Fermentation

a metabolic process that converts sugar to acids, gases, or alcohol

sugar + yeast = fermentation

Alcohol

CNS depressant, widely consumed and the source of addiction for many problematic drug users

___% of people in treatment have alcohol addiction

64

Why is alcohol viewed as a non-drug?

1. It's legal

2. Widely advertised, seen as normal

3. Large distribution and sales

4. Long history of alcohol

4 kinds of alcohol

Methyl, Isopropyl, Ethylene glycol, Ethanol

Methyl alcohol

poisonous, solvent, fuel, antifreeze, very similar compound so sometimes in bootleg liqour

Isopropyl alcohol

poisonous, rubbing alcohol

Ethylene glycol

poisonous, antifreeze

Ethanol alcohol

drinking alcohol, varying ABV, potency is important

ABV

Alcohol by volume

Proof

2x ABV

Body is affected by alcohol in two ways:

1. Direct contact = Block sensitivity to pain

2. Absorption in bloodstream = Direct effects on CNS

Short term effects of alcohol

Similar to sedative-hypnotics, low vs medium vs high dosing, dosing matters!!

Low dose of alcohol

Disinhibition, unpredictable behavior effects, impaired motor activity

Moderate dose of alcohol

Increase heart rate, decreased blood pressure, stimulates appetite, increase urine output, hangover

High dose of alcohol

Severe CNS depression, drowsiness, death

Long term effects of alcohol

reduction in pathways and neurons in the CNS, brain damage, high blood pressure, heart disease, cancer, cirrhosis, ulcers, addiction, etc.

These effects vary from person to person

BAC

blood alcohol content, commonly used metric of alcohol intoxication for legal and medical purposes

What impacts BAC?

Age and gender, size and body type, presence of food, rate of drinking, amount of carbonation, ratio of muscle to body fat, medications, emotional state, metabolism rate

How does BAC relate to harm/risk?

The higher one's BAC, the higher potential for negative outcomes - lose senses, engage in risky behavior, etc.

Factors that impact problematic alcohol use

Age of onset, genetics, personality factors, psychological states, environmental influences

Tolerance and dependence associated with alcohol

Can cause severe physical and psychological dependence

Polydrug use

the common practice of taking alcohol concurrently with other drugs

roughly 64% of alcoholics use other drugs

Medications used to treat alcohol dependence:

Disulfiram = interferes with metabolism of alcohol, makes them very sick

Naltrexone = an opiate antagonist

Acamprosate = blocks Glutamate release, reduces withdrawal symptoms, physical dependence no psychological dependence

Alcoholic types

Abstainers, binge drinkers, heavy drinkers

Abstainers

no alcohol consumption, relatively small (1/3 of population)

Binge Drinkers

~5+ drinks on same occasion

Heavy Drinkers

binge drinking on 5 occasions in previous month, alcoholics

Statistics for young adult drinkers

18-25 y/o, riskiest group, rate of binge drinking and heavy drinking = 2x national average

Perceptions lead to behavior = perception is they are drinking more than they actually are so they internalize expectation and drink more

Alcohol use and risky/deviant/criminal behaviors

Clear covariance between drinking and risky behavior, 3 hypotheses

Disinhibition Hypothesis

being under the influence --> disinhibition --> risky behavior

ex: "I wouldn't normally drive drunk but..."

Susceptibility Hypothesis

Common cause (e.g., "those kinds of people") --> both alcohol use and risky behavior

"something in history", etc., it's about the individual

Reciprocal Hypothesis

Certain types of people seek out behavior AND intoxication disrupts judgement --> heavy drinking and impulsive behavior

Intoxicated Driving

one of the most harmful effects of alcohol, seen a decrease in traffic incidents as well as a decline in alcohol consumption

Risk for young drivers increases rapidly even with low BAC, under 21 at low levels = risk doubles

Violence and alcohol

covariance, disinhibited, drinkers have higher rates of violence in history, more drunk - greater likelihood of violence, similar patterns with victimization

60% of homicides = perp. was intoxicated

Sexual violence and alcohol

men under the influence are more likely to commit violence, date rape likelihood increases with alcohol (plus greater consumption of alcohol)

Alcohol and drug use

2 conclusions: most people who drink don't use illegal drugs, but people who drink are significantly more likely to use illegal drugs

Diagnosing alcoholism

common characteristics: craving, very impaired or loss of control, physical dependence, tolerance

Characteristics of wet cultures

In these cultures alcohol is integrated into daily life and activities (e.g., alcohol consumed with meals). In these cultures, abstinence rates are low and wine is largely the beverage of preference. European countries bordering the Mediterranean have traditionally exemplified wet cultures.

Characteristics of dry cultures

Alcohol consumption is not as common during everyday activities. Abstinence is more common; however, when drinking occurs, it is more likely to result in intoxication. Scandinavian countries, the United States, and Canada are examples of countries that are dry.

Alcohol and college students

72% of college students consume alcohol, high rates of binge drinking, most heavily abused drug on campus, additional risk factors (academic problems, Greek life, etc.)

Treatment of alcoholism

acknowledging the problem, detoxification, and rehabilitation

Relapsing syndrome

returning to the use of alcohol after quitting, people will almost always relapse

Narcotics

naturally occurring substances derived from the opium poppy and their synthetic substances

Opiate

drugs extracted or derived from the exude of the poppy

opium

Opium

latex, milky exude from unripe pods of the poppy plant

ex: morphine, codeine, heroin

Opioid

synthetic drugs that produce opiate like effects

ex: Demerol, Oxycodone, Fentanyl, Percocet, Methadone, etc.

Heroin

derived from the morphine alkaloid found in opium and is roughly 2-3x more potent, very reinforcing

Opiate History: 1803/04

German pharmacist's apprentice isolates morphine from opium (pure form), used in Civil War, named after the Greek god of sleep

Opiate History: 1874

C.R. Adler Wright creates heroin, twice as potent as morphine

Felix Hoffman

independently produces heroin and Aspirin

Opiate History: 1898

Heroin patented by Bayer, cough suppressant for American soldiers - by 1900, an estimated 1 million American soldiers were dependent on heroin, advertised as non-addictive morphine by Bayer

Primary medical use of Opiates/Opioids

relieve pain = reduction of pain signals reaching the brain, effect areas that control emotion, automatic functioning

Pharmacological Effects of Opiates/Opioids

Attach to opiate receptors, mess with endorphins and block pain signals

Opioid receptors:

opioids act on the same group of receptors that are controlled by endorphins

Opioid receptors: opiates

agonists, activate opioid receptor sites and stimulate endorphin secretions, blocks transmission of pain

Opioid receptors: opioids

agonists or antagonists

Soporific effects of opiates/opioids

Depression of CNS, drowsiness, lethargy

Euphoric effects of opiates/opioids

endorphin rush, dopamine --> reinforcing

Other medical uses of opiates/opioids

acute pain (medically useful and necessary), chronic non-cancer pains, shortness of breath, diarrhea

Side effects of opiates/opioids

Drowsiness, respiratory depression, nausea, vomiting, constipation, inability to urinate, drop in blood pressure, tolerance to analgesic and physical side effects occurs quickly, brain damage

Treatment of chronic pain

wide availability of OTC painkillers that are not classified as narcotics, the risk is much greater with opioids but the therapeutic value is immense, medical field relies on opioids because drugs like Tylenol are too weak

1/3 of Americans live with chronic pain and opioids shouldn't be the first line of defense

Opioid prescriptions

Overdose deaths from prescription pain killers has quadrupled since 1999, most costly

Several contributing factors to the increase in prescription opioid use:

Pill mills, normalization of use/prescriptions, greater social acceptability, aggressive marketing

Opioid tolerance

Tolerance develops after 2-3 weeks, high risk of overdose

Drug mixing

antagonist, additive, or synergistic effects

Heroin gets dangerous with additive or synergistic effects

Speedball effect

in the 70s-80s, mixing cocaine and heroin, produces euphoria and cancels out the negative effects of each

opioid has longer acting effect so once stimulant effects wear off, depressant effects --> comatose, death, etc.

making a comeback recently with prescription opioids

Opioid antagonists

opioid effects can be reversed with this, bind to receptors but don't activate those receptors

ex: naloxone

Opioids and heroin use

Trends show users making switch from prescriptions to heroin, similar chemical similarity

Why? - less expensive, harder to get pills, more potent, etc.

Purity of heroin

Heroin has become purer (60% to 70% purity) and cheaper (~$10/bag), greater purity leads users to administer heroin in less efficient ways,

Heroin effects on the brain

blocks pain signals, reward system (dopamine rush), depresses CNS, tolerance, dependence, withdrawal

Benefits of shooting galleries

reduce costs (hospital visits, etc.), safer place to use, clean needles - reduce infectious diseases

Heroin is dangerous because:

Uncontrolled (purity), combined or contaminated with other drugs, dangerous routes of administration

Heroin epidemic

Media reports from the 1990s suggest that a new epidemic is gripping America

Reality = heroin use is rare

Stimulants

psychological addiction, few clinical uses but very important drugs of abuse (ADHD, narcolepsy)

Psychomotor stimulants

cause excitement, euphoria, decreased fatigue, and increased motor activity, direct influence on brain stem and spinal cord

ex: nicotine, amphetamines, cocaine

Hallucinogens

affect though, perception, and mood, little effect on brain stem and spinal cord

ex: LSD, PCP

Methylxanthines

stimulant, theophylline, theobromine, caffeine

Theophylline

found in tea, long-lasting, prescribed for night time asthma

Thoebromine

found in cocoa

Caffeine

short, activity, most widely consumed psychoactive substance, takes a lot to get to a dangerous point

In the US, daily intake of caffeine =

3 cups of coffee

Methylxanthine drug effects

CNS effects: increased alertness, decreased fatigue

Higher doses = anxiety, tremors, seizures

Nicotine

stimulant, toxic, colorless/yellowish oily liquid, chief ingredient of tobacco, naturally occurring, effective does and lethal dose is small, 2nd most widely used stimulant

Nicotine is absorbed everywhere:

mouth, skin, lungs; commonly consumed via tobacco products

Nicotine drug effects

CNS effects: euphoria, arousal, relaxation, improved attention, adverse effects include irritability and tremors

Higher doses: CNS paralysis, severe hypertension

Social costs of smoking

second hand smoke, stigma, cigarette breaks at jobs (productivity), expensive habit, expensive health insurance, etc.

Amphetamines

More potent CNS stimulant, used medically for ADHD, ADD, weight reduction, etc.

Amphetamine Drug Effects

Block the reuptake on norepinephrine, dopamine, epinephrine, increase heart rate, elevated BP, alertness, anxiety, panic, etc.; tolerance, dependence, withdrawal

Amphetamine psychosis

a delusional and psychotic state, closely resembling acute schizophrenia, that is brought on by repeated use of high doses of amphetamine

"Pouncing"

repeated behaviors that comes with prolonged amphetamine use, bizarre behavior

History of Amphetamine Use: 1800s

first synthesized in 1887 but largely ignored (pharmaceutically valueless), chemist Gordon Alles sought to change that