PSYC 101 Ch. 5 - Consciousness - DRUGS

Substance Use Disorder

Significant impairment or distress associated with one or more drugs

Characteristics of Substance Use Disorder

1. Tolerance/ Sensitization -> only to SPECIFIC effects of a drug

2. Withdrawal

3. Physical & psychological dependence

Tolerance

- Repeated exposure -> diminished effect/ require a higher dose to maintain constant effect

- Classical conditioning

- Only to SPECIFIC effects of a drug

Sensitization

- Repeated exposure -> heightened drug effect

- Only to SPECIFIC effects of a drug

Cross-tolerance

One drug causing tolerance/sensitization to another drug that acts on the same mechanism

Tolerance as Classical Conditioning

- UCS: Drug use

- CS: Context of usage

- UCR: Drug effects

- CR: Compensatory CR

Contingent Drug Tolerance

- Specific tolerance ONLY to experienced drug effects

- not all drug effects are experiences

Rat Tolerance Study

- Heroin every other ay

- Group 1 in home, group 2 in gym, group 3 no heroin

- Massive dose to ALL rats after a few days

- Some receive in normal location, others in diff location

- Control grp highest mortality

- Same location have lower morality than diff location

Withdrawal

Unpleasant effects of reducing or stopping consumption of a drug after one has habitually used it

Factors of Withdrawal

1. Type of drug

2. Duration & degree of exposure

3. Speed of removal

Physical dependence

Continued drug use to avoid withdrawal

Psychological dependence

Continued drug use due to cravings

Explanations of drug use & abuse

1. Sociocultural

2. Addictive personality

3. Learning & experience

4. Genetics

Sociocultural explanation for drug use & abuse

1. Family, friends & peers

2. Environment

3. Religion/ethnic group

4. Life pressures (wages, employment)

- Later life pressures e.g. family may counteract early life pressures to use drugs

Learning & experience explanation for drug use & abuse

- Self medication to relieve anxiety may result in continued use

- Anxiety relief is mostly placebo

Genetic explanation for drug use & abuse

e.g. mutation in ALDH2 may cause unpleasant experiences with alcohol -> less likely to drink

Psychoactive Drugs

- Drugs containing chemicals that mimic or are similar to those found in the brain

- Influence SUBJECTIVE experience/ behavior by acting on CNS

- Exogenous

- Affect physiological functioning in some way

Relationship between drug legality & perceived effects

Legal drugs perceived as less harmful despite alcohol having a high mortality rate and vice versa

Drug Administration & Absorption

1. Ingestion

2. Injection (IM, IV, Subcutaneos)

3. Inhalation

4. Absorption (mucus membranes)

5. Transdermal (skin)

Ingestion

Adv: Easy & relatively safe

Disadv: Unpredictable effects

Injection

IM - intramuscular

IV - intravenous

Subcutaneous - Fatty tissue under skin

Adv: Speedy & predictable effects

Disadv: Speedy, risk infection (HIV, AIDs, Hep B & C)

Inhalation

Adv: Speedy

Disadv: Unpredictable -> hard to control dosage, damage to lungs

Absorption

Disadv: Damage to membrane

e.g. snorting, under tongue, dig up ur ass

Transdermal

e.g. fent patch, nic patch

How Drugs Penetrate CNS

- Diffuse at neuron membranes throughout CNS

- Bind to specific synaptic neurons

- Pre-synaptic neuron: Influence synthesis, transport, release or deactivating spec. neurotransmitters

- Post-synaptic neuron: Influence chain of reaction by activating their receptors

Drug metabolism

Convert active drugs into inactive form e.g. by liver enzymes so they cannot pass blood-brain barrier

Drug excretion

Elimination from body

e.g. sweat, breath, piss, shit, breastmilk

Factors influencing the effects of psychoactive drugs

1. Chemical makeup

2. Genetics

3. Environment

4. Mental set

5. Cultural background

Mental set

Beliefs & expectations about effects of drugs

Types of psychoactive drugs

1. Depressants

2. Stimulants

3. Opiates

4. Psychadelics

Depressants

- Reduce CNS activity

- e.g. alcohol & sedative-hypnotics

Alcohol

- short term effects directly related to blood alcohol content (BAC)

- more alcohol consumed = higher BAC

- rate of increase varies individually

Alcohol Short-Term effects

- low dose: act as stimulant as it depresses brain areas related to emotion & behavior

- mid dose: Imparment to cognition, perception, speaking, motor skills

- high dose: poisoning

Alcohol poisoning

1. Severe confusion

2. Fast shallow breathing -> death

3. Lower BP

4. Faster HR

5. Continuous vomiting

6. Seizures

7. Pale skin & blue lips/fingers

8. Fall unconscious and not wake -> NOT SLEEP

Red flush

Dilation of blood vessels of skin causing hypothermia

Diuretic

Alcohol increasing urine production

Alcohol withdrawal effects

- Mild headache, nausea, vomiting, tremulousness

- aka Hangover

Alcohol Withdrawal Syndrome

- 5hrs: Severe tremors, agitation, headache, nausea, vomiting, abdominal cramps & profuse sweating

- 15-30hrs: Convulsive activity; Potentially fatal

- 1-2days: Delerium tremors (DTs) for 3-4 days; Potentially fatal

DTs

1. Hallucinations

2 Delusions

3. Higher BP & HR

4. Agitations

5. Confusion

6. Fever

Chronic effects of alcohol

1. Brain damage -> Korsakoff's syndrome

2. Cirrhosis of liver -> major cause of death among alcoholics

3. Irritate digestive tract lining -> Risk oral & liver cancer, pancreatitis, gastritis & stomach ulcers

4. Cognitive effects (drunk driving, domestic violence)

5. Fetal Alcohol Syndrome (FAS)

Korsakoff's Syndrome

an alcohol related disorder marked by extreme confusion, memory impairment, and other neurological symptoms

FAS

1. Mental retardation

2. Slow growth, low birth weight, low muscle tone

3. Poor coordination

4. Brain damage

5. Physical deformaties

Sedative-hypnotics

Induce sleep and relaxation

1. Barbiturates -> similar to alcohol -> easiest to abuse

2. Non-barbiturates

3. Benzodiazepines

Stimulants

- Increase CNS activity

- e.g. nicotine(from tobacco), caffeine, cocaine, amphetamines (and meth)

Nicotine

- Activate acetylcholine receptors

- Adjustive value

Adjustive Value

Decreasing negative emotions whilst increasing positive ones

Cocaine

- Most powerful NATURAL stimulant

- FX last shorter and start earlier when snorted compared to other methods

- Effects last 15mins-1hr

- Very dangerous when mixed with other drugs

Cocaine short term effects (low dose)

- Euphoria

- Extreme happiness and energy

- Mental alertness

- Hypersensitivity to light, sound & touch

- Sociabilty & confidence

- Irritability

- Paranoia

Cocaine short term effects (high dose)

- Irregular heart rhythm

- Tachycardia

- Heart attacks & strokes

- Sweating, nausea, confusion

- Seizures

- Uncontrollable muscle movement

- Weak shaky limbs

- Death

Cocaine long term effects

Depend on use

- Snorting: loss of smell, nosebleeds, frequent runny nose, problems with swallowing

- Mouth: Severe bowel decay from reduced bloodflow

- injection: Increased risk for HIV, Hep C, other bloodborne illnesses

Cocaine withdrawal effects

Start 90mins after use, last 7-10 days

- Difficulty concentrating, slower thinking

- Fatigue & exhaustion

- Inability to experience sexual arousal

- Anhedonia

- Increase appetite

Caffeine short term effects

- Increased alertness, focus, urination

- Reduced perception of fatigue

- Increased BP, breathing rate

- Increase endurance

Caffeine long term effects

- Nervousness

- Insomnia

- Stomach irritation

- Fatigue

Caffeine health implications (up to 400mg/day)

- Not linked to cancer or coronary heart disease risk

- Protect from Parkinson's, liver disease, type 2 diabetes

- Caution for children & pregnant people

Caffeine withdrawal

- Headaches

- Fatigue & drowsiness

- Irritability

- Depressed mood

- Difficulty concentrating

Amphetamines

- Different use pattern = different SUBJECTIVE effects

Amphetamines: Orally consumed, low dose, occasional

- postpone fatigue

- improve mood

- intake not part of user's life

Amphetamines: Regular ingestion & obtained from doctor

- euphoria

- psychological dependence

- depression if use is interrupted

Amphetamines: large intravenous dose

- Restless, talkative & excited

- Inject repeatedly to prolong euphoria

- Loss of sleep & appetite

- Suspicous, hostile, paranoid delusions

Meth

- Similar to amphetamines but stronger

- 12-16hrs of euphoria & exhileration

- Destroy tissue & blood vessels

- Weight loss, tremors & dental problems

Narcotics/Opiates

- Reduce pain & induce sleep

- derived from opium poppy

- e.g. heroin, codeine, morphine

Types of Opiates

- Morphine

- Heroin

- Oxycontin/oxycodene

- Fentanyl

- Carfentanyl

Morphine

- Narcotic drug derived from opium, used to treat severe pain

- Morphine addiction aka "soldier's disease"

Oxycontin/oxycodene

Semi-syntetic painkiller, 1.5x stronger than morphine

Fentanyl

- End-of-life care

- Synthetic prescription painkiller, 50-100x stronger than morphine

- Added to other drugs

Carfentanyl

Synthetic anesthetic for large animals, 10000x stronger than morphine

Heroin

- Injected narcotic

- Impurity more dangerous than the drug itself

- Usually fentanyl impurities

Heroin short term effects

- Wave of intense abdominal, orgasmic pleasure that evolves into serene, drowsy euphoria

- Withdrawal after 6 hours without use

Heroin overdose effects

1. Slow, shallow breathing

2. Hypertension

3. Convulsions

4. Coma

5. Death

Heroin chronic effects

1. Constipation

2. Irregular menstruation

3. Reduced sex drive

Heroin withdrawal

Flu-like symptoms

- Abdominal cramps

- Vomitting

- Intense craving

- Runny nose

- Sweating

- Chills

- Gooseflesh

Gooseflesh

Small bumps on skin as hairs become erect caused by cold, fear or excitement

Psychadelics

- Dramatically alter perception, mood & thought

- e.g. marijuana, LSD, Ecstasy, PCP, mescaline

Marijuana

- THC

- physical: red eyes, dry mouth, increased heart rate

- effects last 2-3 hours

- Decreased age onset of mental disorders e.g. dementia

Marijuana Short Term effects

- Low dose: Increase sense of wellbeing, alter perception of space & time, increased sensations

- High dose: Transient memory impairments & psychosis, impairment to speech production, multi-step goal-oriented tasks

Marijuana Chronic effects

1. If habitual smoker: respiratory function deficits, chronic cough, bronchitis, asthma

2. Risk of dependence (10% of users)

Marijuana Medicinal Use

- Cancer or HIV/AIDs induced weight loss, pain, nausea

- Chronic pain: multiple sclerosis, irritable bowel disorder, arthritis

- Epileptic seizures

- Pain from spinal cord disease

LSD

- Interfere with serotonin & dopamine receptors

- hallucinogenic

- brain: decrease electrical activity, increase bloodflow & communication among neural networks (especially visual cortex)

MDMA/Ecstasy

- Hallucinogenic & stimulant

- Increase serotonin production

- Treat: depression, PTSD, OCD, addiction, anxiety

Addict

Can't stop using drugs despite adverse effects AND ATTEMPTS TO STOP

Models of Addiction

1. Moral

2. Biomedical

3. Environmental conditions

4. Psychological

Moral model of addiction

- Addiction = moral failing

- Punishment = treatment

Biomedical model of addiction

- Addiction is an incurable, progressive & fatal if untreated disease

1. Physical dependence theories

2. Positive incentive theories

3. Incentive sensitization theories

Physical Dependence Theories

- Physical dependence traps addicts in cycle of usin & withdrawing

- Criticisms: 1. Stop, restart after some time

2. Mild withdrawal drugs

3.Binge-detox pattern of use

Positive incentive theories

- Primary factor = craving for rewarding properties of drugs

- Criticism: ACTUAL pleasure is NOT the same as ANTICIPATED pleasure

Incentive Sensitization theories

Positive incentive value of drugs increase with repeated use

Criticism of Biomedical Model of Addiction

1. Remove responsibility

2. Spontaneous "recovery"

3. Abstinence may be unnecessary

4. Exposure doesn't guarantee addiction

Environmental Conditions Model of Addiction

"Rat Park" -> negative environment causes need for drugs

Alexander's "Rat Park"

- Cage with lots of activities, food and friends

- Positive environment even addicted rats chose water over water infused with morphine

Criticism of Environmental Condition Model

1. Simplifies causes of addiction

2. Some drugs are addictive

3. Humans are not rats

4. Biological & physiological influences

Behavioral Learning Model of Addiction

- Taste & immediate effects cause pleasure (Positive reinforcement)

- Drugs remove unpleasant feelings (Negative reinforcement)

- Environmental cues (Classical conditioning)

- Observational learning -> drug use is a LEARNED behavior

Cognitive Behavioral Model of Addiction

- Expectancy effects

- e.g. someone expecting alcohol drinks a tonic still experiences alcohol effects