Drug Use, Misuse, and Abuse Notes

Drug Use, Misuse, and Abuse

• In medicine, drugs aid healing or relieve distress.
• A drug is a chemical substance impacting feelings and functions, potentially distorting reality and threatening well-being.
• No drug is entirely safe; all have varied effects.
• Understanding drug effects on the brain, body, and behavior is crucial.
• Risks exist in all drug use, including medication and caffeine.
• DRUG MISUSE: Using a drug for unintended purposes (e.g., cough medicine for a high).
• DRUG ABUSE: Excessive drug use inconsistent with accepted medical practice (WHO definition).
• Drug effects depend on:
  • How the drug enters the body.
  • Dosage.
  • Drug action.
  • Presence of other drugs.
  • Individual's psychological makeup.
  • Setting.
• Ways drugs enter the body:
  • Swallowing: Effects take about 30 minutes.
  • Inhaled: Marijuana, gases, aerosols, solvents.
  • Intravenously: Immediate bloodstream entry.
  • Injected into muscle: Moderately fast absorption.
  • Subcutaneous injection: (below the skin) Effects in 10 minutes.

Doses and Toxicity

• Toxicity depends on the amount of drug taken.
• Toxicity: Dosage level at which a drug becomes poisonous.
• Liver's detoxification enzymes break down drugs.
• Individual Differences:
  • Reactions vary based on circumstances/setting.
  • Enzymes reduce drug levels in the bloodstream.
  • Drugs can intensify emotional states.
  • Illness increases vulnerability to drug effects.
  • Genetic differences cause varying reactions.
  • Personality and psychological attitude influence reactions.
• Setting:
  • The setting influences drug effects.
  • Social sharing vs. unsafe locations yields different impacts.
• Types of Action:
  • Local: e.g., Novocain for tooth pain.
  • General: Affecting a body system, e.g., barbiturates on the central nervous system.
  • Selective: Greater effect on a specific organ or system, e.g., spinal anesthetic.
• Interaction with Other Drugs and Alcohol:
  • Additive: Equal interaction.
  • Synergetic interaction: Combined effect exceeds the sum of individual effects.
  • Potentiating: One drug enhances the effect of another (e.g., alcohol increases antihistamine drowsiness).
  • Antagonistic: One drug blocks or neutralizes another.
• Medications:
  • Take in recommended doses at specific times.
  • Smaller doses are recommended for young persons.
  • OTC (Over-the-counter) medications can be dangerous if combined.
  • Aspirin and alcohol increase blood-alcohol concentration.
  • Excessive food supplements can cause vitamin toxicity.
  • Misused OTC medications: Nasal sprays, laxatives, eyedrops, sleep aids, cough medicines.
• Prescription Drugs:
  • Prescription drugs are not always safe; doses may be incorrect.
  • Most drugs, when taken correctly, cause minor complications.

Side Effects of Prescription Drugs

• Physical side effects:
  • Heart failure
  • Heart attack
  • Seizures
  • Kidney and liver failure
  • Severe blood disorders
  • Birth defects
  • Blindness
  • Allergic reactions
• Psychological side effects:
  • Changes in thinking, feeling, and behavior from both OTC and prescription drugs.
  • Medications causing psychiatric side effects: Hypertension, heart disease, asthma, epilepsy, Parkinson’s Disease, anxiety, insomnia, depression, arthritis.
  • Symptoms: Deliriums, disorientation, forgetfulness, irritability, mood changes.
• Drug Interactions:
  • OTC and prescription drugs interact negatively.
  • Cold medicines and tranquilizers cause drowsiness and coordination problems.
  • Medication timing relative to meals affects absorption.
  • Read instructions carefully.
  • Avoid alcohol, which can change drug metabolism.
  • Consult pharmacists and doctors regarding generic drug effectiveness.

Drug Abuse: Historical and Modern

• Substance abuse has existed for centuries.
  • Ancient Mesopotamia and Egypt: Opium.
  • Hindus: Cannabis in ceremonies.
  • Incas: Coca leaves.
  • Historically limited to small groups.
• Drug use is now global, altering perceptions and easing psychological pain.
• Both genders are vulnerable to substance use disorders.
• 1960s: Explosion in drug use.
• 1960s-70s: Marijuana expansion.
• 1980s: Cocaine emerges.
• 1986: Crack cocaine appears.

Dependence and Abuse

• Scientists prefer "dependence" over "addiction."
• Psychological dependence: Craving for pleasurable feelings or anxiety/stress relief.
• Physical dependence: Tolerance requiring larger doses.
• Unsuccessful attempts to cut down drug use.
• Marijuana usually doesn't cause withdrawal symptoms.
• Some users don't develop tolerance/withdrawal but still experience harm.
• Continued use despite awareness of problems.
• Intoxication and Withdrawal:
  • Intoxication: Maladaptive behavioral and physiological changes from substance use.
  • Withdrawal: Psychological and physical distress when reducing/stopping drug use.
• Most users prefer a certain drug but may engage in “poly-abuse”.
• One-third of individuals with mental disorders also have chemical dependence.
• Causes of Drug Dependence and Abuse:
  • Addiction viewed as a brain disease.
  • Users crave the feelings produced, not the drug itself.

Treating Drug Dependence and Abuse

• The most difficult step: Admitting addiction.
• Intervention by family/friends may be necessary.
• Treatment settings: Outpatient, residential, hospital.
• First step: Detoxification.
• Medications alleviate withdrawal symptoms and prevent complications, then are stopped.
• Individuals with mental disorders need psychiatric medication to manage symptoms and reduce relapse risk.
• Recovery:
  • Dynamic process of personal growth and healing.
  • Transition from active substance use to drug-free recovery.
  • Intense treatment followed by 1-2 years of aftercare.
  • Abuse disorders involve multiple relapses over a lifespan.
  • Relapse prevention: avoid cues and associations that trigger cravings.
  • Recovering addicts need a supportive network.

Sources

• Hales, D (2003) An Invitation to Health 10th Ed. Wadsworth/Thomson Learning. CA.