1. Addictive Behaviors Thomas G. Bowers, Ph.D. Penn State Harrisburg

2. What is addiction? Substance abuse Substance dependence These qualities are only related to addiction

3. Addiction Refers to the use of a substance characterized by: –The development of tolerance –The presence of withdrawal symptoms –The characteristic use of substances across a wide array of circumstances

4. Diagnosis of Substance Dependence Symptoms (at least 3 of): –Tolerance –Withdrawal symptoms –Uses more than intended –Unable to reduce use –Much of time spent to obtain substance or recover from use –Use continues despite physical or health problems –Gives up many other activities

5. Substance Abuse Diagnosis (1 of the following) –Failure to fulfill major obligations, as absences from work or school –Exposure to physical danger –Legal problems (such as a DUI, disorderly conduct) –Persistent social or interpersonal problems

6. Psychoactive Drugs I. Stimulants –“uppers” –Speed, meth –Amphetamines –Methylphenidate –Caffeine –Nicotine II. Depressants –“downers” –Sedatives –Hypnotics –Ethanol –Minor tranquilizers –Barbiturates

7. Stimulants Increase heart rate, respiration, release or facilitate neurotransmitters Increased speech, pace of motor behavior, alertness and concentration Can yield agitation, anxiety, flood of ideas, euphoria Extreme doses can lead to paranoia, suspiciousness, guardedness, excessive withdrawal

8. Depressants Reduce muscle tone, relax, sedate induce sleep Reduced respiration, heart rate, gastric motility Loss of judgment, higher cognitive processes Loss of behavioral inhibition

9. Other Classes of Drugs Hallucinogens Methylated Hallucinogens Ketamines (as PCP) Marijuana Ethanol Nicotine

10. Hallucinogens Relatively recent discovery D-Lysergic Acid Diethlamide –Hoffer discovered LSD 25 quite by accident in his laboratory in 1938 –Took, as a test, what was thought to be a very small dose, and had an extreme hallucinatory experience –Initially felt likely to be consciousness expanding

11. Hallucinogens Early uncontrolled trials of experimental therapeutic use was described as “promising” However, the work was poor controlled, lacked objective measures, no follow-up A culture of “consciousness enhancement” followed <3ng/ml yields intense psychic changes Poorly absorbed, only 1% to brain

12. Hallucinogens There has been culture use of peyote buttons (mescaline) in religious experiences among the southwestern native Americans Enhanced hallucinations and the religious or spiritual nature of the experience

13. Hallucinogens Subjective effects mimic schizophrenic range disorders Synesthesia – overflow of one sensory modality to the other Vibrant, intense colors and sensory experiences Alteration of time experience Fragmentation of self

14. Hallucinogens Mood can be labile and amplified Much greater sensitivity for stimulation and feelings “Bad trips” occurred early in experimentation, now quite rare Some rare individuals experience a psychosis

15. Hallucinogens Lethal dose estimated at ~ 14 mg in humans Tolerance develops slowly, if at all For the curious: A. Huxley “Doors of Perception”

16. Hallucinogens More recent developments in hallucinogens “Club” drugs –Methylated hallucinogens –Ecstasy –MDA or MDMA –Methylenedioxyamphetamine –Methylenedioxymethamphetamine

17. Hallucinogens “Club” drugs –Reported to improve intimacy and insight, improves interpersonal awareness, enhances aesthetic awareness –Some overdoses have occurred as have severe toxic reactions

18. Hallucinogens PCP –Ketamine –“Angel dust” –Animal tranquilizer –Quite potent, can overdose –Extremely relaxing, violent or aggressive actions can occur

19. Hallucinogens Marijuana –Cannabis sativa –Hashish, a more potent form of cannabis –Use (18 year olds) Approximately 35% in past year Low rates about 25% to high of 40%

20. Hallucinogens Marijuana –Dosage difficult to anticipate –Active agent is delta 9 tetrahydrocannabinol (THC) –Acute effects impair intellect and possibly memory –Inconsistent evidence of persisting memory impairment

21. Hallucinogens Marijuana –Some findings of adjustment difficulties among marijuana smokers –Somatic effects 1. Dry mouth, red and itchy eyes 2. Increased appetite 3. Some blood pressure elevation 4. Long term use impairs lung function 5. Use patterns tend to amply effects

22. Hallucinogens Marijuana –Addictive Aspects? 1. Some evidence of tolerance to more potent doses of marijuana 2. Doubtful of withdrawal symptoms

23. Hallucinogens Marijuana –Learning aspects: Becker –“On becoming a marijuana user” –Noted the social learning process 1. Needs to learn how to smoke effectively 2. Needs to learn to attend to subtle changes of consciousness 3. Needs to learn to label changes as “high”