An Invitation to Health Chapter 10 Drug Use, Misuse, and Abuse Dr. Lana Zinger. ©2004 Wadsworth Publishing Co.

Drug Terminology Drug: any substance that alters the user’s ability to function, Including over-the-counter drugs, prescription medications, and illegal substances. Drug Misuse: the intentional or inappropriate use of over-the-counter or prescribed medications. Drug Abuse: excessive drug use that’s inconsistent with accepted medical practice. Toxicity: the dosage level at which a drug becomes poisonous to the body, causing either temporary or permanent damage.

Routes of Administration of Drugs Figure 10.1

Drug-Drug Interactions Additive Synergistic Potentiating Antagonistic

Commonly Misused Over-The-Counter (OTC) Drugs Aspirin Nonsteroidal Anti-Inflammatory Drugs Ibuprofen Nasal Sprays Laxatives Eye Drops Sleep Aids Cough Syrup

Prescription Drugs Potential Complications Nonadherence Recurrent infections, serious medical complications, and emergency hospital treatment. Physical Side Effects Heart failure, heart attack, seizures, kidney and liver failure, severe blood disorders, birth defects, blindness, memory problems, and allergic reactions. Psychological Side Effects Depressive symptoms vs. agitation and anxiety. Drug Interactions OTC drugs, prescription drugs, alcohol, vitamins and minerals, and food components.

Drug Interactions Figure 10.2

Substance Use Terminology ADDICTION The habitual use of substances, such as alcohol, psychoactive drugs, and nicotine, and also to compulsive behaviors, such as overeating. DRUG ABUSE The use of chemical substances that results in physical, mental, emotional, or social impairment. DRUG MISUSE The occasionally inappropriate or unintentional use of a medication. PHYSICAL DEPENDENCE When a person develops tolerance to the effects of a drug and needs larger and larger doses to achieve intoxication or another desired effect. PSYCHOLOGICAL DEPENDENCE A state in which individuals crave drugs to satisfy some personality or emotional need.

Warning Signs Of A Substance Use Disorder An Abrupt Change In Attitude Mood Swings A Decline In Performance Increased Sensitivity Secrecy Physical Changes Money Problems Changes in Appearance Defiance of Restrictions Changes in Relationships

What Causes Drug Dependence and Abuse? The Biology of Dependence Dopamine, glutamine, GABA, and norepinephrine. The Psychology of Vulnerability Difficulty controlling impulses, a lack of values that may constrain drug use, low self-esteem, feelings of powerlessness, denial, and depression or anxiety. Early Influences Lower socioeconomic backgrounds, family instability, a lack of realistic, rewarding alternatives and role models, and increased hopelessness. Teen Drug Use Early use of tobacco and alcohol is linked with a greater likelihood of marijuana use, which in turn increases the likelihood of other illegal drug use.

Dopamine Levels For Cocaine Figure 10.3

Factors Influencing Student Drug Use Race/Ethnicity Sexual Identity Perception of Risk Environment Alcohol Use

Club Drugs/ Designer Drugs Common Drugs Of Abuse Cannabis Club Drugs/ Designer Drugs Stimulants Depressants Hallucinogens Inhalants Marijuana MDMA, MDA, MDEA Rohypnol GHB Amphetamines Cocaine Tobacco/ Nicotine Alcohol Barbituates Tranquilizers Narcotics/ Opioids PCP LSD Mescaline Solvents, Aerosols Nitrates Nitrous Oxide

Cannabis Marijuana and Hashish The Facts Marijuana is the most widely used illegal drug in the United States (~12 million Americans). Marijuana is a drug derived from the cannabis plant that contains the active ingredient THC. How Users Feel A mild sense of euphoria, a sense of slowed time, a dreamy type of self-absorption, and some impairment in thinking and communicating. The euphoria peaks within a half hour and usually lasts about three hours. Potential for marijuana withdrawal syndrome.

Some Bodily Effects of Marijuana Figure 10.4

Do Students Want Marijuana Legalized? Student Snapshot

Club Drugs (Designer Drugs) Alcohol LSD (acid) MDMA (ecstasy) GHB GBL Ketamine (Special K) Fentanyl Rohypnol Amphetamines Meth- amphetamine

Club Drugs Ecstasy The Facts How Users Feel Ecstasy is the common street name for methylenedioxymethamphetamine (MDMA). MDMA belongs to a family of drugs called enactogens. How Users Feel MDMA is a mood elevator which produces a relaxed, euphoric state, but does not produce hallucinations. The effects of MDMA begin in 45 minutes and last for 2 to 4 hours.

Club Drugs The Risks of Ecstasy Psychological Difficulties Confusion, depression (neurotoxicity), sleep problems, drug cravings, severe anxiety, and paranoia. Physical Symptoms/Side Effects Muscle tension, involuntary teeth clenching, nausea, blurred vision, rapid eye movement, faintness, chills, sweating, and increased heart rate and blood pressure. Hyperthermia and hepatitis. Psychological Dependence

Club Drugs GHB/GBL The Facts How Users Feel GHB stimulates the release of human growth hormone, but has no known effects on muscle growth. When GLB, an industrial solvent, is ingested it is converted to GHB. How Users Feel Smaller doses induce euphoria and enhance sex due to a rise in dopamine in the brain. Larger doses can cause individuals to pass out and possibly fall into a coma.

Club Drugs The Risks of GHB/GBL Side Effects Nausea, amnesia, hallucinations, decreased heart rate, convulsions, and sometimes blackouts/coma. Long Term Side Effects Withdrawal reaction including rapid heartbeat, tremor, insomnia, anxiety, and occasionally hallucinations that last a few days to a week. The danger is greatest when GHB is mixed with alcohol or opiates.

Club Drugs Ketamine (K) The Facts Ketamine is an anesthetic used by veterinarians. K blocks chemical messengers in the brain that carry sensory input thereby leading to hallucinations. Side Effects At high doses, K can cause delirium, amnesia, impaired motor function, high blood pressure, depression, and potentially fatal respiratory problems.

Stimulants Amphetamines & Methamphetamine The Facts Amphetamines trigger the release of epinephrine (adrenaline) which stimulates the central nervous system. Methamphetamine is a powerful addictive stimulant. Meth remains in the central nervous system and the body, producing prolonged stimulant effects. How Users Feel Amphetamines produce a state of hyper-alertness and energy. High doses make users feel wired: talkative, excited, restless, irritable, anxious, and moody. Meth produces long-lasting toxic effects, including psychosis, violence, seizures, and cardiovascular abnormalities.

Stimulants Amphetamines & Methamphetamine Side Effects Bingeing and crashing. Feelings of grandiosity, anxiety, tension, anger, agitation, paranoia, and impaired judgment. Increased heart rate and blood pressure. Long Term Side Effects Malnutrition, skin disorders, ulcers, insomnia, depression, vitamin deficiencies, sexual dysfunction and impaired concentration or memory, and, in some cases, brain damage.

Cocaine An estimated 5 million people in the United States use cocaine. Cocaine is a white crystalline powder extracted from the leaves of the South American coca plant. Routes of Administration: Smoked (freebasing/crack) Sniffed/Snorted Injected (speedballing) How Users Feel Cocaine stimulates the central nervous system producing feelings of soaring well-being and boundless energy. After a brief period of euphoria, users slump into depression.

Forms of Cocaine

Some Effects Of Cocaine On The Body Figure 10.6

Depressants Benzodiazepines and Barbiturates The Facts Benzodiazepines are sedative-hypnotics. Commonly prescribed for tension, muscular strain, sleep problems, anxiety, panic attacks, anesthesia, and in the treatment of alcohol withdrawal. Rohypnol – date rape drug. How Users Feel Low doses reduce or relieve tension, but may cause rapid mood changes, impaired judgment, and impaired social and occupational functioning. High doses produce slurred speech, drowsiness, and stupor.

Depressants Benzodiazepines and Barbiturates Side Effects Physical and psychological dependence within two to four weeks. Cross-tolerance. Mood and behavior changes, slurred speech, poor coordination, unsteady gait, involuntary eye movements, impaired attention or memory, and stupor and coma. Synergistic effect when used in combination with alcohol.

Depressants Opioids and Nonopioid Synthetic Drugs Opium “Mother drug”; A base compound for all natural narcotics. Creates euphoria and escape from reality. Morphine Main alkaloid found in opium; used medically to kill pain and sedate. Ten times stronger than opium. Heroin Narcotic drug derived from morphine that is 35 times stronger than morphine. Skin-popping vs. mainlining. Codeine A natural derivative of opium used as a cough suppressant or mild painkiller. Dilaudid Semisynthetic derivative of morphine, legitimately used as a cough suppressant and an analgesic for treating severe pain. Percodan A semi-synthetic cough-suppressing and analgesic medication which is more potent than codeine. Demerol Short-acting synthetic narcotic used as an analgesic or a painkiller; usually injected.

Depressants Opioids and Nonopioid Synthetic Drugs How Users Feel All opioids relax the user, and impart feelings of euphoria and provide pain relief. Side Effects Addiction, lethargy, weight loss, loss of sex drive, anxiety, insomnia and restlessness. Overdose causes shock, coma, and depressed respiration. Long Term Injection of Opioids: infections of the heart lining and valves, skin absesses, and lung congestion. Methadone Maintenance

Hallucinogens Definition: a group of mind-altering drugs that affect the brain and nervous system bringing about changes in thought, self-awareness, emotion and sensation. Natural Sources of Hallucinogens Morning glories, jimsonweed, nutmeg, mace, peyote cactus, and psychodelic mushrooms Synthesized Hallucinogens LSD PCP LSD: lysergic acid diethylamide-24; a psychedelic drug that produces distorted reality. PCP: an anesthetic that blocks nerve receptors from pain and temperature without producing numbness; angel dust.

Inhalants Definition: drugs that produce vapors that cause psychoactive Effects when inhaled or sniffed. Examples Model airplane glue, gasoline, paint thinner, transmission fluid, lighter fluid, liquid shoe polish, and fingernail polish remover. Potential Side Effects Gastroenteritis, depressed muscle tone, damage to the liver and kidneys, nervous system dysfunction, and bone marrow disorders.

Treating Drug Dependence and Abuse Recognize the reality of the problem. Consult a physician, counseling center, or local mental health clinic. Intervention modalities: Medical care Medication Detoxification Individual psychotherapy Marital and family therapy Behavior modification 12-step programs