SOCW 4340 Introduction to Alcohol/Drug Addiction

1. SOCW 4340Introduction to Alcohol/Drug Addiction CHAPTER 7 Other Drugs/Addictions

2. Other Drugs • Inhalants • Sports Drugs • Herbals/Smart Drugs

3. Inhalants • Volatile chemical • Inhaled, absorbed through lungs • Anesthetics – nitrous oxide, halothane • Household solvents • Office supplies • Gases – butane, propane, etc. • Propellants • Organic solvents e.g. nitrates

4. Inhalants • WHO??? • Mostly adolescents • 20% of kids by end of 8th grade • 95% of deaths occurred in males

5. Inhalants • Effects • Acute • Rapid intoxication – similar to alcohol • Progresses through sedation, disinhibition, staggering, etc. • Severe intoxication can lead to general anesthesia and/or death • Can be treated by supportive therapy such as oxygen • Chronic • CNS dysfunction • Liver/kidney failure • Fetal Solvent Syndrome

6. Sports Drugs • Therapeutic drug • Analgesics • Muscle relaxants • Anti-inflammatories • Asthma Meds

7. Sports Drugs • Performance Enhancers • Steroids • Growth Hormone • Blood/products • Stimulants

8. Sports Drugs • Recreational • Mood-altering

9. Anabolic Steroids • Why abused? • Increase muscle mass • Enhance strength, endurance, appearance, performance • What is abused? • Testosterone related steroids • Testosterone precursors- androstenedione

10. Anabolic Steroids • Mechanism • Hypothalamus and pituitary sense and regulate hormone production • Controls all sexual characteristic/fertility functions in males and females • Exogenous androgens overwhelm normal function of this regulatory system

11. Anabolic Steroids • Mechanism • Substituted steroids less metabolized than testosterone • Testosterone penetrates cell and causes biological effects by production of specific proteins

12. Anabolic Steroids • Physiological effects • Muscle mass increase with or without exercize • No improvement of aerobic performance • Anticatabolic – prevents protein metabolism • Anabolic – protein synthesis and GH release • Motivational – aggression – “roid rage” • Males: • Decreased sperm production, testicular atrophy, reduced libido, impotence • Females • Increased facial/body hair, lowered voice, coarser skin, menstrual cessation/irregularity

13. Anabolic Steroids • Adverse effects • Cardiovascular • Fatal MI • Atherosclerosis, reduces HDL, elevates LDL • Thromboembolic – strokes, hypertension • Liver • Jaundice • Tumors – including carcinoma • Liver enzymes elevated

14. Anabolic Steroids • Psychological effects • Aggression, competitiveness, combativeness, mood, judgement • Steroid receptors - large number in limbic system • Some people become severely manic • Symptoms can take weeks to develop

15. Anabolic Steroids • Physical dependence • Withdrawal • Depression • Fatigue • Restlessness • Insomnia • Loss of appetite • Decreased libido • Drug craving • Headache • Body image • Rare suicidal attempts

16. Anabolic Steroids • Abuse reduction • Bans by athletic associations • Education – dangers, alternatives • Cultural attitudes • Winning • Physical appearance

17. Anabolic Steroids • Androstenedione • Available as ‘nutritional supplement’ • Mark McGuire • OK in MLB until 2004 but not MLB minor leagues, IOC, NBA or NFL

18. Herbal Medicines • St. John’s Wort • Anxiety, Depression, Insomnia • Presumed active drugs: Hypericin, pseudohypericin • 15-20% absorbed • Mild inhibition of MAO • HT, DA,NE reuptake • Effective better than placebo • Adverse effects • Inhibits drug metabolizing enzymes • Photodermatitis, hypomania, nerve toxicity, Anticholinergic, GI problems, dizziness • SSRI interaction

19. Herbal Medicines • Ginkgo • Cognitive disorders – dementia • Antioxidant • Readily absorbed • Effects • Inflammation/oxidation stress moderator? • Increased alertness • Similar response as caffeine • Slightly better than placebo • Adverse effects • Inhibition of drug metabolism • Headache • GI

20. Herbal Medicines • Kava • Anti-anxiety • Native use similar to alcohol • Sleep inducer • Kava ‘lactones’ • Side effects • Drowsiness • Nausea • Weakness • Blurred vision • Yellow skin discoloration

21. Herbal Medicines • Ephedrine (Ma-huang) • Stimulant – related to amphetamines • Releases neurotransmitters • Short acting • Increased • BP, heart rate, cardiac contraction, cardiac output • Synergistic with caffeine • Deaths from heart attack, arrhythmia • Appetite suppressant • Fairly dangerous. Now illegal.

22. Herbal Medicines • Valerian • Anxiolytic • GABA source (distribution problem) • 5HT agonist / MAOI ?? • German Chamomile • Insomnia, anxiety treatment? • Evening primrose • Schizophrenia, ADHD?? • Hops • Mild sedative/hypnotic • Lemon Balm/passion flower/skullcap • Sedative/Anxiolytic?

23. Herbal Medicines • Cautions • Few studies of effectiveness/dosing • None superior to conventional treatment • Safety/efficacy? • Positives • Long history of use in some cultures • Some studies confirm pharmacological effects (e.g. St. John’s Wort) • May be useful for other diseases as well

24. Other Addictions • Compulsive Behaviors • Compulsion • Tolerance • Withdrawal • Abuse • Denial • Relapse

25. Other Addictions • Drug Use • Gambling • Eating

26. Other Addictions • Heredity • Twin studies • Significant correlation • Greater propensity/risk

27. Other Addictions • Environment • Gambling – abundance of opportunities • Overeating – fast food/lack of activity • Sex – abundance of exposure • Internet – unlimited • Shopping – credit/internet