Chapter Twelve

1. Chapter Twelve Drugs and Addictive Behavior: Use, Abuse, and Control

2. What is a Drug? • Drug: a substance other than food that affects the structure or function of the body through its chemical action • Psychoactive drugs: substances that cause changes in brain chemistry and alter consciousness, perception, mood, and thought • Drug of abuse: medical drugs used for non-medical purposes or a drug that has no medical uses • All drugs have the potential to be toxic, poisonous, dangerous, or deadly

3. Types of Drugs • Drugs are classified in several different ways • Legal drugs include: • Medication prescribed by physicians • Over the counter (OTC) medications • Herbal remedies • Illicit drugs are unlawful to possess, manufacture, sell, or use Table 12.2 summarizes the controlled substance schedules

4. Drug Use, Misuse, and Abuse • Drug use can refer to something as common taking two aspirin for a headache • Drug misuse: use of prescription drugs for purposes other than those for which they were prescribed or in greater amounts than prescribed • Drug abuse: the use of a substance in amounts, situations, or a manner such that it causes problems, or greatly increases the risk of problems, for the user or for others

5. Routes of Administration • Orally • Injection • Usually involves a hypodermic needle delivered into the bloodstream by: • Intravenous injection • Intramuscular injection • Subcutaneous injection • Inhalation • Application to skin or mucous membranes • Dermal absorption • Transdermal absorption

6. Factors Influencing the Effects of Drugs • Characteristics of the drug • Chemical properties of the drug and its actions • Characteristics of the person • Age • Gender • Body weight and mass • Physical condition • Mood • Experience with the drug • Expectations • Characteristics of the situation • Environmental experience

7. Drug Dependence • A condition characterized by a strong craving for a drug and by compulsive use of the drug despite serious negative consequences • Dependence usually means that physiological changes have taken place in the brain and body chemistry • Tolerance usually occurs because the body seeks to compensate for the chemical imbalance caused by the drug and achieves a ‘new normal’ • Withdrawal symptoms are different for different drugs and lead to unpleasant feelings

8. Effects of Drugs on the Brain • Many addictive drugs act on neurons in three brain structures: • The ventral tegmental area (VTA) in the midbrain • Nucleus accumbens • Prefrontal cortex • These neurons form a pathway called the Pleasure and Reward Circuit(see Figure 12.2) • Once drugs reach this area, productions of dopamine increase • All or nearly all addictive drugs operate via this pleasure and reward circuit

9. Addictive Behaviors • Many experts now extend the concept of addiction to other areas in which behavior can be compulsive • Such as gambling, exercise, and sex • These behaviors may follow the same pleasure pathway as drugs do in the brain • These behaviors produce a ‘high’, and the brain adjusts in such a way that the person experiences a strong desire to repeat the behavior as well as a craving for the behavior when it stops

10. Stimulants Depressants Opioids Hallucinogens Inhalants Marijuana Drugs of Abuse

11. Central Nervous System Stimulants • Drugs that speed up activity in the brain and sympathetic nervous system • Effects evoke a ‘fight or flight’ response • May produce intense feelings of euphoria and create a sense of well-being • Examples are: • Caffeine • Amphetamines • Cocaine • MDMA (ecstasy)

12. CNS Depressants • Slow down activity in the brain and sympathetic nervous system • Can be deadly if misused, especially when mixed with alcohol • CNS depressants carry a high risk of dependence • Examples include: • Barbiturates and Hypnotics • Anti-anxiety drugs (benzodiazepines) • Rohypnol • GHB (Gamma hydroxbutyrate)

13. Opioids • Natural and synthetic derivatives of opium • Have a long history of medical use for pain relief and treatment of dehydration • Prescribed as pain relievers, anesthetics, antidiarrheal agents, and cough suppressants • Examples include: • Morphine • Heroin • Codeine • Oxycodone • Produce feelings of pleasure and block sensation of pain

14. Hallucinogens • Also known as psychedelics • Alter perceptions and thinking in characteristic ways • They produce intensification and distortion of visual and auditory perceptions as well as hallucinations • Schedule I drugs with no current medical uses • Examples are: • LSD (Lysergic acid diethylamide) • Psilocybin • Mescaline • PCP (Phencylclidine)

15. Inhalants • Breathable chemical vapors that alter consciousness, typically producing a state of intoxication that resembles drunkenness • Commonly classified into 4 categories: • Volatile solvents • Aerosols • Gases • Nitrates • The most significant negative effect for chronic users is widespread and long-lasting brain damage

16. Marijuana • The most widely used illicit drug in the United States • Marijuana is derived from the hemp plant, Cannabis sativa • The active ingredient is delta-9-tetrahydrocannabinol (THC) • Marijuana produces mild euphoria, sedation, lethargy, short-term memory, impairment, distorted sensory perceptions, and impaired coordination • Researchers have found that THC has a variety of effects on the brain, creating decision-making problems

17. Demand Reduction Strategies • Incarceration for Drug-related Crimes • Prevention Strategies through Education • Primary Prevention • Secondary Prevention • Tertiary Prevention • Drug Treatment Programs • Narcotics Anonymous (NA)

18. Chapter Twelve Drugs and Addictive Behavior: Use, Abuse, and Control