Title: Drugtaking Behavior: Personal and Social Concerns
1- Chapter 2
- Drug-taking Behavior Personal and Social
Concerns
2JUDGING DRUG TOXICITY THROUGH ED AND LD MEASURES
- Effective dose (ED) The minimal dose of a
particular drug necessary to produce the intended
drug effect in a given percentage of the
population - Lethal dose (LD) The minimal dose of a
particular drug capable of producing death in a
given percentage of the population
3EXAMPLES OF LD AND ED MEASURES
- ED50 --- The dose that produces the intended drug
effect in 50 percent of the population under
study - ED100 --- The dose producing the intended drug
effect in 100 percent of the population - LD50 --- The dose producing death in 50 percent
of the population under study - LD100 --- The dose producing death in 100 percent
of the population
4ED-RESPONSE AND LD-RESPONSE CURVES
5WHICH DRUG WOULD YOU PREFER?
6TWO MEASURES OF DRUG SAFETY
- Therapeutic index The ratio of LD50 to ED50. If
LD50 is 100 and ED50 is 20, then the therapeutic
index is 5. - Margin of safety The ratio of LD1 to ED99. If
the LD1 is 100 and ED99 is 20, then the margin of
safety is 5. - The higher the ratios, the safer the drug.
- However, a drug with a margin of safety of 5 is
safer than a drug with an equivalent therapeutic
index. The margin of safety is the more
conservative measure in the direction of safety.
7DAWN
- The Drug Abuse Warning Network (DAWN) program
reports the number of drug-related emergency
department (ED) visits in major metropolitan
hospitals in the United States. - Drug-related ED visits can be due to a wide range
of personal circumstances.
8DRUG-RELATED ED VISITS BY TYPE OF CIRCUMSTANCE
9FREQUENCY OF DRUGS INVOLVED IN ALCOHOL-IN-COMBINAT
ION ED VISITS
10TRENDS IN DRUG-RELATED ED VISITS INVOLVING
HYDROCODONE AND OXYCODONE
11TWO TYPES OF DRUG TOXICITY
- Chronic toxicity The physical or psychological
harm a drug might cause over a long period of
time. - Acute toxicity The physical or psychological
harm a drug might cause to the user immediately
or soon after the drug is ingested into the body.
12EXAMPLES OF ACUTE TOXICITY
- Accidental lethal overdose of heroin
- Behavioral dangers from being high
- Dangerous combinations of several drugs
- Dangerous combination of alcohol with any drug
- Overmedication of precription or OTC drugs
13EXAMPLES OF CHRONIC TOXICITY
- Liver disease due to chronic alcoholic
consumption - Lung cancer due to chronic tobacco smoking
- Cardiovascular disease due to chronic tobacco
smoking - Pulmonary disease due to chronic tobacco smoking
14COMPARING CHRONIC TOXICITY LEVELS WITH RESPECT TO
ILLICIT AND LICIT DRUGS
15DRUG TOLERANCE
- The capacity of a specific dose of a drug to have
a gradually diminished effect on the user as the
drug is taken repeatedly. - Requires that a higher dose of a drug to be
taken to produce an equivalent effect. - Behavioral (conditioned) tolerance is a form of
tolerance that occurs when a drug is used in the
same surroundings or under the same
circumstances.
16MODELS OF DRUG DEPENDENCE
- Physical dependence - drug abuser continues to
take a drug to avoid the consequences of physical
withdrawal symptoms. - Psychological dependence - abuser is motivated by
a strong craving for the pleasurable effects of
the drug.
17PSYCHOLOGICAL DEPENDENCE A SIMPLIFIED
ILLUSTRATION OF HOW DRUGS ARE SELF-ADMINISTERED
IN RATS
18SUBSTANCE DEPENDENCEDSM-IV CRITERIA
- At least 3 out of the following must apply within
the past year - Tolerance
- Withdrawal
- Unintentional overuse
- Persistent desire or efforts to control drug use
- Preoccupation with the drug
- The reduction or abandonment of important social,
occupational, or recreational activities in order
to engage in drug use - Continued drug use despite major drug-related
problems - Symptoms must have persisted for more than a
month or occurred repeatedly over a longer period
of time.
19SUBSTANCE ABUSEDSM-IV CRITERIA
- At least one of the following must apply within
the past year - Recurrent drug use resulting in a failure to
fulfill major obligations at work, school, or
home - Recurrent drug use in situations in which use is
physically hazardous - Recurrent drug-related legal problems, such as
arrest for disorderly conduct or drug-related
behavior - Continued drug use despite the knowledge of
persistent social, occupational, psychological,
or physical problems that would be caused or made
more difficult by the use of the drug - Note The person must have never met the criteria
for substance dependence for
this particular drug.
20SPECIAL PROBLEMS
- Drug abuse during pregnancy
- Fetal alcohol syndrome
- Physical defects, lower birth weight
- Postnatal withdrawal symptoms
- Drug abuse and infectious diseases
- Hepatitis and HIV contamination
21HIV INFECTIONS AND INTRAVENOUS DRUG USE
22ASSOCIATION OF VIOLENCE WITH ALCOHOL AND OTHER
DRUGS
23PHARMACOLOGICAL, ECONOMICALLY COMPULSIVE AND
SYSTEMIC VIOLENCETHE DRUG-VIOLENCE CONNECTION
24PHARMACOLOGICAL, ECONOMICALLY COMPULSIVE AND
SYSTEMIC VIOLENCETHE DRUG-VIOLENCE CONNECTION
25COMPULSIVE AND SYSTEMIC VIOLENCE
26(No Transcript)
27EFFORTS TO REGULATE DRUGS
- Before 1900 A policy of laissez faire
- 1906 Pure Food and Drug Act
- 1914 Harrison Act
- 1920-1933 National Prohibition
- 1937 Marijuana Tax Act
- 1970 Comprehensive Drug Abuse Prevention
and Control Act
28THE COMPRHENSIVE DRUG ABUSE PREVENTION AND
CONTROL ACT OF 1970
- Defined five categories of drugs, called
schedules of controlled substances (I through V)
--- as a function of abuse potential - Transferred drug enforcement responsibility from
Treasury Department to Justice Department
29- FIVE SCHEDULES
- OF CONTROLLED
- SUBSTANCES
30FEDERAL AGENCIES INVOLVED IN ILLICIT DRUG
INTERDICTION
- Drug Enforcement Administration (DEA)
- U.S. Customs and Border Patrol Agency
- U.S. Coast Guard
- Immigration and Naturalization Service (INS)
- Departments of Defense and State in more than
forty foreign countries
31PRINCIPAL TRADE ROUTES FOR THREE ILLICIT DRUGS
32 THE FLOW OF COCAINE FROM SOUTH AMERICA INTO THE
UNITED STATES
33TWO APPROACHES IN NATIONAL DRUG-ABUSE POLICY
- Zero Tolerance --- The eventual eradication of
drug-taking behavior in the United States - Harm Reduction --- The minimization of medical,
psychological, and social costs associated with
drug-taking behavior