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Drugtaking Behavior: Personal and Social Concerns

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Effective dose (ED): The minimal dose of a particular drug ... TRENDS IN DRUG-RELATED ED VISITS INVOLVING HYDROCODONE AND OXYCODONE. TWO TYPES OF DRUG TOXICITY ... – PowerPoint PPT presentation

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Title: Drugtaking Behavior: Personal and Social Concerns


1
  • Chapter 2
  • Drug-taking Behavior Personal and Social
    Concerns

2
JUDGING 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

3
EXAMPLES 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

4
ED-RESPONSE AND LD-RESPONSE CURVES
5
WHICH DRUG WOULD YOU PREFER?
6
TWO 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.

7
DAWN
  • 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.

8
DRUG-RELATED ED VISITS BY TYPE OF CIRCUMSTANCE
9
FREQUENCY OF DRUGS INVOLVED IN ALCOHOL-IN-COMBINAT
ION ED VISITS
10
TRENDS IN DRUG-RELATED ED VISITS INVOLVING
HYDROCODONE AND OXYCODONE
11
TWO 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.

12
EXAMPLES 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

13
EXAMPLES 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

14
COMPARING CHRONIC TOXICITY LEVELS WITH RESPECT TO
ILLICIT AND LICIT DRUGS
15
DRUG 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.

16
MODELS 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.

17
PSYCHOLOGICAL DEPENDENCE A SIMPLIFIED
ILLUSTRATION OF HOW DRUGS ARE SELF-ADMINISTERED
IN RATS
18
SUBSTANCE 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.

19
SUBSTANCE 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.

20
SPECIAL 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

21
HIV INFECTIONS AND INTRAVENOUS DRUG USE
22
ASSOCIATION OF VIOLENCE WITH ALCOHOL AND OTHER
DRUGS
23
PHARMACOLOGICAL, ECONOMICALLY COMPULSIVE AND
SYSTEMIC VIOLENCETHE DRUG-VIOLENCE CONNECTION
24
PHARMACOLOGICAL, ECONOMICALLY COMPULSIVE AND
SYSTEMIC VIOLENCETHE DRUG-VIOLENCE CONNECTION
25
COMPULSIVE AND SYSTEMIC VIOLENCE
26
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27
EFFORTS 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

28
THE 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

30
FEDERAL 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

31
PRINCIPAL TRADE ROUTES FOR THREE ILLICIT DRUGS
32
THE FLOW OF COCAINE FROM SOUTH AMERICA INTO THE
UNITED STATES
33
TWO 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
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