Unit 15: Drugs

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Unit 15 Drugs
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Overview

• Drug any substance other than food or water
  that is taken in order to change the structure or
  function of the body
• Ex. Caffeine, Tylenol, alcohol
• Psychoactive drugs influence the brain
  chemistry so as to cause a change in perception,
  mood, thinking and/or behaviour
• Ex. Cocaine, marijuana
• In order for any drug that affects the brain to
  work it must cross the blood-brain barrier

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Routes of Administration

• Injecting/smoking drugs reaches the brain more
  quickly/ effects wear off more quickly, higher
  chance for dependence
• Injecting drugs possibility for infection
• Smoking drugs can damage your lungs
• Oral pills it takes longer to feel the effects
  because they have to travel down to your
  intestines first before they are absorbed

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Common Psychoactive drugs
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Caffeine

• most widely used drug in North America
• Coffee, espresso, tea, cola, caffeine pills,
  energy drinks
• Effects are relatively harmless, it is a mild
  stimulant
• generally recognized as safe -FDA
• Excess consumption shaking, difficulty
  concentrating, insomnia
• Half-life 5 hours
• Functions as diuretic, compromises vitamin C/
  iron absorption
• Withdrawal may cause irritability, drowsiness,
  headache

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Tobacco

• Occurs naturally and contains nicotine
• Leading cause of preventale death worldwide (WHO)
• Nicotine mild stimulant
• Tobacco tar carcinogenic
• It kills 1/10 adults woldwide! (WHO 2010)
• Chronic smoking also causes bronchitis,
  emphysema
• Smoking is strongly associated with CVD too
  (strokes, heart attacks...)

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Smoking and youths

• Knowledge about the health risks is high,
  however, knowledge does not change behaviour
• There have been sharp declines in smoking rates
  among teens in the past 10 years!
• Due to law enforcement against underage smoking?
• Due to limiting tobacco advertising?
• Due to increasing the cost of tobacco?

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Quitting smoking

• Approximately 70 of smokers want to quit, most
  do so on their own.
• Nicotine patches, gum can help
• Combining behavioural therapy works best
• Think ASE model, Transtheoretical model

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Cocaine

• Cocaine stimulant derived from the leaves of the
  coca plant found in S. America
• Either snorted as a powder or mixed with water
  and injected (crack)
• Acutely it leads to rapid heart/breathing rate,
  dilated pupils, sweating, paleness and decreased
  appetite
• Users experience exaggerated alertness,
  competency and power, even feelings of
  invincibility
• Chronic use leads to scars in the nose, mood
  imbalances
• Cocaine overdose is often due to heart
  irregularities

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Amphetamines

• Ex. Dextroamphetamine (cat) and
  methamphetamines (speed, meth, crank)
• Powerful stimulants
• Can be taken orally, smoked or injected
• Chronic use
• tolerance
• Psychological dependence
• Compulsive patterns of use
• Withdrawal (depression, excessive sleeping,
  increased appetite)

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Faces of Meth
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Cannabis

• AKA marijuana, weed, pot hash and hash
  oil
• Most widely used controlled drug in Canada and
  the world
• 12 of Canadians have used cannabis in the past
  year (2002)
• THC is the main active ingredient
• Acute (short term) effects of cannabis use
  include mild euphoria, heightened perception,
  increased appetite, red eyes and drowsiness are
  common
• Use is rarely associated with violence

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Cannabis

• Evidence is not always conclusive as far as the
  chronic health effects
• Associated with decreased reproductive function
• Chronic use may interfere with memory and
  learning
• Main health risk lung damage such as bronchitis
• Smoking one joint smoking about 5 cigarettes
• More potent
• People usually inhale it more deeply, hold it in
  their lungs for longer

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Cannabis

• The tar in marijuana may be carcinogenic
• However, cannabinoids may slow the progression of
  cancer
• Also, there are potential benefits (that are not
  conclusive) such as in the treatment of anorexia,
  nausea/vomitting, chronic pain, epilepsy, MS,
  glaucoma and migraines

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Hallucinogens

• ex. Peyote and magic mushrooms, LCD
• Second most commonly used drugs in Canada
• Cause a profound alteration in perception which
  can last up to 8 hours
• The environment you do the drug in can affect
  whether you have a positive experience (a good
  trip) or a negative one (a bad trip)

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Ethanol aka alcohol

• A central nervous system depressant, though it
  may seem like a stimulant
• Acute effects mild euphoria and relaxation,
  altered judgement
• When ethanol gets into your body it goes straight
  to your blood. Therefore a smaller person with
  less blood volume would have an increased
  reaction to alcohol
• Almost 80 of Canadians over 15 have consumed
  alcohol in the previous year (2004)

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Ethanol aka alcohol

• Chronic effects of ethanol consumption include
• Gastritis
• Pancreatitis
• CVD
• liver disease
• cancers of the mouth and throat
• Malnutrition
• mental illness
• brain damage
• reproductive effects......

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Opiate Narcotics

• Ex. Opium, heroine, methadone, morphine, codeine,
  demerol, oxycodone are all from or similar to the
  opium poppy
• Produce euphoria as well as slowed breathing,
  slurred speech and impaired balance and
  coordination
• Higher doses can cause stupor and unconsciousness
  and can be fatal
• Regular use may lead to a criminal lifestyle to
  support the habit

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Club Drugs

• Often used by teens at raves
• MDMA (Ecstasy) is a psychoactive drug that can
  be fatal if combined with exercise
• Chronic use can lead to changes in brain function
• GHB, ketamine and Rohypnol are central nervous
  system depressants
• All are disgustingly used as date rape drugs

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Addiction/ Dependence
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Addiction

• There is a biological basis
• There are pleasure centers in the brain which
  are close to the centers for thirst, hunger, sex
• Injecting/smoking/snorting more likely to cause
  addiction because they trigger these pleasure
  centers immediately upon administration
• There is also an environmental component
• Can develop as a learned behaviour
• Parental/friend influences
• There may be a hereditary component

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Addiction in physical terms

• The following is the previous model of addiction
• A diagnosis of addiction was made if someone met
  all of these criteria
• 1. After regular use, tolerance develops
• 2. Next, dependence may develop
• 3. Withdrawal symptoms are evident when the users
  stops using
• However, this model has a couple of problems
• Does not explain marijuana or hallucinogens
• May stop people from getting treatment if they
  dont see themselves as addicts

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Dependence in physical terms

• The following is a modern concept of substance
  dependence. We no longer refer to it as
  addiction
• A person is considered dependent if they meet
  three of the following criteria
• Tolerance
• Withdrawal
• Loss of control
• A persistent desire to reduce use
• Compulsive use
• Reducing the importance of other activities in
  favour of the drug
• Continued use despite perceived consequences

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Treatment and prevention of substance abuse
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Dependence Treatment

• First of all, the user must admit they have a
  problem and want to change
• They may deny that they have a problem
• However, failing to address your loved ones
  problem may enable them to continue
• Successful treatment is multifaceted
• Need to improve self image
• Find ways to manage urges/stress
• Learn to recognize situations that may lead to
  drug use
• Rebuild relationships

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Dependence Treatment

• A complete change in lifestyle may be necessary
• Changing jobs
• Move
• Leave a dysfunctional/enabling relationship
• Develop substitute interests and activities
• Finding new friends that do not share the habit

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Dependence Treatment

• Some can quit on their own, others may need
  counselling
• Harm reduction involves substituting a less
  harmful drug for the current one
• Needle exchange programs
• Alcoholics Anonymous is a universally employed
  method of helping alcoholics quit

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Twelve Steps

• 1 We admitted we were powerless over
  alcohol--that our lives had become
  unmanageable. 2 Came to believe that a Power
  greater than ourselves could restore us to
  sanity. 3 Made a decision to turn our will and
  our lives over to the care of God as we
  understood Him. 4 Made a searching and fearless
  moral inventory of ourselves. 5 Admitted to
  God, to ourselves and to another human being the
  exact nature of our wrongs. 6 Were entirely
  ready to have God remove all these defects of
  character. 7 Humbly asked Him to remove our
  shortcomings. 8 Made a list of all persons we
  had harmed, and became willing to make amends to
  them all. 9 Made direct amends to such people
  wherever possible, except when to do so would
  injure them or others. 10 Continued to take
  personal inventory and when we were wrong
  promptly admitted it. 11 Sought through prayer
  and meditation to improve our conscious contact
  with God, as we understood Him, praying only for
  knowledge of His will for us and the power to
  carry that out. 12 Having had a spiritual
  awakening as the result of these steps, we tried
  to carry this message to alcoholics, and to
  practice these principles in all our affairs.