Drugs and Our Society
Drug Taking Behavior
Part 3
Drug Dependence and Toxicity
1.
2.
3.
No other word in the field of drug research
causes more misunderstanding or has been
abused more than the term “dependence”
The American Psychiatric Association uses the
term ‘substance’ because of this confusion
- they use ‘substance abuse’ and ‘substance
misuse’
Drug toxicity is the physical or psychological
harm a drug might present to the user
- acute toxicity refers to the harm that is
immediate, soon after the drug is taken
Dependence and Toxicity, cont.
4.
5.
6.
Describing dosages
- dose refers to the quantity of a drug taken
into the body
- it is usually measured in milligrams (or
micrograms)
A milligram is 1/1000th of a gram
- there are a little over 28 grams per ounce
The effect of the drug is related to its
concentration in the body rather than the
absolute amount administered
Dependency and Toxicity, cont.
7.
8.
9.
The same amount of drug given to persons of
different sizes will reach different concentrations in the body
To insure drug presence in the same concentrations in the brain, different doses are given
according to body weight
They are usually reported in terms of milligrams (mg) per kilograms (kg) of body weight
- 6.5 mg per kg (kilogram = 2.2 pounds)
- 220 lb person gets 650 mg / 110 lb person
gets 325 mg
Dependence and Toxicity, cont
10.
11.
12.
Drug toxicity impacts both licit and illicit drugs
- the book shows the dose-response curve
- S-shaped graph to show toxicity of a drug
Effective dose (ED)
- shows effectiveness on a certain percent of
drug-taking group
- ED50: effective on 50% of those using that
drug
Lethal dose (LD)
- shows % of lethal drug dose for that group
Dependence and Toxicity, cont
13.
14.
15.
- LD99: lethal for 99%
- individual batch of heroin, meth, etc.
ED response curve (S)
- 0 to 100: shows effectiveness (how much
taken)
LD response curve (S)
- 0 to 100: shows lethal dose (how much
taken)
50/50 ED-LD is called the therapeutic index
- margin of safety means higher ratio
- safer / less toxic
Drug Dependence and Tolerance
1.
2.
The term dependence is generally used in two
ways
- first, a state in which discontinuation causes
withdrawal symptoms
- secondly, where a person compulsively
takes a drug
Physical dependence
- our body needs the drug to continue
functioning
- to avoid the pain of withdrawal
Dependence and Tolerance, cont
3.
4.
The actual symptoms vary according to the
drug being withdrawn
- some have no physical dependence at all
- such as marijuana
- the body builds a “tolerance” to the ingested
drug
Tolerance
- “A state of progressively decreasing responsiveness to a drug”
- as tolerance develops, increasing amounts
of the drug is required
Dependence and Tolerance, cont
5.
6.
Pharmacological tolerance
- body adjusts/compensates for presence of a
particular drug
- to achieve desired effect, increase amount
or frequency
Behavioral tolerance
- individual learns to adjust to the presence of
drugs
- normal surroundings / settings for drug use
- new people / new location / greater high
Dependence and Tolerance, cont
7.
8.
Cross-tolerance
- gives one tolerance to chemically similar
drugs
- LSD: tolerance to other hallucinogens
Reverse tolerance
- user will feel effects from lesser amounts of
the drug
- drug stored in the fatty tissue which later
breaks down
- LSD users who feel effects weeks / months
later after having stopped its use
Psychological Dependence
1.
2.
3.
A person will compulsively use drugs that do
not cause unpleasant withdrawal symptoms
- also referred to as ‘psychic addiction’
This is a belief by the user that they cannot
function without the drug
- they have developed a psychological craving
- they desire the pleasurable drug effects
They have a fear of doing something without
taking the drug
- speaking before a large group of people
- meeting members of the opposite sex
Drugs, Violence, and Crime
1.
2.
Studies show that the majority of those
arrested for personal and property crimes had
ingested or were under the influence of drugs
at the time
- we do associate violence with drugs and we
have several types of drug induced violence
Pharmacological violence
- violent acts committed while under the
influence of a particular psychoactive drug
- this type of violence suggests that the drug
caused the violence
Drugs, Violence, and Crime, cont
3.
4.
- certain drugs cause individuals to become
suspicious / irritable / to lash out at people
- alcohol / crack cocaine / methamphetamine
Economically Compulsive Violence
- the use of violence to finance use of drugs
Systemic Violence
- violence used in establishing territory for
drug sales
- gang violence
- organized crime violence
Drugs and the Law
1.
2.
Whiskey Rebellion (1791)
- federal government placed an excise tax on
whiskey
- farmers in southwest Pennsylvania violently
objected
- Washington sent in the militia
It was important because:
- it produced income for federal government
- it also showed that the government had the
power to enforce federal laws in the states
Drugs and the Law, cont
3.
4.
Pure Food and Drug Act (1906)
- patent medicines were unregulated
- 1890 to 1906: golden age of patent meds
- President Theodore Roosevelt established
the Food and Drug Administration (FDA)
Harrison Act (1914)
- began to control narcotics / opiates
- prescriptions were required to obtain
- narcotics could not be bought over-thecounter
- believed to be a racist act aimed at Chinese
Drugs and the Law, cont
5.
6.
Marijuana Tax Act (1937)
- believed it was also a racist act aimed at
Mexican immigrants
- federal government placed a large tax on
growing / transporting / selling
Food, Drug, and Cosmetic Act (1938)
- pharmaceutical companies needed to be
controlled
- turn out drugs they said were helpful
- people were dying from these drugs
Drugs and the Law, cont
7.
- 1906 act protected drug companies from
lawsuits
FDA allowed to place drugs into 3 categories
- Category I: drugs determined to be safe,
effective, and properly labeled
- Category II: those not generally recognized as safe or effective, or mislabeled, and
must be withdrawn within 6 months
- Category III: those for which data are
insufficient to determine general recognition
of safety and effectiveness
Drugs and the Law, cont
8.
9.
Comprehensive Drug Abuse Prevention and
Control Act of 1970
- Uniformed Controlled Substances Act
(VUCSA)
- placed drugs in 5 schedules to control
manufacturers / distributors / and users
Anti-Drug Act (1988)
- emphasized stringent punishment of users
- punishment could be waived by treatment
- drug czar / zero tolerance / registration