BPK140:
Contemporary Health Issues
Unit 10
Drugs and Alcohol
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Terminology of Addiction
• Drug: ______________________________
• Psychoactive drug: ___________________
• Intoxication: _________________________
• Addictive behaviour: __________________
• Addiction: __________________________
Read Ch. 14 to
define the terms
above
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Characteristics of Addiction
• Reinforcement
• Compulsion or craving
• Loss of control
• Escalation
• Negative consequences
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Types of Addictive Behaviours
• Substance use
disorder
• Gambling disorder
• Social media disorder
• Gaming disorder
• Compulsive buying or
shopping
• Work addiction
• Compulsive exercise
• Sex addiction
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Routes of Administration
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Routes of Administration
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Routes of Administration
• Injecting/smoking drugs is more likely to
cause dependence
– Strong stimulus-response pairing
– They wear off more quickly
– Users may take more frequent doses
• Injecting drugs is more likely to transmit
infectious diseases such as hepatitis and HIV
• Smoking drugs can damage the air passages
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How Drugs Affect the Brain
• Changes in brain
chemistry
• Altered effects of
neurotransmitters
• Some increase the
effects of dopamine in
the brain’s reward and
pleasure pathway
• Nicotine, cocaine,
alcohol, heroin and
amphetamines all
affect dopamine levels
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Factors that Influence Drug Effects
• Pharmacological properties (e.g. composition)
• Dose-response function (e.g. intensity)
• Time-action function (e.g. lag time)
• Drug use history (e.g. first time or not)
• Route of administration (e.g. oral or injection)
• Physical factors (e.g. weight)
• Psychological factors (e.g. setting)
Read Ch. 14 to
learn more about
these terms
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Simulants
• CNS stimulants speed
up the activity of the
nervous and/or
muscular system
• Some examples include:
• Caffeine
• Nicotine
• Cocaine
• Amphetamines
• Ecstasy
• Ritalin
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Caffeine
• Most popular psychoactive drug
• Coffee, tea, cocoa, energy drinks
• Mild stimulant, effects at low
doses are relatively harmless
• Excess consumption can
cause shaking, difficulty
concentrating, insomnia, and
irregular heartbeat
• Withdrawal can cause
irritability, drowsiness and
headaches
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Nicotine
• Stimulant drug in cigarettes and e-cigs
• Tobacco use is the leading preventable
cause of disease, disability and death
– Smoking is strongly associated with
CVD and lung cancer
– Carcinogens in cigarette smoke
damage DNA, and poisons weaken
tumor fighters
– Chronic smoking can also cause
bronchitis, emphysema and
reproductive complications
• If you quit before age 30, health can
become close to that of a non-smoker
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E-Cigarettes & Vaping
• Uses a mouthpiece, heating
element, battery and liquid
• Not yet known to be safer
than traditional cigarettes
• Vapour still may contain
harmful chemicals or unsafe
levels of nicotine (currently
unregulated)
• May help with quitting smoking,
may also perpetuate addiction
• WHO does not recommend
use until studies determine
safety
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Read Ch. 16
pages 705-711
on smoking
14
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Cocaine
• Potent CNS stimulant
• Derived from coca plant
• Rapid heart/breathing rate,
decreased appetite
• Users may experience feelings of
euphoria, alertness, competency,
power, invincibility
– Activates the brain’s reward
pathway (dopamine)
– Short lasting and ends abruptly
– Repeated use can lead to insomnia,
weight loss, impotence
– Overdose can cause death due to
heart irregularities
• ‘Crack’ is a less pure freebase form
of cocaine
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Some
Effects of
Cocaine
Use
Death is
typically due to
heart
irregularities
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Amphetamines
• Powerful stimulants; effects similar
to cocaine; highly addictive
• Methamphetamine; “meth”
• Can be made from household
ingredients, therefore cheap
• Cause high levels of dopamine
• Promote tolerance, powerfully
addictive, very high relapse rate
• Chronic use may lead to severe
weight loss, heart attack, stroke,
paranoia, psychosis, violent behavior.
• Amphetamine psychosis: psychotic
features including paranoia, visual
and auditory hallucinations, and
delusions
Credit: American Dental Association and Dr. Brett Kessler
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MDMA/Ecstasy
• “X", "molly"; stimulant and mild
hallucinogen
•
•
•
Mood elevator (increases serotonin)
Euphoria, increased energy,
heightened sense of belonging
“Coming down' associated with
serotonin imbalances, promoting
depression
• In a club/rave setting can produce
dangerously high body temperature
and potentially fatal dehydration
• Especially dangerous when tolerance
develops and user to take drug at a
higher dose or mix with other drugs
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Hallucinogens
• A group of psychoactive drugs that
alter perceptions (e.g. visual,
auditory), feelings and thoughts.
• Some examples include:
• LSD (”acid”)
• Psilocybin (“magic” mushrooms)
• MDMA (primarily a stimulant)
• DMT
• Ketamine
• PCP
• Generally, less addictive
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LSD, PCP and Psilocybin
• LSD (“acid”), PCP (angel dust); psilocybin (magic mushrooms)
are hallucinogens
• These drugs alter perception, feelings and/or thoughts
• Cause “altered states of consciousness"
• Typically ingested, effects last ~8+ hrs
• Risks of irrational acts while on the drug; LSD users may
experience flashbacks
• Tolerance develops, but with little physical dependence or
withdrawal symptoms (generally not addictive)
• Environment, mood, dose and one’s expectations can have a
profound effect on whether one has a ‘good trip’ or a ‘bad trip’
• Recent research suggests ‘guided trips’ may have therapeutic
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application for treating addictive behaviours
Opioids
• Opioids are a class of drugs that relieve
pain, cause drowsiness and euphoria
• Opium, heroin, methadone, morphine,
codeine, Demerol, oxycodone, fentanyl
• Derivatives or synthetic analogues opium
from the opium poppy
• Some prescribed for pain but most are
powerfully addictive
• Relaxation, euphoria, slowed breathing,
slurred speech, impaired balance
• Higher doses can cause stupor,
unconsciousness, coma and death
• Ongoing opioid (fentanyl) crisis in BC
• Naloxone can reverse effects
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Cannabis
• Can be classified as a CNS depressant,
hallucinogen or stimulant (various effects)
• 45% of Canadians have tried cannabis (use
is legal in Canada, see pg. 635)
• Active compound (THC) acts on
cannabinoid receptors
• Acute effects: mild euphoria, heightened
perception, drowsiness, red eyes
• Chronic effects:
– May interfere with memory/learning
– Associated with reproductive dysfunction
– May promote schizophrenia in those susceptible,
especially if used during adolescence
– Biggest health risk is effects on airways
– Marijuana smoke contains carcinogens
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Benefits of Cannabis
• May relieve nausea, vomiting, chronic pain
• May help treat glaucoma, epilepsy,
anorexia, MS, arthritis and migraines
• Safest way to consume is probably
ingestion or with a vaporizer; smoking
joints is probably the most harmful
• Recreational marijuana use is now legal in
Canada; logistics of sales and approving
business licences is ongoing
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Alcohol (Ethanol)
• Alcohol is a CNS
depressant, though it
may initially feel like a
stimulant
• Most highly abused
psychoactive substance
• Acute effects include
mild euphoria, relaxation,
altered judgement,
impaired motor skills
• Binge drinking and/or
chronic use associated
with many health risks
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One Standard Serving of Alcohol
Equals Approximately:
Do some research
to fill in the blanks
below
Maximum intake should be ≤
drinks/week for females,
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≤
drinks/week for males
Alcohol Absorption
•
•
Alcohol is not digested, it is
absorbed directly into the blood
through the stomach or small
intestinal wall
Several factors influence the
rate of alcohol absorption and
metabolism:
•
•
•
•
•
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Sex (Male vs Female)
Size (Weight ad BMI)
Fruit sugar
Food in stomach, especially
fats
Liver enzyme activity
20% in
stomach
80% in the
intestine
Short-Term Risks of Alcohol Use
• Alcohol affects judgement and changes mood
• Consumption (especially to excess) can result in:
• memory loss
• decreased blood sugar levels; flushing, sweating;
indigestion
• slurred speech, blurred vision, impaired motor skills
• impaired sexual function
• increased likelihood of riskier behaviours, violence,
suicide
• increased urine output and dehydration
• hangover; withdrawal symptoms
• alcohol poisoning; in extreme cases, death
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Long-Term Risks of Alcohol
Use/Abuse
• Addiction
• CVD
• Cirrhosis of the liver
• Cancers
• Malnutrition
• Mental illness
• Brain damage
• Impaired
immune
function
• Negative social effects
• Reproductive effects
(impotence, infertility)
• Fetal alcohol syndrome
(in offspring)
• Increased chances of
harm to ones self and
others (e.g. riskier
behaviours, accidents,
violence, suicide)
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Risk Factors for Addiction
• Other mental health conditions,
e.g. depression, anxiety, bipolar
disorder and schizophrenia
• Genetic, physiological,
personality, social, lifestyle and
environmental factors may lead
to the development of addiction
• Stress, low self esteem, easy
access and high social
acceptance
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Treatment
• User first needs to realize they have a
problem and address underlying causes
• Treatment varies, some people quit on
their own, others need help
• Some examples of treatment options:
• Medication-assisted treatment
• Treatment centers
• Group and Peer Counselling (e.g. AA)
• Harm-reduction strategies
• Prevention is preferable to treatment
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Take Home Messages
• Don’t smoke cigarettes (or vape)
• Some drugs have therapeutic benefits, but for
most, the risks outweigh the benefits, so,
generally, say no to drugs
• A little bit of alcohol (1-2 servings per day may
reduce overall disease risk, too much (>3 per
day) increases disease risk
• For all activities that can potentially lead to
addiction, stay in control and remember that
moderation is key
• Don’t use drugs or alcohol as coping mechanisms.
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Up Next: Relationships and Sex
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