Unit 15: Drugs
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”
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
COMMON PSYCHOACTIVE
DRUGS
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
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...)
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?
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
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
Amphetamines
• Ex. Dextroamphetamine (“cat”) and
methamphetamines (“speed”, “meth”, “crank”)
• Powerful stimulants
• Can be taken orally, smoked or injected
• Chronic use =
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tolerance
Psychological dependence
Compulsive patterns of use
Withdrawal (depression, excessive sleeping, increased
appetite)
Faces of Meth
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
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
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
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”)
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)
Ethanol aka “alcohol”
• Chronic effects of ethanol consumption include
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Gastritis
Pancreatitis
CVD
liver disease
cancers of the mouth and throat
Malnutrition
mental illness
brain damage
reproductive effects......
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
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”
ADDICTION/ DEPENDENCE
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
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 don’t
see themselves as “addicts”
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:
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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
TREATMENT AND PREVENTION OF
SUBSTANCE ABUSE
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 one’s
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
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
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
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.