Your goals in this lesson are to recognize the magnitude of drug use and abuse in America, and attempt to create viable solutions to the problems of drug abuse, alcoholism and tobacco consumption.

By the end of this lesson you should be able to:

What are Drugs?

Drugs can be defined as any non-food chemicals that alter the way a person thinks, feels, functions and behaves. Examples include legal drugs like alcohol and caffeine as well as illicit/illegal drugs like marijuana, LSD, and ecstacy.

Drug Effects

Psychoactive drugs have mood, or mind altering effects Drug Use, Misuse, and Abuse

• Misuse is the temporary and improper use of a legal drug

• Abuse is the intentional improper or non-medical use of a drug

• Use negatively affects the health and well-being of the user, his or her family, or society

Psychoactive drugs are more likely to be abused than other drugs because of their effects on the mind

Other Abuses

• Polyabuse is the improper use of more than one drug at a time

• Synergism may result in symptoms including a multiplied effect that may result in death

• Interactions can occur with legal or over-the-counter drugs (non-prescription) resulting in a deadly combination

  • Alcohol and Tylenol

DRUGS AND THEIR CLASSIFICATIONS

Marijuana, hash, hashish oil

• Most widely used illicit drug in the U.S.

• THC (delta-9 tetrahydrocannabinol) is the psychoactive substance

• Alters normal perceptions and thought processes

• Long term use is associated with ammotivational syndrome (extreme apathy) and increased risk of lung disease

• Males suffer from erectile dysfunctions
  

Stimulants

Caffeine, nicotine, mphetamines, methamphetamines, cocaine

• Enhance chemical activity in the brain that influence emotions, attention, sleep and learning

• Relieve fatigue, suppress appetite and improve mood

• Used to treat hyperactive disorders in children and to treat narcolepsy in adults

• Previously used as a diet aid, but is currently being banned by the FDA

• Caffeine is the most widely used psychoactive drug in the world

• Approximately 26% of Americans smoke

  • Decrease of 18% since 1965
    

Types of Tobacco

• Cigarettes

• Cigars

• Pipes

• Smokeless Tobacco

  • Approximately 3% of Americans use smokeless tobacco products

  • Loose leaf

  • Snuff

Why Use Tobacco?

• Use usually begins in adolescence

• Most adolescents do not believe there is a great risk in smoking cigarettes

• Friends and family smoke

• Low self-esteem, susceptibility to peer pressure

• Sensation-seeking

• Rebelliousness

• Anxiety

Why Continue to Use Tobacco Products?

• Nicotine addiction

• It becomes a habit

• It is perceived as pleasurable

• Arousing and provides energy

• Relieves anger, tension, depression, and stress

• Helps concentration and lifts mood

• Reduces anger, tension, depression, and stress

Immediate Effects of Tobacco Use

• Nicotine increases heart rate and blood pressure

• Carbon monoxide reduces ability of blood to carry oxygen

• Chemicals and particles irritate lungs and mucous membranes

• Tars accumulate on cilia lining airways

Long-term Health Effects of Tobacco Use

• Acute bronchitis

• Chronic bronchitis

• Pneumonia

• Emphysema

• Cardiovascular disease (hypertension and stroke)

• Cancer

• Periodontal disease

• Osteoporosis

You should know….

• Smokers are more likely to die from heart attack or stroke

• Women who take birth control pills and smoke increase their risk of heart attack several times

• “Light” cigarettes do not lower the risk of heart disease

• After quitting, recovery time for heart attack risk to reach that of a non-smoker is 3-9 years

Secondhand Smoke

• Nonsmokers are at increased risk of cardiovascular disease, heart attack, and lung cancer if they live or work in smoke-filled environments

• Other negative effects on nonsmokers include coughing, mucus production, chest discomfort, reduced lung function

• Infants and young children suffer significant consequences

  • Bronchitis, influenza, pneumonia and asthma

Quitting

• For a person addicted to nicotine, quitting “cold turkey” may be best

• Withdrawal symptoms peak 1-2 days following quitting

• Use of nicotine patch, nicotine gum, or buproprion may help reduce withdrawal symptoms

• Support groups are available through ALA, AHA, ACS

• Snack on fat-free, low-calorie snacks to prevent weight gain

• Avoid events that “trigger” the urge to smoke

Prevention

• Prevention programs target 7th & 8th graders and focus on resisting social influences to smoke and learning short-term negative effects of smoking

• Eliminate advertising that targets adolescents

• Lessen access to minors

• No vending machines

• Restrict the age for purchase
  

Depressants (Sedative-Hypnotics)

Alcohol, barbiturates, benzodiazepines

• Slow the activity of the central nervous system producing calming and trance-like (hypnotic) effects as well as drowsiness

• Alcohol is the most used and abused drug on the planet

• Rohypnol, also known as the date-rape drug produces sedation as well as memory loss

• Used to treat sleeping and anxiety disorders
  

The Chemistry of Alcohol

• Ethyl alcohol, is the psychoactive component in alcoholic beverages

• Sugar from fruit, berries, vegetables or grains combines with yeast in the air to make ethyl alcohol and carbon dioxide

• Fermentation yields a potential of 14% alcohol

• Distillation, invented c. 800 A.D. by the Arabs, can yield up to 100% ethyl alcohol

Proof of Alcohol

• When alcohol reaches 50% alcohol it can be ignited with a flame providing PROOF that a drink contains alcohol

• Proof = 2 times the amount of alcohol in a beverage

  • 80 proof equals 40% alcohol

  • 190 proof equals 95% alcohol

Alcohol Use, Abuse and Dependence

• Approximately 65% of Americans use alcohol

• 35% are very light drinkers

• 22% are light to moderate drinkers

• 8% are heavy drinkers

• Over 90% of college students reported using alcohol within the last 12 months during 1992

• Approximately 8 million Americans are alcoholics

Alcohol Contents

• Serving Sizes

  • 12 oz. Beer

  • 7 oz. Malt liquor

  • 6 oz. Wine

  • 10 oz. Wine cooler

  • 1.5 oz. Distilled spirits (80 proof liquor)

All contain approximately the same amount of alcohol per serving and the alcohol provides seven calories of energy per gram, but is void of any nutrients. The barley and malt in beer as well as the fruit juices in wine do provide some nutrient value : )

Blood Alcohol Concentration

• BAC = The percent of alcohol that is in the blood

• BAC is generally related to:

  • Body weight

  • Gender (women metabolize virtually no alcohol in the stomach and because they generally have more fat than men they have less blood to dilute the alcohol)

  • Drinking rate

  • Stomach contents (before and during drinking)

  • Carbonation (relaxes pylorus and allows for quicker absorption

Alcohol Metabolism

• Detoxification begins in the stomach

• Human body recognizes alcohol as a toxin and tries to eliminate it

• Women produce less of a stomach enzyme (alcohol dehydrogenase) that helps with the metabolism of alcohol than men

• Approximately 2-10% of alcohol is eliminated directly

• A small amount is is exhaled via the lungs or excreted through sweat, saliva, and urine

• The remaining alcohol is metabolized by the liver and excreted by the lungs and kidneys

Factors Related to Alcohol Abuse and Dependence

• The exact cause of alcoholism is unknown

• Interaction of various conditions may contribute:

  • Biological

  • Psychological

  • Environmental

Alcoholic Susceptibility

• People with a parent, brother, or sister with alcoholism have a higher risk of developing alcoholism than other persons

• Sons of alcoholic fathers have the greatest risk

• People who are hyperactive, impulsive, aggressive, and have short attention spans are more likely to become alcoholics

• Other alcoholic-type behaviors include thrill-seeking, and inability to delay gratification
  

Alcohol and College Students

• Alcohol abuse often accelerates during college years

• Moderate drinkers cite a variety of reasons for drinking

• Heavy drinkers usually drink for escapist and goal-oriented reasons

• College students who abuse alcohol are likely to be younger, anxious students who have low self-esteem and possibly at least one alcoholic parent

Narcotics (Opiates)

Opium, morphine, heroin, codeine, narcotics (Opiates)

• Alter the perception of pain and induce euphoria and sleep

• Used as pain medication in clinical settings

  • Morphine, codeine

• Over-the-counter medications include non-opioid analgesics that inhibit pain messengers of the nervous system

  • Acetaminophen, ibuprofen, aspirin

Hallucinogens

LSD, peyote, mushrooms

• Stimulate the sympathetic nervous system

• Disruption of visual and auditory centers

• Synesthesia- a crossover or mixing of the senses

  • Seeing music

  • Hearing colors
    

Inhalants

Aerosols, gases, liquids, fumes, solvents, glue, gasoline, plastic cement, varnish remover, paint, paint thinner, lighter fluid and nail polish remover, amyl and butyl nitrite

• Many inhalants previously sold as over-the-counter room fresheners

• Nitrous oxide is still used as a propellant in aerosol canisters

• Produce a temporary stimulation mood elevation and reduced inhibitions
  Dizziness, slurred speech, impaired gait and drowsiness

• Provide a quick, cheap high
  

Anesthetics

• Ether, nitrous oxide, chloroform

• May sometimes be used for their sedative and hypnotic effects

Designer Drugs

MDMA, GHB

• Synthetic drugs using laboratory variations to circumvent illegality

• Illegaility is only temporary because as soon as compound is identified it is placed on drug schedule

• Cause feelings of well-being and euphoria along with some stimulating effects

• Do not last as long as LSD nor do they have the delusional impact, nor the degree of euphoria
  More stimulating than hallucinogens

WHAT DRUGS DO TO THE BRAIN AND THE BODY

How Psychoactive Drugs Affect the Brain

• Drugs interact with nerve cells within the brain after bypassing the blood brain barrier (drugs are rare in their ability to bypass the highly discriminating blood brain barrier)

• They alter the activity of neurotransmitters that carry messages from one nerve cell to another

  • Speed up signals

  • Slow down signals

  • Impede signals

  • Influences the reward-pleasure center of the brain and alters perceptions, thought processes, feeling and behavior

  • Often produce a euphoria

What Happens to Drugs in the Body?

• Detoxification- The liver must metabolize drugs into less harmful products

• Small amounts of certain drugs may be eliminated (unchanged) in the breath, urine, or feces

  • Some drugs are stored in body fat for weeks, e.g. lipid soluble drugs like marijuana

• Most drugs are eliminated in two to three days, but trace amounts are still detectable in urine and blood for a while longer

Drug Highs

• Intoxication occurs when a drug reaches poisonous levels in the body

• Overdose occurs when the body is unable to eliminate excessive amounts of a drug rapidly

• Symptoms vary depending upon the type of drug used

DRUG STATISTICS

The Prevalence of Illegal Drug Use

• In 1995, an estimated 12.8 million Americans were current illicit drug users, meaning they had used an illicit drug in the month prior to being interviewed

• This is 6.1 percent of the population 12 years old and older.
  More than 5 percent of the 4 million women who gave birth in the U.S. in 1992 used illegal drugs at sometime during their pregnancy.

• Marijuana and cocaine were the most frequently used illicit drugs.
  Recent statistice show that:

  • 2.9 percent, or 119,000 pregnant women, used marijuana

  • 1.1 percent, or 45,000 pregnant women, used cocaine.

  • Over 750,000 women, or 18.8 percent, used alcohol at some time during pregnancy.

Examples of Costs to Society

• Illegal drugs burden society with approximately $67 billion in social, health and criminal costs each year

• Approximately 35 percent of all AIDS cases are related to intravenous drug use, and over 60 percent of all pediatric AIDS cases are related to maternal exposure to HIV through drug use or sex with a drug user.

• If tobacco, alcohol and illicit drug abuse were reduced by 20 percent in New York City, then each year $520 million in inpatient hospital costs would be saved.

• The Health Insurance Association of America estimates an expenditure of from $48,000 to $150,000 in costs of maternity care, physicians’ fees and hospital charges for each delivery that is complicated by substance abuse.

• The number of methamphetamine (speed)-related emergency room episodes increased by 35 percent (from 7,800 to 10,600) between the first half of 1994 and the first half of 1995.

Youth Drug Use

• The proportion of eighth graders reporting any illicit drug use in the previous 12 months increased from 11 percent to 24 percent from 1991 to 1996.

• Since 1992, the proportion of 10th graders using any illicit drug in the prior 12 months increased from 20 percent to 38 percent.

• The proportion of 12th graders using any illicit drug in the prior 12 months rose from 27 percent to 40 percent.
  Marijuana use showed an increase at all three grade levels in 1996

• Among eighth graders, annual prevalence tripled from 6 percent in 1991 to 18 percent in 1996
  among 10th graders, prevalence more than doubled from a low point in 1992 of 15 percent to 34 percent in 1996

• Among 12th graders it increased by nearly two-thirds, from a low point of 22 percent in 1992 to 36 percent in 1996.

Drugs and Crime

• According to the most recent Bureau of Justice Statistics state court data, the majority of state felony convictions in 1994 were for drug (31percent) or property offenses (32 percent).

• Thirty-three percent of all murders or manslaughter incidents are related to illicit drug and alcohol use.

• Over 50 percent of spousal murders are drug-or alcohol-related.

• The National Institute of Justice Drug Use Forecasting Program found that the percentage of adult males arrested in 23 cities throughout the U.S. in 1993 who tested positive for drugs ranged from 54 percent in Omaha and San Jose to 81 percent in Chicago.

CAUSES OF DRUG USE AND TREATMENT

Why People Use Psychoactive Drugs

• To relieve boredom

• Satisfy curiosity

• Escape problems

• Self medicate

Levels of Drug Use

• Abstinence

  • No use of a drug unless accidentally

• Experimentation

  • Used to satisfy curiosity

• Recreational or Social Use

  • No established pattern of use

• Habituation

  • Definite pattern of use

• Abuse

  • Continued use despite negative consequences

• Addiction

  • Compulsive use despite negative consequences

  • Denial of a problem

Physiological Dependence

• Dependence occurs when the user develops tolerance to a drug when using and withdrawal symptoms when not using

• Tolerance occurs when the usual dose of a particular drug no longer produces the desired effects

• Withdrawal is a temporary physical and psychological state that occurs when certain drugs are discontinued
  Tremors, anxiety, vomiting, headache
  

Psychological Dependence

• May produce withdrawal symptoms found similarly in physiological dependence

• Psychosomatic withdrawal

• Preoccupation with obtaining the drug and using it

• Absence of tolerance

• Marijuana addiction is controversial as studies have been unable to substantiate tolerance or any physiologically based withdrawal symptoms, but funding for studies has been non-existent

Over-the-Counter Drugs

• Look-alike drugs

• Caffeine containing over-the-counter drugs look like controlled substances

• Unsuspecting people may purchase look-alike drugs that are sold as amphetamines on the street

• Weight loss aids

• Drugs containing phenylpropanolamine (PPA) as their active ingredient suppress appetite and act as a mild stimulant

• Ephedrine (Ma Huang, Phen-fen, Metabolife)

• Produces stimulating effects that may result in death

Drug Treatment

• Most drug-dependent individuals require medical supervision in special clinical settings

• Combination of individual and group therapy after successful withdrawal

• Alcoholics Anonymous

  • 12 step recovery program

  • Free

  • Requires only a sincere desire to stop using

  • NA, Al-Anon, and many other groups modeled after the 12 step program

Drug Prevention

• Efforts to stop the flow of illegal drugs into the U.S. have had little success

• Prevention programs educate young people about the hazards of drug use, but these programs have had mixed outcomes

• Current theory rests on delaying the age of first experimentation hoping that as an individual ages they are less likely to experiment

• Most drug experimentation occurs between the ages of 15 and 24

• National Institute on Drug Abuse

• A Parent's Guide on Drug Abuse

• Substance Abuse and Mental Health Services Administration

• Drug Abuse Statitistics

• Prescription Drug Abuse

• Alcoholics Anonymous

• American Lung Association

• Herbal Supplement Definitions Page