Chapter 16Using Drugs Responsibly

Using Drugs Responsibly

• What is a Drug?• The Overmedicating of Americans• The FDA and You• Drug Misuse, Abuse, and Addiction• Stimulants• Club Drugs• Depressants• Marijuana

Using Drugs Responsibly

• Hallucinogens• Phencyclidine (PCP)• Inhalants• Anabolic Steroids• Reducing Drug Use

What is a Drug?

• Drug Laws• How Drugs Work• Pharmacogenics• Unintended Harmful Effects of Drugs• Routes of Drug administration• Effectiveness of Drugs

What is a Drug?

• A drug is a chemical in a medicine that alters the structure or function of some of the bodies biological processes.

• Alteration can be to start, stop, speed up, or slow down a process.

• A medicine is a drug (or combination of drugs) that is used to prevent illness, cure disease, aid healing, or suppress symptoms.

• Drugs are classified according to the particular biological process they affect rather than by their chemical properties.

What is a Drug?

• Drug Laws– Drugs are categorized into the following five

groups:• Prescription drugs – chemicals so potent that

only a doctor can permit their use• Over-the-counter drugs – chemicals that are not

so potent so that consumers can obtain them directly from stores

• Dietary supplements – plant extracts or vitamins act as drugs and can be obtained from stores

What is a Drug?

• Drug Laws– Drugs are categorized into the following five

groups:• Addictive drugs – tobacco and alcohol,

taken by choice• Illegal drugs – considered so dangerous

that they are outlawed

What is a Drug?

What is a Drug?

• How Drugs Work– Many drugs act by interacting with specific

cells in the body that carry receptors, which are proteins on the surface or inside a cell to which a drug or natural substance can bind and affect cell function.

– When a drug binds to a receptor, it affects the biological processes of cells or organs.

How Drugs Work

What is a Drug?

• Pharmacogenetics– A major assumption in the prescribing of

drugs is that everyone’s body uses a drug in the same way

– The science of pharmacogenetics is to ID many of the genes that affect drug responses and adverse effects.

– The hope is that drugs will one day be able to be tailored to a patients specific biology to produce optimum benefit and minimal risk.

What is a Drug?

• Unintended Harmful Effects of Drugs– Even though a drug may be intended to have

a single effect, it often does not because it binds to different kinds of receptors on different cells.

– Unintended drug actions are called side effects.

– Some side effects include allergic reactions called drug hypersensitivity.

Common Side Effects of Drug Use

What is a Drug?

• Unintended Harmful Effects of Drugs– Contraindication

– a medical reason for not taking a drug

What is a Drug?

• Routes of Drug Administration– Drugs can be taken:

• By mouth• By inhalation• By injection into the muscle or bloodstream• By implant under the skin• Through the skin • Through mucous membranes of the eyes,

nose, vagina, and anus– Drugs remain active in the body for a

relatively short time, often only a few hours.

What is a Drug?

• Effectiveness of Drugs– The dose of a drug is the amount that is

administered or taken.– Effectiveness of a particular dose of a drug is

influenced by:• Person’s body size• How rapidly the drug breaks down and is

eliminated• The presence of other drugs or food in the

body• The person’s mental state• Person’s expectations of the drug’s efficacy

What is a Drug?

What is a Drug?

• Effectiveness of Drugs– Tested by doing a double blind study

• Those receiving a drug and those administering the drug don’t know who is receiving the drug and who is receiving a placebo

Effectiveness of Drugs

The Overmedicating of Americans

• Americans consume huge amounts of drugs every year both prescription and non –prescription

• Psychoactive drugs– More than 25% of legal drugs sold in America– Alter thoughts, feelings and sensations.– Psychoactive drugs include:

• Tranquilizers• Sleeping pills• Mood modifiers • E.g. alcohol, tobacco, caffeine

The Overmedicating of Americans

The Overmedicating of Americans

• Lifestyle Drugs– Lifestyle drugs are sold to basically healthy

middle-class Americans.– Lifestyle drugs are used in the place of

making healthy choices such as eating a diet of vegetables and fruit and staying active.

– Psychotropic drugs – useful for treating specific diseases but not intended to mask problems caused by stress or relieve anxieties of daily living

The Overmedicating of Americans

• Lifestyle Drugs– Some are used to target normal changes that

occur with aging, hair loss, reduced sexual drive, and sagging or wrinkled skin.

– Weight loss or appetite suppressant drugs

The Overmedicating of Americans

• Drug Company Advertising– Pharmaceutical companies market to doctors

by “courting” them for business.– In the United States, pharmaceutical

companies are also allowed to advertise directly to consumers through television and print media.

The FDA and You

• A number of tests are run on groups of volunteers to test a drug’s effectiveness.

• Drugs are also watched for side effects.• Only after trials are done does the FDA give

approval for sale.

Drug Misuse, Abuse, and Addiction

• Using any drug to the point where health is adversely affected or the ability to function in society is impaired can be defined as drug abuse.

• Drug abuse refers to the person taking the drug being personally or socially impaired.

• A drug is being abused if the user cannot control taking it and the drug is being used continually to mask anxiety, combat stress, or seek pleasure.

Drug Misuse, Abuse, and Addiction

Drug Misuse, Abuse, and Addiction

• Addiction – Progressive, chronic condition characterized

by:• Compulsion – overwhelming preoccupation

desire, or drive to use a psychoactive drug• Loss of control – inability to control use of a

drug or loss of control over ones behavior because of taking a drug

Drug Misuse, Abuse, and Addiction

• Addiction – Progressive, chronic condition characterized

by:• Continued drug use despite adverse

consequences – tendency not to stop using a drug in the face of arrest, job loss, family breakdown and health problems

• Distortions in normal thinking - not admitting that problems are the result of drug taking (denial)

Drug Misuse, Abuse, and Addiction

• Physical Dependence– Physical changes take place so that

continued taking of the drug is necessary.• Alcohol• Caffeine

Drug Misuse, Abuse, and Addiction

• Tolerance– An adaptation of the body to a drug so that

larger doses are necessary to produce the same effect

• Withdrawal– A consequence of physical dependence,

occurs when the body adapts to the absence of a drug on which it has become physically dependent.

Drug Misuse, Abuse, and Addiction

• Withdrawal– In general, withdrawal from nervous system

depressants leads to:• Anxiety • Irritability• Susceptibility to seizures

– Withdrawal from stimulants can produce:• Sleepiness• Depression• Loss of consciousness

Drug Misuse, Abuse, and Addiction

• Psychological Dependence– When repeated use of a drug causes an

intense craving for the drug– May lead to compulsive drug-seeking

behavior that is injurious to relationships, jobs and families.

Stimulants

• Substances that increase the activity of the central nervous system and are referred to as “uppers.”

• Common stimulants include cocaine, amphetamines, and caffeine.

• Main effects include:– Increased mental arousal and physical energy– A state of euphoria

• Long-term use causes physical and psychological dependence.

Stimulants

• Cocaine– Stimulant obtained from the coca shrub.– Induces euphoria, sense of power and clarity of

thought, increased physical vigor, increased heart rate and blood pressure.

– Continued use can result in:• Loss of appetite and weight loss• Malnutrition• Sleep disturbance• Altered thought and mood patterns

Stimulants

• Cocaine– Frequent cocaine sniffing can damage the

nasal septum.– Routes of administration:

• Sniffing (“snorting”) it as a white powder• Injecting it directly into the bloodstream • Smoking it in the form of “free base” or

“crack”

Stimulants

• Cocaine– Produces tolerance, physical dependence, and

withdrawal.– Potential for psychological dependence with

cocaine is very high. – Can consume an individual’s entire life

Stimulants

• Amphetamines• Manufactured chemicals that stimulate the central

nervous system• Most common are:

–Dextroamphetamine–Methamphetamine–Dextromethamphetamine–“Ice” is a dangerous form that is smoked.

• Produce a hallucinogenic effect that lasts for hours

Stimulants

• Amphetamines– Usually taken orally, but can be injected– Can be prescribed by physicians, but have little

medical use – Produce feelings of euphoria, increased

energy, greater self-confidence, increased ability to concentrate, increased motor and speech activity, perceived improvement in physical performance

Stimulants

• Amphetamines– Excessive use can cause:

• Headaches• Irritability• Dizziness• Insomnia• Panic and confusion• Delirium• Crash• Tolerance• Mild physical dependence

Stimulants

• Caffeine• Natural substance found in a variety of plants

used in making coffee, tea, chocolate, and soft drinks

• Produces decreased drowsiness and fatigue, faster and clearer flow of thought, increased capacity for sustained performance, nervousness, tremors, insomnia, and inability to perform complex tasks

Stimulants

• Caffeine• Psychological dependence can result from chronic

use and tolerance can gradually develop.• Mild withdrawal symptoms can occur when caffeine

use is ceased, including:–Headache– Irritability–Restlessness–Lethargy

Stimulants

Club Drugs

• Consist of several psychoactive chemicals that are often used at social events

• These include:– Ecstasy– GHB– Ketamine– Rohypnol

Club Drugs

• Ecstasy– Methylenedioxymethamphetamine—an

amphetamine that has become popular in recent years.

– Also called “Ecstasy,” “Adam,” “XTC,” “Clarity,” “Essence,” MDMA, or MDM.

– Users experience hallucinogenic effects and euphoria.

– Stimulates the release of serotonin, producing a high that can last hours.

Club Drugs

• Ecstasy– Risks:

• Confusion, depression, sleep problems, drug craving, severe anxiety and paranoia during and after taking the drug

• Muscle tension, involuntary teeth clenching, nausea, blurred vision, rapid eye movement, faintness, chills or sweating

• Increases heart rate and blood pressure• Long term damage to serotonin-producing

nerve cells in brain• Liver damage with long term use.

Club Drugs

• GHB– Gamma-hydroxybutyrate – Also called “G” or “Liquid Ecstasy”– Causes sedation, increased sexual interest,

relaxation, short-term amnesia– Very dangerous to mix with alcohol– Large doses can cause users to become

comatose and stop breathing

Club Drugs

• Ketamine– Is a dissociative psychedelic used medically

as a veterinary and human anesthetic– Also called “K,” “Special K,” or “Cat

Tranquilizer”– Causes hallucinations, bizarre behavior,

psychosis

Club Drugs

• Rohypnol– Flunitrazepam is a benzodiazepine used as a

sleep medication favored for its short duration.

– Also called “Ruffies” or “Roofies.”– Reduces anxiety, inhibition, and muscular

tension.– Has received a lot of attention as a “date rape

drug.”

Depressants

• Reduce the level of arousal, motor activity, and awareness of environment

• Increase drowsiness and sedation• Produce mild state of euphoria, reduction in

inhibitions, feeling of relaxation• May impair mood, speech, and motor

coordination

Depressants

• Carry the potential for:– Physical and psychological dependence– Tolerance– Withdrawal symptoms

• If two or more depressants are taken at the same time, they produce an effect much stronger than either drug produces when taken alone (synergistic effect).

Depressants

• Sedative and Hypnotic Drugs– By prescription only. – Sedatives promote mental calmness and

reduce anxiety.– Hypnotics promote sleep or drowsiness.– Most common sedative-hypnotic drugs are

called benzodiazepines, popularly known as tranquilizers.

Depressants

• Opiates– Opiates are a group of chemically related

drugs derived from the opium poppy; depress the central nervous system (CNS).

– Cause physical dependence, habituation, tolerance, and serious withdrawal symptoms.

– Can be fatal because of respiratory failure. – Morphine and heroin are derivatives of

opium; they block nerve transmission in the CNS, suppressing mental and physiological functions.

Marijuana

• Forms:– Hashish—sticky resin of the Cannabis sativa plant– Ganja—dried tops of female plants– Bhang—contains smaller amounts of THC– Sinsemilla—potent form of marijuana

• Active ingredient is THC.• Low doses of THC produce:

– Euphoria, Sense of relaxation– Sometimes altered perception of time and space

Marijuana

• THC consumption can invoke:– Confusion– Anxiety– Hallucinations– Paranoia

• Research indicates that marijuana contains carcinogens.

Marijuana

• Many states have legalized use for medical purposes, such as:– Nausea caused by chemotherapy– Anorexia as a result of cancer– AIDS– Chronic pain– Migraines

Hallucinogens

• Derived from as many as 100 kinds of plants and from chemical synthesis in the lab

• Alter perception, thought, mood, sensation, and experience

• Most often ingested orally• Produce tolerance but do not create physical

dependence or symptoms of withdrawal; there is a danger of psychological dependence

Hallucinogens

Phencyclidine (PCP)

• AKA “Angel Dust”• PCP was originally used as an animal

anesthetic; it is no longer legal and is used now only as an illegal recreational drug.

• The effects of PCP vary, depending on the dose and route of administration; it can be: – A stimulant– A depressant– A hallucinogen

Inhalants

• Depressants of the CNS• Intended effect: Loss of inhibition • Unintended effects:

– Dizziness – Amnesia – Inability to concentrate – Confusion– Impaired judgment – Hallucinations – Acute psychosis

Inhalants

• Chemical substances that vaporize rapidly and when inhaled produce various kinds of depressant effects similar to alcohol

• Model airplane glue, nail polish remover, paint thinner, gasoline, aerosols, amyl nitrite, and chloroform

• Do not produce tolerance or withdrawal, nor do they induce physical dependence

• Can damage the kidneys, liver, and lungs

Inhalants

(c) Jones and Bartlett Publishers. Photographed by Kimberly Potvin.

Anabolic Steroids

• Synthetic derivatives of the male hormone testosterone.

• Taken orally or injected.• Produce increased lean muscle mass, strength,

and ability to train longer and harder.• Side effects include liver tumors, jaundice, fluid

retention, high blood pressure, severe acne, and trembling.

Reducing Drug Use

• People are overmedicated and overly dependent on drugs.

• The healthiest approach is to be as free of drugs as possible.

• Wellness is not achieved by taking drugs.• All drugs can be dangerous, and illegal

recreational drugs are especially dangerous.

Using Drugs Responsibly

• What is your opinion on the amount of drugs we tend to use in the United States? Is it appropriate or not?

• How do you respond to the prospect of taking a drug for a medical condition? Are you ever critical of what the doctor recommends?

• Is it bad to have caffeine on a daily basis? Why or why not?

• What does or would motivate you to avoid recreational drugs?