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Chapter 14
Understanding SubstanceAbuse and Addictive Behavior
A Wellness Way of Life
Seventh EditionRobbins/Powers/Burgess
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Chapter 14 Objective
After reading this chapter, you will be able to:1. Name the three common elements found in addiction.2. Describe how addiction starts in the brain.
3. List five factors that affect alcohol absorption and list threereasons why women can get drunk faster than men.
4. Differentiate between low-risk alcohol use and high-risk alcoholuse.
5. Define binge drinking.6. Identify the blood alcohol concentration (BAC) at which a person
is regarded as legally drunk.7. Describe the Zero One Three Rule for Lower-Risk
Drinking.8. List the harmful effects of alcohol on the body and how to help afriend who has passed out from alcohol overindulgence.
9. List five tips/strategies for drinking less or not at all.
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Chapter 14 Objectives
10. Identify the cause of fetal alcohol syndrome (FAS) and fetalalcohol effect (FAE).
11. Identify the number one cause of preventable death andhealth problems in this country.
12. Identify the health hazards related to passive smoking.
13. Identify the most common illegal drug used in the United
States and the drug the government lists as its top priority onthe war against drugs.
14. Describe psychoactive drugs and their categories: cannabis(marijuana), stimulants, narcotics, depressants,psychedelics, and inhalants.
15. List four drugs that affect physical performance and describe
how they do so.16. List four common kinds of nonprescription drugs that can
lead to physical dependence if overused and describe howprescribed drugs can be abused.
17. Describe the danger of using dietary supplements containingephedra (ephedrine).
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Addiction
A pathological or abnormal relationship withan object or event with three common
elements: Exposure
Compulsion
Loss of control
Any behavior or substance can become anaddiction, e.g., gambling, food, shopping,sex, work, etc.
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Drug Dependence as a Disease
The disease can be described.
The course of the disease is predictable andprogressive.
The disease is primary. The disease is permanent.
The disease is terminal.
Key questions: Is the drug causing any continuing disruption inmy life or the lives of those close to me?
If the answer is yes, but the person doesnt stopthe behavior, could be harmful dependence!
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Addictive Personality
Not confirmed by research, but genetic linkfor alcoholism has been.
Family environment the most importantcomponent.
Who is vulnerable? Those who have: Low esteem, sense of alienation, unable to accept
comfort, need for instant gratification, rebelsagainst authority, enjoys dangerous behavior, lies
easily, is a perfectionist, fears personal criticism,overly concerned with how others perceive them,tends to be submissive and dependent, and hashigh levels of negative emotions.
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Alcohol
Alcohol is technically known as ethyl alcohol or ethanol.
It is a central nervous system depressant drug.
Slows brain function
Slows reaction time
Dulls alertness
Impairs coordination
Intensifies emotions
Increases risk taking
Lowers inhibitions
Disrupts judgment and reasoning.
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Alcohol Absorption
The amount of alcohol in the blood is measured by bloodalcohol concentration (BAC) which is a percentage. .08%is the legal limit in CO. BAC of .4% could cause death.
Alcohol is processed by the liver at an approximate rateof 1 oz. per hour.
Speed of absorption depends on: weight, gender, speedof consumption, food intake and type of beverage 12oz.Beer, 5oz. Wine, 12oz. Wine Cooler, and 1 shot of 90proof liquor have about same amount of alcohol.
Women get drunk faster because: less of the enzyme thatbreaks down alcohol, higher level of body fat, lowerweight.
Tolerance is the bodys physical adjustment to thehabitual use of a chemical. Due to tolerance, anexperienced drinker with a BAC of .08% may not feeldrunk, but they are still intoxicated and at risk!
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All standard sizedrinks provide thesame amount ofalcohol.
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Photo credit:Courtesy of GwenRobbins/DebraPowers/SharonBurgess
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Impact of Alcohol
Alcohol is by far the most devastating drug!
Alcohol is a factor in: 50% of deaths in motor vehiclecrashes, 33% drownings, 50% deaths caused by fire,50% homicides, 33% of suicides, 66% of assaults,
50% domestic violence, 90% of campus rapes, 40% ofacademic problems.
#1 killer of teenagers: drinking and driving.
Significant factor in all risk behavior especially sexual
decisions. Most dangerous consequence may be the false sense
of confidence and invulnerability that leads to disregardfor health, safety and welfare of self and others.
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Long Term Effects
Alcohol is a toxin, and harmful effects on thebody are great!
Brain damage Nerve damage
Heart disease, high blood pressure, stroke
Cancer
Depress immune function
Liver failure
Malnutrition
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Low Risk and High Risk Alcohol
Consumption About 2/3 of Americans use alcohol. Low-risk use is drinking no more than one drink per day for
women and no more than two drinks per day for men.Lowest risk is no consumption.
High-risk user doesnt follow the guidelines for low risk useand is guilty of binge drinking.
A binge is typically five drinks for a man and four drinks for awoman in about two hours that brings the BAC to .08%.
Binge drinking is dangerous for the drinker and society.
Frequent bingers are 17 times more likely to miss class, 10times more likely to vandalize property, and 8 times morelikely to get hurt.
If you drink while pregnant or driving a car, you are abusingalcohol.
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The Zero One Three Rule
The Michigan Guidelines: The Zero One
Three Rule for Lower-Risk Drinking.
0= no level of drinking is recommended. Neverdrink and drive or drink when pregnant.
1= drink only one alcoholic beverage per hour ifyou do drink.
3= never drink more than three alcoholicbeverages per day (or more than five per week).
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Alcoholism
A chemical dependence to alcohol. About 10%of Americans are alcoholics.
It involves progressive preoccupation withdrinking, leading to physical, mental, or socialdysfunction.
Genetics: history of alcoholisms in family putsyou at higher risk. Family norms influence youradult behavior.
The alcoholic should completely quit usingalcohol (with supervision to deal with addictionissues). Alcoholics Anonymous offers a goodsupport system for alcohol cessation.
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Coping Strategies
Get a professional assessment if you thinkyou may be alcoholic help is available:counseling, medical assistance, groups, AA
Listen to those around you. Your friends, co-workers, and family members can providegood insight into your behavior.
Take self-responsibility! If you drinkdontdrive or make sexual decisions. Set a limitand stick with it, dont chug or do shots, drinknon-alcoholic drinks.
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Strategies for Dealing with Alcohol
Let your waistline be your incentive.
Switch to juice or soft drinks.
Eat first before you drink.
Avoid drinking after exercise, drink water first.
Dont hold the drink in your hand. Put it downbetween sips.
Try cocktails without alcohol.
Dilute your drinks. Make sure the alcohol is properly measured.
Volunteer to be the driver and then dont drink.
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Helping a Friend
If a friend passes out from drinking or showssigns of alcohol poisoning:
Put them on their side. Do not give them anything to eat or drink.
Be sure they are breathing normally notshallow, but deeply.
Cover them with a sheet, not a blanket. If they are shivering, call for medical help.
If they dont respond, call for medical help.
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Other Important Risks
Alcohol should be completely avoidedduring pregnancy.
Alcohol use during pregnancy cancause Fetal Alcohol Syndromeleading cause of mental retardation inthe Western world.
Even a small amount can cause FetalAlcohol Effect (FAE).
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One in fivewomen drinkduring
pregnancy.
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Photo credit: PhotoDisc
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Tobacco Use
Regular smokers lose 6 minutes of life with everycigarette they smoke! 2 hours lost per day!
Even moderate use of any tobacco product couldreduce life expectancy by 5 to 7 years.
#1 preventable cause of death more than 400,000deaths per year in the U.S.
Factor in heart disease, cancer, emphysema, COPD,high blood pressure, stroke, high LDL levels, etc.
Quitting at any point can help health. Heart attackrisks decreases by 50% after the first year of quitting;within 10-15 years the risk is the same as if they hadnever smoked (as long as no damage already done).
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Why Do People Smoke Smoking is becoming socially unacceptable and more
states are becoming smoke free.
About 25% of Americans smoke but smoking is upamong young people and college students.
Most important influence: family and friends. Most start before age 18, to fit in, to appear cool, to
rebel authority.
Nicotine is physically and psychologically addictive.
Most smokers want to quit. It is possible but may takemultiple tries.
Many resources are available. See your instructor forlocal resources.
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How to Quit Smoking
Identify your reasons.
Identify your barriers toquitting.
Make a plan for dealingwith temptations.
Change to a brand youfind distasteful.
Involve your friends andfamily.
Set a date.
On the day you quit,toss out all cigarettes,tobacco, and other
paraphernalia. After quitting, change
your normal routine.
When you crave, chewon carrots, pickles,sugarless gum or atoothpick.
Mark your progress.
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Courts ruled that tobacco companies conspired to sell adangerous product.
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When SmokersQuit
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Passive Smoking
Passive smoking or secondhand smoke isbreathing air polluted by tobacco smoke.
Passive smoking causes more than 60,000deaths per year.
It acts as a carcinogen.
It can worsen medical conditions such as
asthma, emphysema, and anemia, increasesSudden Infant Death Syndrome, increasesinfections in children.
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Psychoactive Drugs
Mind-affecting or mind-altering
Change ones thinking, feelings, perceptions,behaviors
Classification based on effect on Central NervousSystem Depressants
Cannabis (Marijuana)
Stimulants
Narcotics or opiates
Psychedelics
Inhalants
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Club Drugs party drugs
Refers to a variety of drugs used atdance clubs or parties, i.e., raves
Attractive due to these factors: Inexpensive
Produce increased stamina
Intoxicating
Examples include: MDMA, GHB,Rohypnol, and ketamine
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Depressants
Sedatives
Slow down Central Nervous System,
relax, produce sleep Alcohol
Date rape drugs: GHB and Rohypnol
(roofies) All become dangerous when mixed with
other sedatives or narcotics.
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Date Rape Drugs
Are used to cause women to become overly relaxed orpass out and may yield unknowingly in a sexual way.
To reduce the risk: Do not leave beverages unattended.
Do not take beverages from someone you do not know andtrust.
Accept drinks only from the bartender or wait staff.
At parties, do not accept open container drinks from anyone.
Do not drink anything that has an unusual taste or appearance
(salty, foamy, residue or strange color). Watch out for your friends.
Anyone who may have ingested these drugs should be taken tothe ER or call 911 for them.
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Cannabis (Marijuana)
Most widely used illegal drug in the U.S. THC (tetrahydrocannibinol) is the primary
psychoactive ingredient.
It is fat soluble. Stored in fatty tissues of the brain, body, and
reproductive organs. Causes brain cell damage and lower sperm count.
Causes amotivational syndrome (low energy,apathy, and little drive to do anything). Smoking it increases risk for cancer. Impair the ability to use a car, boat or machinery.
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Stimulants
Speed up the CNS, resulting inalertness and excitability
Examples include: Cocaine/crack (crystallized freebase
cocaine)
Methamphetamine
MDMA (ecstasy)
Caffeine
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Narcotics or Opiates
Powerful pain killers
Also known as opioids
Brings pleasurable feelings and caninduce sleep and depress breathing
Examples include:
Heroin Morphine
Opium
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Psychedelics
Known mind-expanders orhallucinogens
Affect perception, awareness, andemotions
Examples include:
LSD (lysergic acid diethylamide)
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Inhalants
Volatile chemicals (household products)
Diverse group of breathable chemicals thatproduce mind-altering vapors
Huffing produces drug-like effects orintoxication
Examples include:
Commercial solvents Aerosols
Anesthetics
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Drugs Affecting Physical
Performance
Anabolic steroids Artificial form of testosterone
Stimulates bone, muscle, skin, and hairgrowth characteristically found in the adultmale
Widely used and abused by male and
female athletes from teens toprofessionals
Can alter mood and behavior, aka roidrage
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Affects of Steroids
Men
Shuts down productionof testosterone
Causes breast growth Testicular atrophy
Prostate enlargement
Premature cessation
of bone growth
Women
Deepens voice
Male pattern baldness
Increases facial and bodyhair
Loss of body fat
Enlarges clitoris
Decreases breast size Absence of menstruation
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Other Problem Drugs
Amphetamines: has increased tolerance, canlead to high blood pressure, convulsion,psychosis.
Diuretics: cause the body to pass water by
increasing urine output. Can result indehydration, weakness fatigue, andincreased susceptibility to heat illness.
Caffeine in large amounts can have the sameeffects as amphetamines. Increased risk forosteoporosis and diabetes. Limit to less than200 mg. per day i.e., no more than 2 smallcups of coffee.
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Over-the-Counter and Prescription
Drugs Over-the-counter (OTCs)
Aspirin Cold medicines Cough syrups Laxatives
OTCs that can produce side effects or dependence: Nasal sprays, laxatives, eyedrops, alcohol/codeine cough
syrups, stimulants
Prescription drugs Most are put to good use; some are abused:
Amphetamines, barbiturates, narcotics, tranquilizers
Synergistic reaction Phenomenon that occurs when various drugs are taken in
combination, where the cumulative effect is greater than theeffects of the drugs when taken separately.
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Dietary Supplements with Ephedra
Ephedra, also known as Ma huang, is anamphetamine-like drug found in some dietsupplements and herbal supplements.
Side effects include: Raised blood pressure Irregularities in heart rate Insomnia Tremors, headaches and seizures
Heart attacks
Stroke Death
Ephedra is especially dangerous for people withhypertension or other cardiovascular disease.
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What Do You Think?
How does addiction affect the brain? Are you committed to low-risk alcohol consumption? What should you do to help a friend that is passed
out? If you drink, how could you drink less or not at all? If you smoke, do you want to quit? Do you know your
resources? Is using marijuana dangerous?
What over-the-counter drugs do you use and are youat risk for addiction?
Do you use products with Ma huang? Do youunderstand the dangers?
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Questions?