What is the ratio of individuals in the U.S. who abuse alcohol or are alcohol dependent?
1 in 12 people
What is the lifetime and yearly prevalence of alcohol abuse?
Lifetime 17.8% 12 month = 4.7%
What is the lifetime and yearly prevalence of alcohol dependence?
Lifetime 12.5% 12 month = 3.8 %
What are congeners?
By-products of fermentation and aging that give distilled their distinctive colors and tastes acetone aldehydes Acetaldehyde esters other alcohols
What order kinetics does alcohol exhibit?
zero order kinetics (i.e. clear a drink/hour)
What is the legal limit of intoxication?
0.080 g/DL (80)
At what level of intoxication do individuals experience nystagmus, blackouts, and severe behavioral disinhibition?
0.200 - 0.300 g/DL
At what level of intoxication is alcohol fatal? *for individuals who are not tolerant/in withdrawal
0.300 - 0.400 g/ DL
What are the symptoms of alcohol intoxication?
Slurred speech Incoordination Unsteady gait Nystagmus (jerky eye movements) Impairment in attention or memory Stupor or coma
Define binge drinking.
- Binge drinking is any drinking that leads to a BAL of 0.08% or more. - Usually 4 drinks (for a woman) or 5 drinks (for a man) within a 1-2 hour period.
What are the symptoms of alcohol withdrawal?
- Hypertension, tachycardia - Changes in level of consciousness, tremors, nausea, vomiting, hallucinations - Can involve seizures (monitor reflexes) - Can be fatal
Describe how alcohol withdrawal occurs.
Chronic exposure to alcohol causes changes: - Down regulate endogenous GABA (-) - Up regulate glutamate (+) - Cessation of alcohol --> net excitation (i.e. tachy, tremor, seizures) - Use benzodiazepines (cross tolerant) to re-establish control - Gradually reduce (taper) benzo dose
What are the major effects on the body from chronic alcoholism?
- Fatty liver --> Cirrhosis - Dilated cardiomyopathy - Brain damage --> diffuse cortical atrophy - Fetal alcohol syndrome
What system is implicated in cannabis addiction?
Mesocorticolimbic dopamine system
What molecule in cannabis causes the release of dopamine in the nucleus accumbens?
Endocannabinoid system overlaps with which neurotransmitters?
GABA, Glutamate, AcH, and dopamine
What are the 2 cannabinoid receptor subtypes?
CB 1- located in the brain CB 2- located on immune tissues
Name the 5 Endocannabinoids:
Anandaminde (1992) 2-Arachidonylglycerol (2-AG) 2-Arachidonoyl glyceryl ether (noladin ether) N-arachidonoyl-dopamine (NADA) Virodhamine
What is the main psychoactive ingredient in cannabis?
Describe the effects of CB1 receptors
What are the major effects of cannabis?
Rapid heart rate
Conjunctival injection (blood shot eyes)
What are signs of cannabis "overdose"?
tachycardia, anxiety/panic, paranoia
What are signs of cannabis withdrawal?
Characterized by anxiety
Decreased mood and food intake
What percentage of the population reports using cannabis within the past year?
What percentage of the U.S. population smokes cannabis daily?
What percentage of cannabis users become dependent?
8% of users become dependent
What does marijuana increase the risk for?
Marijuana use is associated with earlier age at first psychotic episode in male patients with schizophrenia
How does synthetic cannabis (cannabinomimetics) compare to natural cannabis?
Cannabinomimetcs can have 4-5 x potency of classical cannabinoids
How do cannabinomimetics work?
CB1 receptor agonist:
–Potent inhibitor of post-synaptic excitatory currents
–Increased ERK ½ MAPK phosphorylation
–Induced rapid CB1 receptor internalization