The philosophy of exerting as little governmental control and regulation as possible. A “hands-off” philosophy of government.
The dose producing death in 50 percent of the population under study
Substances in this schedule have a low potential for abuse relative to substances in Schedule III.
Three cocaine treatment options
Option 1: Inpatient treatment in a hospital facility
Option 2: Outpatient treatment
Option 3: Shortened inpatient program followed by intensive outpatient treatment
FOUR CATEGORIES OF DRUG-TAKING BEHAVIOR
-Illicit drug/instrumental use -Illicit drug/recreational use -Licit drug/instrumental use -Licit drug/recreational use
The nervous system consists of
the peripheral nervous system and the central nervous system, with the latter divided into the brain and the spinal cord.
Cell's life support center
The margin of safety is the more conservative measure in ________.
the direction of safety
Drugs are broken down for elimination by
enzymes in the liver
Process from coca to crack
-Coca leaves to coca paste (purity 60%) >
Coca paste to cocaine hydrochloride (powder cocaine/ 99% pure)>
Powder cocaine to free-base cocaine through removal of hydrochloride portion from the salt form of cocaine>
Powder cocaine to crack cocaine through treatment with baking soda (less hazardous than free-base)
The ratio of LD50 to ED50
Medulla – Heart rate, blood pressure, respiration Pons – Regulates sleep stages Cerebellum – Involved in physical coordination
Speed, meth, crank
ACUTE EFFECTS OF COCAINE
Powerful burst of energy
General sense of well-being
Aphrodisiac properties disputed
Heart rate and respiration are increased
Appetite is diminished
Blood vessels constrict and blood pressure is increased
Pupils are dilated
Schedule I drug examples
heroin, lysergic acid diethylamide (LSD), marijuana (cannabis), peyote, methaqualone, and 3,4-methylenedioxymethamphetamine (“Ecstasy”).
The minimal dose of a particular drug necessary to produce the intended drug effect in a given percentage of the population
Effective dose (ED)
Integrates visual input (lobe)
the capacity of a specific dose of a drug to have a gradually diminished effect on the user as the drug is taken repeatedly
Lobes of the brain
Frontal – Thinking and reasoning abilities, memory, planning
Parietal – Touch recognition
Occipital – Integrates visual input
Temporal – Recognition of sights and sounds, long-term memory storage
A drug’s harmful effects
When a person is taking the drug for the sole purpose of experiencing its psychoactive properties (e.g., to get “high”).
EXAMPLES OF ANTAGONISTIC DRUG INTERACTIIONS
Morphine with naloxone or naltrexone Norpramin or related antidepressants with bran or oatmeal Soy products with Coumadin Broccoli, cabbage and asparagus with Coumadin
EXAMPLES OF HYPERADDITIVE DRUG INTERACTIONS
Alcohol with sleep medications, insulin, painkillers Headache remedies with Coumadin Lanoxin with licorice Lanoxin with bran and oatmeal Tagamet with Coumadin
Within the CNS, cocaine blocks the reuptake of receptors sensitive to
dopamine and norepinephrine as a result, the activity level of these two neurotransmitters in the brain is enhanced.
The ratio of LD1 to ED99
Margin of safety
Coordinates movement with sensory input
Contains parts of the reticular activating system (RAS)
three examples of drugs prescribed for children diagnosed with attention deficit/ hyperactivity disorder (ADHD)
Methylphenidate (brand name: Ritalin), dextroamphetamine and levoamphetamine (brand name: Adderall), and dextroamphetamine and the amino acid lysine (brand name: Vyvanse)
Substances in this schedule have a high potential for abuse which may lead to severe psychological or physical dependence.
roles in behavior and cognition, motivation, and reward, sleep, mood, attention, and learning
The dose producing the intended drug effect in 100 percent of the population
the extension of a neuron, ending in branching terminal fibers, through which messages are sent to other neurons or to muscles or glands
a condition in which an individual feels a compulsive need to continue taking a drug.
Substances in this schedule have a low potential for abuse and consist primarily of preparations containing limited quantities of certain narcotics.
is derived from coca leaves grown in the mountainous regions of South America.
a form of drug-taking behavior that results in some form of physical, mental, or social impairment
CHRONIC EFFECTS OF COCAINE
Formication hallucinations (cocaine psychosis)
Continuously stuffy or runny nose
Bleeding of nasal membranes (if cocaine has been snorted) Intense cocaine craving Kindling Effect – repeated cocaine use causes a hypersensitization to the drug
Chronic Effects of Methamphetamine Abuse
Addiction to meth is characterized by compulsive drug-seeking and drug use which is accompanied by functional and molecular changes in the brain. Chronic users may exhibit violent behavior, anxiety, confusion, and insomnia. Tolerance results in users taking higher doses of the drug, taking it more frequently, or changing their method of drug intake Often users will forego food and sleep while indulging in a form of binging known as a “run,” injecting as much as a gram of the drug every 2 to 3 hours over several days until the user runs out of the drug or is too disorganized to continue. Chronic abuse can lead to psychotic behavior, characterized by intense paranoia, visual and auditory hallucinations, and out-of-control rages that can be coupled with extremely violent behavior. No physical manifestations of a withdrawal are evident, however, when methamphetamine use is stopped, there are several symptoms that occur including depression, anxiety, fatigue, paranoia, aggression, and an intense craving for the drug.
Substances in this schedule have no currently accepted medical use in the United States, a lack of accepted safety for use under medical supervision, and a high potential for abuse
Schedule III drug examples
combination products containing less than 15 milligrams of hydrocodone per dosage unit (Vicodin®), products containing not more than 90 milligrams of codeine per dosage unit (Tylenol with Codeine®), and buprenorphine (Suboxone®).
Typical cocaine user in 1988
not gone to college, earned less than $25,000 per year, and was more likely to be smoking crack cocaine
Two types of drug toxicity
Chronic and Acute
are four basic ways to administer drugs into the body
oral administration, injection, inhalation, and absorption through the skin or membranes
Dangers of cocaine effects
cerebral hemorrhage, cardiac arrhythmia, or congestive heart failure
Substances in this schedule have a potential for abuse less than substances in previous Schedules and abuse may lead to moderate or low physical dependence or high psychological dependence.
Recognition of sights and sounds, long-term memory storage (lobe)
Connects central nervous system to involuntary muscles
the process of changing the molecular structure of a drug into forms that make it easier for the body to excrete it.
Available data on typical methamphetamine users reveal that most are
white, are in their 20’s or 30’s, have a high school education or better, and are employed full- or part-time.
An index of how long urinary excretion and liver break down take is known as
refers to the length of time it takes for the drug to be reduced to 50 percent of its equilibrium level in the bloodstream.
drug’s elimination half-life
produced by an excitation of the sympathetic autonomic system and an inhibition of the parasympathetic autonomic system.
effects of cocaine
Long-term cocaine exposure causes a depletion of
dopamine receptors, continuing as long as four months following the last instance of cocaine use
The dose producing death in 100 percent of the population
Models of drug dependencies
The physical or psychological harm a drug might cause over a long period of time.
When a person is taking a drug with a specific socially-approved goal in mind.
alertness and arousal (fight or flight), and influences on the reward system.
drugs are those drugs that affect our feelings, perceptions, and behavior
Electrical signal traveling down the axon
anger, aggression, body temperature, mood, sleep, sexuality, appetite, metabolism, as well as stimulating vomiting
nurturance and renewal
produce analgesia and a sense of well-being; work as "natural fever relievers", whose effects may be enhanced by other medications
A phenomena that produces a heighted sensitivity to repeated administrations of some drugs such as cocaine. Opposite of the phenomn of tolerence
results from one drug substituting for whatever physiological effects have been produced by a second drug that has been discontinued.
Most sensory, emotional, and cognitive processing Two specialized hemispheres
Brain and spinal cord (part of nervous system)
Central nervous system
the bushy, branching extensions of a neuron that receive messages and conduct impulses toward the cell body
The minimal dose of a particular drug capable of producing death in a given percentage of the population
Lethal dose (LD)
Schedule V drug examples
cough preparations containing not more than 200 milligrams of codeine per 100 milliliters or per 100 grams (Robitussin AC®, Phenergan with Codeine®), and ezogabine.
an early enthusiast of cocaine as an important medicinal drug, promoting cocaine as a cure for morphine dependence and depression.
First step for all treatment options is
detoxification and total abstinence
SOURCES OF INDIVIDUAL DIFFERENCES IN DRUG RESPONSES
Body weight Gender Ethnic background Expectations of the drug user
Acute Effects of Amphetamines
Effects resemble those of cocaine abuse In small doses meth can increase wakefulness and physical activity and decrease appetite. A brief, intense sensation, or rush, is reported by those who smoke or inject methamphetamine. Oral ingestion or snorting produces a long-lasting high instead of a rush, which reportedly can continue for as long as half a day. Both the rush and the high are believed to result from the release of very high levels of the neurotransmitter dopamine into areas of the brain that regulate feelings of pleasure Heavy use results in disturbing hallucinations, compulsive or repetitive behaviors. Heavy use includes feelings of paranoia, intense mood swings, and tendencies toward violence (amphetamine psychosis). The large release of dopamine produced by methamphetamine is thought to contribute to the drug’s toxic effects on nerve terminals in the brain. High doses can elevate body temperature to dangerous, sometimes lethal, levels, as well as cause convulsions
Forms of drug interactions
Additive interaction (additivity) Hyperadditive (synergistic) interaction Antagonistic interaction
PHYSICAL SIGNS OF POSSIBLE COCAINE ABUSE
Dilated (enlarged) pupils
Increased heart rate
Sneezing and irritability in the nose
Feelings of depression
Decreased appetite and significant weight loss
cognitive functions like learning and memory in the brain.
SEVEN MAJOR NEUROTRANSMITTERS
Acetylcholine - it is excitatory – produces arousal and reward
Norepinephrine - influences attention and responding actions- fight or flight response
Dopamine - motor activity, motivation, reward, sleep, mood attention, and learning
Serotonin - regulation of anger, aggression, body temperature, mood, sleep, vomiting, sexuality, and appetite
Gamma aminobutyric acid (GABA) - inhibitory transmitter in CNS and retina, can be excitatory,
Glutamate - key in digestion; excitatory neuron; implicated in seizures
Endorphins - natural pain killers, sense of well being; feel good neurotransmitters.
reports the number of drug-related emergency department (ED) visits in major metropolitan hospitals in the United States
The Comprehensive Drug Act of 1970 organized the federal control of drugs under five classifications called
If the LD1 is 100 and ED99 is 20, then the margin of safety is
a long term inhibitor in adipose tissue; decreases associated with energy conservation; increases with energy expenditure. Declines as people lose weight.
Factors in an individual’s life that decrease the likelihood of involvement with drugs and reduce the impact of any risk factor
marketed in 1932 as a synthetic form of ephedrine
The drug amphetamine (brand name: Benzedrine
a set of symptoms including hallucinations, paranoia, and disoriented thinking produced by chronic use of cocaine
Factors in an individual’s life that increase the likelihood of involvement with drugs
Typical cocaine user in 1983
college educated, employed, earning more than $25,000 per year, and taking cocaine powder intranasally
a form of tolerance that occurs when a drug is used in the same surroundings or under the same circumstances
Behavioral tolerance/conditional tolerance
Treatment strategies for cocaine addicts
Cocaine Anonymous, cognitive-behavior therapy, and pharmacological treatments
Touch recognition (lobe)
Readies body for activity, use of energy
cocaine abusers crave the drug more than ever
Even though acute effects of euphoria from cocaine are no longer strong
a layer of fatty cells segmentally encasing the fibers of many neurons *enables vastly greater transmission speed of neutral impulses
Connects central nervous system to voluntary muscles
Cocaine produces pleasure by blocking
reuptake of Dopamine
Most drugs are eliminated from the body through
A chemical substance that, when taken into the body, alters the structure or functioning of the body in some way, excluding those nutrients considered to be related to normal functioning
brain monitors body’s energy, such as glucose and fat
Form junctions with other cells
Terminal branches of axon
If LD50 is 100 and ED50 is 20, then the therapeutic index is
The American Psychiatric Association currently recognizes two major conditions associated with drug-taking behavior
substance dependence and substance abuse.
a form of drug-taking behavior in which a prescription or nonprescription (over-the-counter) drug is used inappropriately
Readies body for energy restoration
Schedule II drug examples
Examples of Schedule II narcotics include: hydromorphone (Dilaudid®), methadone (Dolophine®), meperidine (Demerol®), oxycodone (OxyContin®, Percocet®), and fentanyl (Sublimaze®, Duragesic®). Other Schedule II narcotics include: morphine, opium, and codeine.
The physical or psychological harm a drug might cause to the user immediately or soon after the drug is ingested into the body.
*a nerve cell *basic building block of the nervous system
Specific risk factors for drug taking behaviors
-Irregular school attendance -Poor relationship with parents -Getting into trouble in general -Membership in a deviant subculture Note: Economic hardship and parental abuse do not represent significant risk factors.
Risk factors for drug-taking behavior in adolescence include a tendency toward ________
nonconformity within society and the influence of drug-using peers.
Schedule IV drug examples
alprazolam (Xanax®), carisoprodol (Soma®), clonazepam (Klonopin®), clorazepate (Tranxene®), diazepam (Valium®), lorazepam (Ativan®), midazolam (Versed®), temazepam (Restoril®), and triazolam (Halcion®).
the second of the two major psychoactive stimulants, have their origin in a Chinese medicinal herb, used for thousands of years as a bronchial dilator; its active ingredient, ephedrine, was isolated in 1887
plasticity and excitation, arousal, reward, and memory function.
Relapse rate in methamphetamine abuse treatment is
one of the highest for any category of illicit or licit drug abuse
results from the chronic use of one drug inducing a tolerance effect with regard to a second drug that has never been used before.
regulates neuronal excitability throughout the nervous system. Also directly responsible for the regulation of muscle tone.
Gamma aminobutyric acid (GABA)
Spinal and cranial nerves (part of nervous system)
Peripheral Nervous System
drug with the closest connection to social violence
cause the user to be less inclined toward violent behavior rather than more so
heroin and marijuana
Drug Abuse Warning Network
The dose that produces the intended drug effect in 50 percent of the population under study
Thinking and reasoning abilities, memory, planning (lobe)