Transcript Drugs - Community Health Science 102

Psychoactive Drugs
Classification and History
CAS 712R
definitions
2
What is a Psychoactive Drug?
Definitions
Any substance that directly alters the normal
functioning of the central nervous system.
Any substance that when entering the body
can change either the structure or function of
the organism.
Each culture, each generation, each
profession, and each user has a definition of
what constitutes a psychoactive drug.
3
Psychoactive Drugs
Uppers
Stimulants
Downers
CNS depressants.
All-Arounders
Psychedelics, hallucinogens, marijuana.
Other drugs.
Inhalants
Steroids and other sports drugs
Psychiatric medications
4
Process / behavioral addictions
Compulsive gambling
Compulsive shopping
Hoarding
Eating disorders
Sexual addiction
Internet / electronic addictions
5
Drug Scheduling
Developed in 1970 to classify and regulate
controlled substances.
V
VI
III
II
I
Most
Dangerous
Least
Dangerous
6
Then and Now
Historical Perspective
Alter their state of
consciousness
Reduction of pain
Forget harsh surroundings
/ discomfort
Alter mood
Medicate a mental illness
Enhances senses
Current Perspective
To feel good
…looking for pleasure
To feel better
…looking for relief
To do better
…looking for improvement
Curiosity and “because
others are doing it”
7
Current Societal Concerns
What is getting our attention currently?
Continued debate of legalization of marijuana
Development of SYNTHETIC THC and
methamphetamine-like drugs
Development of more “designer” drugs
Impact of increased prescription drug abuse
8
Costs of addiction – work productivity, medical
costs, impact on family members, legal action,
financial issues, etc.
Connection between drug use and crime
Increase in electronic based addictions
Continued legalization and expansion
of all forms of gambling
9
Societal Focuses, Continued
Steroids and performance enhancing drugs
Limitations on where people can smoke
cigarettes and efforts by tobacco companies to
find new methods of delivery
Understanding, recognizing and treating cooccurring disorders in persons with addictions
and mental illness
Historical Themes for Drug Use
1. Coping with the environment and
enhancing existence.
Ingesting certain plants could ease fear and
anxiety, reduce pain, treat some illnesses, give
pleasure, and let them talk to their gods.
1
Historical Themes
2. Human brain chemistry can be affected
by psychoactive drugs, behavioral
addictions and mental illness to induce an
altered state of consciousness.
If psychoactive drugs and behavioral addiction
did not work, we wouldn’t do it.
1
Historical Themes
3. The ruling classes, governments, and
businesses as well as criminal
organizations have been involved in
growing, manufacturing, distributing,
taxing, and prohibiting drugs.
Demand for
Substances
Control of
Supplies /
Distribution
1
Historical Themes
4. Technological advances in refining,
synthesizing, and manufacturing drugs has
increased the potency of these
substances.
Distilling, refining and synthesizing substances
has increased the potency.
Marijuana in 2007 has up to 14x as much THC as the
average street marijuana in the 1970’s.
Coca leaves contain only 0.5% to 2.0% cocaine,
whereas street cocaine is often 60% to 70% pure.
1
Historical Themes
5. The development of faster and more
efficient methods of putting drugs into
the body has intensified their effects.
Mixing drugs together for a greater impact.
Inhaling, snorting, smoking and injecting all
increase the speed with which drugs impact
the brain.
1
Hiking through history
16
So How Far Back Does It Go?
About 4000 plants yield psychoactive
substances . . . only about 60 of these
plants have been in continuous use
somewhere in the world throughout
history.
Evidence shows that 50,000 years ago
Neanderthals in Europe and Asia
used medicinal and psychedelic
plants in shamanistic religions.
17
Ancient Civilizations
(4000 B.C. to A.D. 400)
Alcohol was the most popular substance.
The earliest crops were wheat and barley,
used to make bread . . . and beer.
First written references to alcohol are on
Sumerian clay tablets from 4000 B.C.
18
Ancient Civilizations
(4000 B.C. to A.D. 400)
In many ancient cultures, alcohol was
considered a gift from the gods . . BUT . . it
caused both the desired effect and side
effects capable of creating social and health
problems.
Most civilizations throughout history
have placed religious, social, and
legal CONTROLS on the use of
alcohol and other drugs.
19
Ancient Civilizations
(4000 B.C. to A.D. 400)
And then there is the opium poppy.
5,000 years ago, Egyptians used opium for
soothing crying babies, treating mental illness,
soothing female hysteria and for pain control.
In A.D. 312 in Rome, an excise tax was
placed on stores selling opium
which generated 15% of the
city’s revenue.
20
Ancient Civilizations
(4000 B.C. to A.D. 400)
Marijuana
Historically, cannabis has been prized as a
source of oil and fiber, for its edible seeds, as
a medicine, and as a psychedelic.
Peyote and psychedelic mushrooms.
Sacramental use of these plants can be traced
back approximately 7000 years.
21
Ancient Civilizations
(4000 B.C. to A.D. 400)
Finally there is tobacco and the coca leaf.
Plants containing stimulant alkaloids occurred
65 to 250 million years ago – the bitter
alkaloids were the plants’ way of repelling
dinosaurs, herbivores and insects.
Discoveries in the Andes show the use of coca
leaves for spiritual and medical practices
going back to 3000 B.C.
22
Middle Ages (A.D. 400 to 1400)
Psychedelic herbs and molds.
Psychoactive plants from the
nightshade family were used in
religious, magical and social ceremonies.
Low Dose
Medicine
Moderate
Dose
Psychoactive
Drug
High Dose
Deadly
poison
Datura, henbane, belladonna and mandrake
23
Middle Ages (A.D. 400 to 1400)
ERGOT, a fungus which grows on infected
rye and wheat plants, contains the natural
active ingredient LSD, the precursor to the
modern hallucinogen.
Middle Ages (A.D. 400 to 1400)
Distillation of alcohol.
Knowledge / techniques became
widespread. Evaporation process now
raised the alcohol content from 14% to
40%.
Religious ceremonies began using less and
less alcohol until it was only used
symbolically.
It was thought that the excessive use of alcohol
led users away from God.
Controlling drinking becomes a MORAL ISSUE.
25
Middle Ages (A.D. 400 to 1400)
And they found caffeine.
First coffee was consumed by chewing the
beans or by infusing in water. Then people
learned how to roast and grind the beans.
It was not until 1820 that the active ingredient,
caffeine was identified.
Approximately 60 plants contain caffeine.
Chocolate has been traced back to
1500 B.C.
26
Renaissance (AD 1400 to 1700)
Trade routes put drugs and drug-using
customs in the hands of the rest of the
world and so drugs spread.
Laws were developed
Limiting the use of alcohol
Produced hefty tax revenue
27
Age of Enlightenment (1700 – 1900)
Seeing more substance users, more mental
and physical problems, more ties to
financial arena.
London Gin Epidemic from 1710 to 1750
when the English Parliament
ENCOURAGED the production
and consumption of gin.
1751 prohibition laws were put in
place to control consumption.
28
Age of Enlightenment (1700 – 1900)
Rum was the chief “coin” of exchange in the
slave trade.
Whiskey and tobacco were
mainstays of the economy of
colonial America.
The federal government enacted a tax on
liquor to help pay off federal debt – led to the
Whiskey Rebellion.
Age of Enlightenment (1700 – 1900)
Opium was refined to create morphine and
then to heroin.
Opium
Morphine
Heroin
Morphine was about 10x more powerful than
opium.
Heroin was about 2x – 5x stronger than morphine.
30
Age of Enlightenment (1700 – 1900)
The alkaloid cocaine was isolated from the
coca leaf.
Users went from experiencing only a mild
stimulatory sensation to an intense rush followed
by ecstatic feelings.
Age of Enlightenment (1700 – 1900)
Invention of hypodermic needles led to new
methods of drug delivery.
Meant drugs could be put directly into the
bloodstream creating a more intense effect.
20th Century
Government and
business exploit
psychoactive
substances
Government
starts regulating
psychoactive
substances
33
Addiction as a moral issue
Regulation activities varied from trying to
control the supply to providing treatment.
Eliminated over-the-counter tonics – opiates
and cocaine.
Alcoholics Anonymous, a spiritual program that
teaches twelve steps to recovery was founded
by Bill Wilson and Dr. Bob Smith in 1934.
Marijuana cultivation and use banned in 1937.
34
Early 20th Century
Alcohol prohibition . . . and treatment.
Alcohol consumption is illustrated in the fact
that between 1870 and 1915, between 1/2 and
2/3 of the U.S. budget came from the liquor
tax.
In 1920 the 18th Amendment
prohibited the manufacture
and sale of any beverage
with an alcohol content of
greater than 0.5%.
35
Experimentation, Changing Values, and
Governmental Response
In 1963 the first legislation was created to
treat addiction (under the guise of mental
illness).
In 1965 Drug Abuse Control Amendment
prohibited the illicit manufacture of
stimulants and depressants.
In 1970 laws expanded the 1965 legislation and
developed “schedules” to rate drugs.
President Nixon declared the “War on Drugs”
Culture of the
“60s”
Counter-culture
Quick-Fix
generation
Attitudes about
Addiction
Counter-Culture: 1956-1974
Negative attitudes about the
Cold War and Vietnam
precipitated the birth of the
Hippie Counter Culture
Drug revolution with increases in
drug experimentation and
popularity (Zinberg, 1984)
Timothy Leary: LSD
Sexual mores: Woodstock
Civil Rights & Race
Change in beliefs about individual rights
2. Quick-Fix
Generation
Microwave meals
Weight loss in a flash
Got a headache?
Credit Cards….
Quick Fix
A medication to fix anything that
ails you
Increased use of prescriptions
and OTC medication
Increased chance of adverse
interactions with alcohol and
other substances
An Era of Ambivalence
Drinking age raised to 21 in 1984.
In 1986 the Anti-Drug Abuse Act strengthened federal
efforts to encourage foreign cooperation in
eradicating drug crops.
1990 Crime Control Act allowed for the seizure of drug
traffickers’ assets, and controlled drug paraphernalia
and money laundering.
Treatment option for first-time nonviolent drug
offenders developed in 2000.
Since 1996, 36 states have passed laws legalizing
medical use of marijuana.
In 2000 legislation in California required a treatment
option for first-time nonviolent drug offenders.
41
20th Century: Office on National Drug
Control Policy
Formal efforts to address problems of abuse,
addiction and crime brought on by misuse of
drugs.
Demand reduction – prevention plus treatment.
Harm reduction – reduce the physical and social
damage cause by abuse and dependence.
Supply reduction – stricter laws concern use and
“war on drugs.”
Treatment of addiction became
a medical as well as social
science.
42
20th Century: Changing Use
Amphetamines –
First synthesized in 1887 and methamphetamines
created in 1919.
Used to fight fatigue, heighten endurance, etc. for
soldiers.
Over past few years there has been intense focus
on amphetamine-type stimulants (ATSs).
Restricted sale of OTC cold medications
containing drugs used in the manufacture
of methamphetamines.
43
20th Century
Steroids and performance enhancing drug
usage prompts Olympic Committee to institute
drug testing.
Synthesizing medications rather than relying
on extracts from natural products.
Recognition of brain chemical imbalances as
the cause of almost all mental illnesses
spurred the development of psychiatric
medications.
Methadone used as a legal substitute for
heroin.
44
20th Century
Development of new ways of preparing and
using cocaine led to the crack epidemic and
then to smokable methamphetamine.
Prescription drug abuse/dependence.
HIV, AIDS and Hepatitis C.
“Raves” and “club drugs.”
Behavioral addictions explode
Now and Future
Worldwide figures –
2.0 billion people drink alcohol with at least 76
million having an alcohol use disorder, and 2.5
million die from it every year.
155 million to 250 million people use illicit
substances.
1 billion use tobacco.
129 million to 190 million smoke marijuana.
2011 Global Commission on Drug Policy
declared, “The global war on drugs has
failed, with devastating consequences for
individuals and societies around the world”
46
2012
Americans voted to legalize marijuana in
Washington and Colorado…
What is next?