Transcript Personal and Social Concerns

Chapter 2
Drug-Taking Behavior:
Personal and Social
Concerns
Drug Toxicity
A drug’s harmful effects are referred to as its
toxicity.
Acute toxicity can be computed from its effective
dose response and lethal dose-response curves.
Two commonly used measures are the
therapeutic index and the margin of safety.
Figure 2.1
for what effect?
therapeutic index: LD50/ED50
margin of safety: LD1/ED99
An effective dose (ED) of a drug depends upon __________.
A. the drug effect under consideration
B. the percentage of the test population you have
specified
C. both A and B
D. neither A nor B
Figure 2.2
The DAWN* Reports
In general, DAWN statistics show that cocaine
and narcotic drugs are both highly toxic and that
many emergencies involve drugs being taken in
combination with alcohol.
There are also recent concerns about the
increasing number of emergencies associated
with club drugs and opiate-based pain relief
medications.
What are the problems associated with using
DAWN reports to estimate the abuse of drugs?
*Drug Awareness Warning Network
From Acute Toxicity to Chronic
Toxicity
The number of people who die each year as a
result of drinking alcohol or smoking tobacco far
outstrips the number of fatalities from the abuse
of illicit drugs.
What is the difference between acute and
chronic toxicity? Alcohol as an example?
In terms of toxicity, a drug with a therapeutic index of two
______ a drug with a therapeutic index of ten.
A. is roughly equivalent to
B. is safer than
C. is more dangerous than
D. cannot be compared to
© Copyright 2011, Pearson Education,
Inc. All rights reserved.
Figure 2.3
Behavioral Tolerance
and Drug Overdose
A tolerance effect is the capacity of a drug to
have a gradually diminished effect over
repeated administrations; in effect, a greater
dose has to be taken to maintain the original
effect of the drug.
Tolerance effects can be quite dangerous,
because experienced drug users often end up
taking potentially lethal dose levels.
Behavioral Tolerance
and Drug Overdose
The setting within which drug-taking behavior
occurs is an important factor in behavioral
tolerance.
Behavioral tolerance effects are based on the
principles of Pavlovian conditioning.
How is tolerance reflected in a dose-response curve?
Tolerance is evidenced by a shift in the dose-response
curve to the right
Higher dose needed to achieve the same effect.
The same dose produces a lesser effect.
Physical and Psychological
Dependence
Drugs can be viewed in terms of a physical
dependence model, in which the compulsive
drug-taking behavior is tied to an avoidance of
withdrawal symptoms, or a psychological
dependence model, in which the drug-taking
behavior is tied to a genuine craving for the
drug and its highly reinforcing effects on the
user’s body and mind.
Physical and Psychological
Dependence
Physical dependence: need for a drug to
restore normal brain function because of
primary changes in the brain induced by the
drug (e.g. tolerance).
Psychological dependence: need for a drug
due to secondary changes in the brain and
experiential (i.e. conditioned) effects. Unlike
physiological dependence, psychological
dependence may generalize between drugs
having very different pharmacological modes of
action.
There is large overlap between the concepts of physical
dependence and psychological dependence.
Figure 2.4
Psychiatric Definitions
The American Psychiatric Association currently
recognizes two major conditions associated
with drug-taking behavior: substance
dependence and substance abuse.
Table 2.1
Psychiatric Definitions
The broader term “substance” is used instead of
“drug,” because there is often confusion in the
public mind about what is defined as a drug and
what is not.
Special Circumstances
in Drug Abuse
Increasing attention has been directed toward
the harmful effects that drug abuse has on
pregnant women, in terms of problems both
with the pregnancy itself and with the neural
development of the fetus.
There is also concern about the increased risk
of HIV infection (and the spread of AIDS)
among intravenous drug users when needles
are shared.
According to the text, what are the effects of using cocaine
or crack during pregnancy?
A. constriction of blood vessels, reducing normal
blood flow to the fetus
B. high rates of spontaneous abortion
C. growth retardation such as lower birth rate and
smaller head circumference
D. all of the above
Drugs, Violence, and Crime
There is an overall association between the
taking of illicit drugs and crime, but careful
analysis indicates that the drug with the closest
connection to social violence is alcohol, and
that heroin and marijuana cause the user to be
less inclined toward violent behavior rather than
more so.
Modern synthetic drugs of abuse, such “spice”
and “bath salts” are unregulated and of
unknown composition. Physiological and
behavioral effects are consequently
unpredictable.
Drugs, Violence, and Crime
It is clear that drug abuse prompts many drug
users to commit criminal acts (most commonly
property theft and prostitution) to support the
drug habit.
It is also clear that there is a high level of social
violence and criminal behavior inherent in the
trafficking and distribution of illicit drugs.
Figure 2.5
Which criterion is not used for a DSM-IV-TR diagnosis of
substance dependence?
A. tolerance
B. withdrawal symptoms
C. persistent desire or efforts to control drug use
D. increased willingness to try new drugs
According to the text, a majority of homicides and sexually
aggressive acts are committed by users of __________.
A. crack cocaine
B. heroin
C. alcohol
D. nicotine
© Copyright 2011, Pearson Education,
Inc. All rights reserved.
Governmental Policy,
Regulation, and Laws
Since the beginning of the twentieth
century, U.S. society’s philosophy toward
drug-taking behavior has been that we
should restrict it by reducing the
availability of illicit drugs and making it as
difficult as possible for the potential drug
user to engage in drugtaking behavior.
Governmental Policy,
Regulation, and Laws
The Harrison Act of 1914 was the first of several
legislative efforts to impose criminal penalties
for the use of opiates and cocaine and of later
marijuana, hallucinogens, and several other
types of drugs.
The Comprehensive Drug Act of 1970
organized the federal control of drugs under five
classifications called schedules.
Table 2.2
Governmental Policy,
Regulation, and Laws
Overall planning and implementation of drug
policy in the United States now originate from
the White House Office of Drug Control Policy.
Enforcement of Drug Laws on
a Global Scale
Today’s drug-law-enforcement program in the
United States places considerable emphasis on
the interdiction of drugs entering the country
and less emphasis on the treatment and
prevention of drug abuse.
Figure 2.6
Enforcement of Drug Laws on
a Global Scale
Attempts to reduce the influx of illicit drugs into
the United States are complicated by a series of
economic and political factors on a global scale,
particularly with respect to international
relations with nations such as Colombia,
Mexico, and Afghanistan that have been
involved either in drug cultivation or in
trafficking.
Enforcement of Drug Laws on
a Global Scale
The intertwining and sometimes opposing goals
of America’s drug-control policy and global
foreign policy continue to be a major challenge.
What approaches might be more effective in controlling drug
abuse in this country?
What aspects of the drug abuse problem would they control?
illegal activities
violence
addiction
other mental/physical health problems