Transcript Lecture topic 2 - People Server at UNCW

HOW HAVE FEDERAL LAWS BEEN EFFECTIVE?
Escalation in drug-related incarceration
rates
Incarcerations have mostly been
for Posession
NOTE: The Increase in Incarceration rates
for Drug-related Crime is International
However, availability of many “Illicit:
substances appear unchanged
Cocaine production seems unaffected
Cocaine prices seem stable
A consideration:Is the War aimed in
the right directions?
Despite the Laws People Still Use
How do we measure use of
Psychoactive substances?
• A difficult issue– Substance Abuse and Mental Health Services
Administration (SAMHSA): measures drug use
prevalence by sponsoring the “National Survey on
Drug us and Health” (NSDUH)- (formerly known as
the “National Household survey on Drug Use”)
• drug use info regarding people of 12 yrs and older
– Data from households from every state and across many
demographic variables..n= 68,736 survey respondents
Appendix A. NSDUH methodology
Example-Drug Use StatsNSDUH a SAMHSA study
(substance abuse and mental Health Services Administration)
Link to 2008 SAMHSA Report
NSDUH 2008 vs. Our Class
Our Class
in last year
Alcohol
MJ
Hall
Stimulants
XTC
91.8%
67.3%
24.2%
22.4 %
4.0%
last month
85.7%
59.1%
6.1 %
14.2%
0.0 %
College Students (2008)
NSDUH
in Last Year
Last month
70.6%
30.9%
8.2%
5.8%
5.1%
50.7%
16.5%
1.7%
1.5%
1.3%
Drug Use by Students in our classCont’
N=49
Ever in the last
year?
In the past month?
In the past Today?
week?
Percentages/
(Freq)
Alcohol
91.8 /45
85.7/42
71.4 /35
8.1 /4
Marijuana
67.3 /33
59.1/ (29
44.8 /22
10.2 /5
Hallucinogens
24.4 /12
6.1/3
2.0/1
0- THANKYOU!
Cocaine or
amphetamines
22.4 /11
14.2/7
8.1/4
0
XTC
4.0/2
0
0
0
Opiates
26.5 /13
14.2/7
6.1/3
4.0/2
Benzodiazepines
20.4 /10
16.3/8
8.1/4
6.1/3
ouch!!!
Legal control of drug use has cost a lot
Have U.S. Drug Policies worked to
reduce drug use or availability??
Complexities of Drug use, Drug abuse
and DRUG TAKING BEHAVIOR
Is there a drug abuse problem in our country?
Does Use Mean Abuse?
The Spectrum of Use
•
•
•
•
Use – Periodic non-problematic use
Misuse – Periodic use
Abuse – A pattern of misuse
Dependence – Compulsive problematic use,
often with physiological dependence
Use
• Many drugs can be used relatively safely
• Most people who use drugs do not develop
problems; however, this varies with the type
of drug
• Drugs are used for many reasons
– Social
– Religious
– Coping
– Experimentation
Misuse
• Periodic circumscribed negative consequences
– College students and alcohol
– “It only happened once.”
– Sometimes the consequences are catastrophic
What is drug abuse?
• The Diagnostic and Statistical Manual – APA
guidelines for diagnostic evaluation of
psychological problems
– “Substance-related disorders”
DSM-IV:Abuse
•
•
•
•
Use-related Failure to fulfill obligations
Use in Physically dangerous situations
Use-related Legal problems
Use-related Social/Psychological problems
– *Dependence criteria not met
– It is assumed that an individual meeting the
criteria for “drug dependence” have already met
the criteria for abuse
What is Drug Dependence?
DSM-IV:Dependence
• Tolerance
Tolerance
• After regular use, a larger dose is required to
produce a given effect
• A given dose of the drug has less effect upon
repetition
DSM-IV:Dependence
• Tolerance
• Withdrawal syndromes
Physical Dependence
• An adaptive state produced by repeated use of a
drug which manifests itself by intense physiological
disturbances (withdrawal syndrome) when use of the
drug is halted (abstinence).
• Withdrawal syndrome- a constellation of symptoms
that occur when an individual stops using the drug to
which dependence has developed. Symptoms
typically in reverse direction of the effects caused by
the drug (considered a “rebound effect.”)
Withdrawal Syndromes
Example: Opiate drugs tend to reduce
body temp and decrease activity of the
digestive system.
Opiate withdrawal syndromes include
fever, and diarrhea
For some drugs a withdrawal Syndrome
may be associated with
Psychological dependence
• A condition characterized by intense drive or
cravings for a drug experienced during periods
ob abstinence.
– Abstinence: periods of time when the individual has
stopped using
• Now considered the most prominent factor in
relapse.
– Relapse: return to drug use after a period of abstinence
DSM-IV:Dependence
• Tolerance
• Withdrawal
• Taking more than intended
DSM-IV:Dependence
•
•
•
•
Tolerance
Withdrawal
Taking more than intended
Unable to successfully cut down or control
DSM-IV:Dependence
•
•
•
•
•
Tolerance
Withdrawal
Taking more than intended
Unable to cut down or control
Excessive time spent re: drug
– Thinking about, talking about, acquiring etc…
DSM-IV:Dependence
•
•
•
•
•
•
Tolerance
Withdrawal
Taking more than intended
Unable to cut down or control
Excessive time spent re drug
Important activities given up
– Loss of interest/motivation/ability
DSM-IV:Dependence
•
•
•
•
•
•
•
Tolerance
Withdrawal
Taking more than intended
Unable to cut down or control
Excessive time spent re drug
Important activities given up
Continuing use despite problems
How Large is the Problem? Depends how it is
measured… Treatment Statistics
Economic Indications
SO ?
• Whatever your perspective on drug use and abuse,
its difficult to argue that drug use is in no way
problematic.
• Especially when considering the harmful effects of
drug addiction/Abuse to the individual and to
society.
• Yet the issues are complex and simple approaches
are clearly less than optimally effective
Yet there is ample rationale to study
drug taking behavior
• It is a social problem
• Many drugs can cause physical harm to the
individual
• General Insight into behavior
• Insight into the functions of the nervous system
• Insights into pharmacology of neural transmission
Psychopharmacology
• The Study of Psychoactive Drugs and Their
Effects
Names of Drugs
Brand, trade, ‘proprietary’ name: e.g., Adderal® different
preparations, companies, etc.
Generic, (common) ‘nonproprietary’ name:
d-amphetamine
Chemical name: alpha-methylphenethylamine
Street names: e.g..Bennies, black beauties, bumble bees, co-pilots,
Crank, Cross tops, Crystal meth, Dexies, Footballs, Hearts, Hot Ice,
Ice, L.A. glass, Meth, MDMA, Pep pills, Speed, Uppers
Mostly I will use the generic name.
Example: Valium
• chemical
7-chloro--1-methyl-5-phenyl-3H-1,4benzodiazepin-2[1H]-one
• generic
diazepam
• trade
valium
• street
tranks, downers, blues, yellows
Classifying Drugs-another difficult
issue
–
–
–
–
–
–
–
–
Therapeutic vs. non-therapeutic
Legal vs. illegal
Recreational vs. medicinal
Mechanism of action
Site of action
By origin
By chemical structure
Behavioral effects
Classifying Drugs
• Ultimately, as practiced, the classification of
drugs is political/social as much as it is
scientific.
• Two most common classifications
– Scheduling
– Behavioral effects
• Both have associated problems
Behavioral Effects Classification
• Classified by effects on behavior and/or
central nervous system
– Depressants
– Stimulants
– Narcotics/Analgesics
– Psychedelics
Although the Behavioral class system is
generally useful…
• Consider the problem of classification based
on behavioral effects.
– What is the behavioral effect of alcohol?
– What is the behavioral effect of Nicotine?
Nonetheless, the behavioral effect classification
system would generally be as follows:
• Depressants
• Actions in the nervous system lead to
decreased physiological activity and sedation
– Alcohol –
– Barbiturates –
– Benzodiazepines –
Stimulants
• Increase physiological processes and motor
behavior
– Cocaine
– Amphetamine –
– Caffeine –
– Nicotine –
Narcotic Analgesics (Opiates)
• increase activity in the endogenous opiate
system leading to pain suppression, feelings of
euphoria, well-being, and respiratory depression
– Heroin –
– Codeine –
– Morphine –
– Vicodin, Percocet, etc. –
Psychedelics
• Alter mood state and perception via action on
the CNS.
– LSD (acid)
– Psylocibin (mushrooms)
– Phencyclidine (PCP)
Marijuana• Vs. many other drugs, the problems of
classification are at least recognized
• In a class by itself
– Complex behavioral effects
– Main effect is on cannabinoid neurotransmitter
system
Take-Home Message
• Drug classification systems are only a convenient tool
for communicating superficial characteristics of a
drug. Almost all classification systems breakdown
fairly quickly when deeper consideration is given to
the individual drugs within each class.