Drugs of Addiction

1. Drugs of Addiction Elizabeth McQueen, LMHC Clinical Director Stewart-Marchman Center NET Training Institute Freedom Series

2. Course Objectives • To define psycho active chemicals • To examine the routes that drugs take to the brain and the ways in which they affect brain chemistry • To present a system for classifying these psychoactive substances. • To detail the physiological effects of uppers, downers and other commonly abused drugs • To outline the principles of effective prevention and treatment

3. The Addictive Process: Psychoactive drugs: Substances that affect the central nervous system to cause physical and mental changes to take place

4. 3 Factors that determine the effects a chemical will have • The methods by which people put psychoactive chemicals into their bodies • The speed of transmission to the brain • The attraction of the drug for nerve cells, neurotransmitters and other brain chemicals

5. Routes of Administration 1. Inhaling 2. Injecting 3. Mucous Membrane Absorption 4. Oral Ingestion 5. Contact Absorption

6. Inhaling The vaporized drug enters the lungs and is rapidly absorbed through tiny blood vessels in the lungs called capillaries. It travels back to the veins and then the heart where it is pumped directly to the brain and the rest of the body. Time of transmission: 7-10 seconds for change to begin

7. Inhaled drugs • Marijuana • Freebase cocaine • Glue • Aerosols • Cigarettes

8. Characteristics of Inhaled drugs • Effects felt quickly • Easy to regulate the amount of the drug used • Only small amount absorbed with each inhalation

9. Injecting • Intravenous injecting – “Slamming” Injected directly into the blood stream by way of a vein • Intramuscular injecting – “muscling” Injecting into a muscle mass • Subcutaneous – “Skin popping” Injecting just under the skin Time of transmission: 15-30 seconds in the vein

10. Time of transmission for injected drugs: • 15-30 seconds in the vein • 3-5 minutes in the muscle or under the skin

11. Injected Drugs • Heroin • Cocaine • methamphetamines

12. Characteristics of Injected Drugs • Large amount absorbed at once • Instant “RUSH” • Nothing of the drug is wasted

13. Snorting and Mucosal absorption • Insufflation – absorption into the muscosa membranes in the nasal passages • Sublingual – absorption into the mucosa under the tongue • Buccally – between the gums and the cheek • Rectally – absorption into the mucosa in the rectum • Vaginally – absorption into the mucosa in the vagina

14. Time of Transmission • From 3 to 15 minutes depending on the place of administration

15. Drugs of Mucosal Absorption • Cocaine • Herion • nitroglycerin • Chewing tobacco • Morphione

16. Characteristics of Mucosal Absorbed Drugs • Results more rapid • High more intense • Bypasses the digestive acids, enzymes and liver

17. ORAL • Swallowed • Passes through the esophagus into stomach • Absorbed in to the capillaries and enters the vein and liver • Pumped back to the heart and on to the rest of the body

18. Time of transmission • 20-30 minutes from administration

19. Drugs of Oral Admission • Oxycontin • Xanax • Valium • Loratab • Robotussin • Alcohol

20. Characteristics of Oral Ingested Drugs • Low Concentration at Absorption • First Pass metabolism (first absorbed) drugs are most potent

21. Transdermal Absorption • Absorbed through the skin • Lotions • Eye drops • Patches • Stamps

22. Time of Transmission • 1-2 days for effects to be noticed • Up to 7 days of absorption in the average patch

23. Drugs of transdermal absorption • Nicotine • Fentanyl • Clonidine • LSD • Cocaine

24. Characteristics of Transdermal Administration • Usually by prescription • Measured amount of the drug • Seldom used for illegal drugs

25. Drug Distribution: GETTING TO THE BRAIN • Distribution depends on Blood volume and characteristics of the drug • Less blood volume, increased potency • MOST PSYCHOACTIVE DRUGS ARE FAT SOLUABLE • THEY CAN CROSS THE BLOOD BRAIN BARRIER

26. The Blood Brain Barrier • The Gateway to the central nervous system • The wall of the capillary in the brain which is sealed to act as a barrier to the brain. • Only Fat soluble drugs can cross the blood brain barrier

27. The Nervous System • The Central Nervous System – half of the complete nervous system, includes the brain and the spinal cord • The Peripheral Nervous System –the Other part of the nervous system which connects the CNS with the internal and external systems Includes the autonomic nervous system and the somatic nervous system

28. The Central Nervous System • The Brain – Computer of the body, receiving, analyzing and responding to messages from the peripheral nervous system • Controls circulatory response • Respiration • Digestion • Excretory function • Endocrine function • Reproductive function • Enables us to reason and make judgments

29. Autonomic Nervous System • Controls involuntary functions such as • Circulation • Digestion • Respiration • Glandular outputs • Genital reactions • Sympathetic responses

30. Somatic Nervous System • Includes sensory neurons that reach the skin, muscles and joints. Responsible for relaying information about muscle and limb position • Transmits instructions back to skeletal muscles • Provides for voluntary response

31. Understanding how nervous system processes messages • Neurons - nerve cells that act as the building blocks of the nervous system

32. Parts of a neuron: (see handout) • Dendrites- finger like bodies that receive signals from other cells and then relay them to the cell body • Soma – the cell body • Axon – the finger like bodies that carry the signals away from the cell • Terminals – the pathway that carries the signal from one cell to the dendrites of the next cell.

33. Terminals of one cell do not touch the dendrites of the next cell • Synaptic Gap – the microscopic space between the terminals of one cell and the dendrites of the next cell A message jumps the synaptic gap in the form of neurotransmitters.

34. Neurotransmitters – bits of chemicals that are synthesized electrical signals that jump the synaptic gap Vesticles – tiny sacs that store neurotransmitters Synapse – the transmission process across the synaptic gap

35. Receptor Sites – Protein molecules that are activated by neurotransmitters. • When receptor sites are activated, they open a molecular gate that allow electrical charges in or out

36. The process of message transmission (see handout) • Incoming electrical signals force the release of neurotransmitters • From the vesticles • And send them across the synaptic gap • On the other side the neurotranmitters “fit themselves” into • receptor sites • The receptor sites open the ion molecule gate

37. Allowing the electrical charges in or out • When enough electrical charge is achieved, the next signal fires • Once the job is done, neurotranmitters return to the synaptic gap and are reabsorbed by reuptake ports • Auto receptors monitor the amount of neurotransmitter needs for the transmission

38. Psychoactive drugs disrupt the process of message transmission Drugs that enhance the activity of the neurotransmitters and receptor sites are called agonists Drugs that block activity are called antagonists

39. AGONISTS: Cocaine - forces the release of extra neurotranmitters and blocks their reabsorption ANTAGONISTS: Heroin – inhibits the release of neurotransmitters and therefore blocks a message of pain from reaching the brain Specific Drug Examples:

40. The body regards any drug as a toxin, but ifthe use continues over a long time, it is forced to adapt and and develop a tolerancefor the drug Tolerance – the need to use increase amounts to get the same effect!

41. Types of Tolerance • Dispositional Tolerance – the speeding up of metabolism in order to eliminate the drug • Pharmacodynamic Tolerance – nerve cells become less sensitive to the drugs • Reverse Tolerance – when the body systems are no longer able to metabolize drugs and the body can no longer tolerate the drug (alcohol absorption after liver destruction)

42. Acute tolerance – an automatic acceptance of a drug by the body Select Tolerance- When increased quantities of a drug are taken to overcome acute tolerance in order to produce a high Inverse Tolerance – When a person becomes more sensitive to the effects pf a drug as the brain’s chemistry changes

43. Withdrawal – the bodies attempt to rebalance itself Nonpurposive Withdrawal – Physical withdrawal -objective physical signs that are directly observable when a drug is stopped. EXAMPLES: • Seizures Sweating • Goosebumps Vomiting • Diarrhea Tremors

44. Purposive Withdrawal-psychological withdrawal Resulting behavior exhibited by an addict when the drug stops EXAMPLES: • Manipulation • Psychic Conversion (anticipated nonexistent symptoms of withdrawal) • Malingering

45. Protracted Withdrawal: Environmental Influence • Withdrawal stimulated by environmental triggers or cues EXAMPLE: Any white powder may trigger a cocaine addict

46. Body Effect vs Withdrawal See hand out on opioids

47. Metabolism - the body’s mechanism for processing foreign substances • Excretion – the process of eliminating foreign substances

48. What effects Metabolism • Age – after 30 the body produces less enzymes • Race – different ethnic groups have different levels of enzymes • Sex – males and females metabolize at different rates • Health – certain conditions affect metabolism

49. Emotional Health – Metabolism is affected by preexisting chemical imbalance Other Drugs – two or more drugs will have the body fighting for metabolism attention making the process slower

50. Desired Effects of Drug Use • Curiosity Satisfaction • To “get high” and be in dreamlike state • To self –medicate • To have confidence • To have energy • Pain Relief • Anxiety Control • Peer influence • Social Confidence • Boredom Relief