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Drug use, Drug abuse and DRUG TAKING BEHAVIOR. Problem: How to define.

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problem how to define
Problem: How to define
  • Drug addiction? Is once enough? A repetitive behavior pattern associated with increase risk of disease or social problems (Marlatt, 1988)..often characterized by immediate gratification and high relapse rates…but is this the same as “abuse?”
  • Drug abuse-how to define?
drug abuse
Drug Abuse
  • The self-administration of any drug in a manner that deviates from the approved medical or social patterns within a given culture (Jaffe).
  • Drug Dependence- a condition in which an individual requires a drug to function normally. A distinction is often made between Physical dependence and Psychological dependence.
physical dependence
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.
psychological dependence
Psychological dependence
  • A condition characterized by intense drive or cravings for a drug.
illicit drug use reported by state
Illicit drug use reported by state

Problem: How to measure(Reactivity and return rate issues)

for the sake of argument
For the Sake of Argument
  • Lets say there is significant drug use and/abuse in our society.
costs drugs and violence
Costs: Drugs and Violence

Though evidence in regard to violence associated with the pharmacological effects for most illicit substances is weak at best.

slide47

DRUG TESTS BRING WORRIES OF ACCURACYApril 16, 1998 "I go to extraordinary lengths before I call a positive."—Dr. DavidBerg, Medical review officer said.The water-cooler talk is true: Poppy seeds can produce a positive test for heroin, and cold medicine can suggest methamphetamine.

slide48

The wild eyed claim that a third of all people accused of drug use will be innocent is not so ridiculous after all.

Figure 4 shows that the proportion of spurious results among people identified as drug users is surprisingly sensitive to test accuracy. An accuracy of 99% is marginal at best. However the biggest surprise is the fact that the proportion of spurious results among people failing drug tests approaches 100% as the proportion of drug users in the general population approaches zero. Drug testing in a drug free population amounts to a witch hunt.

slide49
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.
what are the causes of drug addiction
What are the causes of drug Addiction?

A difficult question.

  • MORAL MODEL-character
  • MEDICAL MODEL-disease
  • LEARNING MODEL-reinforcement
  • ENLIGHTENMENT MODE-multifactorial
slide51
??
  • Genetics
  • Environment
  • Concordance rates in identical twins separated at birth…does not completely rule out environmental factors.
slide53
Whatever the original causes,
  • 2 additional factors are necessary before drug addiction will occur…..
slide54
Availability – prohibition?
  • Trying it.-”turning on.”
  • But what then leads to dependence?
commonalities in drug addiction
Commonalities in Drug Addiction
  • Taking the drug
  • Decreased initial drug effect (tolerance)
  • Cravings
    • (psychological…but obvious physical dependence is not a common denominator.
    • Dose stabilization
    • Periods of abstinence
other contributing factors to drug dependence abuse
Other contributing factors to drug dependence/abuse
  • Type of drug…
  • Route of administration
factors influencing drug effects systems that the drug affects opioid receptors in the brain
Factors influencing drug effects:Systems that the drug affects..opioid receptors in the brain
drug agonism and antagonism
Drug Agonism and Antagonism
  • Agonism- drug effects that are in the direction of or promote the natural effects of a given NTs at its synapse.
  • Antatgonism- drug effects that are in the opposing direction of or inhibit the natural effects of a given NTs at its synapse.
animal models of reward
Animal Models of reward
  • James Olds and Intra-cranial Self-administration (ICSS)… an accidental discovery
    • Place preference
    • 2 lever choice
    • Lab rats will lever press to the point of exhaustion for ICSS in certain brain regions
icss and brain reward centers how easy it is to misinterpret the meaning of brain study results
ICSS and brain reward centers?How easy it is to misinterpret the meaning of brain study results
  • LH
    • MFB
      • VTA-Accumbens*
  • DA agonist and antagonist effects
    • Implication of the DA-ergic mesolimbic pathaway
brain ccts of drug reward
Brain ccts of drug reward:

1. Intra-cranial drug infusion: a small tube (cannula) is implanted, minute concentrations of drug can be delivered after bar presses

These are very difficult studies to conduct.

** ICDS is supported when the cannula targets the VTA

2 another powerful approach microdialysis techniques
2. Another powerful approach: Microdialysis techniques

This diagram represents a study where ICSS and Microdialysis are combined…to measure effects of stimulation on NT release at cct. terminations

microdialysis probes are implanted at a targeted brain site
Microdialysis probes are implanted at a targeted brain site.

The probe tip allows NTs to diffuse through a membrane where they are then pumped up and out for continuous collection over time.

recent trends
Recent trends?
  • -VTA-cortex (mesocortical DA pathway)
  • -Amygdala-cortex pathway
special issue mj
Special Issue-MJ
  • Quotes
  • On September 12, 2002, the Drug Enforcement Administration, the White House Office of National Drug Control Policy, and the Surgeon General, in response to the expanding world dialog concerning the legalization of marijuana (including our main ally Great Britain, our neighbor Canada and some of our own states), jointly launched a campaign to "dispel the myths about marijuana, and teach parents and children the REAL facts surrounding this drug."
  • This initiative will cost the American taxpayers billions of dollars spent by these agencies on commercials, advertisements and policies that they themselves admit are totally ineffective and fail to achieve their objective (which is the decrease in marijuana use among adolescents). According to the Office of National Drug Control Policy, "Marijuana use has doubled among teens in the last decade."
slide84
ONDCP says, "NO drug matches the threat posed by marijuana."ONDCP is currently spending hundreds of millions of dollars on commercials solely targeting marijuana use with themes taken straight out of the script of the film "Reefer Madness". They have written an open letter to American prosecutors urging them to prosecute marijuana cases more severely, and to work with local authorities and law makers to help enact tougher marijuana legislation. And they have written an open letter to parents filled with lies and scare tactics, such as marijuana causes: reckless and criminal activity, pregnancy, problems with learning and comprehension, psychosis and mental illness. These same "facts", however, do not stop our government from sanctioning the manufacture and sale of alcohol.
slide85
The Surgeon general says, "Marijuana has three to five times the carcinogens as tobacco."Yet Federal Bureau of Mortality statistics state that no deaths have ever been caused by marijuana, while hundreds of thousands of deaths are caused by tobacco every single year! Now shouldn't marijuana be killing three to five times the people that tobacco kills annually? Also, the average tobacco user smokes four to eight times the number of cigarettes versus the number of joints the average marijuana smoker consumes. Now, according to them, this would equal up to 266% more damaging carcinogens than marijuana, yet this is totally legal.
slide86
The DEA and ONDCP both say, "Marijuana is an addictive drug. In 1999 over 200,000 people entered treatment centers for help."This is however not voluntary admissions, as they would like for us to think, but the number of people out of over 700,000 arrests for marijuana use, who were forced by the court system to enter substance abuse treatment programs as part of their sentences. Also, this number includes the people who were forced to enter treatment programs to remain employed after failing a urine test.
slide87
The DEA and ONDCP say, "More children are addicted to marijuana than alcohol and all illicit drugs combined."The lie here is again the word "addicted". "More children USE marijuana than alcohol and other illicit drugs". This is a result of marijuana being more prevalent than these drugs in today's schools, and not that it is more addicting. A recent study showed that children say that marijuana is easier to get than tobacco and alcohol. This says two things: first, that if marijuana were legal, with the restrictions that are placed on tobacco and alcohol, it would be harder for children to obtain, and second, that the war on marijuana is not working!
slide88
The real truth about marijuana's addictiveness can be found on the webpage of UNIMED Pharmaceuticals, the manufacturer and distributor of Marinol(a FDA approved synthetic version of the active ingredient in marijuana)."In 1999, the U.S. Drug Enforcement Administration(DEA), based in part from a concurring recommendation from the U.S. Department of health and Human Services, reclassified Marinol(dronabinol) Capsules from a Schedule II substance to Schedule III. This action was taken after thorough review of the abuse potential of Marinol, which found that the drug has lower abuse potential than drugs or substances in Schedules I and II. The DEA also found little evidence of actual Marinol abuse, despite increased number of prescriptions issued."
slide89
Now consider this, Marinol is 95% pure THC. Meanwhile, the most potent marijuana, even at the exaggerated potency levels that the prohibitionists claim, is only a third of this. In reality the average marijuana being smoked in America is less than 10% THC.
slide90
ONDCP and the DEA say, "87,000 annual emergency room visits are people seeking treatment for marijuana related traumas."What they're not telling you is that hospitals do drug testing, and whether you're pregnant, or you experience any emergency that requires a blood or urine test, at the hospital's discretion, you could be drug tested. A positive marijuana result ends up being a marijuana related emergency room statistic regardless of the injury or circumstances.
slide91
The DEA and ONDCP say, "Marijuana affects a child's learning abilities, and that a child with a "D", or lower, average grade score is four times more likely to smoke marijuana than a child with an "A" average."Now what are they saying here? That a dumb child is more likely to smoke pot, or that a kid who smokes pot will more than likely become dumb? And what formula did they use to calculate the percentage? "D"=4X, "C"=3X, "B"=2X ? Based on this a student with an "A" average will be just as likely to smoke marijuana as any other "A" student who already does.
slide92
ONDCP and the DEA say, "Marijuana not only affects the user but others as well because as many** car crashes are caused by marijuana as are caused by alcohol."Yet FBI and state police statistics state that up to 50% of all highway accidents and fatalities are alcohol related. Now this would mean that the other 50% are marijuana related, leaving these two causes as the only factors contributing to accidents on our nation's roads. In Virginia, in both state police and DMV highway reports, marijuana is not even listed as a cause of crashes or accidents. In spite of this, right now, the federal government is proposing a "zero tolerance" drugged driving law which targets marijuana users.
slide93
An officer can administer a roadside drug test(pulse and/or blood pressure check, saliva, blood or urine samples), and ANY positive result results in an immediate DUI (whether you've recently smoked any amount of marijuana or within days or weeks). Meanwhile, UNIMED Pharmaceuticals has this to say about Marinol and driving: "Patients receiving treatment with Marinol should be specifically warned not to drive, operate machinery, or engage in any hazardous activity until it is established that they are able to tolerate the drug and to perform such tasks safely."** The DEA has changed this statistic from 50% to 40% to 1 out of 3 reckless drivers "who were tested for drugs" tested positive for marijuana. Now, even if all reckless drivers not under the influence of alcohol were tested for drugs then, according to their claims, this would amount to 16% at the highest. In reality, the actual percentage would be negligible when compaired to alcohol!
slide94
The DEA and ONDCP say, "Marijuana is a major factor in crime."Based on a survey of a small select group of prisoners they claim that 40% of all arrestees tested positive for marijuana. But what select group, and from where? Why not a study of every prisoner from every local, state and federal prison? The U.S. Justice Department already has the crime reports and past histories of every prisoner, past and present. And they already drug test in every jail and prison throughout the country. What are the real numbers based on the entire penal system? (Then again, with over 730,000 annual arrests for marijuana use, far more than 1/3 of all total arrests, maybe 40% of all arrestees did test positive for marijuana.) Of course, as long as marijuana remains illegal, this statement will always be true based solely on the fact that the possession and consumption of marijuana is a criminal act.
slide95
ONDCP and the DEA say, "Marijuana will always be a dangerous drug because it inevitably leads its users to harder more dangerous drugs."I will use their own statistics to expose this lie. John Walters, ONDCP director, says, "Marijuana use among teenagers has doubled* over the last decade." But Asa Hutchinson, director of the DEA, says, "Cocaine use has dropped 75% over the last 15 years and that other illicit drug use has been cut by 50%." Now if marijuana use has doubled and marijuana leads to harder drugs shouldn't we be seeing an increase in harder drug use and not a 50% decrease? Also, based on Mr. Hutchinson's statistics, we should expect to see a complete elimination of cocaine use in America after the next five years. (75% in 15 years/ 5 years = 25%) *In May, 2002, ONDCP stated that marijuana use had tripled in recent years. In September, 2002, marijuana use had doubled over the last decade. In November, 2002, ONDCP said marijuana use had declined by 50% since 9-11, proving, they said, "that teenagers were acknowledging the connection between drugs and terrorism". In spite of this ONDCP is cancelling their "drugs=terrorism" ads because it was found that they are totally ineffective, and may actually incite pro-drug attitudes among teenagers.
slide96
The DEA and ONDCP both say that "medical marijuana and/or industrial hemp are nothing more than camouflaged attempts to legalize a dangerous drug." Right now they are attempting to ban all products containing hemp, hemp seed and hemp seed oil, while they themselves currently both grow and import hemp, not only for industrial purposes, but for medicinal use also! And they are waging a compassionless war on both the sick and dying who use marijuana, and the care-givers who supply it, while endorsing synthetic marijuana (Marinol) for these same people! This is all the federal government's camouflaged attempts to keep marijuana illegal, in all forms and at all costs, and to quash these legitimate industries with lies and the long arm of the law! The U.S., by the way, is the only industrialized nation that doesn't allow legitimate hemp cultivation, and one of the very few that prohibit medical cannabis.
slide97
The DEA and ONDCP say, "Not only the illicit drug trade, but also the casual use of marijuana, directly supports domestic and international terrorism."Although they are cancelling their T.V. terrorism ads the Federal government is still emphasizing this theme. They have appointed Asa Hutchinson, DEA director, as the Under Secretary of Borders and Transportation in the Department of Homeland Security. And DHS has already created a new Anti-Narcotics department with a former CIA operative as its "Czar". This is all a deceptive maneuver to coerce support for the failing 90 year old War on Drugs by playing on the fears and emotions of a post 9-11 America! If we are going to start blaming the casual user because somewhere down the trafficking line blood might have been spilled, then everyone take all the money out of your wallets and purses and throw it away because somewhere down the line blood was spilled for that dollar bill. The violence and terrorism involved in the drug trade is created, not because of the psychoactive properties of the drugs themselves, but because of the enormous wealth generated by illegal drugs, which is created through the illicit black market, which is created by the prohibitive laws of the War On Drugs. If I could grow marijuana in my home, as I can grow tobacco, make wine and brew beer, for my own personal use within my home, as I can enjoy a pipe, or a glass of wine, liquor or beer, how would that aid domestic or international terrorism?
slide98
The DEA and ONDCP say, "Not only the illicit drug trade, but also the casual use of marijuana, directly supports domestic and international terrorism."Although they are cancelling their T.V. terrorism ads the Federal government is still emphasizing this theme. They have appointed Asa Hutchinson, DEA director, as the Under Secretary of Borders and Transportation in the Department of Homeland Security. And DHS has already created a new Anti-Narcotics department with a former CIA operative as its "Czar". This is all a deceptive maneuver to coerce support for the failing 90 year old War on Drugs by playing on the fears and emotions of a post 9-11 America! If we are going to start blaming the casual user because somewhere down the trafficking line blood might have been spilled, then everyone take all the money out of your wallets and purses and throw it away because somewhere down the line blood was spilled for that dollar bill. The violence and terrorism involved in the drug trade is created, not because of the psychoactive properties of the drugs themselves, but because of the enormous wealth generated by illegal drugs, which is created through the illicit black market, which is created by the prohibitive laws of the War On Drugs. If I could grow marijuana in my home, as I can grow tobacco, make wine and brew beer, for my own personal use within my home, as I can enjoy a pipe, or a glass of wine, liquor or beer, how would that aid domestic or international terrorism?