Addiction and Substance Abuse Effects

2. Learning Objectives • Define substance abuse and addiction • Outline the acute effects of alcohol, marijuana, and cocaine on the body • List several guidelines that can be used to maintain control over alcohol use • Outline the behavioral and physiological effects of alcohol as a function of the level of alcohol in the blood • Discuss the long-term health consequences of alcohol, marijuana, and cocaine use • Describe the addictive properties of tobacco and the impact of prolonged tobacco use on health • Describe the acute effects of caffeine on the body • Outline products that contain caffeine and list the pros and cons of caffeine use • Identify ways to reduce your risk of drug use

3. What is Addiction? • Habitual psychological and physical dependence on a substance or practice that is beyond voluntary control • Associated with the following traits: • Reinforcement leading to craving • Loss of control • Escalation • Negative outcomes • Denial

4. What is Addiction? continued • Addiction can involve a substance or behavior • Addictive substances include drugs, alcohol, and tobacco • Addictive behaviors can include gambling, internet usage, pornography, sex, gaming, eating, shoplifting or exercising • Addiction can be physical or psychological • Chemical dependence • Withdrawal symptoms • Tolerance

5. Drugs and Their Potential for Dependence Table 15.1

6. Drugs and Their Potential for Dependence Table 15.1 (continued)

7. Causes of Addiction Addictions can result from numerous potential causes, including: • Types of drug used • Genetics • Brain chemistry • Psychological makeup • Social factors • Personality characteristics • Heredity

8. . • All income and education levels, All ethnic groups, All ages • HIGH RISK FACTOR: • Young people are at a higher risk • Males (Twice as likely) • Troubled adolescent • Thrill-seeker • Dysfunctional families • Peer group or family that accepts • Low Socio-economical status • Dating young 8

9. Substance Use vs. Substance Abuse Substance abuse • Use of illegal drugs or inappropriate use of legal drugs to produce pleasure, to alleviate stress, or to alter/avoid reality • Occurs when use of a drug interferes with other areas of one’s life, such as grades, work, relationships, or legal issues Commonly Abused Substances: • Alcohol • Illicit drugs, including: • Marijuana, Cocaine, Heroin • Hallucinogens • Inhalants • Tranquilizers • Stimulants • Sedatives

10. Psychoactive Drugs • Any drug that causes a user to experience an altered state of consciousness • Examples of psychoactive drugs: • Marijuana (stimulant) • Cocaine (powerful stimulant) • “Club drugs” – Ecstasy, LSD, GHB, methamphetamine (addictive stimulant) • Prescription drugs – OxyContin • Over-the-counter drugs such as cough suppressants & expectorants

11. . • Opioids (narcotics) • Natural or synthetic • Opium, morphine, heroin, • Induce euphoria, relieve pain, cause drowsiness • Methods of administration • Injection, snorting, sniffing or smoking • Symptoms of overdose – respiratory depression, coma, death 11

12. Central Nervous System Depressants (alcohol, barbiturates, sedatives) • Slow down the overall activity of the CNS • Effects – mood changes, impaired muscular coordination, speech; drowsiness, sleep • Medical uses – often prescription drugs • From use to abuse • Overdosing – slow respiration, heart beat = death 12

13. Speed up the activity of the nervous or muscular system • Cocaine • Methods of use – snorted or injected (baking soda+water = crack – smoke) • Effects – intense but short • Abuse and Dependence – respiratory collapse, irregular heartbeat, extremely high blood pressure, blood clots, heart attack, stroke 13

14. Amphetamines • Effects-increase motor activity, complex thinking • Dependence-paranoia, hallucinations, delusions, brain damage • Ritalin • Ephedrine • Caffeine 14

15. Cannabis Sativa • THC (tetrahydrocannabinol) • Short term effects and uses • Depersonalization, euphoria, laid-back attitude, increased HR, high dose: distortion and changes in body image, anxious or panicky feeling • Long-term effects and uses • Respiratory damage, increased risk of cancer of head and neck, learning problems, low sperm count and abnormalities 15

16. Altered state of consciousness, perceptions, feelings and thoughts • LSD, Mascaline, DMT, MDMA, Ketamine, PCP (angel dust), and certain mushrooms • Synesthia-feelings of depersonalization, altered states of consciousness 16

17. Nearly all inhalants produce effects similar to those of anesthetics, slow down the bodies functions • Easy to obtain=hard to control • Methods of use: Sniffing, Snorting, “Bagging” • High concentrations-heart failure, death from suffocation, damage to nervous system, hearing loss, damage to kidneys, liver, bone marrow, high risk of cancer 17

18. Health Effects of Psychoactive Drugs • Long-term use of marijuana: • Psychological dependence and lung damage • Long-term complications from cocaine use: • Cardiovascular effects, respiratory effects, neurological effects, GI problems • Long term use of methamphetamines: • Paranoia, aggressiveness, extreme anorexia, memory loss, hallucinations, delusions, and dental problems • Drug use and abuse by pregnant women can have serious health effects on the developing fetus

19. The Nature of Alcohol • Psychoactive ingredient • Depressant • Ethyl Alcohol – only alcohol that can be consumed • Beer 3-6% alcohol by volume • Malt Liquors 6-8% alcohol by volume • Table wines 9-14% alcohol by volume • Fermenting • Fortified wines 20% alcohol by volume • Extra alcohol is added • Hard liquors 35-50% alcohol by volume • Distilling or fermented • Standard drink – 0.6 ounce of alcohol • Ingestion • 7calories per gram • 1 drink 14-17 grams or 100-120 calories

20. Alcohol • Most widely-used recreational drug in the U.S. & most popular on college campuses • 85% of college students use alcohol & 20-25% abuse it • Central nervous system depressant: • Impaired vision, slowed reaction time, impaired motor coordination • The blood level of alcohol determines the extent of central nervous system depression • Blood alcohol concentration (BAC) is determined by the amount of alcohol consumed, and rate of alcohol metabolized by the body

21. Absorption • 20% is rapidly absorbed from the stomach • 75% is absorbed in the upper small intestines • Remain is absorbed along the GI track • Absorption • Carbonation increases absorption • Food in the stomach slows the absorption • Drink of high concentration slows absorption • Eventually all the alcohol ingested will be absorbed

22. Behavioral and Physiological Effects of Alcohol Table 15.3

23. Alcohol Intake and Blood Alcohol Concentration • Blood Alcohol Concentration(BAC) • A measure of intoxication • Body weight • Percentage of body fat • Sex • Balance of alcohol absorbed and rate of metabolism • Genetic factors • Drinking Behavior • Can not be effected by • Exercise • Breathing deeply • Eating • Drinking coffee • Taking other drugs • Metabolism is the same if the person is awake or asleep

24. Alcohol Abuse vs. Alcohol Addiction Alcohol Abuse • Four criteria of abuse: • Alcohol use in hazardous situations • Alcohol-related school problems • Recurrent interpersonal problems • Recurrent legal problems Alcohol Addiction (alcoholism) • Alcohol dependence • Disease that involves craving alcohol and not being able to control the impulse to drink • Binge drinking

25. Health Effects of Alcohol Abuse • Liver disease (e.g. cirrhosis), which can lead to liver failure and death • Damage to the central nervous system, which can result in brain damage • Increased risk of cancers including the esophagus, pancreas, stomach, mouth, tongue and liver • Drinking while pregnant causes fetal alcohol syndrome and other birth defects • Physical, behavioral, and learning problems

26. Use of Tobacco • People use Tobacco • 71 Million Americans, including 13.7 million college-aged Americans. • 2008, nearly 21% of Americans age 18 describe themselves as current smokers. • Nicotine Addiction • Powerful psychoactive drug • Reaches Brain via bloodstream in seconds • Most physically addictive of the psychoactive drugs. • Loss of control • Tolerance and Withdrawal

27. Tobacco • Contains nicotine, the most heavily used addictive drug in the U.S. • Cigarettes, cigars, smokeless tobacco, and pipe tobacco • Nicotine addiction: • Provides immediate “psychological kick” • Causes withdrawal symptoms • Secondhand smoke contains toxic chemicals Health Effects of Tobacco Use: • Tobacco smoking is the leading cause of death in the U.S. & accounts for one out of every five deaths per year • Increases risk of cancers including cancer of the lung, larynx, esophagus, pancreas, bladder, and kidney • Woman smokers are more likely to lose a baby during pregnancy and have babies with low birth weight

28. Carcinogens and Poisons • 43 chemicals are linked to cancer (Carcinogen) • Benzo(a)pyrene • Urethane • Cocarcinogens (formaldehyde) • Combine with other chemicals to cause cancer • Poisonous substances • Arsenic • Hydorgen cyanide • Nicotine • Carbon monoxide • 400 times greater than is considered safe in industrial workplaces • Displaces oxygen in red blood cells • Additives • Nearly 600 chemicals

29. Immediate Effects • Acts on the brain either by exciting or tranquilizing the nervous system • Mild nicotine poisoning • Stimulates the cerebral cortex • Stimulates the discharge of adrenaline • Physiological effects on the body • BP goes up, HR is faster, smoking • depresses hunger, dulls taste buds

30. The Long-Term Effects • Cardiovascular Disease • Coronary Heart Disease (CHD) • Atherosclerosis-fatty deposits • Heart attack • Stroke • Aortic aneurysm • Pulmonary heart disease • Lung and other cancers (mouth, kidney, liver, • colon, stomach)-more cigarettes=bigger risk • Chronic Obstructive Lung Disease • Chronic Bronchitis • Other Respiratory Damage

31. Cumulative Effects • Males before 15 yrs. old are half as likely to live to 75 versus those who did not smoke • Females with similar habits reduce life expectancy by more than 10 years • Female smokers spend 17% more sick days in bed than nonsmokers • Both men and women show a greater rate of acute and chronic diseases

32. The Effects of Smoking on the Nonsmoker • Environmental Tobacco smoke (ETS) • EPA designated ETS as a class A carcinogen • Department of Health and Human Services’ National Toxicology Program - “known human carcinogen” • Surgeon General – 2006 – “there is no safe level of exposure to ETS; even brief exposure can cause serious harm”.

33. Environmental Tobacco Smoke • Mainstream smoke • Smoke exhaled by smokers • Sidestream smoke • Smoke from the burning end of a cigarette, cigar, or pipe. • 85% of smoke in a room is second hand • Twice the tar and nicotine • Three times the benzo(a)pyrene • Three times the ammonia • Smoke from a cigar can be even more dangerous • 30 times more carbon monoxide

34. Caffeine • A substance found in coffee, tea, soft drinks, chocolate, and certain medications • Stimulates the central nervous system (CNS) within 15 minutes • Moderate doses (2-4 cups of coffee) increases alertness and provides an energy boost • Large doses cause restlessness and irritability • Associated with insomnia, headaches, and abnormal heart rhythms. • Creates psychological dependence • Creates withdrawal symptoms including headache, muscle pain, and fatigue

35. Anabolic Steroids • Synthetic male sex hormones (e.g. testosterone) • Available by prescription (tablet or ointment) • Health effects: • Produces psychological effects including aggressiveness, uncontrolled bouts of anger (“roid rage”), depression • Associated with liver cysts and cancer, increased blood cholesterol, increased blood clotting, hypertension, reduced sperm count, testicular shrinkage, impotence, irreversible breast enlargement in men, and development of masculine characteristics in women

36. Strategies to Avoid Drug Abuse • Find productive ways to increase your self-esteem • Learn and practice stress-coping techniques • Develop varied interests • Practice assertiveness

37. Summary • Alcohol, nicotine (tobacco products), marijuana, and cocaine are the most widely used and abused drugs in the United States • Alcohol is the single most common recreational drug used in the United States • Use of alcohol, marijuana, and cocaine increases your risk of accidents, and prolonged use may result in psychological dependence, physical addiction, and damaged health

38. Summary, continued • Tobacco use can lead to an addiction to nicotine and prolonged use leads to increased risk of heart attack, stroke, and cancer • Caffeine is a central nervous system (CNS) stimulant found in common foods and beverages. It is currently unclear whether chronic consumption is a significant health risk • Long-term use of anabolic steroids can cause psychological and physiological side-effects • Decrease your risk of abusing drugs by increasing your self-esteem, learning how to cope with stress, developing numerous interests, and practicing assertiveness