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Addiction and Drug Abuse

Addiction and Drug Abuse. By S.Bohlooli, PhD. Cultural Consideration. Licit or Illicit ?! Resultant criminal activity leads to make an agent considered as illicit. Activity like: robbery, prostitution and other antisocial activity. Drug Misuse

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Addiction and Drug Abuse

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  1. Addiction and Drug Abuse By S.Bohlooli, PhD

  2. Cultural Consideration • Licit or Illicit ?! • Resultant criminal activity leads to make an agent considered as illicit. • Activity like: robbery, prostitution and other antisocial activity.

  3. Drug Misuse • A drug might be used for a wrong indication, or wrong dosage, and or too long period • Drug Abuse • abuse might be construed as any use of drug for non medical purpose

  4. substance dependence (addiction) • cluster of symptoms indicating that the individual continues use of the substance despite significant substance-related problems.

  5. PHYSICAL AND PSYCHOLOGICAL DEPENDENCE • Physical dependence is a state that develops as a result of the adaptation (tolerance) produced by a resetting of homeostatic mechanisms in response to repeated drug use. • Psychological dependence is manifested by compulsive drug seeking behavior in which the individual uses the drug repetitively for personal satisfaction often in the face of known risks to health

  6. Tolerance is the most common response to repetitive use of the same drug and can be defined as the reduction in response to the drug after repeated administrations

  7. Origins of Substance Dependence • Agent (drug) • Host (user) • Environment

  8. Agent (drug) • Availability • Cost • Purity/potency • Mode of administration: • Chewing (absorption via oral mucous membranes) • Gastrointestinal • Intranasal • Subcutaneous and intramuscular • Intravenous • Inhalation • Speed of onset and termination of effects • Pharmacokinetics: combination of agent and host

  9. Host (user) • Heredity • Innate tolerance • Speed of developing acquired tolerance • Likelihood of experiencing intoxication as pleasure • Psychiatric symptoms • Prior experiences/expectations • Propensity for risk-taking behavior

  10. Environment • Social setting • Community attitudes • Peer influence, role models • Availability of other reinforcers (sources of pleasure or recreation) • Employment or educational opportunities

  11. Withdrawal Syndrome • Withdrawal signs and symptoms occur when drug administration in a physically dependent person is abruptly terminated. • Withdrawal symptoms have at least two origins: (1) removal of the drug of dependence, (2) central nervous system hyperarousal due to readaptation to the absence of the drug of dependence.

  12. VII. Co-administration/Co-abuse • Many of these drugs are used in combination with other drugs from one or more categories. • Alcohol is used, for example, with almost everything else. • Smoking (nicotine intake) is prevalent in patients using other drugs. • Be aware of the possibility of combination of drugs when treating intoxication, withdrawal or overdose, each drug will require a specific treatment.

  13. Neurobiology of Abused Drugs • Many drugs acts through G protein coupled receptor (dopamine, opioid and cannabinoid) • Chloride Ion channel associated with GABA (benzodiazepines) • Excitatory amino acid receptors (phencyclidine)

  14. I. Animal Studies • Drug-self administration • Drugs as reinforcers in animals. • High correlation with human dependence liability.

  15. Morphine/Heroin Self-Administration

  16. II. Brain Reward System Changes in brain function => Reward=> Craving Involve the Dopaminergic System • Mesolimbic pathway:Ventral tegmental area (VTA), medial forebrain bundle, nucleus accumbens and the prefrontal cortex. • Nigrostriatal pathway: Sustantia nigra, striatum. • Mesocortical pathway: VTA, cingulate and frontal CTX. • Tubero-Infundibular: Arcuate N. in hypothalamus.

  17. THE DOPAMINERGIC SYSTEM

  18. THE MESOLIMBIC DOPAMINERGIC REWARD PATHWAY

  19. Tyrosine Dopamine Synapse Tyrosine L-DOPA DA

  20. Dopamine Reuptake System

  21. Alcohol consumption • Sedation • Relief of anxiety • Slurred speech • Ataxia • Impaired judgment • Disinhebited behavior

  22. Clinical aspect of opioid use • Rush: an orgasm like reaction • Euphoria • Feeling of tranquility and sleepiness

  23. CNS stimulants

  24. Clinical aspects of stimulants • Rush • Mental alertness • Marked euphoria • Delusion (bugs are crawling under skin!) • Spree use ( up to 4000 mg /day amphetamine) • Lack of food • Lack of sleep

  25. Clinical effect of marijuana • Being high • Euphoria • Uncontrollable laughter • Alteration of time sense • Depersonalization • Sharpened vision • Late: becoming relaxed, experience of introspective and dream-like effect • Difficulty in concentration and thinking

  26. Drugs Kill the Brain

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