Lecture 16 - websites.rcc.eduwebsites.rcc.edu/halama/files/2020/05/Health-Science-1-Lecture-16-Drugs-Spring-2020.pdf5/7/2020 1 Lecture 16 Drug Use and Abuse 1 Lecture 16 1. What is

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Lecture 16Drug Use and Abuse

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Lecture 16

1. What is a Drug?

2. Types of Drugs

3. OTCs (Over the Counter Drugs)

4. Drug Abuse

5. Drug Effects

6. Drugs of Abuse

7. Confronting the Drug Problem

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What is a Drug?

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What Is a Drug?

• Drug – a substance, other than food, that affects the

structure or function of the body through its chemical

action

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What is a Drug?Routes of Administration

• Oral - most drugs are taken orally…

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• Injection

– A hypodermic syringe used to deliver drug into the bloodstream by:

• Intravenous injection – into artery or vein

• Intramuscular injection – muscle (vaccinations)

• Subcutaneous injection – beneath the skin

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• Inhalation - smoking or huffing (e.g. asthma medicine)

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• Application to mucous membranes

• Application to skin (topical application)

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Types of Drugs

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Types of Drugs

Drugs are classified in several different ways…

1. Legal Drugs include:

– Medication prescribed by physicians

– Over-the-counter (OTC) medications

– Recreational (alcohol, tobacco)

– Herbal remedies

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Types of Drugs

2. Pharmaceutical Drugs - are developed for medical

purposes, whether over-the-counter or prescription

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Types of Drugs

3. Illicit drugs - are unlawful to possess, manufacture, sell, or

use (cocaine, marijuana*, crystal meth, etc.), viewed as

harmful

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*Legal in several states

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Types of Drugs

• Drug of Abuse - medical drug used for nonmedical (recreational) purposes, or a

drug that has no medical uses

• Substance - drug of abuse, a medication, or a toxin; the term is used

interchangeably with drug

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Over-The-Counter (OTC)

Drugs

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• Facts

– Nonprescription medicine

– More than 1/3 of the time people self-treat

• How a prescription drug becomes an OTC drug

1) At least three years of prescription sales

2) Use has been relatively high

3) Adverse drug reactions are not significant


• Types of OTC drugs

1. Analgesics – pain relief, GRAS (Generally Recognized as Safe)* GRAE

(Generally Recognized as Effective)

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2. Cold, cough, allergy, and asthma relievers

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3. Sleeping Aids



4. Dieting Aids

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The Over-the-Counter Drug Label


• Rules for proper OTC drug use:

1) Take as directed!!

2) Know what you are taking (e.g. Benadryl)

2) Know the effects

3) Reading warnings and cautions

4) Don’t use anything for more than 1 or 2 weeks

5) Be careful if you also take prescriptions (interactions)

6) Ask your pharmacist if you have questions

7) If you don’t need it, don’t take it!

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Misuse of OTCs

In 2008 A US Food and Drug Administration (FDA) advisory

panel recommended a ban on over-the-counter cough and

cold medicines for children younger than six.

Drug Abuse

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Using, Misusing, and Abusing Drugs

• Abuse often associated with illegal drugs, but

many people abuse and misuse legal drugs

– Drug Misuse – use for purpose not intended

– Drug Abuse – excessive use beyond acceptable

levels

– Misuse and Abuse - may lead to addiction

Who Uses?

Patterns of Illicit Drug Use

• A very complex issue!

• Rates of illicit drug use vary by age, gender, race and ethnicity, education, employment status, and geographical region

• Among Americans aged 12 or older, more than 47% report having used an illicit drug in their lifetime

• The most commonly used drugs are marijuana* and alcohol

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Illicit Drug Use by Age (12 and over)

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Reasons Why 18 – 22 year-olds Use Illicit

Drugs or Controlled Prescription Drugs

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Who Uses?

Patterns of Illicit Drug Use

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Drug Effects

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Drug Misuse and Abuse

• Characteristics of Drug/Substance abuse:

– Addiction - is the chronic relapsing brain disease characterized by

compulsive drug seeking and use, despite harmful consequences

– Tolerance - is reduced sensitivity to the effects of the drug

– Withdrawal Symptoms - uncomfortable feelings when drug use stops

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Why are Drugs (and other substances) Addictive?

• Most addictive drugs act on neurons in three brain

structures:

1. The Ventral Tegmental Area (VTA) in the midbrain

2. Nucleus Accumbens

3. Prefrontal Cortex

• The Pleasure and Reward Circuit

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Pleasure and Reward Circuit

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• Addictive psychoactive drugs activate and cause surge in levels of dopamineand associated feelings of pleasure

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Effects of Drugs on the Brain

• All or nearly all addictive drugs operate via the pleasure and reward

circuit

• Some also operate via additional mechanisms, i.e., the opioids which

block pain when the body undergoes stress

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Drugs of Abuse

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Drugs of Abuse

Drugs of abuse are usually classified as:

–Stimulants

–Depressants

–Opioids

–Hallucinogens

– Inhalants

–Cannabinoids

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Stimulants• Drugs that speed up activity in the brain and Sympathetic

Nervous System (SNS)

• “Fight-or-Flight” response - a physiological reaction that

occurs in response to a perceived threat to survival.

• Acceleration of heart and lung action

• Slowing of digestion

• Etc.

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Stimulants

• May stimulate movement, fidgeting, and talking, and

produce intense feelings of euphoria and create a sense of

well-being

• Examples:

– Cocaine

– Amphetamines

– MDMA (Ecstasy)

– Bath salts

– Caffeine

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Depressants

• Slow down activity in the brain and sympathetic

nervous system

• Can be deadly if misused, especially when mixed

with alcohol

• CNS depressants carry a high risk of dependence

• Examples:– Barbiturates and hypnotics

– Anti-anxiety drugs

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Alcohol

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Opiates and Opioids• Opiates – natural drugs obtained from the opium poppy

• Opioids – synthetic drugs that mimic the effects of opiates;

chemically manufactured

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Opiates and Opioids

• Currently prescribed as pain relievers, anesthetics,

antidiarrheal agents, and cough suppressants

• Produce feelings of pleasure and block the

sensation of pain

• Examples:

– Morphine

– Heroin

– Codeine

– Synthetic opioids (OxyContin, Vicodin, Demerol, Percocet, Percodan)

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Opiates and Opioids

• With low doses opioid users experience:

– Euphoria

– Drowsiness

– Constriction of the pupils

– Slurred speech

– Slowed movement

– Impaired coordination, attention, and memory

• At high dosage users can experience depressed respiration,

loss of consciousness, coma, and death (overdose)

• Opioids have a high potential for dependence

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Hallucinogens

• Also known as psychedelics

• Alter perceptions and thinking in characteristic ways

• Intensify and distort visual and auditory perceptions and

produce hallucinations

• Examples:

– LSD (lysergic acid diethylamide)

– PCP (phencyclidine)

– Peyote

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Inhalants

• Breathable chemical vapors that alter consciousness,

producing a state that resembles drunkenness

• Active ingredients are all powerful toxins and carcinogens

• The most significant negative effect for chronic users is

widespread and long-lasting brain damage

• Examples:

– Paint thinner, gasoline, glue, and spray-can propellant

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Cannabinoids• Marijuana is the most widely used illicit drug* in the United

States

– Derived from the hemp plant, Cannabis sativa

– Active ingredient is delta-9-tetrahydrocannabinol (THC)

– Use produces mild euphoria, sedation, lethargy, short-term memory

impairment, increase in appetite, distorted sensory perceptions,

distorted sense of time, impaired coordination, and an increase in

heart rate

• Researchers have found that THC impairs problem solving

and decision making

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Confronting

the Drug Problem

Approaches to the Drug Problem

1. Supply Reduction Strategies

2. Demand Reduction Strategies

3. Harm Reduction Strategies

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1. Supply Reduction Strategies:

– Interdiction - interception of drugs before they get into

the country

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1. Supply Reduction Strategies:

– Pressure on supplying countries to suppress production

and exportation

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Approaches to the Drug Problem1. Supply Reduction Strategies:

– Prevent domestic production and selling via law

enforcement

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2. Demand Reduction Strategies - reducing the

public desire for illegal and illicit drugs.

– Incarceration for drug-related crimes (current users)

• Follow up incarceration with treatment

• Half the people in U.S. prisons meet the diagnostic

standards for substance use disorders

• Only 7–17% who need drug treatment receive it

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– Prevention Strategies – EDUCATION!

1. Primary Prevention - educate entire population

(https://www.youtube.com/watch?v=GOnENVylxPI)

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– Prevention Strategies (i.e educate potential users)

2. Secondary Prevention - educate subgroups that are

at greatest risk for use or abuse

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https://www.youtube.com/watch?v=GOnENVylxPI

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– Prevention Strategies (i.e educate potential users)

3. Tertiary Prevention – educate at-risk individuals rather

than groups

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2. Demand Reduction Strategies:– Drug treatment programs

• Narcotics Anonymous (NA)

• Treatment is more successful when the program lasts at least three

months

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Approaches to

the Drug Problem3. Harm Reduction Strategies - focus on reducing the harm

associated with drug use...

• Provide containers for needle and syringe disposal

• Make naloxone (Narcan) available in case of opioid overdoes

• Needle exchange programs

• Drug substitute programs (ex: methadone instead of heroin)

• Controlled availability

• Medicalization

• Decriminalization

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Documents

Lecture 16 - websites.rcc.eduwebsites.rcc.edu/halama/files/2020/05/Health-Science-1-Lecture-16-Drugs-Spring-2020.pdf5/7/2020 1 Lecture 16 Drug Use and Abuse 1 Lecture 16 1. What is