1. health and fitness
2. addiction

An Invitation to Health – Chapter 12
Avoiding
Addictions
Prepared by: Richard C. Krejci, Ph.D.
Professor of Public Health
Columbia College of SC
3.27.15
Chapter Objectives
Describe the harmful effects of addictions on every dimension of health.
Identify the risk factors for all addictions.
Compare and contrast the reasons students
choose to use or not use drugs.
Give examples of appropriate and inappropriate
use of over-the-counter and prescription
medications.
Categorize the types of drug dependence, and discuss contributing factors.
Identify the common drugs of abuse; their street names; how they are
abused; acute effects; and health risks.
Describe the treatment methods available for individuals seeking help for
drug dependence.
Evaluate your drug use history (legal and illegal) and identify strategies
to decrease risky behaviors.
The Impact of Addictive Behaviors on the
Dimensions of Health
• Physical Health
• Impair organ systems
• May cause disease, disability, and premature death
• Psychological Health
• Addictive behaviors
• “self-medicating”
• May lead to depression and anxiety, guilt, and shame
• Spiritual Health and Environmental Health
• Loss of connection with others
• Loss or destruction of property due to accidents
• Social Health
• Withdrawal from social interactions
• Isolation
• Intellectual Health
• Loss of concentration, logic, reasoning,
and critical thinking
Characteristics Of College Drug
Users
Risk Factors For Problem Gambling
•
Male sex.
•
Gambling at an early age.
•
A big win earlier in one’s gambling career.
•
Consistently chasing losses.
•
Gambling alone.
•
Feeling depressed before gambling.
•
Feeling excited and aroused during gambling.
•
Behaving irrationally during gambling
•
Poor grades at school.
•
Other addictive behaviors.
•
Lower socioeconomic class.
•
Parents with a gambling or other addiction problem.
•
A history of delinquency or stealing money to fund
gambling.
•
Skipping class to go gambling.
Why Students Use Drugs
Genetics/Family History
Sexual Identity
Parental Attitudes
Alcohol Use and/or
Race/Ethnicity
Gambling
Psychological
Reasons
Why Students Use Drugs
Why Students Don’t Use Drugs
Spirituality and Religion
Academic
Engagement
Athletics
Understanding Drugs and Their
Effects
Drug
Any substance, other than food, that affects bodily
functions and structures when taken into the body.
Drug Misuse
The use of a drug for a purpose (or person) other than that
for which it was medically intended.
Drug Abuse
The excessive use of a drug in a manner
inconsistent with accepted medical practice.
Understanding Drugs and Their
Effects


Dosage and Toxicity

Dose/response curve

Detoxification enzymes (liver)
Individual Differences

Psychology

Anatomy

Gender

Setting or Environment

Six Routes of Taking a Drug

Four Types of Drug Interactions
Routes of Administration
Routes of
Administration of
Drugs
Transdermal
Fig. 12.1, p. 379
Drug to Drug Interactions
Additive
(Drug A + Drug B)
Synergistic
(Drug A + Drug B > A or B)
Be able
to define
each
term
Potentiating Antagonistic
(Drug A or B) > any drug
(Drug A < Drug B)
Caffeine and Its Effects
Facts
•
•
The most widely used psychotropic
(mind-affecting) drug in the world.
80% of Americans drink coffee, our
principal caffeine source – an
average of 3.5 cups per day.
Caffeine and Its Effects
General
Bodily
Effects
•
Relieves drowsiness, helps in
performance of repetitive tasks, and
improves the capacity for work.
•
Improves performance and
endurance during prolonged,
exhaustive exercise, and to a lesser
degree, enhances short-term, highintensity athletic performance.
•
Improves concentration, reduces
fatigue, and sharpens alertness.
Caffeine and Its Effects
Health Effects
•
A few cups of coffee per day is safe and
may offer some benefits such as lowering
the risk for type 2 diabetes, and reducing
the likelihood of gallstones, Parkinson’s
disease, and colon cancer.
High Dosage
Effects
•
Dependence, anxiety, insomnia, rapid
breathing, upset stomach and bowels, and
dizziness.
Table 12-2, p. 392
Caffeine Content in Selected Soft Drinks
Drink
Company
Milligrams of
Caffeine in 12 oz.
Mountain Dew MDX
PepsiCo
120
JOLT
Wet Planet
72
Diet Pepsi Max
PepsiCo
70
Mountain Dew Code
Red
PepsiCo
55
Mountain Dew
PepsiCo
55
Mello Yello
Coca-Cola
51
Diet Coke
Coca-Cola
45
Dr. Pepper
Cadbury
41
Pepsi-Cola
PepsiCo
38
7-Up
7-Up/Dr. Pepper
0
Commonly Misused
Over-The-Counter (OTC) Drugs
•
Analgesics
•
•
•
•
Cough Syrup
•
•
•
•
•
Aspirin
Nonsteroidal AntiInflammatory Drugs
Ibuprofen
DXM
Nasal Sprays
Laxatives
Eye Drops
Sleep Aids
Prescription Drugs
Potential Complications
Non-adherence
Recurrent infections, serious medical complications, and emergency
hospital treatment.
Physical Side Effects
Heart failure, heart attack, seizures, kidney and liver failure, severe
blood disorders, birth defects, blindness, memory problems, and
allergic reactions.
Psychological Side Effects
Depressive symptoms vs. agitation and anxiety.
Drug Interactions
OTC drugs, prescription drugs, alcohol, vitamins and minerals, and
food components.
Generic Drugs
Have the same active ingredients as brand-name prescriptions, but
their fillers and binders, which can affect the absorption of a drug, may
be different.
Prescription Drug Abuse Is
Increasing
Highest nonmedical use of
prescription medication is among
young adults age 18 to 25
Most widely abused medications are
prescription stimulants and pain
killers
Key Terms Related to Drug Use
•
•
•
•
•
•
•
Psychoactive – “mind altering”
Addiction - A behavioral pattern characterized by compulsion, loss
of control, and continued repetition of a behavior or activity in spite
of adverse consequences.
Psychological Dependence - The emotional or mental attachment
to the use of a drug.
Physical Dependence - The physiological attachment to, and need
for, a drug.
Intoxication - Maladaptive behavioral, psychological, and
physiologic changes that occur as a result of substance abuse.
Withdrawal - Development of symptoms that cause significant
psychological and physical distress when an individual reduces or
stops drug use.
Polyabuse - The misuse or abuse of more than one drug at a time.
What Causes Drug Dependence
and Abuse?
The Biology of Dependence
• Dopamine
The Psychology of Vulnerability
• Difficulty controlling impulses, a lack of values that may
constrain drug use, low self-esteem, feelings of
powerlessness, denial, anxiety, and depression.
Early Influences
• Lower socioeconomic backgrounds, family instability, a
lack of realistic, rewarding alternatives and role models,
and increased hopelessness.
• Teen Drug Use
•
Early use of tobacco and alcohol is linked with a greater
likelihood of marijuana use, which in turn increases the likelihood
of other illegal drug use.
The Biology of Dependence:
Dopamine Levels For Cocaine
Terminal of
neuron
Uptake
pump
Synapse
Dopamine
receptor
Dendrite of
adjacent
neuron
Dopamine
Cocaine
Fig. 12.2, p. 400
Drugs and Driving
•
Alcohol affects perception, coordination, and
judgment.
•
Marijuana affects a wide range of motor skills.
•
Sedatives, hypnotics, and anti anxiety agents
slow reaction time.
•
Amphetamines, after repeated use,
impair coordination.
•
Hallucinogens distort judgment.
Categories for Common
Drugs Of Abuse
Cannabis
Club Drugs/
Designer
Drugs
Stimulants
Depressants
Hallucinogens
Inhalants
Marijuana
MDMA, MDA,
MDEA
Amphetamines
Benzodiazepines
LSD
Solvents
Methamphetamine
Rohypnol
PCP
Gases
Cocaine
Barbituates
GHB
Ketamine
Nitrites
Opioids (pain
killers)
Cannabis
Marijuana and Hashish
The Facts
• Marijuana is the most widely used illegal drug in the
United States (~12 million Americans).
• Derived from the cannabis plant that contains the active
ingredient THC.
How Users Feel
• A mild sense of euphoria, a sense of slowed time, a
dreamy type of self-absorption, and some impairment in
thinking and communicating.
•
The euphoria peaks within a half hour and usually lasts
about three hours.
•
Potential for marijuana withdrawal
syndrome.
Negative Long-Term Effects
Brain and central nervous system
• Dulls sensory and cognitive skills
• Impairs short-term memory
• Alters motor coordination
• Causes changes in brain chemistry
• Leads to difficulty in concentration,
attention to detail, and learning new,
complex information
Cardiovascular system
• Increases heart rate
• Increases blood pressure
• Decreases blood flow to the limbs,
which in extreme cases could require
an amputation
Respiratory system
• Damages the lungs (50% more tar
than tobacco)
• May cause lung cancer
• May damage throat from inhalation
Reproductive system
• In women, may impair ovulation and
cause fetal abnormalities if used during
pregnancy
• In men, may suppress sexual functioning
and may reduce the number, quality and
mobility of sperm, possibly affecting
fertility
Positive Short-Term Therapeutic
Effects for Patients
Brain and central nervous system
• May help minimize pain from
the spread of cancer
Vision
• Reduces intraocular pressure,
helping those afflicted with
glaucoma
Digestive system
• Combats nausea from
chemotherapy and helps
minimize vomiting
• Helps restore appetite in people
who have lost weight from
cancer or AIDS
Muscular system
• May help calm spasms from
spinal-cord injury, multiple
sclerosis, and possibly epilepsy
Impact of
Marijuana
Fig. 12.3, p. 394
Common Names Of Club Drugs
Ecstasy GHB Nitrites GBL
Love drug hug Beans Herbal
X
Georgia home boy
Cloud 9 Liquid
Ecstasy
Herbal bliss XTC G
Grievous bodily harm
Club Drugs (Designer Drugs)
Ecstasy
The Facts
•
Ecstasy is the common street name
for methylene-dioxymethamphetamine
(MDMA).
•
Has both stimulant and mildly hallucinogenic
properties.
Common Characteristics of Ecstasy Users
•
They are more likely to use marijuana, binge
drink, spend more time socializing and less
time studying, have more sexual partners,
smoke cigarettes, rate parties as more
important than academics, and view religion
as less important.
Club Drugs (Designer Drugs)
GHB/GBL
•
•
The Facts
•
GHB stimulates the release of human
growth hormone, but has no known
effects on muscle growth.
•
When GBL, an industrial solvent, is
ingested it is converted to GHB.
How Users Feel
•
Smaller doses induce euphoria and
enhance sex due to a rise in dopamine in
the brain.
•
Larger doses can cause individuals to
pass out and possibly fall into a coma.
The Risks of GHB/GBL
Side Effects
•
Nausea, amnesia,
hallucinations, decreased
heart rate, convulsions, and
sometimes blackouts/coma.
Long Term Side Effects
•
Withdrawal reaction including
rapid heartbeat, tremor,
insomnia, anxiety, and
occasionally hallucinations that
last a few days to a week.
•
The danger is greatest when
GHB is mixed with alcohol or
opiates.
Club Drugs
Ketamine (K)
The Facts
•
Ketamine is an anesthetic used by veterinarians.
•
K blocks chemical messengers in the brain that
carry sensory input thereby leading to
hallucinations.
Side Effects
•
At high doses, K can cause delirium, amnesia,
impaired motor function, high blood pressure,
depression, and potentially fatal respiratory
problems.
Other Common Club Drugs
Nitrites
Herbal Ecstasy
The Facts
•
Clear, amber-colored liquids
especially abused in gay and
bisexual men.
•
Used recreationally for a high
feeling, a slowed sense of
time, a carefree sense of wellbeing, and intensified sexual
experiences.
Side Effects
•
Headache, dizziness, a drop in
blood pressure, changes in
heart rate, increased pressure
within the eye, and skin
flushing.
The Facts
•
A mixture of stimulants such as
ephedrine, pseudosphedrine,
and caffeine.
•
Sold as a “nautral” and safe
alternative to ecstasy.
Side Effects
•
Stroke, heart attack, and a
disfiguring skin condition.
Stimulants
Amphetamines & Methamphetamine
The Facts
•
•
•
Amphetamines trigger the release of epinephrine
(adrenaline) which stimulates the central nervous system.
Methamphetamine is a powerful addictive stimulant.
Meth remains in the central nervous system and the body,
producing prolonged stimulant effects.
How Users Feel
•
Amphetamines produce a state of hyper-alertness and
energy.
•
•
High doses make users feel wired, talkative, excited, restless,
irritable, anxious, and moody.
Meth produces long-lasting toxic effects,
including psychosis, violence, seizures,
and cardiovascular abnormalities.
Amphetamines & Methamphetamine
Potential Side Effects
•
Binging and crashing.
•
Feelings of grandiosity,
anxiety, tension, anger,
agitation, paranoia, and
impaired judgment.
•
Increased heart rate and blood
pressure.
Long Term Side Effects
•
Malnutrition, skin disorders,
tooth loss, ulcers, insomnia,
depression, vitamin
deficiencies, sexual
dysfunction, impaired
concentration or memory, and,
in some cases, brain damage.
Prescription Stimulants
•
Abuse of stimulants
prescribed for attention
deficit/hyperactivity
disorder (ADHD) has
increased among young
people, 18-25 years.
•
Most students who have
tried stimulants so not
feel that the drugs had a
positive effect on their
academic performance in
the long run.
Prescription Stimulant Abuse on
Campus
Stimulants (Cocaine)
•
Cocaine is a white crystalline powder extracted
from the leaves of the South American coca
plant.
Routes of Administration
•
Sniffed/Snorted
•
Injected intravenously (speedballing)
•
Smoked (freebasing/crack)
How Users Feel
•
Cocaine stimulates the central nervous system
producing feelings of soaring well-being and
boundless energy.
•
After a brief period of euphoria, users slump into
depression.
Central nervous system
• Repeated use or high dosages may cause
severe psychological problems
• Suppresses desire for food, sex, and sleep
• Can cause strokes, seizures, and
neurological damage
Some
Effects
Of Cocaine
On The
Body
Nose
• Damages mucous membrane
Cardiovascular system
• Increases blood pressure by constricting
blood vessels
• Causes irregular heartbeat
• Damages heart tissue
Respiratory system
• Freebasing causes lung damage
• Overdose can lead to respiratory
arrest
Reproductive system
• In men, affects ability to maintain erections and
ejaculate; also causes sperm abnormalities
• In women, may affect ability to carry pregnancy
to term
Fig. 12.4, p. 403
Depressants
Benzodiazepines and Barbiturates
The Facts
•
Benzodiazepines are sedative-hypnotics and have
largely replaced barbiturates.
•
Commonly prescribed for tension, muscular strain,
sleep problems, anxiety, panic attacks, anesthesia,
and in the treatment of alcohol withdrawal.
•
Rohypnol – date rape drug.
How Users Feel
•
Low doses reduce or relieve tension, but may cause
rapid mood changes, impaired judgment, and
impaired social and occupational functioning.
•
High doses produce slurred speech, drowsiness,
and stupor.
Selected Benzodiazepines
Generic Name
Trade/Brand Name
Medical Purpose
alprazolam
Xanax
Tranquilizer
chlordiazepoxide
Librium
Tranquilizer
clonazepam
Klonopin
Anticonvulsant
clorazepate
Tranxene
Tranquilizer
diazepam
Valium
Tranquilizer
slurazepam
Dalmane
Insomnia
oxazepam
Serax
Tranquilizer
triazolam
Halcion
Insomnia
Dosages of these prescription drugs range from .5 mg to 30 mg
Drug images taken from the DEA website
Benzodiazepines and Barbiturates
Side Effects
•
Physical and psychological dependence within two to four
weeks.
•
Cross-tolerance.
•
Mood and behavior changes, slurred speech, poor
coordination, unsteady gait, involuntary eye movements,
impaired attention or memory, and stupor and coma.
•
Synergistic effect when used in combination with alcohol.
Depressants
Opioids (Narcotics: Opium, Morphine, Codeine, and Heroin)
Prescription Opioids (Hydromorphine and Oxycodone)
How Users Feel
•
All opioids relax the user, and impart feelings of euphoria
while acting as powerful narcotics, or painkillers.
Side Effects
•
Addiction, lethargy, weight loss, loss of sex drive, anxiety,
insomnia and restlessness.
•
Overdose causes shock, coma, and depressed respiration.
•
Long Term Injection of Opioids: infections of the heart lining
and valves, skin abscesses, and lung congestion.
Treatment of Addiction
Methadone Maintenance
Hallucinogens
Definition: a group of mind-altering drugs that affect the
brain and nervous system bringing about changes in
thought, self-awareness, emotion and sensation.
Natural Sources Morning glories, jimsonweed, nutmeg, mace,
of Hallucinogens peyote cactus, and psychedelic mushrooms
Synthesized
Hallucinogens
LSD: lysergic acid diethylamide-24; a
psychedelic drug that produces distorted
reality.
• PCP: an anesthetic that blocks nerve
receptors from pain and temperature without
producing numbness; angel dust, peace pill.
•
Inhalants
Definition: drugs that produce vapors that cause
psychoactive effects when inhaled or sniffed.
Examples
Potential Side
Effects
Model airplane glue, gasoline, paint
thinner, transmission fluid, lighter fluid,
liquid shoe polish, and fingernail polish
remover.
Gastroenteritis, depressed muscle tone,
damage to the liver and kidneys, nervous
system dysfunction, and bone marrow
disorders.
Inhalants – A Risk For Young
People
Only alcohol is more widely used than inhalants
Slightly stimulated
Effect
Less inhibited
Interference with thinking and impulse
control
Irritation of throat, lungs and nose
Nausea and headache
Risks
Tolerance occurs
Suffocation
Cardiac arrhythmia
Treating Drug
Dependence and Abuse
•
•
Recognize the reality of
the problem.
Consult a physician,
counseling center, or local
mental health clinic.
Modes of Intervention
•
•
•
•
Medical care
Medication
Detoxification
Counseling
•
•
•
•
Individual psychotherapy
Marital and family therapy
Behavior modification
12-step programs
Stabilization and
Self-Assessment
Education
Involvement of
Significant
Warning-sign
Relapse-Prevention
Planning
Others
Identification and
Review of the
Recovery
Program
Management
Inventory Training
Page 418
Choosing An Addiction
Free Lifestyle
•
Set goals for getting
help.
•
Participate in drug-free
activities.
•
Educate yourself.
•
Choose friends with a
future.
The End
This slide show was developed by:
Richard C. Krejci, Ph.D.
Professor of Public Health
Columbia College of SC
All Rights Reserved