Drugsch2 - Chapter 2 Chapter Drug-Taking Behavior Drug-Taking The Personal and Social Concerns Concerns Risk/Benefit Analysis of Drug Risk/Benefit

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Unformatted text preview: Chapter 2 Chapter Drug-Taking Behavior: Drug-Taking The Personal and Social Concerns Concerns Risk/Benefit Analysis of Drug Risk/Benefit Drugs per se are not bad. Behavior and Drugs health risks associated with drug is viewed as acceptable or not in society as 1: What are the potential physical risks to 1: self and others? self 2: What is the potential for psychological 2: and/or physical dependency? and/or 3: What is the connection between a 3: particular drug and crime/violence? particular Terminology Terminology Acute Toxicity – immediate harm Chronic Toxicity – long-term harm Dose-Response curve – depiction of Dose-Response drug’s effects as dose increases drug’s Effective Dose – minimal dose of a drug Effective needed to produce intended effect in a percentage of population (50%) percentage Lethal Dose – minimal dose needed to Lethal produce death in percentage of population (50%) (50%) Terminology Terminology Therapeutic Index: the measure of a Therapeutic drug’s relative safety for use, computed by the ratio of the lethal dose for 50% of the population over the effective dose for 50% of the population: LD50 / ED50 LD50 Example: LD50 for drug ‘X’ is 15 mg Example: and the ED50 is 5mg, then the Therapeutic Index = 3 Therapeutic Dose Response Curve Dose EFFECTIVE DOSE (ED) EFFECTIVE LETHAL DOSE (LD) • The effective dose is the minimal dose The necessary to produce the intended drug effect in a given percentage of the population under study. population The lethal dose is the minimal dose The necessary to produce death in a given percentage of the population under study. percentage • EXAMPLES OF LD AND ED MEASURES MEASURES • ED50 — the dose that produces the intended drug effect ED50 in 50 percent of the population under study in ED100 — the dose that produces the drug effect in 100 ED100 percent of the population percent LD50 — the dose producing death in 50 percent of the LD50 population under study population LD100 — the dose producing death in 100 percent of the LD100 population population • • • Margin of Safety Margin Safety Margin: The ratio of a lethal dose for 1% of the The population to the effective dose of 99% of the population of Example: LD1 / ED99 LD1 = 110 mg ED99 = 10 mg Safety margin = 11 Which is a more conservative measure? Therapeutic Index or Safety Margin? DAWN STATISTICS DAWN • • DAWN: Drug Abuse Warning Network DAWN does not report alcohol alone! DAWN ED episode: An instance of a person coming to the emergency An department (ED) of a hospital seeking treatment for a department of drug-related problem drug-related ED mention: The substances (“mentioned”) referred to by the The substances patient during a given ED episode patient ME mention: The substances involved in a particular drug-related death, as reported by the medical examiner (ME) medical • • DAWN 2005 DAWN 2005 ED Mentions Alcohol in combination Cocaine Marijuana Heroin Misc. anti­anxiety and sedative medications Methamphetamine Number of Mentions 207,335 199,198 119,472 93,519 21,816 17,696 % of total ED episodes 31% 30% 18% 14% 3% 3% DRUG TOLERANCE DRUG • Definition: the capacity of a drug to produce a Definition: gradually diminished physical or psychological effect upon repeated administrations effect • Alternate Definition: the necessity for a dosage to be increased Alternate upon repeated administrations in order for the drug effect to remain the same remain • • Behavioral Tolerance: the process of drug Behavioral tolerance that is linked to drug-taking behavior occurring consistently in the same surroundings or under same circumstances. or Reinforcement and repetition are key DEPENDENCE DEPENDENCE Physical Dependence User continues to take a drug because he User fears the physical consequences of not taking the drug. Heroin produces painful withdrawal symptoms symptoms Psychological Dependence User continues to take a drug because she User wishes to experience the positive effects of the drug – no fear of withdrawal the Rat studies SUBSTANCE DEPENDENCE DEPENDENCE DSM-IV CRITERIA At least 3 out of the following must apply within the past year: • • • • • • • Tolerance Withdrawal Unintentional overuse Persistent desire or efforts to control drug use Preoccupation with the drug Reduction or abandonment of important social, occupational, or Reduction recreational activities in order to engage in drug use recreational Continued drug use despite major drug-related problems Symptoms must have persisted for more than a month or occurred Symptoms repeatedly over a longer period of time. repeatedly SUBSTANCE ABUSE ABUSE DSM-IV CRITERIA At least one of the following must apply within the past year: • • • • Recurrent drug use resulting in a failure to fulfill major obligations at Recurrent work, school, or home work, Recurrent drug use in situations in which use is physically Recurrent hazardous hazardous Recurrent drug-related legal problems, such as arrest for disorderly Recurrent conduct or drug-related behavior conduct Continued drug use despite the knowledge of persistent social, Continued occupational, psychological, or physical problems that would be caused or made more difficult by the use of the drug caused Note: The person must have never met the criteria for substance Note: dependence for this particular drug. Drug Abuse and College Drug Abuse and College Students Have you gotten into financial trouble as a result of drinking or other drug use? Is alcohol or other drug use making your college life unhappy? Do you use alcohol or other drugs b/c you are shy with other people? Has drinking alcohol or using other drugs ever caused conflicts with close friends of the opposite sex? Has drinking alcohol or using other drugs ever caused conflicts with close friends of same sex? Has drinking alcohol or using other drugs ever damaged other friendships? Has drinking alcohol or using other drugs ever been behind your losing a job (or direct reason)? Do you lose time from school due to drinking and/or other drug use? Has drinking alcohol or using other drugs ever interfered with preparations for exams? Has your efficiency decreased since drinking and/or using other drugs? Rutger’s Collegiate Substance Abuse Screening Test con’t Abuse Rutger’s Collegiate Substance Abuse Screening Test con’t Abuse Do you drink alcohol or use other drugs to escape from worries or troubles? Is your drinking and/or using other drugs jeopardizing your academic performance? Do you drink to build your self confidence? Has your ambition decreased since drinking and/or drug using? Does drinking or using drugs interfere with sleeping? Rutger’s Collegiate Substance Abuse Screening Test con’t Abuse Have you ever felt remorse after drinking and or using other drugs? Do you drink or use drugs alone? Do you crave a drink or other drug at a definite time daily? Do you want a drink or other drug the next morning? Have you ever had a complete or partial loss of memory as a result of drinking or using other drugs? Rutger’s Collegiate Substance Abuse Screening Test con’t Abuse Is drinking or using drugs affecting your reputation? Does your drinking and/or drug use make you careless of your family’s welfare? Do you seek out drinking/drugging companions and drinking/drugging environments? Has your physician ever treated you for drinking and/or other drugs? Have you ever been to the hospital on account of drinking or drug use? Drugs and Pregnancy Drugs 12% of pregnant women report smoking cigarettes 14% report consuming some alcohol Underestimates due to social desirability Increased risk of miscarriage/spontaneous abortion and Increased malformation of fetus during early phases of pregnancy (4-8 weeks) (4-8 Drug use after 8th month – more likely to experience growth retardation, pre-maturity, and neurological damage damage DRUGS, VIOLENCE, AND CRIME: DRUGS, THE SPECIFIC ISSUES • Pharmacological violence — acts of violence committed Pharmacological while under the influence of a particular drug: Violence against a persons against Economically compulsive violence — acts of violence Economically that are committed by the drug abuser to secure money to buy drugs: Violence against property: ROBBERY Violence Systemic violence — acts of violence committed by Systemic aggressive behaviors within a network of illicit drug trafficking and distribution: Turf battles, gang warfare, organized crime organized • • Pharmacological Violence Pharmacological Violence Rape 52% % of violent episodes associated of % of violent episodes associated With alcohol and drugs With with alcohol/drugs Spousal abuse 50% Traffic fatalities 50% Child abuse 38% Murder 49% Drowning 69% Assaults 62% Suicides 20­35% MAJOR DRUG REGULATORY LAWS, 1906–PRESENT LAWS, • • • • • • • 1906 Pure Food and Drug Act 1914 Harrison Act 1919 Volstead Act 1933 Prohibition Ends 1937 Marijuana Tax Act 1970 Comprehensive Drug 1970 Abuse Prevention and Control Act Abuse 1988 Omnibus Drug Act FIVE SCHEDULES OF CONTROLLED SUBSTANCES SUBSTANCES • Schedule I — high potential for abuse, no accepted medical use • heroin, LSD, mescaline, marijuana, PCP • Schedule II — high potential for abuse, some accepted medical use • codeine, morphine, cocaine, methadone, amphetamines, short-acting codeine, barbiturates barbiturates • Schedule III — some potential for abuse, accepted Schedule medical use (with potential dependence) medical • barbiturates, codeine or opium in alcohol mixtures • Schedule IV — low potential for abuse, accepted medical use • antianxiety drugs and sedative-hypnotics • Schedule V — minimal potential for abuse, widespread Schedule medical use medical • prescription cough medicines not containing codeine, laxatives ZERO TOLERANCE VERSUS HARM REDUCTION VERSUS • A “zero tolerance” policy means that the “zero objective is to totally eliminate illicit drugobjective taking behavior. A “harm reduction” policy means that the “harm objective is to minimize the medical, psychological, and social costs associated with drug-taking behavior. • Point/Counterpoint Debate Point/Counterpoint Debate Should we legalize drugs? What about certain drugs? What about certain drugs under certain circumstances? Reasons for? Reasons against? ...
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This note was uploaded on 05/09/2011 for the course CHLH 243 taught by Professor Lange during the Fall '08 term at University of Illinois at Urbana–Champaign.

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