Recognizing and Avoiding Addiction and Drug - PowerPoint Presentation

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Recognizing and Avoiding Addiction and Drug Abuse

© 2015 Pearson Education, Inc.Slide2

LEARNING OUTCOMES

Identify the symptoms of addiction and explain the difference between addiction and habit.Discuss the types of addictions, including compulsive behaviors such as gambling and shopping.

Identify the six categories of drugs and distinguish between drug misuse and drug abuse.

Discuss the issues of over-the-counter and prescription drug misuse and abuse, including their impact on college campuses.

Profile illicit drug use in the United States, including who uses illicit drugs, financial impact, and prevalence on college campuses.Discuss the use and abuse of controlled substances, including cocaine, amphetamines, marijuana, opioids, hallucinogens, inhalants, and steroids.Discuss treatment and recovery options for addicts, and discuss public health approaches to preventing drug abuse and reducing the impact of addiction on our society.

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What Is Addiction?

Defined as continued involvement with a substance or activity despite its ongoing negative consequences.Classified by the American Psychiatric Association (APA) as a mental disorder.

Physiological dependence results in tolerance and withdrawal.

Psychological dependence is the dependency of the mind on a substance or behavior that can lead to psychological withdrawal symptoms, such as anxiety, irritability, or cravings.

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The Process of Addiction

Compulsion, which is characterized by obsession with, or excessive preoccupation with, the behavior and an overwhelming need to perform it

Loss of control

, or the inability to predict reliably whether any isolated occurrence of the behavior will be healthy or damaging

Negative consequences, such as physical damage, legal trouble, financial problems, academic failure, or family dissolution, which do not occur with healthy involvement in any behaviorDenial, the inability to perceive that the behavior is self-destructive

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Cycle of Psychological Addiction

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Habit versus Addiction

Addiction involves elements of habit, a repeated behavior in which the repetition may be unconscious.A habit can be broken.

Addiction involves repetition of a behavior that occurs with compulsion, and considerable discomfort occurs if the behavior is not performed.

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Addiction Affects Family and Friends

Codependence, a condition in which a person is controlled by an addict

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s addictive behavior

Defined by lack of ability to set boundariesLiving in a chaotic, crisis-oriented modeAssuming responsibility for meeting others' needs to the point of subordinating own needs or even being unaware of personal needsEnablers, people who knowingly or unknowingly protect addicts from the consequences of their behavior

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Addictive Behaviors

Drug chemicals are not the only source of addiction. People can become addicted to certain behaviors.Process addictions are behaviors known to be addictive because they are mood altering.

Gambling, compulsive buying, compulsive exercise, and compulsive Internet or technology use are all process addictions.

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Disordered Gambling

More than 2 million Americans are considered compulsive gamblers, and 6 million more are considered to be at risk for developing gambling addiction.Previously called pathological gambling and now referred to as

disordered gambling

by the APA, it is recognized as a mental disorder.

There is strong evidence for a biological component.© 2015 Pearson Education, Inc.Slide10

Compulsive Buying Disorder

Shopping is often used as a way to make people feel better about themselves, but for some people it becomes compulsive buying disorder.Symptoms include the following:

Buying more than one of the same item

Keeping items in the closet with tags attached

Repeatedly buying more than is needed or can be affordedHiding purchases from relatives and loved ones© 2015 Pearson Education, Inc.Slide11

ABC News Video: Woman's Shopping Addiction Revealed

Discussion Questions

How

can you identify if someone has a shopping addiction?

What methods can be used to help someone who has a shopping addiction?Discuss possible reasons someone may become addicted to shopping. Are there psychological abnormalities that may manifest in the need to overspend?© 2015 Pearson Education, Inc.Slide12

Exercise Addiction

A large portion of people with eating disorders use exercise to purge, instead of or in addition to, self-induced vomiting.Warning signs include working out alone, rigid exercise patterns, exercising for more than 2 hours daily, exercising when sick or injured or to avoid social events, school, or work.

Addictive exercise results in negative consequences similar to those in other addictions.

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Technology Addictions

Cell phones, video games, PDAs, networking sites, and the Internet can all be addictive.An estimated 1 in 8 Internet users will likely experience Internet addiction.

Symptoms include general disregard for one

'

s health, sleep deprivation, neglecting family and friends, lack of physical activity, euphoria when online, lower grades in school, and poor job performance.Internet addicts may feel moody or uncomfortable when they are not online.© 2015 Pearson Education, Inc.Slide14

What Is a Drug?

Drugs are substances other than food that are intended to affect the structure or function of the mind or body through chemical action.Prescription medications; over-the-counter (OTC) medications; legal substances such as alcohol, caffeine, and tobacco; and illegal substances such as heroin and methamphetamines are all drugs.

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What Is a Drug (cont.)

Abuse is often associated with illegal drugs, but many people abuse and misuse legal drugs.Drug misuse

—use for purpose not intended

Drug abuse

—excessive useMisuse and abuse may cause serious harmNine percent of Americans report being currently addicted. By late adolescence, 42 percent have used an illicit drug, and over 21 percent of high school students have taken a prescription without doctor supervision.Costs $193 billion in health care costs, public costs related to crime, and lost productivity annually.

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How Drugs Affect the Brain

The brain is wired to repeat pleasurable experiences.Life-sustaining activities activate a "pleasure circuit" of nerve cells. One nerve cell set uses dopamine, a neurotransmitter, and sits at the top of the brain stem in the ventral tegmental area (VTA).

This "pleasure circuit" is known as the mesolimbic dopamine system.

All addictive drugs activate the brain

's pleasure circuit, and addiction alters the way the pleasure center and other parts of the brain function.Psychoactive drugs—affect chemical neurotransmission, either enhancing it, suppressing it, or interfering with it.

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The Action of Cocaine at Dopamine Receptors in the Brain, an Example of Psychoactive Drug Action

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Types of Drugs

Prescription: obtained only with a prescription from a licensed physician

Over-the-counter (OTC)

: no prescription needed and more than 100,000 available

Recreational: most are legal substances, such as alcohol, tobacco, coffee, etc.Herbal preparations: products of plant originIllicit (illegal): all are psychoactiveCommercial: found in commercially sold products such as household cleaners, pesticides, etc.

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Routes of Administration

Oral Ingestion

Inhalation

Through the nose or mouth

InjectionIntravenous—into bloodstreamIntramuscular—into muscleSubcutaneous—just under the skinTransdermalThrough the skin

Suppositories

Through the vagina or anus

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Drug Interactions

Polydrug Use

Taking several substances simultaneously

Synergism (Potentiation)

Effects of both drugs are multiplied beyond the effects of each on its own. InhibitionEffects of one drug are reduced or eliminated by the presence of another at the same receptor site.AntagonismDrugs work at same receptor site so that one drug blocks the action of another.

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Drug Interactions (cont.)

IntoleranceWhen drugs combine to produce extremely uncomfortable reactionsCross-tolerance

Tolerance for one drug creates a similar reaction to another drug.

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Drug Misuse and Abuse of Over-the-Counter Drugs

High doses can cause hallucinations, bizarre sleep patterns, mood changes, and sometimes death.

Those most vulnerable to abusing OTC drugs are teenagers, young adults, and people over the age of 65.

Sleep Aids

Excedrin PM, Sominex, Unisom, and Tylenol PMCan cause problems with the sleep cycle, weaken areas of the body, or induce narcolepsy.Cold MedicinesRobitussin, Vicks, Coricidin, and NyQuil

Dextromethorphan (DXM) can cause hallucinations, loss of motor control, and "out-of body" sensations.

Diet Pills

Contain stimulants such as caffeine or

Hoodia gordoni

Ephedra was banned in 2004 after more than 16,000 adverse side effects were reported.

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Prescription Drug Abuse

About 6.1 million Americans aged 12 and older used prescription drugs for nonmedical reasons in the past month.

It is particularly common among teens and young adults.

The problem may be getting worse among the youngest segment of society, with nearly 15 percent of 12th graders reporting prescription drug abuse by the time they graduate.

Risks vary from irregular heart rate to death. Injecting prescription drugs may result in exposure to HIV, hepatitis B and C and other bloodborne viruses.© 2015 Pearson Education, Inc.Slide24

College Students and Prescription Drug Abuse

Increased dramatically over the past decadeStudents who abuse Vicodin, OxyContin, or Percocet say they do so to relax or get high.

Students who abuse Adderall and Ritalin (intended to treat attention-deficit disorder [ADHD]) say they do so for academic gain.

Most commonly reported side effects are sleeping difficulties, irritability, and reduced appetite.

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ABC News Video: GovernmentCrackdown on Painkillers

Discussion Questions

How

have some medical doctors contributed to the prescription drug epidemic?

Will greater restrictions on Vicodin and other painkillers help reduce drug use and appeal or will people become more aggressive in searching for the drug(s)? Explain your answer.Given the number of Americans hooked on Vicodin, how might restrictive measures decrease use? What are appropriate measures of restriction?© 2015 Pearson Education, Inc.Slide26

Illicit Drugs

Illicit drug use spans all age groups, genders, ethnicities, occupations, socioeconomic groups.Marijuana use has risen in recent years.

Illicit Drug Use on Campus

In 2009 just over 50 percent of college students reported trying any drug; the vast majority used marijuana.

College offices are concerned about the link between substance abuse and poor academic performance.© 2015 Pearson Education, Inc.Slide27

30-Day Drug Use Prevalence, Full-Time College Students vs. Respondents 1–4 Years beyond High School

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Illicit Drugs (cont.)

Why Do Some College Students Use Drugs?Positive expectations

Genetics and family history

Substance use in high school

Mental health problemsSorority and fraternity membershipWhy Don't Some College Students Use Drugs?Parental attitudes and behavior

Religion and spirituality

Student engagement

College athletics

Healthy social network

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Common Drugs of Abuse—Stimulants

Stimulants: increase activity of the central nervous system.

Cocaine

White crystalline powder

Derived from the leaves of the South American coca shrubCocaine rapidly enters bloodstream.Exposed fetus is likely to suffer damage.Methods of use varyFreebase cocaine

Crack

Treatment for cocaine addiction involves mainly psychiatric counseling and 12-step programs.

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Drugs of Abuse: Uses and Effects

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Drugs of Abuse: Uses and Effects (cont.)

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Drugs of Abuse: Uses and Effects (cont.)

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Common Drugs of Abuse—Stimulants (cont.)

AmphetaminesSynthetic agents that stimulate the central nervous system (CNS)

Some are used for medicinal purposes.

Ritalin and Adderall are used for attention-deficit/hyperactivity disorder (ADHD).

High potential for abuseMethamphetamineAffects brain and CNSEuphoria lasts 6 to 8 hours.Methods of use: snorted, injected, smoked, and ingestedShort-term effects include increased physical activity, alertness, rapid breathing, increased body temperature, insomnia, tremors, anxiety, confusion, and decreased appetite.

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Caffeine

Most popular and widely consumed drug in the United StatesCaffeine is derived from the chemical family called xanthines, which are found in plant products such as coffee, tea, and chocolate.

Enhances mental alertness and reduces feelings of fatigue.

Side effects include wakefulness, insomnia, irregular heartbeat, dizziness, nausea, indigestion, mild delirium, and heartburn.

Caffeine meets the requirements for addiction: tolerance, psychological dependence, and withdrawal symptoms.© 2015 Pearson Education, Inc.Slide35

Caffeine Content Consumption

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Marijuana and Other Cannabinoids

Derived from either the Cannabis sativa or

Cannabis indica

(hemp) plant.

Tetrahydrocannabinol (THC) is the psychoactive substance in marijuana; average concentration is 10 percent, but some forms can contain up to 27 percent.Has many medical purposes as it controls nausea and vomiting, improves appetite, forestalls loss of lean muscle mass associated with AIDS wasting syndrome, and reduces muscle pain and spasticity caused by multiple sclerosis.Frequent and/or long-term use may increase risk for testicular cancer, serious mental health problems, suppressed immune system, and impaired memory.

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Narcotics and Depressants

OpioidsCause drowsiness, relieve pain, and induce euphoriaCalled narcotics

Derived from opium

Include morphine, codeine, heroin, and black tar heroin

Depress CNS and lower heart rate, respiration, and blood pressureDecrease sex drive© 2015 Pearson Education, Inc.Slide38

Narcotics and Depressants (cont.)

Opioids (cont.)Physical effects of opioids

Depress CNS and lower heart rate, respiration, and blood pressure

Cause weakness, dizziness, nausea, euphoria

Decrease sex driveCause visual disturbances and lack of coordination© 2015 Pearson Education, Inc.Slide39

Narcotics and Depressants (cont.)

Heroin Addiction Heroin is a white powder derived from morphine. Black tar heroin is a sticky, dark brown, foul-smelling form of heroin that is relatively pure and inexpensive.

Heroin withdrawal is distinct, including an intense desire for the drug, sleep disturbances, dilated pupils, and muscle tremors

Mainlining

—intravenous injection of powdered heroin mixed in a solution; the most common route of administration© 2015 Pearson Education, Inc.Slide40

Treatment for Heroin Addiction

Methadone MaintenanceBlocks effects of opiates withdrawalPotentially addictive itself

Naltrexone (Trexan)

Opiate antagonist

Lose compulsion to use heroinTemgesic (Buprenorphine)Blocks cravings for heroinNonaddictive© 2015 Pearson Education, Inc.Slide41

Narcotics and Depressants (cont.)

Benzodiazepines and Barbiturates

Benzodiazepines

(tranquilizers)

The most common sedative-hypnotic drugs Valium, Ativan, and XanaxBarbiturates Sedative-hypnotic drugs Amytal and Seconal

Less safe than benzodiazepines

Synergistic effect, when combined with alcohol, can lead to respiratory failure and death.

Can produce physical and psychological dependence in several weeks.

Cross-tolerance is a complication specific to sedatives.

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Narcotics and Depressants (cont.)

Rohypnol

A tranquilizer and "date rape" drug

Produces a sedative effect, amnesia, muscle relaxation, and slowed psychomotor responses.

Has gained notoriety as a growing problem on college campuses as it has been added to punch and other drinks at parties in hopes of lowering women's inhibitions and facilitating potential sexual conquests.Gamma-hydroxybutyrate (GHB)CNS depressant known to have euphoric, sedative, and anabolic (body-building) effects

Another "date rape" drug

Side effects include loss of memory, unconsciousness, amnesia, hallucinations, and death.

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Hallucinogens

Hallucinogens create auditory or visual changes in mood, thoughts, and feelings.

Synesthesia

—mixing of sensory messages

May "hear colors" and "smell tastes"Lysergic Acid Diethylamide (LSD) (acid)In 1970 it was placed on controlled substances list.About 6 percent of Americans between age 18 and 25 have used LSD at least once in their lifetime.Commonly sold as a "blotter" on paper, it is one of the most powerful drugs known to science, and minute quantities produce strong effects.

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Hallucinogens (cont.)

Ecstasy (methylene-dioxymethamphetamine [MDMA]) Most common club drug causes feelings of extreme euphoria, openness, and warmth.

Risks include inappropriate emotional bonding, jaw clenching, tongue and cheek chewing, short-term memory loss or confusion.

Chronic use can damage the brain.

Combined with alcohol, Ecstasy can be fatal.© 2015 Pearson Education, Inc.Slide45

Hallucinogens (cont.)

PCP – PhencyclidineOriginally developed as a dissociative anesthetic

Effects depend on dose and include slurred speech, impaired coordination, fever, nausea, and total loss of sensitivity to pain.

Doses greater than 10 mg can cause convulsions and death.

MescalineDerived from peyote cactus; Native Americans have used it for religious purposes.It is a powerful hallucinogen and CNS stimulant.Generally induces immediate vomiting.

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Hallucinogens (cont.)

PsilocybinSimilar to LSD in effect

Effects generally wear off in 4 to 6 hours.

Cultivated from spores or harvested wild.

Mushroom varieties can be easily misidentified, and mistakes can be fatal.Ketamine (Special K)Used as an anesthetic in many hospitals and veterinary clinics.Causes hallucinations and sensory distortions.© 2015 Pearson Education, Inc.Slide47

Inhalants

Users inhale chemicals causing hallucinations and euphoric effects.Legal to purchase and not commonly recognized as drugs, though dangerous when used incorrectly

Include glue, paint thinner, and rubber cement.

Amyl nitrate and nitrous oxide are also abused.

Users experience dizziness, disorientation, impaired coordination and judgment; combined with alcohol, may be fatal.© 2015 Pearson Education, Inc.Slide48

Anabolic Steroids

Artificial forms of the male hormone testosterone that promote muscle growth and strengthProduce state of euphoria, diminished fatigue, and increase bulk and power in both sexes

Adverse side effects include mood swings

("

roid rage"), acne, liver tumors, elevated cholesterol, hypertension, and kidney disease.In women, large doses trigger development of male attributes; in men, anabolic steroids shut down testosterone production, causing men's breasts to grow and testicles to atrophy.© 2015 Pearson Education, Inc.Slide49

Treatment and Recovery

An estimated 21.6 million Americans needed treatment for illicit drug or alcohol abuse in 2011, but only 2.3 million received treatment.Detoxification is an early abstinence period when the addict physically and cognitively adjusts to being free from the addiction

'

s influence.

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Treatment Approaches

Outpatient Behavioral TreatmentCognitive behavioral therapyMultidimensional family therapy

Motivational interviewing

Motivational incentives (contingency management)

Residential Treatment ProgramsTherapeutic communities (TCs) are highly structured programs in which addicts remain at a residence, typically for 6 to 12 months.12-Step ProgramsNonjudgmental treatment programs that aim to work on personal recovery

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Treatment Approaches

Vaccines against Addictive DrugsA promising new cocaine vaccine is in development.The vaccine does not eliminate the desire for cocaine; it prevents the user from getting high by stimulating the immune system to attack the drug when it

is taken.

Clinical trials are expected soon.© 2015 Pearson Education, Inc.Slide52

Drug Treatment and Recovery for College Students

Early intervention increases the likelihood of successful treatment.Private therapy, group therapy, cognitive training, nutrition counseling, and health therapies all help with recovery.

A growing number of colleges are offering special services to students who are recovering from alcohol and other drug addictions and want to stay in school without being exposed to excessive drinking or drug use.

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Addressing Drug Misuse and Abuse in the United States

Drug abuse has been part of human behavior for thousands of years and is not likely to disappear in the near future.Harm Reduction Strategies

Needle-exchange programs

Changing legal sanctions and increasing treatment services

Minimizing potential hazards with drug use rather than the use itself© 2015 Pearson Education, Inc.