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153 Cards in this Set
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What are the six questions we must ask ourselves before we evaluate extent of drug problem or propose solutions?
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1. Who is taking the drug
2. What drug is being consumed by individual or group of individuals 3. When and where drug use is occurring 4. Why an individual uses a drug (social motives or pressures/personal problems) 5. How is the drug being consumed (ex. coca leaf versus crack) 6. How much of the drug is consumed |
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Four basic principles that apply to all psychoactive drugs
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1. Drugs are not good or bad; drug has no ability to create good or evil - individual's use creates evil (eradicating the drug does nothing to curb the individual's desire to use)
2. Every drug has multiple effects - affects the brain in a number of ways 3. Effect of the drug based on the amt taken - greater amts amplify effects 4. Prior experience with the drug - greater experience with drug lessens effects |
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What role does media play in popularizing drug fads of ecstasy and GHB?
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Media reports on current drug use - 1980s focus on cocaine moved toward ecstasy and GHB b/c newest most widely used drugs; these news articles about the drugs were attempts to bring awareness to growing problem but may publicize the drug and lead to rapid spread
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Monitoring the Future Study
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Tracks drug usage over last 30 yrs (specifically marijuana use in high school seniors); usage increased until about 1980 and began to decline reaching low pt in '92 - usage increased from this pt on until the last few years when usage tapered off
- perceived risk by seniors of using marijuana compared to perception of ease of availability mirror images - while the perceived risk was high the use declined and vice versa *90% of high school seniros believed they could easily obtain marijuana |
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Why should we view definitions of the following terms with caution: drug, drug abuse, illicit drug, drug addiction, deviant drug use and drug misuse?
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- Should be viewed with caution b/c these ideas have variety of definitions - meanings can be vague
Examples: - drug is any substance that chemically alters organism question then becomes what do we specifically classify as food - illicit drugs are those sold or obtained illegally (paint supplies are sold for various purposes but take on illicit nature when used for purpose of getting "high") - drug abuse has complications because some people view any use of illicit drugs as abuse however, some people think drugs like marijuana that may have no negative effects should not be considered drug abuse |
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Why is it difficult to get an overall picture of drug use in today's society?
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Beyond tobacco and alcohol most drugs are illegal - impossible to get head count or even rough est. of # of illegal drug users or amt of drugs within the US; alcohol/tobacco/prescriptions have paper trail but can be complicated by things like moonshine or unused portions of pres. drugs so tough to get accurate #
- questionnaires ask questions regarding drug use but may not be accurate because ppl not likely to share usage habits about illicit drugs |
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Graph in Figure 1.1
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Information in book or on answer sheet
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Information in Figures 1.1, 1.2, 1.3
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Information in book or on answer sheet
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Name 3 factors that correlate w/ drug use and explain correlations; name factors shown not to correlate w/ drug use
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Gender: males more likely to use tobacco, marijuana, cocaine than females
Ethnicity/Race: whites more likely to drink alcohol, use tobacco, cocaine and mari. - when studying American society at large and discussing low-level, infrequent use - looking at smaller group of drug abusers minorities in urban areas more likely to abuse than whites Edu. level: adults w/ college degrees (compared to hs diploma) more likely to drink alcohol, less likely to use tobacco and marijuana/cocaine Non-correlates: personality problems plays small problem in determining whether someone tries alcohol or mari. but may play larger part in whether use of drugs becomes major problem, socioeconomic status |
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Describe typical sequence of involvement w/ drugs that was studied in '70's - Gateway Theory
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Studies of involvement w/ drugs focuses on high school students who 1st begin experimenting with drinking beer/wine or smoking cigarettes (known as GATEWAY SUBSTANCES)- student will consume one of these substances b4 moving into illicit drugs (1st stage); the second stage involves individual moving to hard liquor and/or cigarettes; third stage involves marijuana use; fourth stage involves illicit drug use such as cocaine
- gateway theory is general in sequence and need not be followed exactly by each individual |
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Describe "laissez-faire" as well as 3 main concerns that aroused public interest and brought 1st drug laws
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"Laissez-faire" econ term regarding idea that laws governing sale of goods/services (including drugs) not important - if there is buyer and seller willing to complete transaction should be allowed to do so w/o gov't controls
- 1st concern: toxicity - drug sellers providing chemicals/substances to public w/o labels creating public health concern - 2nd concern: dependence - drug sellers providing addictive substances w/o proper lables/warnings - 3rd concern: drug users seen as most likely to commit violent crimes |
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Define acute and chronic toxicity; two examples of behaviroal toxicity
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Acute: use of drug on sprecific occassion - affects when drug is actually in person's system (includes overdosing)
Chronic: affects of drug use on long-term basis regardless of whether or not drug is actually in system (ex. use of cigarettes) - behavioral toxicity refers to drug affecting person enough so normal behaviors become dangerous (ex. person who consumes too much alcohol danger behind the wheel; consuming alcohol may lead to aggressive behavior/violence |
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Describe DAWN system and 2 types of info it collects. What 2 things do we need to remember when looking at DAWN results? Why does DAWN not keep data on "alcohol alone" emergency room problems?
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Drug Abuse Warning Network (DAWN) - collects data on drug-related emergency room visits at hospitals in metro areas around country - personnel records which drugs are present during visit and cause of visit: injury, overdose, panic reaction, etc.
2 things to remember: not every hospital contributes data to DAWN thus is estimate of # of visits; DAWN does not correct for usage differences "Alcohol alone" is not a separate category b/c large portion of US consumes alcohol on reg. basis and the large # of alc. related emergencies and deaths would dwarf the effects of the other drugs thus causing the data on other drugs to look insignificant and possibly lessen the concern of these drugs- DAWN only tracks alcohol related emergencies in concert w/ other drugs |
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Review Questions 15,16, and 19 of lesson 1
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Info on answer sheet
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Discuss 3 processes that may occur w/ repeated drug use and explain why psychological dependence is more important than physical dependence
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1. Tolerance: individual repeatedly uses drug and effects become less substantial requiring the person to use more of drug to get "high"
2. Physical dependence involves withdrawal symptoms after a person has repeatedly used a drug and built up a tolerance - drug use disrupts body's normal balance and repeated drug use cause body to counteract imbalance by changing functioning of affected body system (ex. heroin causes slow intestinal movement, body compensates by speeding up movement - when drug removed withdrawal symptom is diarrhea 3. Psychological dependence involves change in behavior essentially where individual craves drug and goes out of way to obtain it - a psychological drug dependence is more severe b/c an individual will crave the drug either to receive pleasurable effects (positive reinforcement) or relief from pain or discomfort (negative reinforcement) |
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Discuss addiction as a disease or family disorder or if addiction is biological or substance-specific.
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Substance: blaming substance for person's addiction (giving it human characteristics) - some drugs have been proven to be habit forming but more so based on method of usage (ex. injection which is more habit forming); along w/ idea of blaming drug for addiction comes idea that neurotransmitter dopamine (responsible for positive reinforcement) caused individual to continually seek drug - have not been able to pinpoint one section of brain however responsible
Family disorder: focuses on idea that family adapts to one member's addiction to drug (ex. wife compensates for husband's alcoholism by calling in sick for him) - makes it difficult for individual to seek necessary treatment to rid himself or herself of addiction Disease: argue drug addiction is stand alone medical disease (groups like AA hold this idea) - opponents argue that does not have typical characteristics of disease, argue that overeating, gambline, etc. should be classified as diseases as well then |
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What are the four ways theoretically that drug use might cause crime?
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1. change in personality - drugs essentially create criminals by affecting one's mental capacity to distinguish between right and wrong
2. Influence of the drug while in one's system - acute toxicity - little evidence to support that acute drug effects cause criminality 3. Drug users committing crimes to obtain money to support drug habit 4. Drug use and crime related simply for fact that drug use is a crime |
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Why do the authors refer to laws about drug use as "patchwork quilt"?
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- 1st regulation came w/ Whiskey Rebellion - gov't taxed whiskey and militia used to inforce tax against those that refused to pay - showed that gov't had power to enact laws/regu. and enforce them
- gov't attemtps to understand what is best for public and creates regulations to protect; social ideals about health, morality, personal choice, etc. constantly in state of flux (patchwork quilt idea) thus gov't tries to react to changes |
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Discuss 4 drug-related problems brought to attention of American public and how helped build pressure for drug regulation.
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1. Opium - used by doctors as pain reliever prescribed generously; 1830s morphine created from opium, highly addictive and easy access (advent of syringe offered new quicker use method)
2. Patented medicines: offered by traveling salesmen and stores throughout country allowing for self medication - many contained dependence forming substances like alcohol 3. Opium and the Chinese: Chinese immigrants that came to US after Civil War to build railway system brough opium smoking into country - resulted in state legislation and eventually federal opium law in 1890 (allowed only American citizens to import and manu. opium) 4. Cocaine: avail. in US in 1800s through patent meds, mail orders, and pharmacies - easy availablity caused concern for dependence and misuse |
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Describe how/why we came to 1906 Pure Food and Drug Act and summarize act
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Theodore Roosevelt's push for passage of law regulating tainted food and drugs and Upton Sinclair's "The Jungle" causes for act
- act essentialy prevented interstate commerce in adulterated or misbranded fooods/drugs - misbranding dealt w/ labeling and act made reference to specific substances like alcohol, morphine, opium, cocaine, heroin, mari, etc. - these and other drugs had to simply have label containing the ingredients (even if habit forming) * did not regulate what substances could be included |
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Describe the creation of Harrison Act of 1914 and its affects on dealers, dispensers, physicians, dentists, and vets.
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Concern about drug use in many nations in early 20th cent.; Dr. Hamilton Wright proposed that helping China reduce opium trade network could result in US gaining favorable trading position; int'l conference 1912 grouped opium, cocaine, morphine and heroin as drugs that needed regulation - Wright commissioned Senator Harrison to present bill, which passed by Congress
Act required registration of drugs and unique order forms b4 sale - physicians, dentists, and vets legal distibutors if registered w/ gov't * considered more of tax law than prohibitive act |
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What gov't actions/amendments came after 1906 and what did they say?
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Pure Food and Drug Act did not mention anything about therapeutic claims (claims of healing power of drug w/o being warranted - SHERLEY AMENDMENT OF 1912 to the Food and Drugs Act made it illegal to make false/fraudulent claims of therapy - gov't responsibility to prove claim false
-Sulfanilamide first liquid antibiotic - made ready for sale on notion that it smelled and tasted fine - killed 107 users - FDA confiscated drug w/o legal grounds though b/c there was no law against making drugs safe - led to passage of 1938 Food, Drug, and Cosmetic Act - required that manu test drug for toxicity and register w/ FDA for approval b4 sale (FDA now approved every drug before sale); act also distinguised between OTC drugs and prescription drugs 1962 Kefauver-Harris Amendment to Food, Drug and Cosmetic Act - drug thalidomide used by pregnant women to overcome morning sickness caused variety of birth defects - act required companies to gain approval b4 conducting human test trials - required FDA approval of effective |
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Describe process of introducing new drug.
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Company first has to file "Notice of Claimed Investigational Exemption for a New Drug" along w/ pre-human testing investigation results (animal testing) - drug must be admin. to 2 animal species in different doses and one test where human dosage amt given regularly to animal
Human tests require planned clinical procedures for tests and participant notification of investigational compound Company must submit to FDA any undesirable side effects of drug use |
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Describe the 3 phases of clinical investigation for a drug.
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1st phase: test drug on healthy individuals - studies how body receives drug
2nd phase: test drug on individuals w/ illness drug is intended to treat (few hundred ppl) 3rd Phase: test drug on larger group of individuals that have the illness |
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Describe changes to drug approval procedure (question 7) since 1962
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Orphan Drug Act 1982 - provides protection to pharm companies that produce new drugs by providing 7 yrs exclusive right to sell drug (drugs must treat disorders that afflict 200000 or less) - made difficult to recoup on investments, research on rare disorders declined end up costing patients more for drugs
Prescription Drug Mkting Act 1988 limits # free samples drug salesppl can provide docs (prevents mass dispersion and misuse); also worked to combat importaion of counterfeit and adulterated drugs 1997 FDA Modernization Act: adjusted requirements of companies on submitting side effects |
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1994 Dietary Supplement Health and Edu Act. Describe. How different from drugs evaluated by FDA?
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Dietary supp not considered drugs rather considered more food - require no approval b4 sale
Act broadened def of supplement to include vitamins, minerals, proteins, herbs and herbal extracts and prevented drug lables from making unwarranted or direct claims (cannot claim to cure illness) can make claims about overall health - if it does make overall health claim must put statement on lable that claim has not been FDA approved |
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List 5 provisions of Controlled Substances Act of 1970
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1. Provided more $ to dept of health, edu and welfare for treatment and prevention research
2. Allowed for certain drugs to be regulated by Drug Enforcement Agency (DEA) instead of tax/interstate commerce laws) 3. Doing away w/ mandatory min. penalties and death sentence 4. Probation became option for first time possessors 5. Est. 5 schedules of substances categorized by potential for abuse |
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Discuss different drug testing methods
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Urine testing: can detect drugs up to 3 days after use depending on amt used and how much required to indicate + result (if greater amt necessary for +, time of detection shorter, vice versa) - controversial test b/c potential of drug user to switch urine sample or dilute sample
Hair testing: components of drugs grow into person's hair and detected up to 90 days after use - less invasive than urine testing Saliva testing: less invasive but only detect recent drug use (up to one day) * concern for all tests is accuracy - all have potential for producing false-positive results |
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Review question 12,13,14, 15 in lesson 2
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Information in lesson
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Describe central and somatic nervous system and main functions of automatic nervous system
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Somatic nervous system: contains nerve cells interact w/ outside environment and transport info from envir. to central nervous system and signals for movement back to periphery; responsible for voluntary actions (contains nervers for: vision, hearing, taste, smell, chewing, spinal nerves, etc.)
Central nervous system: brain and spinal cord; sensory nerves go into these structures and motor nerves come out (works w/ somatic system); accounts for most of information integration, learning/memory, and coordination Autonomic system: regulates involuntary bodily functions like heart rate; composed of sympathetic ("flight or fight response" - heart rate increase, fast breathing, sweating, etc.) and parasympathetic (calming actions - reduced heart rate, slower breathing )branches |
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Define cerebral cortex, basal ganglia, hypothalamus, limbic system, brain stem
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Cerebral cortex: tissue layer covering top and sides of upper parts of brain - processes visual/auditory info, involved in reasoning/language
Basal Ganglia: maintains muscle tone/tension, w/o person would not be able to stand w/o falling over Hypothalamus: base of the brain serves as link between brain and pituitary gland hormonal output (feeding, drinking, temp. regulation, sexual behavior) Limbic system: charge of emotion regulation & physical activity level Brain stem: connects structures of brain to spinal cord; involved in sensory and motor reflexes and coordination of complex movements; contains most of the cells neurons use to produce dopamine, norepinephrine and serotonin |
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Explain two brain imaging techniques.
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Positron Emission Tomography (PET)- tagged chemical injected into bloodstream - device will track areas of brain chemical transported and which areas had most amt of chemical; this scanning method useful in discovering where drugs bind to receptors (dopamine, serotonin, etc.) in brain
Magnetic Resonance Imaging: applies magnetic field to body and measures energy released by various molecules as field collapses |
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Define brand names, generic names, chemical names
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Chemical name is the chemical description of the molecule and is only used in lab settings
Generic names are legal drug names found in US Pharmacopoeia - simplistic description of chemical name - offers no trademark rights Brand names: contains descriptive nature pertaining to use of drug (ex. Elavil- antidepressant meant to elevate mood) - provide trademark protections for the name but the chemical structure and manufacturing methods are covered under patent law |
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7 Categories of Drugs based on effects
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1. stimulants: provide energy/ alertness; excessive doses of certain stimulants like cocaine can cause mania
2. Depressants: major drug in category is alcohol - causes loss of inhibitions in low doses - slowed reactions, uncoordinated movements in high doses Analgesics (opioids aka narcotics): pain-killing in nature - mindset of relaxation in low doses and sleep in high doses; produce clouding of consciousness w/o forgetting normal bodily functions (as caused by alcohol) 4. Hallucinogens: create abnormal images and skewed perception of oneself/surroundings 5. Psychotherapeutic drugs: treat mental problems typcially obtained by prescription 6. Nicotine: mild stimulant also w/ some relaxant properties 7: Marijuana: relaxant, depressive type of drug w/ some hallucinogenic properties |
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Explain what is meant by specific and nonspecific factors in regard to psychoactive drugs
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Nonspecific (placebo) factors result not solely rom quality or amt of drug taken but also individual's past experiences/expectations of drug; these effects are not experienced b/c of chemical makeup of drug (called placebo b/c same effects that would occur if person took "fake" drug - effects from placebos are self-induced)
Specific effects: effects from presence of actual chemical components of drug in certain concentrations in the body |
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Review answers to question 4 and 5 lesson 3
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Information on answer sheet
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Define safety margin, potency, side effects, time course
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Safety margin: combines questions - what is effective dose of drug and what dose of drug will be toxic to individual? - the effective dose is amt that produces desired effects (reducing pain, euphoria, etc.) while the 2nd questions determines at what dose the drug becomes toxic - safety margin is area between effective dose and toxic dose
Side effects: effects occur as result of treating disease by using drug Potency: drug amt necessary to achieve desired or expected effect - smaller the dosage required to produce effect more potent the drug and vice versa Time course: depends on how the drug administered, how rapidly absorbed and how eliminated from body |
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Name 3 primary drug delivery methods and describe pros and cons of each
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1. oral administration: most complicated way to enter bloodstream b/c goes through gastrointestinal tract - drug must avoid deactivation by stomach acid/enzymes and then must be absorbed by cells in stomach lining and then go directly to liver (if drug is one metabolized by liver may not be dispersed throughout body); however this is the easiest admin. method
2. injection: directly injecting drug into bloodstream, muscle mass or into upper layers of skin - effects felt much more rapidly b/c high concentrations can be injected; vein collapsings can occur around injection sight where vein loses strength and elasticity; also danger of injecting bacteria/disease along with drug (AIDS) and irritating material (fastest effects felt from injecting into bloodstream, then muscle, then skin) 3. Inhalation: rapid form of absorption (sometimes faster than injection) - can cause irritation of mucous membranes/lungs; difficult to control dosing vs. pill or injection |
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Drug Deactivation
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Occurs when drug no longer has effect on user's body or mind; two methods for deactivation involve 1) drug exiting body w/o changing chemical composition/having effect on person or 2) drug chemically altered so typical effect of drug no longer experienced - typically occurs through enzymes in liver changing composition and drug excreted by kidneys
*kidneys first filter water/water soluble molecules - excess water reabsorbed and lipid soluble particles higher chance of being reabsorbed - if enzymes could transform drug into more water soluble particles instead of lipid, more could be excreted *CYP450 enzymes constantly in liver awaiting foreign substances to deactivate |
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Define tolerance and explain 3 possible reasons it develops
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1. Drug disposition: increased use of drug has effect on rate of drug metabolizing - greater amt consumed can increase rate of drug excretion from system - results in user consuming more of drug to feel effects
2. Behavioral tolerance: person who has consumed enough of drug in past to learn the effects that accompany usage - results in intentional behaviroal changes to compensate for this knowledge 3. Pharmacodynamic tolerance: involves the brain's attempt to compensate for presence of drug and maintain normal functioning |
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Define anxiety disorders, psychosis, schizophrenia, bipolar disorder, depression
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Anxiety, reaction to perceived, uncontrollable threats - defense mechanism to stress; results in flushed skin, gas problems, increased heart rate, etc. - problems can be avoided by anticipating upcoming events; anxiety disorders occur when these worries become unrealistic resulting in chronic uneasiness, fear of impending doom or terror or panic
Psychosis: deviation from reality; intellectual capacity and societal norms become blurred; involves hearing voices, belief oneself is person from history, etc.; organic psychosis results from physical stimulus such as brain tumor; functional psychosis from non-physical cause Schizophrenia: typcial disorder diagnosed to individual suffering from functional psychotic disorder; means "shattered mind" b/c mental disease w/ no definable causes Bipolar disorder: manic and depressive states reached in person's daily life Depression: abnormally low mood |
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Define panic disorder, specific phobia, social phobia, OCD, post-traumatic stress disorder
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Panic disorder: extreme version of anxiety disorder; involve panic attacks, shortness of breath, dizziness, fear of dying, etc.; agoraphobia part of panic disorders - fear of mktplace, specifically fear of inability to escape embarrassing situations (ex. loss of bladder control)
Specific phobia: excessive or unreasonable fear of some social event OCD: persistent thoughts of some event that individual fears; involves performance of rituals to reduce anxiety Post-traumatic stress disorder: individual exposed to actual or threatened death/serious injury event and reacted w/ intense fear, helplessness or horror |
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What are some indicators of a major depressive episode besides sadness?
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- lack of concern for daily activities
- physical symptoms: change in body weight, insomnia, hypersomnia (excessive sleepiness - constant desire to sleep) - psychomotor agitation - increased activity - type of retardation - decreased activity - feelings of extreme guilt or feeling that the individual does not deserve what he or she has - thoughts of death or suicide |
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What are the positives and negatives of antipsychotics (phenothiazines)?
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Positives: improved condition of 75% of schizophrenic patients tested comapred to placebo
- generally shown to improve mental condition of patients compared to placebos - do not create dependency and very difficult to make suicide attempt by overdosing on antipsychotics Negatives: cessation of antipsychotic regiment caused 75 to 95% of patients to relapse - reported skin reactions - agranulocytosis - depletion of white blood cells - pseudoparkinsonism - symptoms of Parkinson's disease w/o actual disease |
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Why is Prozac the most widely prescribed antidepressent?
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- introduced in 1987 as selective serotonin reuptake inhibitor - proved to be safer than tricyclic antidepressants b/c led to fewer overdose deaths
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What was worldwide value of antidepressant sales in 03? Why is it expected to decline?
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Prozac and drugs like it are heavily prescribed - espcially to children - sales in 2003 of antidepressants exceeded 15 billion dollars
Antidepressants implicated in causing potential suicide or suicidal thoughts - meds began to be required to have warning lables about possibility of causing suicidal thoughts - sales began to bounce back when docs began prescribing antidepressants for generalized anxiety disorder Decreased sales also due to ineffectiveness of drugs - studies showed little positive effect over placebo in regard to serotonin re-uptake inhibitors - plus many studies that show no or little positive effect are never published, only those w/ positive outcomes **one final reason is that these drugs are becoming available in generic form soon** |
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Review Question 16 in lesson 3
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Information on answer sheet
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Give 3 early uses of coca leaves by Incas and mountain natives
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1. alleviating fatigue; oxygen levels were low in mountain terrain easier to grow tired
2. discovered that when coca leaves combined with calcified lime, cocaine could more rapidly and easily reach individual's bloodstream; civilizations built near mines; coca plant thrives in Andes Mountains where most crops fail - became crop of choice for the region 3. Used in religious cermonies 4. Before Europeans arrived was heavily used as a payment method |
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Name three men who gained economic well-being and fame from cocaine. What did each do with cocaine to gain notoriety?
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Angelo Mariani - French chemist - used extract from the leaves and created series of cocaine laced products (coca lozenges, tea, wine, etc.) - wine made him famous - hit among public b/c helped eliminate fatigue
Dr. W. S. Halsted - physician in 1880s experimented w/ cocaine as local anesthetic - at the time coca leaves began to be processed for pure cocaine (500 kg produced 1 kg of pure cocaine) - Halsted experimented w/ this Sigmund Freud: believed the drug could treat mental illnesses (depression and withdrawal symptoms) - recommended use to friends and family and avocated its use to psychiatrists |
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Describe difference between coca paste, freebase and crack
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Coca leaves mixed first with gas or kerosene left to soak, ground down and mixed - excess is COCA PASTE - can be combined w/ tobacco and smoked or transformed into cocaine hydrochloride snorted or injected
Freebase: extracting cocaine into volatile organic solvent such as ether (the freebase) which is heated and vapors inhaled *dangerous b/c ether fumes combustible Crack: cocaine mixed with household products such as baking soda and dried forming crack rocks |
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3 messages that came out of media focus on cocaine in 1986. Describe drug law that resulted from this
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Crack was cheap and widely available leading to 3 media messages in 1986: 1) there was widespread use of drug 2) drug was cause of aggressive or violent action 3) responsible for creating very stong dependency
Anti-Drug Abuse Act of 1986 passed due to belief there was a cocaine epidemic in US - punishment from act based on amt in possession (targeted dealers/manufacturers) and was in ratio form (ex. 5grms of crack 5 yrs in prison; would take 500 grams of cocaine to reach same sentence) |
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Discuss 4 ways ppl can "do" cocaine and different effects of each
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1. coca leaf: chewing on leaf slowly introduces drug into the body through mucous membranes; effects experienced slowly and content in bloodstream lower
2. snorting: gets cocaine into nasal passages - effects fairly rapid 3. injection into bloodstream: puts concentrated amt of drug into bloodstream - effects felt rapidly but briefly 4. smoking in form of crack: becoming popular b/c process less invasive |
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Review Questions 6 and 7 in Lesson 4
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Information in answer sheet
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Describe 4 major causes for concern regarding cocaine
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1. acute toxicity: small doses no health concern - large doses overstimulate central nervous system causing convulsions in turn causing cardiac (preventing vagus nerve from controlling heartrate)/respiratory (allergic reaction from cocaine or additives to drug causing lungs to fill w/ fluid) arrest
2. Chronic toxicity: use of cocaine on regular basis causing constant runny nose; binge use of the drug causes irritability, restlessness, paranoia and even psychosis 3. dependence potential: cocaine very easy to become addicted to 4. reproductive effects of cocaine use: no scientific confirmation of "crack baby" baby born from mother using cocaine during pregnancy still not recommended b/c causes spontaneous abortions |
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Review Questions 9 and 10 in Lesson 4
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Information answer sheet
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Contrast typical "speed freak" of 1960s w/ typical cocaine user of early 80's and w/ stereotype of modern crack smoker
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Speed initially combined w/ heroin or cocaine to make "speedballs"; amphetamines widely available after WWII so combined w/ heroin to form current form of speed or used by themselves for speed addicts who could not obtain heroin; speed users typically were young ppl seeking new ways to experiment w/ substances their parents thought were dangerous; highest use of speed was in San Francisco "flower children" focused on peace - this group combined w/ IV drug users of the time (heroin users) creating speed scene of 1960s
Cocaine use of the 80s was representative of wealth and fame b/c only form on the mkt was the hydrochloride form making use an expensive habit - creation of crack was a cheaper form so use increased by a greater population (specifically black, urban dwellers) |
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What three reactions continued to affect drug scene even after controls tightened on legally manufactured amphetamines.
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Look-alike pills - less intense stimulants (typcially caffiene or ephedrine) - resembled amphetamine drugs in terms of color, shape, etc. - used OTC products so could not be prevented from being sold
Price of speed continually increased and quality questionable (look a likes) drug users resorted back to other stimulants like cocaine Creation of illegal production laboratories that produced street name of methamphetamine, crank |
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List and describe 5 beneficial uses of amphetamines
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50s and 60s amphetamines prescribed to treat depression (which is not simply sadness - it is loss of hope and loss of desire to complete normal tasks) - amph. kept individual in normal mood range for short time so person had to keep using the drug to maintain normalcy, many times resulted in inability to sleep so patient also prescribed sleeping pill
Prescribed for weight control purposes however effects small and in short duration - b/c drugs can cause dependency and tolerance not approved for weight loss Treat narcolepsy (frequent episodes of falling asleep) - amph. used to keep patients awake during day so they could sleep theoretically at night Treat hyperactive children by creating calming effect on the child Labeled as "smart pills" and mkted as a means to learn quickly by stimulating a person during times of fatigue |
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What similarities and differences are there in the toxic effects of cocaine and amphetamines? Compare the dependence potential of cocaine with that of amphetamines.
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Similarities: in large, acute (acute toxicity) doses cocaine and amph. can cause bouts of paranoia and chronic use can result in psychosis
Amphetamines result in impairment of ability to make complex decisions and incidences of violence; chronic use of amph. can result in compulsive, repetitive behaviors Dependency: both found not habit forming in small doses; large, more accute doses cause dependency and upon cessation both drugs cause craving of the drug, sluggishness, depression |
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Define sedatives, hypnotics, depressants, benzodiazepines, barbiturates, inhalants
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Sedatives: have calming effects on person; reduce stress and relax
Hypnotics: induce sleep - used as sleeping pills Depressants: work to slow down central nervous system; encompass alcohol, barbiturates and # of other sedatives Benzodiazepines: as effective as barbiturates but safer; antianxiety pills Barbiturates: class of drugs that include sedative-hypnotic drugs - the more lipid soluble the drug the quicker it will be absorbed into brain and shorter the duration (ex. lower dose long-acting barbiturate would be more effective in keeping person calm during day w/o causing sleep Inhalants: volatile solvents inhaled to produce intoxication (glue, paint, lighter fluid, nail polish, etc. ) |
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Review Question 16 Lesson 4
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Information on answer sheet
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Reasons methaqualone became popular in US in late 60s and 70s
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Created in India popular in Germany and Japan b/c of sedative properties began to be abused and resulted in overdoses; two brand names of the drug introduced in the US in 1965 and FDA found little to no possibility of dependence; became popular b/c seen as safer drug than barbiturates - nickname "love drug" b/c of aphrodisiac effects however effects more closely resembled alcohol - drug was overprescribed and easy to come by
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What was the 1990 version of the "Mickey Finn"? How used today?
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Original Mickey Finn was chloral hydrate induced sleep in less than hour; 1990s version was rohypnol which was a benzodiazepine; has become known as date rape drug b/c culprit in # of cases where women's drinks laced w/ the drug
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List guidelines one should follow when having trouble w/ insomnia, especially chronic insomnia
**FINISH LAST ? OF LESSON 4 |
1. create sleep schedule
2. when in bed, relax mind 3. est. exercise routine 4. create comfortable sleeping environment 5. keep track of diet before sleep (hunger causes disruptive sleep as does caffeine or alcohol) 6. Don't use tobacco 7. Do not create relationship between your bed and restlessness - if you cannot fall asleep w/in 30 of lying down get out of bed and do something 8. avoid napping during day 9. avoid chronic use of sleeping pills |
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Define fermentation and distillation
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Fermentation: chemical process yeast reacts w/ sugar and water where the carbon, hydrogen and oxygen of sugar recombined to create ethyl and carbon dioxide - process ends when mixture reaches 15% alcohol concentration (yeast is killed at or above) (process can be conducted w/ cereal grains but grains must be converted to sugar 1st through use of malt)
Distillation: used to create higher concentrated beverages - heat alcohol and collect vapors which condense to form liquid again - creates higher concentration b/c alcohol lower boiling pt than water so higher % of alcohol in distillate than in original solution |
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Define proof and how it was coined
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Amt of alcohol in beverage - amt of alcohol in beverage is half amt of proof
* came from British Army b/c they found crude method for determining alcohol content of beverage - poured over gunpowder and ignited if alcohol content high enough alcohol would burn and ignite gunpowder |
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Define lager, ale, malt liquor, light beer, generic wine, varietal wine, grain neutral spirits, bourbon, blended whiskeys, and liqueur
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Lager: German word meaning "to store" - beer remains in storage after fermentation & yeast sinks which then heated or filtered out
Ale: uses yeast that sits at top of mixture during fermentation - uses more hops and malt giving it savory taste Malt Liquor: same fermenting process as lager but storage longer resulting in less carbonation and more calories and 1 to 3 % more alcohol Light beer: fermentation occurs at lower temperature for greater period of time - more of sugars converted to alcohol - alcohol then reduced by adding water Generic wine: one of the two main American wines - known as blended wine because use all available grapes ("blended wines") Varietal Wine: 2nd type of American wine contains at least 51% of same grapes when wine produced - names correspond to major type of grape used (ex. merlot) Grain neutral spirits: created by combining whatever grain available at cheap price & corn syrup or other sugars - produces clear substance that is pure alcohol *REVIEW QUESTION FOR REST OF ANS |
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Review Question 4 Lesson 5
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Information on lesson
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Describe trends in US regarding consumption of beer, wine, wine coolers and distilled spirits
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Alcohol consumption on rise for most of '70s reached peak in 1981 - beer is beverage of choice by most Americans (avg. person consumes 25 gallons of beer anually) - wine and spirits consumption has declined since 1981 but has slightly increased since mid to late 90's
*avg. consumption of pure alcohol per person: 1 gallon from beer 2/3 gallon from spirits 1/3 gallon from wine |
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List 7 Characteristics of regional differences in alcohol use
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1). Whites have a greater tendency to consume alcohol than blacks
2). Northerners have a greater tendency to consume alcohol than southerners 3). Younger people have a greater tendency to consume alcohol than older adults 4). Catholics and Jews have a greater tendency to consume alcohol than Protestants 5). Nonreligious individuals have a greater tendency to consume alcohol than religious individuals 6). Urban dwellers have a greater tendency to consume alcohol than those living in rural areas 7). People living in large cities tend to have a greater alcohol consumption rate than those in smaller cities |
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State behavioral effects when blood alcohol level (BAL) is .05,.10, .20, .30, and .40%
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.05%: inhibitions relaxed, good feelings
.10%: motor skill impairment/slowed reaction times .20%: intoxication; typical capabilities impaired as well as sensory capabilities (ability to recognize environmental stimuli - touching, tastin, etc.) .30%: conscious but not concept of what's going on .40%: individual at min. leathal level - greater chance of death; individual typically passes out |
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About how much more likely are men than women to engage in frequent heavy drinking? About how many standard drinks can the typical human metabolize each hour? For your sex and weight, about how many standard drinks are required for you to reach the minimum BAC for driving under the influence?
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Heavy drinking defined as binge (5 or more drinks on same day) drinking 5 or more days during month; 22% of males claim binge drinking in last month - 17% of females and 8% males 4% females claim heavy drinking in last month
Typical human metabolizes .25 oz of alcohol per hour (one half of a standard drink) * I would have to consume 4 beers in an hour to reach .08% alcohol |
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It has been demonstrated that danger of combining alcohol w/ autos dose related. Explain relation.
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No way to definitively measure exact # of fatalities caused by alcohol related crashes - states have begun to enact regulations that require corner to test blood alcohol level of individuals killed in car crashes (showed that 60% of fatally injured ppl in accidents resulted from alcohol)
Studies have shown that BAC of .08% increased risk of fatal car crash 3fold compared to sober driver (increases to 5fold when examining younger, less experienced drivers at BAC of .08%) |
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Effects of alcohol on sexual behavior discussed since Shakespeare. Was he right?
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Shakes. suggested that alcohol frees inhibitions leading individual to have more relaxed opinion about sex but may inhibit ability to perform - verdict still out on effects of alcohol on sexual desire - consensus that alcohol may induce sexual desires or allow individual to perform riskier sexual behavior such as unprotected sex
- unreliable evidence to support that males w/ high BALs have difficult time getting erections (may be more do to inability to concentrate or process erotic info when intoxicated) and impotence may result from prolonged alcohol use; opposing evidence suggests sexual desire inhibition may be more attributed to psycohological effects |
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In the fall of 2004, three young college students died after drinking for many hours. As a result, colleges and universities began re-examining their alcohol-use policies. They concluded that there are two pieces of advice worth mentioning to someone who sometimes drinks enough alcohol to pass out. What are they?
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1: if friend drinks enough alcohol to pass out he or she should be attended to not left to sleep; breathing should be monitored and person kept on side to prevent choking on vomit
2: after vomitting person should not consume more alcohol - vomiting occurs at BAC of around .12 but around BAC of .2% vomiting reflex inhibited so person could continue drinking w/o vomiting |
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Describe hangover symptoms and ways to avoid them
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Upset stomach (alcohol irritates stomach lining), fatigue (blood sugar increased w/ alcohol giving more energy and then crash), headache (accumulation of acetaldehyde), thirst (cellular dehydration), depression, anxiety, melancholy - only cure is analgesic for headache, rest and time
Only prevention is moderation |
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Other than hangovers, what are major health concerns about alcohol discussed?
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Brain damage: loss of brain tissue directly related to alcohol toxicity - specific disease is Wernicke-Korsakoff syndrome
Liver damage: associated w/ chronic alcohol consumption - normal liver uses fatty acids for energy and these acids get stored in liver, if alcohol present takes precedence as means of energy and fatty acids get stored up in liver Alcohol hepatitis: inflammation/impairment of liver function Cirrhosis of liver: deteriorating of the organ - liver tissue replaced w/ scar tissue Heart disease, high blood pressure and stroke Cancer: mouth, tongue, pharynx, larynx, esophagus, stomach, liver, lung, pancreas, colon and rectum |
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Why is it difficult to diagnose children w/ Fetal Alcohol Syndrome? Is there an acceptable level of alcohol consumption for pregnant women?
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Criteria: growth retardation, abnormal physical features (ex. small eyes, mid-facial area) and CNS defect (mental retardation)
Problem 1: determining if these physical/mental retardations due to alcohol or not Problem 2: identifying alcohol habits of the mother of child diagnosed with FAS (easier for doc to determine FAS if he/she knows the consumption patterns of the mother) *Difficult to diagnose b/c it is a judgement call by the physician based on above factors and the fact that these mental/physical defects can be seen in babies w/o mothers that consumed alcohol Safe drinking level: shown that more alcohol consumed greater likelihood of FAS - cannot be claimed on either end of spectrum that moderate consumption acceptable or that complete abstinence necessary to prevent FAS |
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Describe abstinence syndrome - the progression of withdrawal from alcohol
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1st stage: tremors, rapid heartbeat, hypertension, sweating, loss of appetite, insomnia
2nd stage: hallucinations (auditory, physical or visual) 3rd stage: delusions, disorientation, delirium and potentially amnesia 4th stage: seizures *stages tend to occur in succession but vary in time course |
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Review questions 16,17,18,19 lesson 5
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Information on answer sheet
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Describe formation of Alcoholics Anonymous. Did the early founder view alcohol dependence as a disease?
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Originated as a bood written 60yrs ago - detailed experiences of group that wanted to eliminate alcohol from their lives
View dependence as progressive disease involving inability to control one's drinking - believe there is no cure and abstinence is only treatment |
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Describe the 4 transitions that tobacco use has gone through since the 18th century
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18th snuff (ground tobacco insufflated through nose)replaced original method of tobacco use - smoking
Next transition chewing tobacco (19th century) - US "country on go" chewing t. hands free use of drug, less cumbersome - smoking drastically surpassed by chewing - these two forms did not equalize in amt used until 1911 - 20th cent. peak for chewing Next transition cigars, combined chewing and smoking aspects of cigarettes, reached peak in 1920 but cost of prod increased - cigars replaced by cigarettes Cigarettes first produced in US 1870 and popularity increased rapidly - 1885 US produced over a billion |
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What are smokeless tobacco's advantages over smoking? What are the hazards associated with smokeless tobacco? Addictive?
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Advantages: less risk of lung cancer, cost lower than cigarettes, more convenient (hands free), more socially accepted to use in public settings
Hazards: cancer of mouth, pharynx, esophagus (whether loose-leaf or moist snuff, chewing put between gum and cheek hence these type of cancers); leukoplakia - whitening, thickening and hardening of tissue in mouth (pre-cancerous condition) *smokeless tobacco addictive |
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Describe adverse health effects of tobacco use
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85% of lung cancer cases result from smoking and 80 to 90% of chronic obstructive lung disease caused by smoking
30% or 160000 deaths by any type of cancer caused from smoking and plays major part in cardiovascular disease (30% or 140,000 deaths) Total, smoking causes 440,000 deaths annually (20% of all deaths) |
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Review questions 4,5,6 of lesson 6
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Information on answer sheet
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List negative effects on a fetus or newborn that can be attributed to smoking mother
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Chemicals/gases - nicotine, hydrogen cyanide, carbon monoxide - that are introduced to mother while pregnant also introduced to fetus's blood; fetuses of smoking mothers on avg. weigh half pound less (more for heavier smokers) - in general newborns of smokers are normally proportioned just smaller perhaps b/c of decreased oxygen supply to fetus during pergnancy; neurological problems; problems w/ math and reading skills; smoking contributes to SIDS (sudden infant death syndrome)
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What role did Revolutionary War and Prohibiton play in influencing American coffee consumption?
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Coffee very popular beverage in England and France in 1600s - popularity spread to English colonies - tea still most popular drink but 1765 tax on tea made coffee more desired beverage - tax started war, coffee becoming most popular drink, side effect
Prohibition on alcohol thought to spur coffee drinking but the consumption continued to increase after prohibition so theory lost |
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Name and describe 6 sources of caffeine - compare energy drinks w/ coffee
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1. Coffee: two major types in US, Arabica 1% caffeine (Mexico, Brazil, Colombia); Robusta 2% caffeine (Vietnam, Indonesia, Thailand)
2. Tea: contains higher concentration of caffeine than coffee but lower concentration per cup compared to coffee (herbal teas contain no actual tea just various plant leaves and flowers) 3. Chocolate: contains caffeine like substance, theobromine - cup of cocoa contains 200mg of theobromine and 4mg of caffeine 4. Soft drinks: most popular, Coca-cola - in 1981 FDA required cola drinks containing caffeine to have no more than .2mg/ml or 6mg per ounce 5. Energy drinks: soft drinks that contain max amt of caffeine allowed in 12oz can - targeted at high energy crowd however only magic ingredient is caffeine however most contain less than a 4oz cup of coffee 6. OTC drugs like NoDoz keep person alert/awake |
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Review question 10 Lesson 6
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Information on answer sheet
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Describe 4 behavioral effects of caffeine
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1. stimulation: prevents fatigue of body and mind - study showed that chronic consumers of caffeine had decreased ability to perform tasks when not taking caffeine however shown that significant dose can reduce fatigue
2. Reduction of headaches by constricting blood vessels in brain and dialates vascular muscles 3. Some evidence that large caffeine doses can be used to treat hyperactivity disorder in children 4. Coffee does not cure hangover but the caffeine may make an intoxicated person feel more alert |
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Describe the health problems that are causes for concern regarding caffeine
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Cancer: pancreatic cancer associated w/ coffee drinkers i 80s but no verifiable proof
Reproductive abnormalities: sign consumption of caffeine can reduce ability to get pregnant, increase chances of spontaneous abortion, slower growth of fetus - reduced birth weight Inconclusive evidence on caffeine consumption and heart disease Caffeinism: excessive use of caffeine causing nervousness, irritability, muscle twitching, insomnia |
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Review Question 13 of Lesson 6
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Information on answer sheet
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What is the main difference between OTC drugs and dietary supplements?
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Review answer
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What are criteria for deciding whether drug should be sold OTC or by prescription?
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Every drug has potential for being OTC drug but if there are certain hazards like toxicity may only be sold prescription
Difference may be the amt of active ingredient - prescription contain a higher concentration of drug per dose than OTC FDA responsible for altering preparations of OTC meds (higher or lower dose) and deciding which prescription drugs should be offered OTC |
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Name and explain the 3 effects of aspirin that are the primary reasons for its clinical use
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1. analgesic that blocks somatic (bodily) pain - specifically continued pain such as arthritis
2. antipyretic which is a fever reducer that acts on area of hypothalamus that regulates body temperature - stimulates this area to increase amt of heat loss 3. anti-inflammatory - helps reduce swelling, inflammation and soreness of affected area |
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What are the four adverse effects of using aspirin?
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1. blood thinning - can last 4 to 7 days which why docs won't let you take it prior to surgery b/c of inability to form clot; this property useful for ppl at risk of heart attack or stroke
Aspirin implicated in gastrointestinal bleeding - miniscule but still greater than what's considered normal Reye's syndrome in ppl under 20 - rare, occurs after onset of some other viral infection like the flu; side effects - continual vomiting, disorientation, personality changes, lethargy, etc. - not directly implicated but syndrome more likely to occur in individuals administered aspirin to treat illness Aspirin implicated in accidental child poisonings as well as suicide attempts |
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What are the four things you need to know to avoid catching colds from others and to avoid reinfecting yourself?
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1. 100 times as many viruses are produced and shed from nasal mucosa as from throat - saliva contains very few cold viruses
2. A dried virus can survive on dry skin and nonporous surfaces for over three hours 3. Nostrals and eyes are port of entry into body for most viruses - hands contain viruses that are ingested by individual rubbing his or her nose or eyes 4. Wive's tale of sitting in the cold causing a cold has no medical backing |
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Review question 19 Lesson 6
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Information on answer sheet
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Who was Thomas De Quincey, when did he live, what did he do, and why is he so important to the topic of opium?
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Lived in 18th century into 19th century and was author - living in England he bought a dose of laudanum for a toothache(created by Euro. clinician Paracelsus, advanced by Dr. Thomas Sydenham) - raved about how the drug removed negativity in his body mental or physical - went so far as to describe drug as secret to happiness
Avid opium user and described how drug did not create alternative realities for user only enhances the one the user is living in; compared opium use to alcohol use, while former provides pleasure for sustained period later takes time to achieve similar state and pleasure short lived He wrote the book "The Confessions of an English Opium-Eater" |
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The major increase in the use of morphine came as a result of two nondrug developments, one technical and one political. Describe these developments and explain how they contributed to morphine use.
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Technological component: hypodermic syringe created in 1853 by Alexander Wood - allowed morphine to be injected directly into bloodstream allowing much quicker effect
Political Event: the American Civil War, the Prussian-Austrian War and the Franco-Prussian War affected the spread of morphine use - morphine used largely in the field to reduce pain rapidly; dependence grew b/c of easy availability |
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How is it possible that heroin was at first sold as a nonaddicting pain reliever?
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Heroin same effects as morphine and chemical structure is exactly the same except heroin has two acetyl groups which increases lipid solubility of molecule brining more rapidly to the brain where acetyl groups discarded and user left w/ morphine
First mkted as substitute for codeine addicts b/c it was potent and not habit forming - thought process until beginning of 20th cent. - heroin's addictive properties may have been masked by effects of codeine use hence the reason it was not thought to be addictive |
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How did typical opioid abuser change from the early 1900s to the 1920s?
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1900's -1% of population dependent on opioids - no laws against drug at the time so users not scorned (typically pitied) plus most did not smoke opium b/c effects lasted for hrs and interfered w/ daily activities (and smoking was the method of Asian immigrants who were scorned) - concerns over dependence influenced passage of Pure Food and Drugs Act of 1905, opium still heavily imported (blamed highly on doctors who used opium based meds); however the drug worked to treat many ailments and was seen as viable, cheaper alternative to alcohol - typically opium user of the time was middle-class white woman between 30 and 50
Passage of Harrison Act of 1914 changed opium use in country - required prescribers of opium to be registered before prescribing the drug and in 1915 act expanded to make it illegal to possess opium w/o a prescription - for a short time opium prescriptions were outlawed as well but this was reversed in 1925 1920s user had to obtain drug from illegal dealer and drug of choice typically her |
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Review question 5 of Lesson 7
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Information on answer sheet
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What are some of the lessons learned about heroin dependence as result of Vietnam experience?
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Major concern was that in process of fighting military would become drug users - fear realized when marijuana was being used by troops in combat as well as rest zones
- Task Force on Drug Abuse est. in 1967 by dept of defense 1970 concern shifted to heroin use - in US heroin about 5% pure while about 95% in Vietnam and readily available w/ no legal rami. and very cheap - extreme purity meant drug could be smoked or sniffed instead of injected (which was believed to cause dependency) almost half sniffed, and half smoked 1971 est. 10 to 15% military dependent on heroin so gov't implemented urine testing for troops leaving Vietnam - # testing positive was relatively small and among those testing positive only small % continued use of opioids 8 to 12 months after returning to US * Major takeaway: occasional, recreational use of opioids unlikely to develop dependence |
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What are 3 beneficial uses of opioids?
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1. relief of pain - morphine reduces individual's perception of pain, no longer feels as intense - removes pain stimulus w/o causing sleep in individual
2. Treatment of intestinal disorders: relieve colic (intense abdominal pain) and counteract diarrhea by slowing stomach contractions that move food through intestines - this slowing causes constipation 3. Cough suppression: nonproductive coughing becomes problem so opioids helpful |
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What are four potential causes of dependence on narcotics?
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1. Tolerance: chronic use to treat pain or for recreation will result in diminshed effects so higher doses needed
2. Withdrawal symptoms: nausea, vomiting, diarrhea, aches and pains, insomnia, restlessness, weight loss - methadone (synthetic opioid like drug) used to treat withdrawal symptoms instead of user going back to drug 3. psychological dependence: occurs b/c of positive reinforcement received after taking drug (euphoria) - indicates injection can create rapid dependence b/c positive reinforcement quickly follows admin; negative reinforcement is the prevention or relief of pain or discomfort 4. needle habit: for many users events leading up to drug use can be stimulus enough to continue habit - association of buying drug, etc. w/ positive effects of use (ex. one user suggested he could just as well shoot up water as heroin) |
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Discuss major misconception most ppl, including many professionals, have about nonmedical use and misuse of opioids.
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Heroin users experience orgasmic, euphoria which is why they keep using - reality, many experience great discomfort after use but eventually w/ increased use, negative side-effects subside b/c of tolerance against them and pleasurable effects take over
Misconception that withdrawal process is excruiatingly painful - only true for large dose user; avg. user only ingests low doses so withdrawal resembles mild intestinal flu Misconception that one use of the drug results in lifetime dependency - reality, takes a week of consistent use (3 or 4 injections a day) to cause dependency |
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Review question 10 Lesson 7
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Information on answer sheet
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What are the distinctions among phantastica, psychedelics, psychotomimetics, entheogens, and hallucinogens?
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Phantastica is group of drugs that create fantasy worlds for user (ex. peyote, LSD) - overall title given to these drugs and one of their properties is psychedelic effect - term psychedelics coined in 60s when users claimed to be able to see into their own minds, visionary type of effect; this drug type also has hallucinogenic properties which can contribute to psychotic states - further drug classification as psychotomimetic drugs; entheogens is description of phantastica type drugs that are thought to create spiritual or religious experiences
* all of these catergories share property of ability to produce hallucinations thus referred to as hallucinogens |
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What were the 3 therapeutic uses of LSD in 50s and 60s?
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1. LSD used to access subconcious mind (our dream-like state) - psychiatrists thought LSD could be used to induce this dream-like state in patients where they could acess their subconscious thoughts
2. alcohol dependence treatment - initially this use was effective 3. terminal cancer patients - thought that if patients could explore their feelings while on this drug they could better grasp the concept of their own mortality |
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The Army-sponsored research with LSD between 1956 and 1967 violated many of the ethical codes established as a result of the Nuremberg war crime trials after World War II. What were the ethical codes that were violated?
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Thought that LSD could be used in interrogations of prisoners - effects of drug similar to truth-syreme - studied 585 soldiers and 900 civilians - many of the "volunteers" were actually not volunteers; among those studied many could not walk away from an experiment once it began; many of the subjects not told what experiment entailed - kept in the dark about details of experiment and why they were observed (ex. CIA lacing drinks of civilians w/ LSD and observing effects)
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What were the 4 main problems w/ Leary's research at Harvard in the early 60's?
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Wanted to experiment on effects of psilocybin - original experiments were sound using proper controls w/ doctor present - soon doc ousted and controls dropped; Leary advocated that experimentor should partake in drug use along with subjects to be able to better communicate w/ them
3 other problems: - no doc present - experiments not performed in lab setting - undergrads used in experiments |
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What 5 factors contributed to decline of LSD use?
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1. Widely publicized "bad trips"
2. Prolonged psychotic reactions 3. Worries about possible chromosome damage 4. Self-injurious behavior 5. "Flashbacks" which is when an individual experiences the symptoms of LSD use weeks or months after the use |
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Discuss the 3 botanical species of cannabis.
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Cannabis sativa: orig. from Asia seen worldwide (weed in US/Canada) - used for its fibers which are made into hemp rope; tall, gangly plant grows 18ft
Cannabis Indica: grown throughout world including illegally in US in backyards/homes - used for psychoactive purposes (vary in psychoactive characteristics); grows 2 to 3 ft Cannabis ruderalis: not grown in US, primarily grown in Russia |
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Explain how the body absorbs and eliminates THC
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THC is main psychoactive ingredient in Cannabis found in the plant resin; absorbed in body rapidly when marijuana smoked, enters brain initially and moves throughout body - user experiences peak psychological/cardiovascular effects w/in 5 to 10 min.; effects from oral consumption takes around 90 min; THC has high lipid solubility so taken up/stored in fatty tissue to be released slowly
Eliminated through feces typically - makes THC content in blood or urine impossible to determine |
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What are the short-term physiological effects of cannabis at typical levels of American social usage?
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Increase in heart rate (dose dependent-larger dose faster heart rate) - person's heartrate will peak after 10 min when smoking mari. and return to normal rate after 1 1/2 hrs - peaks in 90min when orally consumed and takes up to four hrs to resume normality
Inconclusive evidence on adversely affecting blood pressure and cardiovascular system Reddening of eyes; dryness of mouth and/or throat |
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What four factors contributed to declining prescription rate of cannabis?
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1. creation of meds that were better able to treat ailments than cannabis
2. variability of the medicinal preparations of cannabis - varied in potency leading to adverse effects 3. active ingredient in cannabis not very water soluble so injectable prepartion could not be formed (asking patients to smoke cannabis as treatment prob would not go over well) 4. if patient took drug orally onset of desired treatment effects would be sluggish - 1 to 2 hrs |
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What are the possible medicinal uses for marijuana that were of interest in the 70s and 80s?
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1971 mari. discovered to help relieve fluid pressure around eye for glaucoma patient - one such patient Robert Randall arrested for growing mari. for this use, charges dropped when doc varified that he needed the drug to prevent going blind; gov't started providing him and other such patients mari. on compassionate use protocol
Another use for cancer treatment - alleviated nausea associated w/ cancer drug treatments (chemotherapy) - stimulated appetite for patients to gain weight (useful for AIDS patients as well) Also used in asthma, spacticity, nervous system disorders **LOOK UP LAST 3 TREATMENTS** |
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What are the two main behavioral problems associated w/ marijuana smoking?
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TEACHER ANSWER: PANIC REACTION, TRACKING BEHAVIOR ESPECIALLY WHEN DRIVING**
LOOK UP** |
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What are the social trends that affect drug use?
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80s brought about health conscious mindset focused on working out, dieting, consuming less alcohol, caffeine and drugs (like mari.) - conservatism grew and using mari. countercultural
Drug use can be trend based so fashionable perhaps in the 70s to use mari. but maybe not in 80s - was rebound in the 90s Monitoring the future study shows trends: mari. use peaked in 1978 - 79 b/c perceived risk low (60% of hs seniors had tried), 1992 % dropped to 32% (higher perceived risk) but increased to 45% in 2005 (lessening perceived risk) |
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What were the recommendations of the Commission on Marijuana and Drug Abuse in its 1972 report?
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Recommended that fed. and state laws change so private possession of small amts of mari. for personal use and for distribution w/o profit no longer be offenses; American Medical Association supported commission w/ notion that mari. use and crime not correlated; American Bar Association also supported making minor possessions of mari. punishable by fine only
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Review Questions 10,11,12 in lesson 8
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Information on answer sheet
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Oregon abolished criminal penalties for marijuana use in Octoboer 1973 - what happened?
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Substitued civil fines up to $100 in place of criminal penalties - fines similar to traffic tickets in how they were handled - marijuana use increased in state as result - over 3 yr period # of adults (age 18 and over) who used mari. increased from 19% to 25% while chronic users increased by 1%
Other states enacted similar laws which helped reduce court costs and costs of juries and jails |
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How did attitudes toward decriminalization change during 1980s and 1990s?
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70s push toward decriminalization for possession of small amts of mari. (even backed by Jimmy Carter and his wife)
80s (presidency of Reagan) halted decriminalization process and moved toward zero tolerance policy toward illicit drugs (included stopping shipments mari. from abroad as well as stopping cultivation at home - resulted in 100 million plants confiscated and imposed fines on boats, cars, etc. w/ traces of mari.) states increased fines and reinstituted jail time for possession - much of the recriminalization of possession occurred in early 90s |
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Why is there so much concern over drug use by athletes? Explain 3 reasons for concern
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1. athletes (especially for children) are role models; ppl look up to athletes b/c they are strong, active and at peak physical condition - news of drug use (namely steroids) may shed positive light on drug use to impressionable youth - athletes have great influence hence the reason corps pay money to have them endorse products
2. actual physical effects of drug on athlete - performance enhancing drugs do what their name implies causing the viewpt that the use of steroids is cheating 3. physical health of athlete who uses steroids - concern that athletes are not weighing risks of use against temp. boost they receive |
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Describe the four performance-enhancing stimulants and their effects.
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1. amphetamine 1st used in athletic competition in 1952 Oslo Winter Olympics, used for energy producing effects (have been shown to provide athletes w/ brief, explosive power as well as endurance; study showed that greater performance by athletes was relatively small, few % pts, but that can mean a huge difference when talking about world class competition - effects are typically shown b/c exhaustion is masked by drug
2. Caffeine: studies have shown that energy and endurance enhanced; caffeine banned from many sports thus effects must be somewhat substantial 3. Cocaine: never studied in regard to athletic competion but effects similar to amphetamines, but works in shorter time period meaning shorter duration (not good for high endurance competition) 4. Ephedrine: not concern for MLB (despite NFL banning) b/c many MLB players used drug as energy supplement and weight loss pill (negative outcome was Orioles pitcher Steve Bechler who died from 108 degree body temp induced by ephedrine) |
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What are the adverse effects of steroids on the body?
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One of the concerns is younger steroid users - drugs may stunt growth by closing prematurely the growth plates
Other concerns: bloody cysts in liver known as peliosis hapatitis as well as advent of heart disease and high blood pressure ; acne, baldness, atrophy of the testes, breast enlargement (typical of men) Effects on women: steroids put extra testosterone in body result in effected muscle growth, reduction in breast size, facial hair, deepening of voice |
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Review questions 18,19,20 Lesson 8
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Information on answer sheet
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The institute of medicine has proposed a new classification of "the continuum of care" compare the 4th classification to the 1st, 2nd and 3rd.
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Begins w/ primary prevention and focuses on you of population most of which have not experimented w/ drugs or only w/ tobacco or alcohol - goal is to teach kids to abstain from drug use altogether and to show the potential influence of drugs on their lives, emotions and relationships; concern that introducing kids to info about drugs may arouse curiosity
Second classification helps those that are already using drugs to not use more potent drugs or increase use of current drugs Third classification is tertiary prevention or "relapse prevention" - goal is to stop substance abuse Fourth classification categorizes 3 target populations: universal prevention works to spread techniques/info to entire population (ex. schoolchildren); selective prevention treats selected group w/in broader classification (ex. those schoolchildren w/ poor grades); indicated prevention works w/ those that are expected to have further problems in future b/c of some prior problem like smoking/drinking at early age |
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Describe the following Prevention Programs in the Schools: Knowledge Attitude Behavior Model, three kinds of affective education, and two anti-drug norms.
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Review Answer (lesson 9)
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What are the five successful components of the social influence model for smoking prevention?
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Social influence model focuses on cigarette smoking b/c great # of adolescent smokers plus verifiable health risks
1. training refusal skills: example would be 8 ways to say no (set up hypothetical situations where students pressured into smoking and provide students w/ useful answers to combat pressure) 2. public commitment requires child to promise in front of peers to not start smoking and sign pledge 3. Countering advertising shows students cigarette ads and then ads are dissected to expose hidden messages (using models to adverstise) - students discuss realities of smoking such as bad breath, cancer, etc. 4. Normative edu provides students w/ figures about smoking trends among peers to downplay the idea that "everyone is doing it" 5. Use of teen leaders b/c they back up ideals enforced by model |
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What distinguishes DARE from other similar programs based on the social influence model? Based on info from the 94 study has DARE been successful in reducing drug use by young ppl?
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Started in LA '83 drug edu program admin. by police officer that undergoes extensive training and teams up w/ classroom teacher - program teaches students how to refuse drugs, implements teen leaders, provides alternatives to drug use, gives students decision making edu (police officer present shows the weight of consequences of drug use)
W/ drug free schools program est. in 80s providing money to drug edu, DARE received financial/political support and program spread quickly until in every state '94: one study looked at effectiveness of program among rural, suburban and urban students - showed small increases in self-esteem but no results regarding reduced drug use; 2nd study had control group, pretest postest and found that drug knowledge among students increased but only small reductions in prevention and use |
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Describe 2 prevention programs shown to work. what do you think are the successful components of each?
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Project ALERT implemented in Cali and Oregon targeted cigarette smoking and alcohol and marijuana use - classified students as either nonuser, experimentor or user of one of the 3 substances - control schools persisted w/ current program in the school - follow up surveys to Project ALERT schools found that no effect on the initiation of cigarette smoking by students but reduction in continued smoking among smoking students; alcohol results insignificant; showed significant results in reducing marijuana use (initial use and overall consumption)
Life Skills Training Program: 3yr program following social influence model teaching students different life skills (resistance skills, social skills, and teaches students about media influences) shown to reduce use of tobacco, marijuana and alcohol |
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Describe the 2 peer-prevention programs
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1. peer influence: makes assumption that students respect opinions of peers and seek their approval - focus of program in on group discussions that do not necessarily focus on drugs, more focus on open communication and developing sense of belonging
2. peer participation program: focuses on students in high risk areas - put students in different environments (such as paid community service, operation of a money making business, etc.) to teach them life skills; pt is not drug resistance, rather helping students become participating members of society |
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What are the 4 approaches used w/ parenting programs?
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1. informational: parents given info about alcohol/drugs and about student use as well as signs to look for about their own children using
2. get parents to recognize their own habits/problems regarding substance use to better inform their children 3. parenting skills: parents taught decision making skills, setting goals, how to say no to child; use role-playing exercises 4. parent supprt groups: groups of parents that discuss problem solving techniques, how to address problems, etc. - parents discuss new skills and techniques |
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What are the 2 basic reasons for trying to organize prevention programs at the community level?
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1. coordinated approach using schools, parent groups, civic org., police, newspapers, radio, tv has greater motivation/influence on student population than drug edu. program at school alone
2. Drug use is controversial and emotional and can drive wedges between schools, parents, church groups, etc. if not implemented w/ suppot of community **REVIEW ANSWER SHEET LESSON 9** |
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What is the most common component of "drug free workplace" plans? Who follows these plans?
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Random urine screening - companies that work w/ gov't required to screen - promoted to cover entire private sector but no law yet
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Describe Alcoholics Anonymous as a treatment program.
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Views alcohol dependence as disease w/ no cure and only abstinence as treatment - moves blame of excessive drinking away from individual and onto disease - does not remove responsibility of individual to recognize problem and seek to correct it (removes feelings of guilt from individual)
uses group support and buddy system to keep on track *not shown to be overly effective in treating alcoholism but does provide alcoholics w/ other ppl going through same situation |
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Steps of AA
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Review answer and book (lesson 9)
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What are the 4 steps of change in motivational enhancement therapy, and what is happening in each stage?
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Treatment method that focuses on motivation individual has towards quitting the substance abuse; knowing the stage of motivation to quit (through motivational interviewing) can aid in treatment process
Stage 1: precontemplation stage: individual does not recognize that problem exists Stage 2: contemplation stage: admits to problem and may be open to changing behavior Stage 3: preparation stage: individual makes commitment to change and begins implementing that change 4. Actions stage: strategy developed in preparation stage begins and individual takes first step such as joining AA 5. final final stage is maintenance stage |
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Describe contingency mgmt
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Very effective in reducing substance abuse among variety of populations - provides incentives in form of rewards for a clean drug urine sample (rewards get larger as samples continually come back clear) - if drug test not clear individual loses right to reward; rewards are coupled w/ group therapy
**problem is that rewards can become expensive** |
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Describe relapse prevention
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Method for lessening and eventually preventing use of drugs/alcohol by abusers - provides training in understanding behaviors, places, individuals that lessen the person's chances of abstaining from substances (ex. avoid bars)
Shown to be very effective in counteracting substance abuse but may ask too much from someone w/ mental incapcity to avoid drugs |
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Describe 3 major maintenance strategies that are used to keep an individual from relapsing to abused drug
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1. agonist or substitution therapy: agonist is agent that produces some type of reaction - ex would be a nictoine replacement drug that produces similar results to nicotine but has safer means of admin. and may be less potent - agonists reduce relapse potential and diminishes withdrawal symptoms
2. antagonist therapy: prevents user from experiencing reinforcing effects of abused drug 3. Punishment therapy: more extreme drug prevention method - this therapy (and drugs used) create unpleasant reaction when abused drug used such as causing headache or vomiting |
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What role do the benzodiazepines play in alcohol detox?
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Shown to have strong cross-tolerance w/ alcohol thus used as substitutes for alcohol in order to safetly complete withdrawal process - increases the inhibition effects of GABA (used by body to reduce effects of stress - increased heart rate, blood pressure, feelings of anxiety) on nervous system to reduce potential for seizures
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List 5 types of nicotine replacement therapy
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1). Transdermal nicotine patch
2). Nicotine gum 3). Nicotine nasal spray 4). Nicotine vapor inhaler 5). Nicotine lozenge |
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Describe newest version of anticholinergic drugs
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Historically used to treat opioid dependence by creating state of delirium where individual goes through withdrawal process w/ no recollection of negative side effects - person is put under essentially and withdrawal process occurs while unconscious
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How big a problem is cannabis dependence and what seems to be the most promising drug treatment being studied?
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Small % of users become dependent on drug (1 in 11 users) - more ppl are requesting treatment b/c withdrawal effects include irritability, anxiety, sleep disruption, aches
Dronabinol (oral form of THC) shown to be effective treatment - process involves administering alternative drug and keeping patient on for period of time, eventually reducing amt of drug until drug free while at same time not experiencing withdrawal effects |
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REVIEW ? 19 on lesson 9 pts should be given
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The data on drug use suggest the bulk of our substance abuse treatment should focus on what?.
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US Substance Abuse and Mental Health Services Admin receives substance abuse data each yr - '06 data showed that 90% of abuse cases resulted from alcohol, opioids (heroin), marijuana, and cocaine (crack)
Data showed that 50% of abusers treated as outpatients thus focus of substance abuse treatment in US should be on developing interventions for these 4 drugs that can be admin. on an outpatient basis |
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Explain the pharmacology of LSD, including absoption, metabolism, tolerance, cross-tolerance, and physical dependence
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LSD oderless, colorless, tasteless drug - absorbed rapidly through gastrointestinal tract; oral consumption most common; brain shown to have least LCD of any organ so not selectively taken up by brain - every three hours body metabolizes half of LSD in individual's blood (relatively rapid); tolerance is rapid w/ doses becoming ineffective w/in 3 to 4 days; cross tolerance between LSD, mescaline, and psilocybin; no proof that LSD or other hallucinogens create dependence
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Review Question 17 of Lesson 7
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Information on answer sheet
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Dried mushrooms are 0.2 to 0.5 percent psilocybin. The hallucinogenic effects of psilocybin are quite similar to those of LSD and the catechol hallucinogen mescaline, and cross-tolerance exists among these three agents. Describe the psychoactive drug reactions of these agents and explain how they are related to the amount used.
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Four mg of hallucinogenic drugs (LSD, mescaline, psilocybin) produce recreational effects (relaxation, pleasant experience) - as dosage increases begin to affect perceptions of individual leading to hallucinations - alongs w/ psychological effects # of sympathetic nervous system symptoms - this system responsible for utilizing body's resources during stressful situations (flight or fight response) - drug induced alterations take body out of homeostasis
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6 Concerns of Marijuana use
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Review e-mail
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