Chapter 16

Using Drugs Responsibly

Using Drugs Responsibly

What is a Drug?
The Overmedicating of Americans
The FDA and You
Drug Misuse, Abuse, and Addiction
Stimulants
Club Drugs
Depressants
Marijuana

Using Drugs Responsibly

Hallucinogens
Phencyclidine (PCP)
Inhalants
Anabolic Steroids
Reducing Drug Use

What is a Drug?

Drug Laws
How Drugs Work
Pharmacogenics
Unintended Harmful Effects of Drugs
Routes of Drug administration
Effectiveness of Drugs

What is a Drug?
A drug is a chemical in a medicine that alters the
structure or function of some of the bodies
biological processes.
Alteration can be to start, stop, speed up, or
slow down a process.
A medicine is a drug (or combination of drugs)
that is used to prevent illness, cure disease, aid
healing, or suppress symptoms.
Drugs are classified according to the particular
biological process they affect rather than by their
chemical properties.

What is a Drug?
Drug Laws
Drugs are categorized into the following five
groups:
Prescription drugs chemicals so potent
that only a doctor can permit their use
Over-the-counter drugs chemicals that
are not so potent so that consumers can
obtain them directly from stores
Dietary supplements plant extracts or
vitamins act as drugs and can be obtained
from stores

What is a Drug?
Drug Laws
Drugs are categorized into the following five
groups:
Addictive drugs tobacco and alcohol,
taken by choice
Illegal drugs considered so dangerous
that they are outlawed

What is a Drug?

What is a Drug?
How Drugs Work
Many drugs act by interacting with specific
cells in the body that carry receptors, which
are proteins on the surface or inside a cell to
which a drug or natural substance can bind
and affect cell function.
When a drug binds to a receptor, it affects the
biological processes of cells or organs.

How Drugs Work

What is a Drug?
Pharmacogenetics
A major assumption in the prescribing of
drugs is that everyones body uses a drug in
the same way
The science of pharmacogenetics is to ID
many of the genes that affect drug responses
and adverse effects.
The hope is that drugs will one day be able to
be tailored to a patients specific biology to
produce optimum benefit and minimal risk.

What is a Drug?
Unintended Harmful Effects of Drugs
Even though a drug may be intended to have
a single effect, it often does not because it
binds to different kinds of receptors on
different cells.
Unintended drug actions are called side
effects.
Some side effects include allergic reactions
called drug hypersensitivity.

Common Side Effects of Drug Use

What is a Drug?
Unintended Harmful
Effects of Drugs
Contraindication
a medical
reason for not
taking a drug

What is a Drug?
Routes of Drug Administration
Drugs can be taken:
By mouth
By inhalation
By injection into the muscle or bloodstream
By implant under the skin
Through the skin
Through mucous membranes of the eyes,
nose, vagina, and anus
Drugs remain active in the body for a
relatively short time, often only a few hours.

What is a Drug?
Effectiveness of Drugs
The dose of a drug is the amount that is
administered or taken.
Effectiveness of a particular dose of a drug is
influenced by:
Persons body size
How rapidly the drug breaks down and is
eliminated
The presence of other drugs or food in the
body
The persons mental state
Persons expectations of the drugs efficacy

What is a Drug?

What is a Drug?
Effectiveness of Drugs
Tested by doing a double blind study
Those receiving a drug and those
administering the drug dont know who is
receiving the drug and who is receiving a
placebo

Effectiveness of Drugs

The Overmedicating of Americans

Americans consume huge amounts of drugs
every year both prescription and non
prescription
Psychoactive drugs
More than 25% of legal drugs sold in America
Alter thoughts, feelings and sensations.
Psychoactive drugs include:
Tranquilizers
Sleeping pills
Mood modifiers
E.g. alcohol, tobacco, caffeine

The Overmedicating of Americans

The Overmedicating of Americans

Lifestyle Drugs
Lifestyle drugs are sold to basically healthy
middle-class Americans.
Lifestyle drugs are used in the place of
making healthy choices such as eating a diet
of vegetables and fruit and staying active.
Psychotropic drugs useful for treating
specific diseases but not intended to mask
problems caused by stress or relieve
anxieties of daily living

The Overmedicating of Americans

Lifestyle Drugs
Some are used to target normal changes that
occur with aging, hair loss, reduced sexual
drive, and sagging or wrinkled skin.
Weight loss or appetite suppressant drugs

The Overmedicating of Americans

Drug Company Advertising
Pharmaceutical companies market to doctors
by courting them for business.
In the United States, pharmaceutical
companies are also allowed to advertise
directly to consumers through television and
print media.

The FDA and You

A number of tests are run on groups of
volunteers to test a drugs effectiveness.
Drugs are also watched for side effects.
Only after trials are done does the FDA give
approval for sale.

Drug Misuse, Abuse, and Addiction

Using any drug to the point where health
is adversely affected or the ability to function
in society is impaired can be defined as drug
abuse.
Drug abuse refers to the person taking the
drug being personally or socially impaired.
A drug is being abused if the user cannot
control taking it and the drug is being used
continually to mask anxiety, combat stress, or
seek pleasure.

Drug Misuse, Abuse, and Addiction

Drug Misuse, Abuse, and Addiction

Addiction
Progressive, chronic condition characterized
by:
Compulsion overwhelming preoccupation
desire, or drive to use a psychoactive drug
Loss of control inability to control use of a
drug or loss of control over ones behavior
because of taking a drug

Drug Misuse, Abuse, and Addiction

Addiction
Progressive, chronic condition characterized
by:
Continued drug use despite adverse
consequences tendency not to stop using
a drug in the face of arrest, job loss, family
breakdown and health problems
Distortions in normal thinking - not
admitting that problems are the result of
drug taking (denial)

Drug Misuse, Abuse, and Addiction

Physical Dependence
Physical changes take place so that
continued taking of the drug is necessary.
Alcohol
Caffeine

Drug Misuse, Abuse, and Addiction

Tolerance
An adaptation of the body to a drug so that
larger doses are necessary to produce the
same effect
Withdrawal
A consequence of physical dependence,
occurs when the body adapts to the absence
of a drug on which it has become physically
dependent.

Drug Misuse, Abuse, and Addiction

Withdrawal
In general, withdrawal from nervous system
depressants leads to:
Anxiety
Irritability
Susceptibility to seizures
Withdrawal from stimulants can produce:
Sleepiness
Depression
Loss of consciousness

Drug Misuse, Abuse, and Addiction

Psychological Dependence
When repeated use of a drug causes an
intense craving for the drug
May lead to compulsive drug-seeking
behavior that is injurious to relationships, jobs
and families.

Stimulants
Substances that increase the activity of the
central nervous system and are referred to as
uppers.
Common stimulants include cocaine,
amphetamines, and caffeine.
Main effects include:
Increased mental arousal and physical
energy
A state of euphoria
Long-term use causes physical and
psychological dependence.

Stimulants
Cocaine
Stimulant obtained from the coca shrub.
Induces euphoria, sense of power and
clarity of thought, increased physical vigor,
increased heart rate and blood pressure.
Continued use can result in:
Loss of appetite and weight loss
Malnutrition
Sleep disturbance
Altered thought and mood patterns

Stimulants
Cocaine
Frequent cocaine sniffing can damage the
nasal septum.
Routes of administration:
Sniffing (snorting) it as a white powder
Injecting it directly into the bloodstream
Smoking it in the form of free base or
crack

Stimulants
Cocaine
Produces tolerance, physical dependence, and
withdrawal.
Potential for psychological dependence with
cocaine is very high.
Can consume an individuals entire life

Stimulants
Amphetamines
Manufactured chemicals that stimulate the
central nervous system
Most common are:
Dextroamphetamine
Methamphetamine
Dextromethamphetamine
Ice is a dangerous form that is smoked.
Produce a hallucinogenic effect that lasts for
hours

Stimulants
Amphetamines
Usually taken orally, but can be injected
Can be prescribed by physicians, but have little
medical use
Produce feelings of euphoria, increased
energy, greater self-confidence, increased
ability to concentrate, increased motor and
speech activity, perceived improvement in
physical performance

Stimulants
Amphetamines
Excessive use can cause:
Headaches
Irritability
Dizziness
Insomnia
Panic and confusion
Delirium
Crash
Tolerance
Mild physical dependence

Stimulants
Caffeine
Natural substance found in a variety of plants
used in making coffee, tea, chocolate, and soft
drinks
Produces decreased drowsiness and fatigue,
faster and clearer flow of thought, increased
capacity for sustained performance,
nervousness, tremors, insomnia, and inability to
perform complex tasks

Stimulants
Caffeine
Psychological dependence can result from
chronic use and tolerance can gradually
develop.
Mild withdrawal symptoms can occur when
caffeine use is ceased, including:
Headache
Irritability
Restlessness
Lethargy

Stimulants

Club Drugs
Consist of several psychoactive chemicals that
are often used at social events
These include:
Ecstasy
GHB
Ketamine
Rohypnol

Club Drugs
Ecstasy
Methylenedioxymethamphetaminean
amphetamine that has become popular in
recent years.
Also called Ecstasy, Adam, XTC,
Clarity, Essence, MDMA, or MDM.
Users experience hallucinogenic effects
and euphoria.
Stimulates the release of serotonin, producing
a high that can last hours.

Club Drugs
Ecstasy
Risks:
Confusion, depression, sleep problems,
drug craving, severe anxiety and paranoia
during and after taking the drug
Muscle tension, involuntary teeth clenching,
nausea, blurred vision, rapid eye
movement, faintness, chills or sweating
Increases heart rate and blood pressure
Long term damage to serotonin-producing
nerve cells in brain
Liver damage with long term use.

Club Drugs
GHB
Gamma-hydroxybutyrate
Also called G or Liquid Ecstasy
Causes sedation, increased sexual interest,
relaxation, short-term amnesia
Very dangerous to mix with alcohol
Large doses can cause users to become
comatose and stop breathing

Club Drugs
Ketamine
Is a dissociative psychedelic used medically
as a veterinary and human anesthetic
Also called K, Special K, or Cat
Tranquilizer
Causes hallucinations, bizarre behavior,
psychosis

Club Drugs
Rohypnol
Flunitrazepam is a benzodiazepine used as a
sleep medication favored for its short
duration.
Also called Ruffies or Roofies.
Reduces anxiety, inhibition, and muscular
tension.
Has received a lot of attention as a date rape
drug.

Depressants
Reduce the level of arousal, motor activity,
and awareness of environment
Increase drowsiness and sedation
Produce mild state of euphoria, reduction in
inhibitions, feeling of relaxation
May impair mood, speech, and motor
coordination

Depressants
Carry the potential for:
Physical and psychological dependence
Tolerance
Withdrawal symptoms
If two or more depressants are taken at the
same time, they produce an effect much
stronger than either drug produces when
taken alone (synergistic effect).

Depressants
Sedative and Hypnotic Drugs
By prescription only.
Sedatives promote mental calmness and
reduce anxiety.
Hypnotics promote sleep or drowsiness.
Most common sedative-hypnotic drugs are
called benzodiazepines, popularly known
as tranquilizers.

Depressants
Opiates
Opiates are a group of chemically related
drugs derived from the opium poppy;
depress the central nervous system (CNS).
Cause physical dependence, habituation,
tolerance, and serious withdrawal
symptoms.
Can be fatal because of respiratory failure.
Morphine and heroin are derivatives of
opium; they block nerve transmission in the
CNS, suppressing mental and physiological
functions.

Marijuana
Forms:
Hashishsticky resin of the Cannabis sativa
plant
Ganjadried tops of female plants
Bhangcontains smaller amounts of THC
Sinsemillapotent form of marijuana
Active ingredient is THC.
Low doses of THC produce:
Euphoria, Sense of relaxation
Sometimes altered perception of time and
space

Marijuana
THC consumption can invoke:
Confusion
Anxiety
Hallucinations
Paranoia
Research indicates that marijuana contains
carcinogens.

Marijuana
Many states have legalized use for medical
purposes, such as:
Nausea caused by chemotherapy
Anorexia as a result of cancer
AIDS
Chronic pain
Migraines

Hallucinogens
Derived from as many as 100 kinds of plants
and from chemical synthesis in the lab
Alter perception, thought, mood, sensation, and
experience
Most often ingested orally
Produce tolerance but do not create physical
dependence or symptoms of withdrawal; there is
a danger of psychological dependence

Hallucinogens

Phencyclidine (PCP)
AKA Angel Dust
PCP was originally used as an animal
anesthetic; it is no longer legal and is used now
only as an illegal recreational drug.
The effects of PCP vary, depending on the dose
and route of administration; it can be:
A stimulant
A depressant
A hallucinogen

Inhalants
Depressants of the CNS
Intended effect: Loss of inhibition
Unintended effects:
Dizziness
Amnesia
Inability to concentrate
Confusion
Impaired judgment
Hallucinations
Acute psychosis

Inhalants
Chemical substances that vaporize rapidly and
when inhaled produce various kinds of
depressant effects similar to alcohol
Model airplane glue, nail polish remover, paint
thinner, gasoline, aerosols, amyl nitrite, and
chloroform
Do not produce tolerance or withdrawal, nor do
they induce physical dependence
Can damage the kidneys, liver, and lungs

Inhalants

(c) Jones and Bartlett Publishers. Photographed by

Kimberly Potvin.

Anabolic Steroids
Synthetic derivatives of the male hormone
testosterone.
Taken orally or injected.
Produce increased lean muscle mass, strength,
and ability to train longer and harder.
Side effects include liver tumors, jaundice, fluid
retention, high blood pressure, severe acne, and
trembling.

Reducing Drug Use

People are overmedicated and overly dependent
on drugs.
The healthiest approach is to be as free of drugs
as possible.
Wellness is not achieved by taking drugs.
All drugs can be dangerous, and illegal
recreational drugs are especially dangerous.

Using Drugs Responsibly

What is your opinion on the amount of drugs we
tend to use in the United States? Is it
appropriate or not?
How do you respond to the prospect of taking a
drug for a medical condition? Are you ever
critical of what the doctor recommends?
Is it bad to have caffeine on a daily basis? Why
or why not?
What does or would motivate you to avoid
recreational drugs?