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Lecture Eighteen

Drug Abuse I

What distinguishes use from abuse? 1. Time spent using, getting the drug 2. Amount use 3. Situations - working, driving. 4. Recurrent problems
What are four key changes that have occurred over the last 200 years and are reasons why drugs abuse is more common now? Know what to say to discuss them!!! 1. Chemical advances - in isolation of pure chemicals, synthetic compounds and chemical modification 2. Global availability 3. intervention of the hypodermic needle 4. Internet
Methamphetamine is a drug derived from ...? Amphetamine
Amphetamine's general mechanism of action is...? so this is also methamphetamines mxn of action! Primarily promotes the release of biogenic amines (DA, NE 5HT)
What is the mode of action of amphetamine's that is why it is taken recreationally? Psychostimulant
Amphetamine is completely _____________?. What is an amphetamine derivative we learnt about briefly? synthetic, MDMA (ecstasy - and how you need fancy lab equipment, high grade chemicals to make it)
Amphetamine derivatives such as methamphetamine have dose dependent effects. What are they? Low dose is stimulant effect, med dose is psychedelic/enactogen effect, high dose is tremors, convulsions and death.
Methamphetamine is an amphetamine molecule with a methyl group attached. What is the implication of this? The methyl group attached makes the molecule very lipothilic, make it go through the BBB and is very potent so you get very high
What do you need to make meth? 1. Basic chemistry supplies and multiple cooking agents which are easily accessible. 2. Pseudoephedrine (main psychoactive base ingredient)
A key mode of action pseudoephedrine is? Psychostimulant
What is methamphetamines mxn of action? prompts massive release of DA, NE and 5HT
What is the key mode of action for methamphetamine? (the one that is why its used recreationally) Psychostimulant
You need to recognise a few things about the drugs we abuse. What are these things? - Not all drugs of abuse are illegal/illicit. -Some are legally obtainable (nicotine, alcohol have huge social costs) -Some are Rx obtainable. - u can get addicted to anything e.g. drug or behaviour (sex, gambling as similar brain circuitry is activated)
What are the five identified risk factors for drug use to segue into drug abuse? 1. Early experimentation 2. Psychiatric Co-morbidity 3. Environment 4. Genetics 5. Availability
Explain the first identified risk for drug abuse 1. Early experimentation - also called The Gateway Theory is when early drug use esp. cannabis serves as a gateway to future drug use.
Explain the second identified risk for drug abuse 2. Psychiatric Co-morbidity - also called The Addiction Vulnerability Hypothesis where people with psychiatric disorders exhibit higher rates of drug abuse/addiction. Here accurate dual diagnosis is critical to know what is driving what
Explain the third identified risk for drug abuse 3. Environmental - home, social, communities. So if in your home, others abuse drugs or if you live in a poor neighbourhood where this is common or you live in a country with a bad government
Explain the second identified risk for drug abuse 4. Genetics - still controversial but some research shows that there is a difference in receptors in drug abusers versus non-drug abusers
Explain the second identified risk for drug abuse 5. Availability - the more available drugs are, the more likely you are to abuse drugs.
What are the common defining features of drug ADDICTION that fit in with the common defining features of drug abuse? Compulsive use (time), craving, binging (amount), continued use despite recognized negative consequences (problems)
What does drug addiction equal? physical and psychological dependence on a chemical compound
What are the two key points when defining drug abuse for 476? Won't stop, drugs are important
What are the two key points when defining drug addiction for 476? Can't stop, drugs are #1 priority
Drug addiction is ______________. They know it is not good but they keep doing it irrational
What is the best way to deal with drug addicts? Demand reduction. - reducing the desire/demand for the drug using rehab and psychotherapy. Rather than sending them to prison as if it is irrational thinking then prison doesn't fix it
Drug addiction is a state of..... pathological decision making
How did we traditionally define/identify drug addiction? Focused on physical withdrawal symptoms - if person stopped taking drug and exhibited withdrawals then they are addicted. But people get withdrawals from drugs taken in hospital for weeks.
Because traditionally physical withdrawal symptoms were the focus of how to define/identify drugs, what was the focus of treatment at this time? Detox - thought that if you get the person over the withdrawal period, then they should go back to normal.
How do we define/identify drug addiction NOW? We now appreciate that drug reinforcement is the unifying feature of addiction - if you want a drug over and over, you are an addict.
We now appreciate that drug reinforcement is the unifying feature of addiction - if you want a drug over and over, you are an addict. How does this have implications for how you treat drug addiction? You cannot just treat the withdrawal or do detox. You have to treat the psychological drive with psychotherapy.
Describe the positive reinforcement during life as a recovering addict You still have memory of good feeling/highs associated with drug use. So this is positive reinforcement towards relapsing
Describe the negative reinforcement during life as a recovering addict In recovery, person must adapt to state where drug is absent an this can be very bleak e.g severe boredom, anhedonia (no pleasure), depression.So this is neg. reinforcement towards relapsing
Describe the contextual reinforcement during life as a recovering addict Contexual cues such as friends (who you used to get high with) can UNKNOWINGLY spark cravings. This suggests that the brian forms strong, salient, and long-lasting associations.You need to separate your new life completely from your old life.
Describe the stigma reinforcement during life as a recovering addict Being an "addict" is now part of your life story. Everyone knows you were an addict and you have to tell/explain to people you were an addict. This can lower self-esteem and be detrimental to recovery. It is a label with negative connotation/stigma
So how to we see a past drug addict now? As a recovering addict (rather than a normal person) as they will always be dealing with psychological desires and contextual cues
Created by: alice476