13 Drug Abuse Flashcards

1
Q

Common Drugs of Abuse/Recreational Use

A

Psychomotor stimulants

  • Amphetamine (‘speed’)
  • Cocaine (including ‘crack’)

Psychotomimetic agents

  • Cannabis
  • Lysergic acid diethylamide (LSD, ‘acid’)

Opioids

  • Morphine
  • Diacetylmorphine (Heroin, ‘smack’)

CNS depressants

  • Ethanol
  • Barbiturates (‘yellow jackets’, ‘goofballs’)
  • Benzodiazepines (‘jellies’)
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2
Q

Health triangle - A

A

A. MENTAL/EMOTIONAL
INTERFERENCE WITH BRAIN FUNCTIONS

• Psychiatric co-morbidity is commonly reported – depression, anxiety, difficult concentration,
– personality and psychotic disorders

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3
Q

Health triangle - B

A

B. PHYSICAL
SLEEPINESS, IRRITABILITY, HEART FAILURE, STROKE

• Risk of blood-borne diseases – HIV
Infection from IV drug use
– Hepatitis B and C

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4
Q

Health triangle - C

A

C. SOCIAL
WITHDRAWING FROM FAMILY AND FRIENDS LOSS OF INTEREST IN SCHOOL AND OTHER ACTIVITIES

• A link between drug use and acquisitive crime
– Around 75% of the users of heroin and crack cocaine admit to committing crime to support their habit

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5
Q

Principle dopaminergic tracts

1. Nigrostriatal tract

A

Extrapyramidal pathway - begins in the substantia nigra and ends in the caudate nucleus and putamen of the basal ganglia

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6
Q

Principle dopaminergic tracts

2. Mesolimbic tract

A

Originates in the midbrain tegmentum and innervates the nucleus accumbens and adjacent limbic structures

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7
Q

Principle dopaminergic tracts

3. Mesocortical tract

A

Originates in the midbrain tegmentum and innervates anterior corticol area

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8
Q

Principle dopaminergic tracts

4. Tuberoinfundibular tract tract

A

Projects from the arcuate and periventricular nuclei of the hypothalamus to the pituitary

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9
Q

Role of dopamine in addiction

A

Low D2 receptors cause increased pleasure from abused drugs which leads to further drug abuse

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10
Q

Drug Addiction (dependence)

A

a complex disorder (disease) in the brain
• a state in which an organism functions normally only in the presence of a drug
• compulsive drug-seeking and drug-taking behaviour and an inability to control intake (addiction);
• behavior is reinforcing (rewarding or pleasurable)
• continued abuse of drugs despite negative consequences cause serious, long-term consequence

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11
Q

Withdrawal syndrome

A

There may be symptoms of withdrawal when the drug becomes unavailable

  • Adaptions in brain reward system manifest as dysphoria and drug craving
  • Physical/psychological adverse effects of cessation of use of the drug
  • The abuser will use drug again to relieve or avoid withdrawal symptoms
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12
Q

Drug tolerance

A

Decrease in pharmacological effect with repeated use
• short term: due to depleted levels of neurotransmitters in vesicles
• long term: due to down-regulation of the receptors
Marked increase in amounts of substance to achieve intoxication or desired effect

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13
Q
  1. Cannabis (Marijuana)
A

Active agent : Tetrahydocannabinol (THC)

Burning marijuana results in vaporisation of THC absorption into the lungs then into blood plasma

Marijuana high:
initial stimulation (giddiness and euphoria), followed by sedation and a pleasant tranquillity;
begin within a few minutes after inhaling, and can last 2
to 3 hours after initial intoxication.
After peak levels reached, concentration falls through metabolism in liver and fat storage

Marijuana - dried and crumbled leaves, small stems, flowering tops

Sinsemilla - pollination prevented (↑ potency)

Hashish (“Solid”) -prepared from resin

Hash oil - alcoholic extract

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14
Q

Acute effects of cannabis

A

• Psychological effects
– Sensation of relaxation and wellbeing
– Sharpened sensory awareness: sound/light appear more intense – Impairment of short-term memory and simple learning
– Impairment of motor co-ordination

• Physiological effects
– Increase in heart rate: tachycardia (sensation of a pounding pulse)
– Increase of blood flow to skin: sensation of warmth – The “munchies”: increase in hunger

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15
Q
  1. Psychomotor stimulants
A
Amphetamine
Dopamine
Noradrenaline
Pseudoephedrine
Cocaine
Atropine
MDMA (ecstasy)
Serotonin
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16
Q

Amphetamine

A
  1. Inhibit monoamine reuptake NA, DA, 5-HT

2. Release stores of NA

17
Q

Cocaine

A

• crystalline alkaloid
• obtained from the leaves of the coca plant
• can be snorted, smoked or injected into a vein
• giving rise to a euphoric sense of happiness and increased energy
• a stimulant of the CNS and an appetite suppressant;
• Inhibition of reuptake transporters for monoamines:
DA, (enhance dopaminergic transmission) NA
5-HT;

18
Q

Opioids

A

• u-opioid receptor agonists produce euphoria – feeling of wellbeing and contentment
– contributes to analgesic action
– opium, morphine, heroin, codeine, dilaudid

19
Q

Heroin

A
  • Desired Effects Euphoria rush
    Decrease in anxiety Reduction in pain
  • Undesired/Long term effects Hypothermia; Nausea/vomiting;
    Bone and muscle pain; Liver/kidney disease; Veins collapsing; Increase chances for stroke; Lung infections; Pulmonary complications; HIV/AIDS; Hepatitis
20
Q

Opiates abuse

A

• Characteristic of opiates abuse/overdoes: – respiratory depression
breathing slows down, sometimes to a stop – pinpoint pupils
an important diagnostic feature in opioid poisoning – decreased level of consciousness
– hypotension and bradycardia
heart rate slows down, sometimes to a stop
blue lips, nails (due to insufficient oxygen in the blood)
• Morphine / Heroin abuse/overdoses are the most common single cause of death from drug overdose,
account for 25% of the total;

21
Q

Alcohol

A

Alcohol is a CNS depressant
and has multiple actions on the CNS :
enhancing the inhibitory actions of GABA at the GABAA receptor;
decreasing the excitatory actions of Glutamate at NMDA receptor;
causing releasing dopamine in the nucleus accumbens; increasing serotonin concentrations in certain regions; stimulating release of endogenous opiates,
producing euphoria and pain attenuation;
• With acute alcohol intake
– an initial depression of inhibitory neurons, producing a sense of relaxation
– followed by progressive depression of all CNS functions (loss of coordination, poor judgment, slowed reflexes)

22
Q

Alcohol dependence

A

• Recommended limits: 21 units /week for men, 14 units / week for women;
• Chronic drinking can lead to dependence and addiction to alcohol;
• Psychological dependence;
• Physiological dependence;
• Withdrawal symptoms:
shaking (tremors), anxiety, sleep problems, and nausea;
hallucinations and even seizures;

23
Q

Summary

Stimulants

A

Stimulants
amphetamines cocaine ecstasy

Primary target - DA receptor

Main effects/transmitters - DA

24
Q

Summary

Mimetic

A

Mimetic
cannabis LSD

Primary target - CB1 receptor 5-HT receptor

Main effects/transmitters - DA, opiates? 5-HT

25
Q

Summary

Opiates

A

Opiates

Primary target - Mu opiate rec

Main effects/transmitters -Opiates

26
Q

Summary

Sedative

A

Sedative
alcohol Benzos

Primary target - GABA receptor

Main effects/transmitters -GABA

27
Q

define drug abuse:

A

is the recurrent use of
illegal drugs, or the misuse of prescription or over-the-counter
drugs with negative consequences

28
Q

Risk factors

A

Family history of addiction
Abuse, neglect, or other traumatic experience in childhood
Mental disorders, e.g. depression, anxiety
Early use of drugs
Method of drug administration