Drugs Use and Abuse 1-4 Study Guide Flashcards
psychoactive drugs
term more percise than just drugs, how drugs affect the body
licit drugs
legal (ex: tobacco, alcohol, coffee)
drugs
any substance that modifies mind/body functions
anabolic steroids
synthetic male hormone testosterone increase body tissue and treat allergies
Androgens are the hormones most likely to be abused in US
Compounds chemically like the steroids that stimulate production of tissue mass
Schedule III systems
OTC drugs
over-the-counter drugs
legal without prescription
use of legal more common than illegal drugs and way more deaths sickness illness crime (ex: tobacco alcohol)
medicine
a compound or preparation used for the treatment or prevention of disease, esp. a drug or drugs taken by mouth.
prescriptions
can be received through a doctor or medical professional
narcotics
depress CNS
highly addictive
ex: heroine, codeine, opium
equal-opportunity afflictions
no one immune to it
dynamic affliction
always changing
common tests for drug use
urine, blood, hair
addiction
o Defined as a complex disease
o Compulsive, at times uncontrollable, drug craving, seeking, use that persist even in the face of extremely negative consequences
o Comes from Latin word addicere
• Process of binding things
o Largely refers for chronic adherence to drugs
o Physical and psychological dependence
o Considered a brain-disease by NIDA
tolerance
need for increased amounts or diminished effect of the same amount
withdrawal
experience of a characteristic withdrawal syndrome for the specific substance, which can be avoided by taking closely related substances; unsuccessful attempts to cut down
abuse
the improper use of something.
moral model
belief that people abuse alcohol because they choose to do so, traditional
disease model
model of addiction in the US; belief that people abuse alcohol because of some biologically cause condition
deviant model
theory emphasizing that other people’s perceptions directly influence one’s self-image
o Does not fully explain why initial drug use occurs but details processes by which many people come to view themselves as socially deviant from others
o Labeling theory says that other people whose opinions we value have a determining influence over our self-image
o Implied that we apply only a small amount of control over the image we portray
o Labels we use to describe people have a profound influence on their self-perceptions
primary deviance
any type of initial deviant behavior in which the perpetrator does not identify with the deviance
secondary deviance
any type of deviant behavior in which the perpetrator identifies with the deviance; perceives self as deviant
social learning model
a theory that places emphasis on how an individual learns patterns of behavior from the attitudes of others, society, and peers
conditioning
o Drug use is a learned behavior
o Focuses on how drug use and abuse are learned through interaction with other drug users
o Emphasizes pervasive influence of primary groups
primary group - groups that share a high amount of intimacy and spontaneity and whose members are emotionally bonded (ex: families and long-term friends)
o Once drug use has begun, continuing the behavior involves learning the following sequence:
• 1) Identifying where and from whom the drug can be purchased
• 2) Maintaining steady contact with drug dealers
• 3) Preoccupation with maintaining secrecy of use from authority figures
• 4) Reassuring yourself that the drug is pleasurable
• 5) Using with more frequency
• 6) Replacing non-drug using friends with drug-using friends
Form of psychiatric disorder
o Ex: bipolar, schizophrenia, depression
Sometimes difficult to distinguish between the two problems of substance-related mental disorders and primary psychiatric disorders
o For proper treatment, the cause of psychological symptoms must be determined
o DSM-IV-TR criteria says that substance abuse disorders can be identified by:
• Occurrence and consequence of dependence
• Abuse
• Intoxication
• Withdrawal
o DSM-IV-TR criteria to help distinguish between substance induced and primary mental disorders
• Personal and family medical psychiatric, and drug history
• Physical exams
• Laboratory tests to assess physiological functions and determine the presence or absence of drugs
o Coexistence of underlying psychiatric problems in a drug user is suggested by:
• Psychiatric problems do not match the usual drug effects
• Psychiatric disorder present before patient began abusing substance
• Mental disorder persists for more than 4 weeks after substance use ends
o DSM-IV-TR that knowing the difference between the mental disorders and substances of abuse is important for proper diagnosis, treatment, and understanding
Phase I
Initial Clinical Stage
o 20-100 volunteers
o Formerly drug inmates not anymore
o Usually healthy people some patients
Phase II
Clinical Pharmacological Evaluation Stage
o Effects of drug tested
o 100-300 volunteers a with medical problem
Phase III
Extended Clinical Evaluation Stage
o By this time company has a good idea of both drug effectiveness and dangers
o Can be offered safely to a wider group of participants
o Safety checks made for side effects
o After testing program ends, careful analysis is made of the effectiveness, side effects, and recommended dosage
o Then company submits new drug application (NDA) as a formal request that the FDA consider approving drug for marketing
• Usually 1,000s of pages
• FDA usually calls for additional tests before the drug is determined safe and effective and marketing
Phase IV
– Post Market Surveillance
o Over $1 billion to develop a new drug
1906 Pure Food and Drug Act
- Required manufacturers to say amounts of alcohol, morphine, opium, cocaine, heroin, and marijuana extract on label of each product
- Most government at the time focus on regulation of food not drug
- Made false-advertisement/misrepresentation illegal
- Amended by Sherley Amendment in 1912
Sherley Amendment in 1912
- Cancer remedy claim false, decided in US Supreme Court
- No false claims
- Law required that government prove fraud which was difficult
- Didn’t improve drug products just encouraged pharmaceutical companies to be more vague in advertisements
Food Drug and Cosmetic Act
- Defined drugs to include products that affected bodily structure or function even in absence of disease
- Companies had to file with the government for all new drugs to prove they were safe (not effective just safe)
- Had to list all ingredients and quantity of each and provide instructions regarding correct use of drug and warnings about its dangers
- Eliminated Sherley Amendment requirement to prove intent to defraud in drug misbranding
- Allowed drug companies to create a class of drugs that could not be sold legally without a prescription
- FDA motivated by misuse of barbiturates and sulfa antibiotics
- Allowed manufacturer to determine whether a drug was to be labeled prescription or nonprescription
Durham-Humphrey Amendment
- After passed almost all new drugs placed in prescription-class
- Established criteria which are still used today for determining whether a drug should a prescription or nonprescription, if does not fall into 1 or following 3 categories it is nonprescription:
- 1) The drug is habit-forming
- 2) No safe for self-medication because of its toxicity
- 3) Drug is a new compound that has not shown to be completely safe
Kefauver-Harris Amendments
- 1938 act did not give FDA authority to supervise clinical testing of drugs, the effectiveness of drugs being sold to public were not being determined
- Supposed to fix problem, but didn’t pass until thalidomide accident
• Required fro the first time that drug manufacturers demonstrate the efficacy as well as safety of their drugs
Orphan Drug Law
Allows drug companies to receive tax advantages if they develop drugs that are not very profitable because they are useful in treating only small number of patients, such as those who suffer from rare diseases
• Rare disease is defined as effecting fewer than 200,000 people in US or one for which the cost of development is not likely to be recovered by marketing
Prescription Drug User Fee Act 1992
- Require drug manufacturers to pay fees to FDA for evaluations of NDAs
- Congress required the FDA to use these fees to hire more revieweres so as to expedite the reviews
Switching policy
Allows agency to review prescription drugs and evaluate their suitability as OTC products
o Following criteria must be satisfied to switch prescription to OTC:
• Drug must have been marketed by prescription for at least 3 years
• Use of drug must have been relatively high during the time it was available as a prescription
• Adverse drug reactions must not be alarming, and the frequency of side effects must have increased during the time the drug was a prescription
o Switching policy has been well received by the public
o But concern over increased misuses and abuse
Harrison Act of 1914
first legitimate effort by the US government to regulated addicting substances
Drug Abuse and Prevention Act of 1970
determines the ways in which law enforcement agencies deal with substance abuse, this act divided substances with abuse potential into categories based on the degree of their abuse potential and their clinical usefulness
• Schedule I – High abuse potential and no currently approved medicinal use, health professionals cannot prescribe them
• Schedule II – High abuse potential but are approved for medical purposes and can be prescribed with prescriptions
• Schedule V - Least addictive and least regulated of the substances of abuse
neurons
specialized nerve cells that make the nervous system and release neurotransmitters
• Highly versatile
• Distinguished by types of chemical substances they release as neurotransmitters to send their messages
• Human brain 100 billion neurons
neurotransmitters
a chemical substance that is released at the end of a nerve fiber by the arrival of a nerve impulse and, by diffusing across the synapse or junction, causes the transfer of the impulse to another nerve fiber, a muscle fiber, or some other structure.
acetycholine
Large quantities of acetylcholine (ACh) are found in the brain
One of the major neurotransmitters in the autonomic portion of PNS
Depending on the region can have either excitatory or inhibitory effects
• Divided into muscarinic and nicolinic
• Muscarinic inhibitory
• Nicotine activate nicolinic (excitory)
anticholinergic
agents that antagonize the effects of acetylcholine
nerve structures
Glia – supporting cells that are critical for protecting and providing sustenance to the neurons
Axons – an extension of the neuronal cell body along which electrochemical signals travel
Receptors – special proteins in a membrane that are activated by natural substances or drugs to alter cell function
Acetycholine – excitatory-inhibitory, mild euphoria, excitation, insomnia, tobacco, nicotine
Synapse – site of communication between message-sending neuron and its message-receiving target cell
• Excitatory – increasing activity in target cell
• Inhibitory synapse – diminishes likelihood of an impulse in the receiving neuron or reduces activity to other target cells
Synaptic cleft – minute gap between the neuron and target cell, across which neurotransmitters travel
Dendrites – short branches of neurons that receive transmitter signals
Effects of sympthomimetic drugs
agents that mimic the effects of norepinephrine or epinephrine
Classified into alpha and beta categories
Norepinephrine act predominantly on alpha receptors