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DBB > Lecture 1 - Intro > Flashcards

Lecture 1 - Intro Flashcards

1
Q

What is a drug?

A

A substance that is used “primarily to bring about a change in some existing process or state”, be it psychological, physiological or biochemical. “Chemical entity, or mixture, other than those providing maintenance of normal health (e.g. food) that alters biological functioning”

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2
Q

What is the Psychoactive Substances Act (2016)?

A

Uses a wide and vague definition of what a drug is. In this act “psychoactive substance” means any substance which
(a) is capable of producing a psychoactive effect in a person who consumes it, and (b) is not an exempted substance. Excludes alcohol, tobacco or nicotine-based products, caffeine, food and drink, medicinal products.

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3
Q

How does the Psychoactive Substances Act (2016) define how a substance produces a psychoactive effect?

A

A substance produces a psychoactive effect in a person if, by stimulating or depressing the person’s central nervous system, it affects the person’s mental functioning or emotional state.

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4
Q

What are the different ways to classify a drug?

A
  1. By source (e.g. opiate)
  2. Chemical structure-function
  3. Mechanism of action (e.g. opioid agonists) - what is it that they do, what is the target that they act on?
  4. Therapeutic use (e.g. analgesic, anxiolytic, antiemetic)
  5. By (proto) typical CNS/behavioural effect
  6. Popular/street designation
  7. Legal/social status
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5
Q

What are sources of active compound?

A
  1. Naturally occurring - the active compound is present in nature. Morphine extracted from the raw sap
  2. Semi-synthetics - take the natural compound and changes the chemical structure. Doesn’t do anything to the basic active compound, it just changes it to get to the brain faster (in morphine to heroin)
  3. Synthetics - e.g. Fentanyl which is purely made in the lab
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6
Q

What are examples of sources of active compound?

A
  1. Naturally occurring - e.g. opium from poppy, morphine from opium, cocaine from coca plant, Ephedrin from Ephedra plant (Ma huang)
  2. Semi-synthetics - e.g. heroin from morphine, LSD from Ergot fungus
  3. Synthetics - e.g. methadone, amphetamine, fentanyl, MDMA.
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7
Q

What is the difference between chemistry and pharmacology?

A 
Chemistry = all amphetamine derivatives
Pharmacology = all opioids
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8
Q

What is the classification by CNS/behavioural effect?

A
  1. CNS stimulants - amphetamine, cocaine, nicotine. Pharmacologically, nicotine and amphetamine and completely different, but in terms of their prototypical effect they are very similar (in their ability to stimulate CNS)
  2. CNS depressants - barbiturates, alcohol
  3. Analgesics - morphine, codeine
  4. Hallucinogens - mescaline, LSD, psilocybin
  5. Psychotherapeutics - prozac, thorazine. Most drugs have psychotherapeutic effects.
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9
Q

What is in Schedule I of the drug scheduling guide (US)?

A

Most potential for abuse and dependence. No medicinal qualities. Examples - Heroin, LSD, Marijuana Ecstasy, Peyote.

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10
Q

What is in Schedule II of the drug scheduling guide (US)?

A

High potential for abuse and dependence. Some medicinal qualities. Examples - Vicodin, Cocaine, Meth, OcyContin, Adderall.

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11
Q

What is in Schedule III of the drug scheduling guide (US)?

A

Moderate potential for abuse/dependence. Acceptable medicinal qualities. Doctor’s prescription required. Examples - Tylenol with Codeine, Ketamine, Steroids, Testosterone.

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12
Q

What is in Schedule IV of the drug scheduling guide (US)?

A

Low potential for abuse and dependence. Acceptable medicinal qualities. Prescription required - fewer refill regulations. Examples - Xanax, Darvon, Valium, Ativan, Ambien, Tramadol.

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13
Q

What is in Schedule V of the drug scheduling guide (US)?

A

Lowest potential for abuse/dependence. acceptable medicinal qualities. Prescription required - fewest refill regulations. Examples - Robitussin AC, Lomotil, Motofen, Lyrica.

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14
Q

What are the UK’s drug-control instruments (1/3)

A

The Misuse of Drugs Act (1971) (“controlled drugs”) + regs. Prevents the misuse of controlled drugs by imposing a complete ban on the possession, supply, manufacture, import and export controlled drugs except as allowed by regulations or by licence from the Secretary or State. Established the classification system in the UK. Classify drugs as either A, B or C based on harm rating.

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15
Q

What are the UK’s drug-control instruments (2/3)

A

The Human Medicines Regs. 2012 - for doctors, says which drugs you can get refills for etc.

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16
Q

What are the UK’s drug-control instruments (3/3)

A

The Psychoactive Substance Act 2016 - psychoactive substances.

17
Q

What is the UK Misuse of Drugs Act (1971)?

A

20 drugs ranked by overall harm along 16 criteria. Potential to produce dependence, tolerance, increase of crime rate, economic cost to community etc. evaluated. Including considerations on whether the drug is medicinal. Came up with ABC classification based on this. Argument that on consideration of these points, alcohol should be classified as the most harmful drug. David Nutt reviewed classification, physical harm v dependence. Alcohol much more harmful than you would think based on its classification.

18
Q

What are the penalties for a class A drug (Psychoactive Substances Act, 2016)?

A

Crack cocaine, cocaine, ecstasy (MDMA), heroin, LSD, magic mushrooms, methadone, methamphetamine (crystal meth). Possession = up to 7 years in prison, an unlimited fine or both. Supply and production = up to life in prison, an unlimited fine or both.

19
Q

What are the penalties for a class B drug (Psychoactive Substances Act, 2016)?

A

Amphetamines, barbiturates, cannabis, codeine, ketamine, methylphenidate (Ritalin), synthetic cannabinoids, synthetic cathinones (e.g. mephedrone, methoxetamine). Possession = up to 5 years in prison, an unlimited fine, or both. Supply and production = up to 14 years in prison, and unlimited fine or both.

20
Q

What are the penalties for a class C drug (Psychoactive Substances Act, 2016)?

A

Anabolic steroids, benzodiazepines (diazepam), gamma hydroxybutyrate (GHB), gamma-butyrolactone (GBL), piperazine (BZP), khat. Possession = up to 2 years in prison, an unlimited fine or both (except anabolic steroids - its not an offence to possess them for personal use). Supply and production = up to 14 years in prison, and unlimited fine or both

21
Q

What are the penalties for temporary class drugs (Psychoactive Substances Act, 2016)?

A

Some methylphenidate substances and their simple derivatives. Possession = none, but police can take away a suspected temporary class drug. Supply and production = up to 14 years in prison, and unlimited fine or both.

22
Q

Why do people take (some) drugs?

A
  1. Experimentation: novelty seeking, exploration
  2. Pleasure: drugs as desired rewards (liking/desire)
  3. Medication: to relieve unpleasant states (anxiety, depression, pain)
  4. Peer pressure
    These reasons describe most drug taking, but taking drugs does not equal addiction.
23
Q

What is not addiction?

A

Pattern of addiction is different for different people.
What is not addiction - experimental use, recreational (casual) use, circumstantial use. Many drink (too much) alcohol regularly but only a minority drink to meet criteria for abuse and/or dependence.

24
Q

What is the DSM-IV criteria for substance abuse?

A
  1. Recurrent substance use resulting in a failure to fulfil major role obligations
  2. Recurrent substance use in situations in which it is physically hazardous
  3. Recurrent substance-related legal problems
  4. Continued substance use despite having persistent or recurrent social or interpersonal problems.
25
Q

What is the DSM-IV criteria for substance dependence?

A
  1. Tolerance - need for increased amount of substance, markedly diminished effect with continued use of the same amount of the substance.
  2. Withdrawal - withdrawal symptoms, same (or similar) substance is taken to relieve/avoid symptoms.
    Tolerance and withdrawal are neither necessary nor sufficient for addiction.
26
Q

What are changes in the DSM-V?

A
  1. Severity (mild, moderate, severe) scale added
  2. Non-drug addictive disorders (gambling)
  3. Dependence used only in pharmacological sense
  4. Removal of legal criteria
  5. Goal was a more neuroscience based diagnosis
  6. ‘Craving’ added to the criteria
  7. Addiction used (very cautiously).
27
Q

What is addiction?

A

“A syndrome manifested by a behavioral pattern in which
the use of a given psychoactive drug … is given much higher
priority than other behaviors that once had higher value.”
“At the extreme, the dependence syndrome is associated
with compulsive drug-using behavior”.
It also, “exhibits the characteristic of a chronic relapsing
disorder”.

DBB (8 decks)

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