Lecture 28: Misuse and Abuse of Stimulants among College and University Students

Question 1

What is the common overall mechanism of methylphenidate and amphetamine?

Answer 1

They increase dopamine in the synapse

Question 2

What does methylphenidate do?

Answer 2

• binds to dopamine transporter protein and INHIBITS dopamine reuptake presynaptically
• simplest MOA
• its has SLOW uptake and SLOW clearance
• chemical structure similar to cocaine (makes sense because stimulant)

Question 3

What was the first depression medication?

Answer 3

Amphetamine

Used for US Air Force pilot fatigue

Question 4

What is Adderall?

Answer 4

Amphetamine (25% L-isomer and 75% D-isomer)

A = Amphetamine = Adderol

Question 5

What is Ritalin?

Answer 5

Methylphenidate

Question 6

What is Benzedrine?

Answer 6

Oldschool amphetamine

-used by college students in 1937 to help study LOL

Question 7

What are appropriate uses for amphetamine?

Answer 7

Narcolepsy

ADHD

Question 8

What does amphetamine do?

Answer 8

1. Binds to dopamine transporter protein on outside of cell membrane and blocks reuptake back into cell
2. Moves into cell where it exchanges with dopamine via the dopamine transporter protein
3. Amphetamine causes dopamine to be released from VESICLES, so more amphetamine in cytoplasm (which allows it to go through dopamine transporter)
4. Amphetamine blocks dopamine reuptake in VESICLES as well

Question 9

What does amphetamine do with serotonin and norepinephrine?

Answer 9

Amphetamine increases serotonin, meaning that your mood gets better
-also increases NE

Question 10

What is Appropriate use?

Answer 10

Use of a controlled substance as prescribed for a defined condition with no signs of misuse or abuse

Question 11

What is Misuse?

Answer 11

Use of a controlled substance for reason other than that for which it was prescribed or in a different dosage than that prescribed
-does not lead to disability or dysfunction

Question 12

What is Abuse?

Answer 12

Use of a controlled substance outside normally accepted standards of use (using Adderall to party)

Question 13

What is Catastrophic use?

Answer 13

Use of a controlled substance that involves illegal activity or places patient in immediate harm

Question 14

What are the characteristics of ADHD who misuse or divert medication?

Answer 14

they have comorbid conduct disorder or substance use disorder

Question 15

What are the signs and symptoms of drug misuse?

Answer 15

1. diversion behaviors
2. past/current abuse of other substance
3. non-adherent behaviors
4. losing/seeking prescriptions from multiple clinicians

Question 16

What do people who use Adderall at risk for?

Answer 16

Marijuana
Cocaine
Binge drinking
Risky behavior with this shit leads to other risky behavior

Question 17

Rostain is bothered by…

Answer 17

How a substantial percentage of students report snorting!! Lmaooo

Question 18

In the college life study at the university of Maryland, what were the key findings?

Answer 18

1. high school prevalence of experience with pot = 40%
   …by fourth year 63% had tried pot…
2. 6% had tried stimulants in high school
   30% had tried by senior year
3. More marijuana use = marijuana dependence  uses stimulant to study  crashed in academic performance
4. Key point: there is a clear longitudinal associations between nonmedical use and DECLINES in academic performance

Question 19

What are the health risks of stimulants?

Answer 19

Cardiovascular
	-sudden death from arrhythmias
	-heart attack
	-stroke
	-hypertension
	-elevated heart rate
Psychiatric
	-psychosis (paranoia, delusions, hallucinations)
	-delirium (clouded consciousness, confusion)
	-mania, agitation, irritability, mood swings
	-anxiety, muscle tension, nervousness
	-insomnia
	-depression
	-hyperactive/hypersexual

Question 20

What are the symptoms of amphetamine intoxication?

Answer 20

Euphoria or affective blunting
Changes in sociability; hypervigilance
Interpersonal sensitivity
Anxiety, TENSION or ANGER
Stereotyped behaviors
Impaired judgement/social/occupational functioning

Question 21

What are the symptoms of amphetamine withdrawal?

Answer 21

Dysphoric mood
Fatigue
Vivid, unpleasant dreams
Insomnia or hypersomnia
Increased appetite
Psychomotor retardation/agitation