Module 10: Drugs and Alcohol Flashcards
define: drug
Drug: Any chemicals other than food intended to affect the structure or function of the body.
define: psychoactive drug
Psychoactive drug: Chemicals that can alter a person’s consciousness or experience.
define: intoxication
Intoxication: The state of being mentally affected by a chemical (literally, a state of being poisoned).
define: addictive behaviour
Addictive behaviour: Any habit that becomes out of control, resulting in a negative effect on a person’s health.
define: addiction
Addiction: A chronic disease that disrupts the brain’s system of motivation, reward, and memory; characterized by a compulsive desire and increasing need for a substance or behaviour, and by harm to the individual and/or society.
List the characteristics of an addiction (5)
- reinforcement
- compulsion or craving
- loss of control
- escalation
- negative consequences
define: reinforcement
Reinforcement: Addictive behaviours reinforce themselves. Reinforcement can be positive—the activity or situation reliably results in pleasure or reward. It can also be negative—avoiding the drug or activity results in stress, anxiety, discomfort, or depression.
define: compulsion or craving
Compulsion or craving: The individual feels a strong compulsion—a compelling need or irresistible “hunger”—to engage in the behaviour. Craving is often associated with environmental cues and accompanied by obsessive planning for the next opportunity to perform it.
define: loss of control
Loss of control: The individual loses control over the behaviour and cannot block the impulse to do it.
define: escalation
Escalation: Addiction often involves a pattern of escalation in response to tolerance. More and more of the substance or activity is required to produce its desired effects.
define: negative consequences
Negative consequences: The behaviour continues despite serious negative consequences, such as problems with academic or job performance, personal relationships, and health; legal or financial troubles are also common.
List the routes of administration in terms of shortest to longest time for drug to reach peak concentration in the brain (4)
- inhalation
- injection (subcutaneous, intravenous, intramuscular)
- snorting
- oral dosage
Which routes of administration are more likely to cause dependence and why?
- Injections and smoking drugs
- Strong stimulus-response pairing
- Wear off more quickly
- Users may take more frequent doses
How do drugs affect the brain?
Alters effects of neurotransmitters; Some increase the effects of dopamine in the brain’s reward and pleasure pathway
How does cocaine affect the brain
- Cocaine blocks the removal of dopamine from a synapse; results in a buildup of dopamine and continuous stimulation of the receiving neurons
- Under normal circumstances, the amount of dopamine at a synapse is controlled partly by the reuptake of dopamine by the transmitting neuron
What are some factors that influence the drug effects? (7)
- pharmacological properties
- dose response function
- time action function
- drug use history
- route of administration
- physical factors (e.g. weight)
- psychological factors (e.g. setting)
define: pharmacological properties
Pharmacological properties (e.g. composition): The overall effects of a drug on a person’s behaviour, psychology, and chemistry.
define: dose-response function
Dose-response function (e.g. intensity): The relationship between the amount of a drug taken and the intensity and type of the resulting effect.
define: time-action function
Time-action function (e.g. lag time): The relationship between the time elapsed since a drug was taken and the intensity of its effect.
define: stimulants
- drugs that speed up the activity of the nervous and/or muscular system
give some examples of stimulants
Examples: caffeine, nicotine, cocaine, amphetamines, ecstasy, ritalin
What is the most popular psychoactive drug
caffeine
What can excessive consumption of caffeine do to you?
Excess consumption can cause shaking, difficulty concentrating, insomnia, and irregular heartbeat
What can caffeine withdrawal do to you?
Withdrawal can cause irritability, drowsiness and headaches
What is the leading preventable cause of disease, disability, and death
tobacco
Chronic smoking can cause emphysema. What is that?
Emphysema: damage to the elastic tissues making it difficult to exhale and requiring you to breathe in deeper; irreversible
What age can you quit smoking at and reverse your health to be close to a non-smoker?
Before the age of 30
define: popcorn lung
Popcorn lung: nickname used for lung disease caused by damage to the smallest airways causing you to feel short of breath and cough. Caused by vaping
define: crack
Crack’ is a less pure freebase form of cocaine
short term effects of cocaine
Users may experience feelings of euphoria, alertness, competency, power, invincibility, rapid heart/breathing rate, decreased appetite
How does cocaine work?
Activates the brain’s reward pathway (dopamine)
Why is cocaine addicting?
Short lasting and ends abruptly which encourages repeated use
long term effects of cocaine
Repeated use can lead to insomnia, weight loss, impotence
- Central nervous system: repeated use or high doses may cause severe psychological problems; suppresses desire for food, sex, and sleep; can cause strokes, seizures, and neurological damage
- Nose: damages mucous membrane
- Cardiovascular system: increases blood pressure by constricting blood vessels; causes irregular heart beat; damages heart tissue
- Respiratory system: freebasing causes lung damage; overdose can lead to respiratory arrest
- Reproductive system: affects the ability to maintain erections and ejaculate; sperm abnormalities; may affect ability to carry pregnancy to term
How can cocaine overdose cause death?
heart irregularities –> death
amphetamine, what type of drug and which neurotransmitter affected?
stimulant; causes high level of dopamine
Why is amphetamine so cheap?
can be made from household ingredients
Chronic effects of amphetamine
Chronic use may lead to severe weight loss, heart attack, stroke, paranoia, psychosis, violent behaviour.
Define: amphetamine psychosis
Amphetamine psychosis: psychotic features including paranoia, visual and auditory hallucinations, and delusions
MDMA/Ecstasy, what type of drug and which neurotransmitter affected?
Stimulant/ mild hallucinogen, increases serotonin
What are some dangers of ecstasy and MDMA
- “Coming down’ associated with serotonin imbalances, promoting depression
- In a club/rave setting can produce dangerously high body temperature and potentially fatal dehydration
- Especially dangerous when tolerance develops and user to take drug at a higher dose or mix with other drugs
MDMA/Ecstasy effect
euphoria, increased energy, heightened sense of belonging
How many chemicals in tobacco smoke are linked to cancer
43
What additives are in cigarettes
Additives: sugars and flavoring agents, humectants (keep tobacco from drying out) and chemicals that enhance addicting properties of nicotine
define: sidestream smoke
Sidestream smoke: The uninhaled smoke from a burning cigarette.
define: chronic bronchitis
Chronic bronchitis: Recurrent, persistent inflammation of the bronchial tubes.
What are the effects of the cigarettes on the body?
- brain
- mucous
- blood vessels
- bronchial tubes
- heart
- adrenal gland
- nicotine
- kidneys
- liver
Brain: nicotine stimulates brain to release chemicals that alter mood
Mucous membranes: tars and toxins irritate membranes and dull taste buds; irritation causes increased mucus production
Blood vessels: nicotine constricts blood vessels especially in the skin, raises blood pressure
Bronchial tubes: smoking damages cilia in bronchial tubes, allowing particles to reach delicate lung tissue
Heart: nicotine accelerates heart rate
Adrenal glands: nicotine stimulates adrenal glands to release adrenaline, causing changes in functioning of heart and other organs
Nicotine depresses hunger contractions
Kidneys: nicotine inhibits production of urine
Liver: nicotine causes the liver to release glycogen, raising blood sugar level
define: hallucinogens
Hallucinogens: A group of psychoactive drugs that alter perceptions (e.g. visual, auditory), feelings and thoughts. Generally less addictive
Give some examples of hallucinogens
Some examples include: LSD (”acid”) , psilocybin (“magic” mushrooms), MDMA (primarily a stimulant), DMT, Ketamine, PCP
How long does LSD, PCP, and Psilocybin typically last
~8+ hours
What are opioids
Opioids are a class of drugs that relieve pain, cause drowsiness and euphoria
Examples of opioids
Opium, heroin, methadone, morphine, codeine, Demerol, oxycodone, fentanyl
Effects of opioids
Relaxation, euphoria, slowed breathing, slurred speech, impaired balance
Risk of opioids at high doses
Higher doses can cause stupor, unconsciousness, coma and death
What reverses the effects of opioids
Naloxone
What type of drug is cannabis
Can be classified as a CNS depressant, hallucinogen or stimulant (various effects)
How many Canadians have tried cannabis
45%
Acute effects of cannabis
Acute effects: mild euphoria, heightened perception, drowsiness, red eyes
What are the chronic effects of cannabis
- May interfere with memory/learning
- Associated with reproductive dysfunction
- May promote schizophrenia in those susceptible, especially if used during adolescence
- Biggest health risk is effects on airways
- Marijuana smoke contains carcinogens
What are the benefits of cannabis
- May relieve nausea, vomiting, chronic pain
- May help treat glaucoma, epilepsy, anorexia, MS, arthritis and migraines
- Safest way to consume is probably ingestion or with a vaporizer; smoking joints is probably the most harmful
- Recreational marijuana use is now legal in Canada; logistics of sales and approving business licences is ongoing
What type of drug is alcohol
Alcohol is a CNS depressant, though it may initially feel like a stimulant
What is the most abused psychoactive substance
alcohol
What is the max intake of alcohol/week for men and women
men: 15
women: 10
How many ounces is 1 drink of:
- beer/cider/cooler
- wine
- distilled alcohol
12 oz of beer, cider, or a cooler (5%)
5 oz of wine (12%)
1.5 oz of distilled alcohol (40%)
How is alcohol absorbed
Alcohol is not digested, it is absorbed directly into the blood through the stomach or small intestinal wall; 20% in the stomach; 80% in the intestine
What are several factors that influence the rate of alcohol absorption and metabolism
- Sex (Male vs Female)
- Size (Weight ad BMI)
- Fruit sugar
- Food in stomach, especially fats
- Liver enzyme activity
Short term risk of alcohol use
- Alcohol affects judgement and changes mood
- Consumption (especially to excess) can result in:
- Memory loss
- Decreased blood sugar levels; flushing, sweating; indigestion
- Slurred speech, blurred vision, impaired motor skills
- Impaired sexual function
- Increased likelihood of riskier behaviours, violence, suicide
- Increased urine output and dehydration
- Hangover; withdrawal symptoms
- Alcohol poisoning; in extreme cases, death
Long term risk of alcohol use
- Addiction
- CVD
- Cirrhosis of the liver
- Cancers
- Malnutrition
- Mental illness
- Brain damage
- Impaired immune function
- Negative social effects
- Reproductive effects (impotence, infertility)
- Fetal alcohol syndrome (in offspring)
- Increased chances of harm to ones self and others (e.g. riskier behaviours, accidents, violence, suicide)
What are some risk factors for developing an addiction
- Other mental health conditions, e.g. depression, anxiety, bipolar disorder and schizophrenia
- Genetic, physiological, personality, social, lifestyle and environmental factors may lead to the development of addiction
- Stress, low self esteem, easy access and high social acceptance
How can drugs be a positive reward and negative reward
Positive reward: drug stimulates the pleasure centre → take drugs to receive more pleasure
Negative reward: stimulates the pain centre → taking drugs to alleviate pain
What are some examples of treatment options for drug addiction
- medication assisted treatment; regulated dose of drug given
- treatment centres
- group and peer counselling
- harm reduction strategies
Explain how we develop tolerance to drugs
Down regulate: Overstimulated receiving neurons will begin to have less receptors, requiring you to have
Up regulate: Transmitting neuron will reuptake more and less will be received by receiving neuron
Fill in the blank: A little bit of alcohol (___ servings per day may reduce overall disease risk, too much (____ per day) increases disease risk
- 1-2
- >3
What are the 4 pillars of Vancouver’s drug strategy
Harm reduction:
- Focus on the harm caused by problematic substance use, rather than substance use
- Supervised injection sites and needle exchanges
Prevention
Treatment:
- Core services at community health centres
- Withdrawal management
- Residential and non-residential services.
Enforcement
