Zastrow Ch. 8 Flashcards

1
Q

Broad Drug Definition

A

Any substance that chemically alters the function or structure of living organism. Definition includes air pollution, food, etc., etc.

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2
Q

Drug Definition - social problems

A

Any habit forming substance that directly affects the brain and the nervous system. Affects mood, perceptions, body functions, or consciousness.

Has potential for misuse because it may be harmful to user.

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3
Q

Drug Abuse

A

Regular or excessive use of a drug when consquences endanger relationships with others, are detrimental to users’ health, or jeopardize society.

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4
Q

Drug Abuse in Society - 2 Key Factors

A
  1. Actual drug effects.

2. Group’s perception of effects.

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5
Q

Legal Drugs vs. Illegal

A

Legal drugs (alcohol and tobacco) are more abused and cause more harm in our society than illegal drugs.

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6
Q

Dependency

A

Habit forming drugs lead to dependency, where user develops recurring craving. Dependency may be physical, psychological, or both.

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7
Q

Tolerance

A

Drug users develop tolerance, which means they must take increasing amounts over time to achieve given effect. Not all drugs create tolerance.

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8
Q

Drug Addiction

A

The intense craving for a drug that develops after a period of physical dependency from heavy use.

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9
Q

History of Drugs in Society

A

Pilgrims - 1620, brought 14 tons water, 10K gallons wine, and 42 tons of beer.

Civil War - wounded were given narcotics to relieve pain and many became addicted. Narcotic addiction serious problem from 1860s to 1910s. Turn of century - 1% of population addicted - highest rate in history.

Opiates readily available at turn of century - used to treat many minor ailments. Sales legally stopped in 1914 by Harrison Narcotics Act.

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10
Q

Tobacco - History

A

Originally only chewed. Began to be smoked after 1870, and was briefly banned in 14 states because it was believed to be a stepping stone to alcohol use, sexual deviance, insanity, and impotence.

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11
Q

Marijuana - Federal Bureau of Narcotics

A

Labeled marijuana as “assassin of youth.” Mass media published stories stereotyping marijuana users as “crazed drug fiends.” To continue receiving funding, director of bureau asserted that it was stepping stone drug.

1960s and 70s - marijuana popular among youth, college students, drug subcultures, and general population.

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12
Q

Drug History - Addressing Social Problem

A

1800s - American Temperance Union, followed by Women’s Christian Temperance Union, Anti Saloon League, and others.

Alcohol was viewed as responsible for many social ills - crime, collapse of family, and unemployment.

Under pressure, several states passed legislation prohibiting sale and distribution of alcohol in 2nd half of 19th century. By WWI, half population lived in dry areas.

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13
Q

Prohibition

A

18th Ammendment to Constitution. Ratified in 1919.

1933, prohibition repealed. Alcohol use became more widespread. People in middle and upper classes began drinking on rather large scale.

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14
Q

Anomie Theory

A

Emile Durkhiem and Robert Merton.

Anomie is condition where acceptance of approved standards of conduct is weakened.

Societies have approved goals (making money) and approved means to achieve goals (working at jobs). When goals are desired but means aren’t available, anomie results. Individuals seek to achieve goals through deviant means.

Theory asserts that if people are unable to achieve goals, they may be “driven to drink.”

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15
Q

Anomie Theory - Drug Abuse Reduction

Merton

A

Drug abuse can be reduced if:

  1. Society sets realistic goals attainable by all.
  2. Society establishes legitimate means of obtaining, also attainable by all.

(Theory does not explain drug abuse by those who are meeting goals. )

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16
Q

Labeling Theory

A

Drug abuse largely stemming from occasional users’ being labeled “abusers.” When use is disapproved of, users are publicly labeled “drunkard,” “pothead,” or “dope user.” Causes occasional users to view themselves as label.

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17
Q

Labeling Theory - Drug Abuse Reduction

A

Drug abuse can be reduced by avoiding labels.

Fails to explain drug abuse among “closet alcoholics.”

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18
Q

Differential Association

Edwin Sutherland

A

Behavior is determined primarily by values and actions considered important by small intimate groups people interact with.

Example: Italians use alcohol frequently in moderation as a group. Drunkenness is rare. Irish subculture has periodic episodes of excessive drinking. Higher rate of alcoholism.

People learn and take on the drug use norms of small groups they associate with.

People can become resocialized into drug use norms of different subculture.

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19
Q

Drug Subculture

A

Group of peers who advocates the use of one or more drugs. Membership in subculture encourages further drug use and rejection of established norms.

Dysfunctional for society but serve important functions for user - instructions and safety guidelines for how to use drugs, how to handle adverse effects, assist in obtaining drug and assist in avoiding arrest.

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20
Q

Alcohol - Depressant

A
  • Most abused drug in America. Extremely widespread use.
  • Ethyl alcohol found in drinks. Also called grain alcohol.
  • Effects vary with percentage in bloodstream. Effects observable when reaches 1/10 of 1%.
  • Women become intoxicated more quickly than men due to lesser amount of enzyme that breaks down alcohol before it reached the bloodstream
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21
Q

Who Drinks Alcohol? Primary Factors

A
  • Biological Factors - close relatives are 4x more likely to become alcoholics.
  • Socioeconomic Factors - drinking more frequent among younger men at higher socioeconomic levels and less frequent among women at lower socioeconomic levels.
  • Gender - men are more likely to use and abuse alcohol. Trend changing because cultural taboos for women and alcohol are weakening.
  • Age - older people less likely to drink. Heavy drinking most common for men at ages 21-30 and women at 31-50.
  • Religion - Nonchurchgoers drink more than churchgoers. More common among episcopalians and catholics.
  • Urban-Rural Residence - urban residents more likely to drink than rural residents.
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22
Q

Legal Drinking Age

A

In 1980s and 90s, Federal Government put pressure on states to change legal drinking age or lose funding for roads. All states have now raised drinking age to 21.

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23
Q

Reasons for Drinking

A

Social Lubricant.
To relax, or to escape pains of living and problems.
Some excessive drinkers seek a continual “buzz” to avoid facing life.
Drinking before flight common for tranquilizing effect.
Insomniacs drink so they can sleep.
Temporarily get rid of unwanted emotions.

24
Q

Alcoholism

A

Repeated and excessive use of alcohol to the extent that it is harmful to interpersonal relations, job performance, or health.
Most alcoholics are male, but female proportion has risen over last 40 years.

25
Q

Homeless Stereotype

A

Only an estimated 5% of homeless are alcoholics.

26
Q

Alcoholism Health Problems

A

10-12 year shorter life expectancy
Cirrhosis of liver causes 27k deaths in US per year.
Vitamin deficiencies. Highly susceptible to infectious disease.
Kidney problems.
Heart ailments. Diabetes. Contributes to cancer.
Associated with thousands of suicides annually.
– odd statistic - moderate/light drinkers have higher life expectancy than nondrinkers.

27
Q

Synergystic Interaction

A

Combining alcohol with other drugs creating much greater effect than either would have alone.

Example: Quaalude with alcohol can depress nervous system to coma or death.

28
Q

Antagonistic Response

A

One drug negates the effects of another. Doctors caution patients not to drink while on certain medications or effects of medication will be lost.

29
Q

Drinking and Driving

A

Alcohol factor in 40% of auto fatalities. One million people arrested annually for drunk driving.

30
Q

Alcohol and Crime

A

Major contributing factor in many crimes - homicides, aggravated assaults, sexual crimes against children, sexual crimes against women.

31
Q

Alcohol and Family

A

Sharon Wegscheider.

  1. Chief Enabler - assumes primary responsibility for family functioning.
  2. Family Hero - positive influence for family. Tries to be “perfect” person. Works to make family appear to be functioning better than they are.
  3. Scapegoat - family member targeted with blame. Often behaves in negative ways which draws spotlight away from addict.
  4. Lost Child - person who seems uninvolved with family. Doesn’t cause any trouble - provides relief from pain.
  5. Mascot - has good sense of humor and appears not to take anything seriously.
32
Q

Barbiturates - Depressants

A

First synthesized in 1900s; now more than 2500 varieties. Used for insomnia and anxiety, epilepsy and high blood pressure and to relax patients before or after surgery.

Higher doses have effects similar to strong alcohol. Relief from inhibitions, euphoria, feel “high” and passively content.

Withdrawal - body tremors, cramps, anxiety, fever, nausea, profuse sweating, hallucinations.

Many believe more dangerous than heroin addiction because it is more resistant to treatment.

Overdose can cause convulsions, coma, poisoning, and death. Most popular suicide drug. Taken orally but some use intravenously.

33
Q

Tranquilizers - Depressants

A

Common brand names - Librium, Miltown, Serex, Tranxene, and Valium.

Moderate potential of dependency.

Taken orally and lasts 4-8 hours.

34
Q

Quaalude and PCP - Depressants

A

Methaqualone = Quaalude (brand name).
Similar to alcohol and barbiturates in effects.
Reputation of being “love drug” - enhances sexual pleasure (lowers inhibitions.)
Reduces anxiety and gives feeling of euphoria.
Overdose - convulsions, coma, delirium, death. Most deaths are in combination with alcohol.

PCP = phencyclidine, or angel dust.
developed in 50s as anesthetic. medical use ended because of negative side effects. Legal today only for tranquilizing elephants and monkeys (they don’t display emotional disturbance side effects.)
Primarily used by young people unaware of hazards. Usually smoked (sprinkled on joints). May also be sniffed, swallowed, or injected. Relatively easy to prepare in home lab.

35
Q

Caffeine - Stimulant

A

Reduces hunger, fatigue, boredom, and improves alertness and motor activity. Many develop dependencies.
Withdrawal symptoms - irritability and mild depression .
Excessive amounts cause insomnia, restlessness, and gastrointestinal irritation, and surprisingly, even death.

36
Q

Amphetamines - Stimulants

A

Called “uppers” for stimulating effects.
Legal when prescribed. Truck drivers and dieters have used them.
Nicknames: speed, ups, pep pills, black beauties, bennies.
Synthetic drugs. Similar to adrenaline. Better known names include Dexedrine, Benzedrine, Methedrine.

Burns fat, heartbeat increased, appetite reduced, respiration increased.

Taken orally in tablet, powder or capsule. Can also be sniffed or injected. Speeding is injecting into vein.

Overdose can cause coma, brain damage, rare cases death. Speeders can develop hepatitis, abscesses, convulsions, hallucinations, delusions, severe emotional disturbances.

37
Q

Amphetamines - Stimulants

Continued

A

Amphetamine high followed by depression and fatigue.

Legal use - treatment of hyperactivity (hyperkinesis) in children. Ritalin is popular and has calming effect on children - the opposite effect of amphetamines on adults. Ritalin may be overprescribed because of parents and teachers who label problem children.

Methamphetamine - Meth or Ice. Liquid form = speed.
Drug increasingly abused because high lasts longer and can be synthesized relatively easily.

Legal form used as last resort for weight loss. Negative side effect: appetite returns with greater intensity when drug is discontinued.

38
Q

Cocaine and Crack - Stimulants

A

From leaves of coca plant. Locals chew leaves. Legally classified as narcotic, but not related to opiates.

Powerful stimulant and anti fatigue.
Taken by sniffing and can also be injected. May be added to cigarette. Used in past as local anesthetic, but replaced by other drugs.

Constricts blood vessels leading to increased strength and endurance. Increases intellectual and creativity. Increases virility. Formication - illusion that bugs crawling on or into skin.

Increased blood pressure, pulse rate, insomnia, loss of appetite.

Crack - also called rock. From cocaine when ingredients are separated and then mixed with water and ammonium hydroxide.

Resembles large sugar crystals, highly addictive. Usually smoked. Has intense high and orgasmic effect. Overdose more common when injected. Communal use of needles spreads AIDS.

39
Q

Amyl Nitrate and Butyl Nitrate - Stimulants

A

Amyl Nitrate - poppers for certain forms of heart failure. Volatile liquid. If vapor is sniffed, user’s blood vessels immediately dilated, increased heart rate. Physical changes create feelings of head rush and body rush.

Butyl Nitrate - legally available in some states without prescription. Effect similar to Amyl Nitrate. Trade names - Rush and Locker Room.

Both Amyl and Butyl used as aphrodisiacs and stimulants while dancing.

40
Q

Narcotics - Stimulants

A

Most commonly used are opiates. (Opium Poppy) Opium, Heroin, Morphine. Narcotic = sleep inducing.

Narcotics are actually painkillers and primarily produce feelings of euphoria.

Opium used for centuries. Morphine main ingredient or opium. Heroin synthesized from morphine.

Heroin more potent than morphine.

Opium usually smoked, but can be taken orally. Morphine and heroin are usually sniffed or injected.

Opiates affect nervous system producing feelings of tranquility, drowsiness, or euphoria. Highly addictive. Users quickly develop tolerance and need up to 100 times stronger dose which would have been fatal for first uses.

Recent increase in well to do using heroin as alternative to prescription painkillers.

Most opiate addicts are under 30, low socioeconomic status, poorly educated. Disproportionate number African American.

Withdrawal symptoms severe.

41
Q

Hallucinogens

A

Five most common: Mescaline (peyote), Psilocybin, Psilocin, LSD, and Ecstasy.

Peyote - from cactus plant. Mescaline synthetic of peyote. Psilocybin and psilocin are magic mushrooms. Long history of use among native americans.

Popular hallucinogen - LSD (lyseric acid diethylamide) synthetic from fungus that grows on rye and other plants.
One ounce will make 300k doses.

Colors seem unusually bright and shift. Users become highly suggestible and easily manipulated.

Trips last 8-16 hours. Aftereffects acute anxiety and depression. Flashbacks can occur much later and are dangerous (example: while driving.)

LSD is most potent of hallucinogens.

Ecstasy. Stimulant and psychadelic effects lasting 3-6 hours. Confusion, depression, sleep problems, anxiety, paranoia, reported even weeks after drug is taken.

42
Q

Tobacco

A

Number one killer drug.
430K deaths in US per year. Double the number alcohol deaths. Hundreds of times deaths caused by cocaine.

Increasingly, Americans viewing tobacco users as pariahs.

1988, surgeon general of US, Everett C. Koop, declared that tobacco is as addictive as heroin or cocaine.

Nicotine can be depressant, stimulant or tranquilizer.

Smokers quickly develop tolerance, and increase consumption.

Biggest civil settlement in US history - tobacco companies in 1998 to pay more than $240 billion to settle claims for health care costs related to tobacco. Payments started in 2000 and are distributed over 25 years.

43
Q

Marijuana

A

Cannabis Sativa. Plant grows throughout world and fibers used for rope, twine, paper, clothing.

Dried leaves and flowers, marijuana.
Dried resin - hashish. several times more potent than marijuana.

Sedative properties creating sense of well being and freedom, joyousness, hilarity, sociability. Mild hallucinations, users highly suggestible.

Threat of physical dependency rated low. Psychological dependency moderate.

Withdrawal unpleasant - insomnia, hyperactivity, loss of appetite.

Frequent users have impaired judgement, memory, concentration, and coordination. Difficulty reading. Users may feel confident under influence, resulting in tragic consequences.

Overdose = panic, fear, confusion, suspiciousness, fatigue, sometimes aggressive acts.

About 60% of users progress to other drugs.

Marijuana may be useful in treating glaucoma, asthma, certain seizure disorders, and spastic conditions as well as nausea from chemotherapy.

1996 - Voters in CA and AZ approved medical marijuana, but Clinton administration threatened sanctions.

2001 - US Supreme Court federal law classifies use of marijuana as illegal.

Today, 20 states and D.C. have laws to legalize medical marijuana. Colorado and Washington have legalized marijuana.

44
Q

Anabolic Steroids

A

Derivatives of hormone testosterone. Used to promote tissue growth and endurance. Floods body with up to 100 times the natural testosterone level.

Steroids cause temporary acne and balding, upset hormonal production, and can damage heart and kidneys. Suspected that they may contribute to liver cancer and atherosclerosis.

Male steroid users have shrinking of testicles, impotency, yellowing of skin and eyes, and development of breasts. Young boys - enlarging effect on sex organs. Females, voice deepens, breasts shrink, periods irregular, clitoris swells, hair loss on head but growth on face and body.

Users prone to moodiness, depression, irritability.

Difficulty in quitting drug because muscles fade quickly after drug ended.

45
Q

Alcohol Treatment - General

A

Alcoholics reluctant to give up “best friend.”
Standard practice used to be confrontation. Now, it is motivational interviewing.

Family members make mistake of taking responsibility to get alcoholic to stop. They don’t own problem though.

Best practice for family members - isolate themselves from alcoholic when drinking.

Self help groups for family members: Al-Anon, Alateen, Adult Children of Alcoholics. Members have intrinsic understanding of problem that helps them to help others. “Helper Therapy Principle.”

New members who are still drinking benefit from having people who have overcome addiction attend meetings. Provide role models and gives reason to believe they too can overcome.

46
Q

Alcohol Treatment Programs

A

Historically, intoxicated people thrown into jail to sober up. Now, many communities use treatment approach.

Outpatient treatment - serves clients who have potential to stop using alcohol while still living at home. Less intense than inpatient treatment. Lasts 3-6 months. Counseling, medical services, and vocational services.

Inpatient treatment - for clients unable to live at home and still drinking excessively. Lasts from days to 3 months. Costs up to $20 per month. Followed up with outpatient treatment.

Most larger companies sponsor alcohol treatment programs for employees.

47
Q

Self Help Programs

A

Modeled after AA, many programs available. Narcotics Anonymous, Pill Addicts Anonymous, Cocaine Anonymous, Marijuana Anonymous.

48
Q

Halfway Houses

A

Assist those who have been hospitalized to reenter community at own pace. Also serve those psychologically dependent but do not need hospitalization.

Offer counseling, vocational training, assistance in finding job, room and board. Staffed by former addicts. Recovering abusers more effective in relating to residents than professional staff.

49
Q

Treatment Using Drugs

A

Methadone - used to treat heroin. Similar to heroin but without “high.” Prevents harsh withdrawal, but also addictive.

Opiate Antagonists - Naloxone and Cyclazone. Prevent addicts from feeling euphoria, motivating them to kick the habit.

50
Q

Codependency

A

Codependents are trapped by loved one’s addiction. Lose own identity in obsessively managing day to day trauma from addict. Some are as dysfunctional as addict.

Addict fills need of codependent - be a caregiver, feel inferior, etc.

Addict may stop using but codependents dysfunctional behaviors continue unless he/she receives treatment. Treatment - recognition that they have a life outside of addict. Addict is alone responsible for behavior. Life and addict’s will improve with stopped caregiving and enabling behaviors.

51
Q

Education - Curbing Future Drug Abuse

A

Programs teach:

  1. Effects of commonly used drugs.
  2. How to recognize signs of abuse.
  3. How to responsibly decide when and when not to use.
  4. How to help someone who overdoses.
  5. How to help friends/family who are abusing.
  6. Treatment resources and programs in community.
  7. What to do if you think you have drug problem.
  8. What to do if loved one refuses to acknowledge problem.
  9. How to help abusers learn ways to meet psychological needs.

Old alarmist approaches ineffective. Programs tailored to age groups. Reason for high US drug abuse - idea that “there’s a pill for everything.” Self medication.

52
Q

Prevention of Illegal Drug Trafficking - Curbing Future Drug Abuse

A

Small time dealers - huge profits.
Middle level - millionaires.
Drug barons - billionaires.

To combat illegal drugs trafficked across borders, treat activity as international crime, indictable by international law. Countries would be expected to arrest and extradite for trial to international court anyone masterminding drug trafficking across borders. UN could impose trade sanctions on countries who didn’t participate.

US continuing efforts to put drug barons out of business. Given financial aid to Colombia and Mexico to help in arresting and extraditing drug barons to our country to face drug trafficking charges.

53
Q

Employee Drug Testing Programs - Curbing Future Drug Abuse

A

1986 President’s Commission on Organized Crime recommended both government and private industry launch drug testing programs for employees. Drug testing programs recommended for safety, health, and increased productivity.

Opponents assert that it is a violation of privacy and ban on unreasonable searches.

54
Q

Stricter Laws and Enforcement - Curbing Future Drug Abuse

A

Public opinion is to impose stricter laws. 1984 legislation to raise drinking age to 21. “Clean Indoor Air” laws also enacted.

To combat illegal drugs, various state and local governments established policy of confiscating property involved in transport or storage of drugs.

55
Q

Decriminalization of Drug Use - Curbing Future Drug Abuse

A

Penalties have become harsher, yet proportion of users remains high. Drug legislation makes penalties equivalent to or excess of grand larceny or second degree murder.

Such harshness discredits criminal justice system.

Increasingly recognized that punitive legislation ineffective. Prohibition demonstrated this. (organized crime grows with prohibition.)

Authorities urging laws to be revised to emphasize treatment rather than punishment of addicts. Seems irrational to send people in possession of one joint to jail at taxpayer expense.

1972 National Commission on Marijuana and Drug Abuse recommended private possession for personal use and distribution of small amounts without profit no longer considered offenses.

Laws also passed mandating treatment for public drunkenness rather than just thrown into jail.

56
Q

Motivational Interviewing

A

Not a technique but a facilitative way of being with people. Spirit that embraces motivational interviewing style is ability to form therapeutic relationship in collaborative, nonjudgemental manner.

  1. Express empathy. See world through client’s lens.
  2. Support Self Efficacy. Belief that one is capable of performing in specific manner to attain specific goals. Readiness to change rule - 1-5, change must come from within individual. Example, if client says, “3” ask “what would it take for you to be very ready to give up drinking?”
  3. Roll with Resistance. Don’t fight resistance. Example: Client - “you’ve already made up your mind about me.” Social worker - “so you feel like your opinion doesn’t matter?”
  4. Develop Discrepancy. Help client examine discrepancy between where they are and where they want to be.
  5. Stages of Change. 1. Precontemplation. 2. Contemplation. 3. Preparation. 4. Action. 5. Maintenance.

Essence of motivational interviewing: empowerment, hope, self determination, respect for clients/consumers, strengths perspective, etc., etc. (pg. 274)

57
Q

Alcoholics Anonymous

A

Founded by Bill Wilson and Dr. Robert Smith. Both remained anonymous until after death.

Members collaborate together - no professional leadership. Only position is secretary - changes frequently.

Donations are how it is funded. Members can call other members when they want to drink.

More effective than all other therapies and programs combined.

(pg. 275-277)