Upload
collin-maxwell
View
217
Download
1
Tags:
Embed Size (px)
Citation preview
Chapter 13
Habits that have gotten out of control, with a resulting negative effect on a person’s health.
Addiction is the habitual use of a drug produced chemical changes in the user’s body.
Drug Addiction (four important characteristics)1. Compulsive desire2. Need to increase the dosage3. Harmful effects to the individual4. Harm to society
2
Often starts to bring pleasure or to avoid pain.Harmless or even beneficial if done in
moderationExamples of addictive behaviors:
GamblingCompulsive ExercisingWork AddictionSex and love addictionCompulsive buying or shoppingInternet addiction
Characteristics of people with addition (e.g., risk takers or genetic disposition)
3
Drugs are chemicals other than food that are intended to affect the structure or function of the bodyPrescription medicinesOver-the-counter substances
CaffeineTobaccoAlcohol
Illegal substances
4
The APA’s Diagnostics and Statistical Manual of Mental Disorders – authoritative reference
AbuseAPA definition
Failure to fulfill major responsibilitiesDrug use in situations that are hazardousDrug related legal problemsDrug use despite persistent social or interpersonal
problemsPhysically dependent may or may not present
5
Substance dependence1. Developing tolerance to the substance2. Experiencing withdrawal3. Taking in larger amounts4. Expressing a persistent desire to cut down5. Spending great deal of time obtaining6. Giving up or reducing important activities7. Continual usage even with recognition of
a problemDiagnosed with at least 3 or more
symptoms during a 12-month period
6
All income and education levelsAll ethnic groupsAll agesYoung people are at a higher riskMales (Twice as likely)Troubled adolescentThrill-seekerDysfunctional familiesPeer group or family that acceptsLow Socio-economical statusDating young
7
ExperimentEscapeReliance Magnification of residence (i.e. the need for
escape from poverty becomes more compelling)
8
Psychological risks
Difficulty in controlling impulsesStrong need for excitementFeelings of rejectionHostilityAggressionAnxietyMental illnessDual (co-occurring disorders)
9
Social Factors
Growing up in a family with drug abusePeer groupPoverty
10
IntoxicationSide effectsUnknown drug constituentsRisks associated with injection drug useLegal consequences
11
Changes in Brain chemistry Drug factors:
Pharmacological properties Dose-Response function Time-action function Drug use history Method of use (e.g., inhalation,
injection, ingest)
12
13
Opioids (narcotics)Natural or synthetic (laboratory-made)
Opium, morphine, heroin, methadone, codeine, hydrocodone, oxycodone, meperidine, and fentanly
Effects on the body: induced euphoriaMethods of administration
Injection, snorting, sniffing or smokingSymptoms of overdose: respiratory depression,
coma, constriction of the pupils, or death.
15
Slow down the overall activity of the CNSSedative-hypnoticsTypes: barbiturates, valium, methaqualone, GHBEffects on the body: reduce anxiety, impair
muscle coordination, induce drowsinessMedical uses: Treat insomnia and anxiety
disorders; control seizuresFrom use to abuse (“Club Drugs”)Overdosing may result in respiratory
complications
16
Speed up the activity of the nervous or muscular systemCocaine
Methods of use (snort or injection)Effects (euphoria sensation for ~5 to 20 minutes)Use during pregnancy (consequences include:
miscarriage, premature labor, stillbirth, and low-birth-weight baby)
18
AmphetaminesEffects (increase in alertness)Dependence (may lead to the development of a
temporary state of paranoid psychosis or delusion)Ritalin (used to treat
attention-deficit/hyperactivity disorder, ADHD)Ephedrine (a less potent form of
amphetamines)Caffeine
19
21
Cannabis SativaTHC (tetrahydrocannabinol)Short term effects and uses: euphoria,
increases in sensation, relaxed attitudeLong-term effects and uses: respiratory
damage such as impaired lung function and chronic bronchial irritation
23
Altered state of consciousness, perceptions, feelings and thoughts
LSD, Mascaline, DMT, MDMA, Ketamine, PCP (angel dust), and certain mushroomsAltered states of consciousness
Flashbacks are perceptual distortions and bizarre thoughts that occur after the drug has been entirely eliminated from the body.
Nearly all inhalants produce effects similar to those of anesthetics, slow down the bodies functions
Volatile solventsNitratesAnestheticsMethods of use
SniffingSnorting“Bagging”“Huffing”
24
Medication-assisted treatmentDrug substitution
Treatment centersSelf-help groups and peer counselingHarm reduction strategiesCodependency
25
http://www.youtube.com/watch?v=J46pvxFWNTY
TobaccoTobacco
27
Use of Tobacco
71 Million Americans, including 13.7 million college-aged Americans.
2008, nearly 21% of Americans age 18 describe themselves as current smokers.
Nicotine Addiction Powerful psychoactive drug
Reaches Brain via bloodstream in seconds Most physically addictive of the psychoactive
drugs. Loss of control Tolerance and Withdrawal
28
Why Start in the First Place? Children and teenagers make-up 90% of all new
smokers in this country. Thousands of children and adolescents (12-17) start
smoking everyday. Average age
13 for smoking 10 for spit tobacco
29
Characteristics which could increase the potential for use.
A parent or sibling uses tobacco Peers use tobacco Child comes from blue-collar family Child comes from low-income home Single parent. Performs poorly in school Child drops out of school Has positive attitudes towards tobacco
Reasons Why College Students Smoke
Chapter 8 31
Health HazardsContains hundreds of damaging chemical
substances, including acetone (nail polish remover), ammonia, hexamine (lighter fluid), and toluene (industrial solvent).
Unfiltered cigarettes = 5 billion particles per cubic mm
50,000 times more than polluted urban airCondensed particles in the cigarette produce
the tar (brown, sticky mass)
Chapter 8 32
Health Hazards (cont)Carcinogens and Poisons 43 chemicals are linked to cancer (Carcinogen)
Benzo(a)pyrene (yellowish tar) Urethane (ex: solution used in making foams)
Cocarcinogens Combine with other chemicals to cause cancer (e.g.,
formaldehyde) Poisonous substances
Arsenic (e.g., insectides and weed killers) Hydrogen cyanide (e.g., flammable liquid used in dye)
Carbon monoxide 400 times greater than is considered safe in industrial workplaces Displaces oxygen in red blood cells
Additives Nearly 600 chemicals
33
34
“Light” and Low-Tar Cigarettes
Low-tar, low-nicotine, or filtered cigarettes No such thing as a safe cigarette Often smoke more
35
The effects of smoking a cigarette
36
Additional Health, Cosmetic, and Economic Concerns
Ulcers Impotence Reproductive health problems Dental diseases Diminished physical senses Injuries Cosmetic concerns Economic costs
37
Cumulative Effects Males before 15 yrs. old are half as likely to
live to 75 versus those who did not smoke Females with similar habits reduce life
expectancy by more than 10 years Female smokers spend 17% more sick days
in bed than nonsmokers Both men and women show a greater rate of
acute and chronic diseases
38
Other Forms of Tobacco Spit (Smokeless) Tobacco
More than 6.6 million adults
8% of all high school students
Cigar and Pipes Cigar smoking has
increased by 148% from 1993-2006.
Cigars contain more tobacco than cigarettes.
Clover cigarettes and Bidis Twice the tar, nicotine,
and carbon monoxide
39
40
The Effects of Smoking on the Nonsmoker
Environmental Tobacco smoke (ETS) Environmental Protection Agency (EPA)
designated ETS as a class A carcinogen Department of Health and Human Services’
National Toxicology Program - “known human carcinogen”
Surgeon General – 2006 – “there is no safe level of exposure to ETS; even brief exposure can cause serious harm”.
41
Environmental Tobacco Smoke
Mainstream smoke Smoke exhaled by smokers
Sidestream smoke Smoke from the burning end of a cigarette, cigar, or
pipe. 85% of smoke in a room is second hand Twice the tar and nicotine Three times the benzo(a)pyrene Three times the ammonia
Smoke from a cigar can be even more dangerous 30 times more carbon monoxide
42
ETS Effects Develop cough, headaches, nasal discomfort, eye
irritation, breathlessness and sinus problems Allergies will be exacerbated Causes 3,000 deaths due to lung cancer Contributes to about 35,000 overall deaths each
year. 20% increase in the progression of atherosclerosis. Contributes to increased asthma attacks
How Cigarette Smoking Damages the Lungs
44
45
46
http://www.youtube.com/watch?v=0hySFt8O11A
47
48
Infants, Children, and ETS More likely to develop
Bronchitis, pneumonia,& respiratory infections More complications from asthma Increased chance of SIDS (sudden infant death
syndrome) Low-birth weight Bronchitis
Chemicals from smoking show up in breast milk Children inhale three times more pollutants per unit
of body weight than adults.
49
Smoking and Pregnancy
Estimated 4,600 infant deaths in the U.S. Miscarriage, premature birth, low birth
weight, long term impairments in growth and intellectual development
Possible higher risks of getting cancer 16% of pregnant women smoke
50
Cost of Tobacco Use to Society
Lost productivity from sickness, disability, and premature death makes it close to $167 billion per year.
1998 Master Settlement Agreement (MSA) 43 states filed suit against tobacco companies
to recoup public health care expenditures Tobacco companies have to pay $206 billion
over 25 years. Limits or bans certain types of advertising,
promotions, and lobbying.
51
How A Tobacco User Can Quit
50.2 % of all adults who have smoked have quit. The Benefits of Quitting Options for quitting
Smoking cessation programs 1-800-QUITNOW
Department of Health and Human Services Smoking cessation products
Chantix (Varinicline) Zyban (Bupropion)
Nicotine replacement products Patches, gums, lozenges, nasal sprays, and inhalers
http://www.videojug.com/interview/the-benefits-of-quitting-smoking-2
AlcoholAlcohol
53
The Nature of Alcohol Psychoactive ingredient Depressant Ethyl Alcohol – only alcohol that can be consumed
Beer 3-6% alcohol by volume Malt Liquors 6-8% alcohol by volume Table wines 9-14% alcohol by volume
Fermenting Fortified wines 20% alcohol by volume
Sugar added Extra alcohol is added
Hard liquors 35-50% alcohol by volume Distilling or fermented
Proof Value Two times the percentage concentration
Ingestion 7calories per gram 1 drink 14-17 grams or 100-120 calories
54
Absorption 20% is rapidly absorbed from the stomach 75% is absorbed in the upper small intestines Remain is absorbed along the GI track Absorption
CarbonationFood in the stomach slows the absorptionEventually all the alcohol ingested will be absorbed
55
Metabolism and ExcretionTransported throughout the body via the
bloodstream.Easily moves through most biological
membranesMain site for metabolism is the Liver.2-20% of ingested alcohol is not metabolized.
Chapter 8 56
57
Alcohol Intake and Blood Alcohol Concentration
Blood Alcohol Concentration(BAC)A measure of intoxication Body weightPercentage of body fatSex
Genetic factorsDrinking BehaviorMetabolism is the same if the person is awake or
asleep
58
The Immediate Effects of Alcohol on Health
Depends on the individual.Low Concentrations .03% -.05%.Higher Concentrations 0.1% -0.2%.
Concentration of .35% and higher.Alcohol hangoverAlcohol poisoningUsing Alcohol with other drugs
59
Drinking and DrivingIn 2004
250,000 were injured in alcohol related automobile crashes
42,000 people are killed in alcohol related accidents
Dose-response functionDriving with a BAC of 0.14% is more than 40 times more likely to be involved in a crash.Greater than 0.14% the risk of fatal crash is estimated to be 380 times higher.
60
61
Angels Pitcher Nick Adenhart Killed In Car CrashApril 9, 2009
Two people who were with him were also killed when, according to police, a minivan ran a red light at a Fullerton intersection and broadsided the gray Mitsubishi they were in. The driver of the minivan, Andrew Thomas Gallo, 22, of Riverside, was arrested on suspicion of drunken driving, hit and run and manslaughter.
© 2010 McGraw-Hill Companies. All Rights Reserved. 62
Approximate blood concentration and body weight
63
The Effects of Chronic Use Diseases of the digestive, cardiovascular systems and some
cancers Digestive system
Liver function liver cell damage and destruction (cirrhosis)
Pancreas inflammation Cardiovascular system
moderate doses may reduce the risk of HD Higher doses elevates BP, may weaken heart muscle or cardiac
myopathy. Cancer
Mouth, throat, larynx, and esophagus 5-6 total drinks
Responsible for the most common form of liver cancer Hepatitis speeds the growth of this cancer
Breast cancer Increase risk when 2-3 drinks per day
Brain Damage Cognitive impairments Memory loss, dementia, and compromised problem-solving Wernicke-Korsakoff syndrome (brain damage)
Mortality Alcoholics average life expectancy is about 15 years less than non-alcoholics
64
65
The Effects of Alcohol use During Pregnancy
Effects are dose-related.Fetal Alcohol Syndrome (FAS)
Full-blown FAS occurs in up to 15 out of every 10,000 live births in the U.S.
Under weight, flat nasal bridge, and long upper lip.Small and have heart defects.Physical and mental growth is slowed. Remain
mentally impaired. Fine motor skill problems, coordination, learning and behavioral problems (ADS).
Alcohol-related neurodevelopment disorder (ARND).
66
Possible Health Benefits of Alcohol
Abstainers and light to moderate drinkers live longer than heavy users.
35 years old and younger, your odds of dying increase in proportion to the amount consumed
Moderate drinking = one drink per day for women and two drinks per day for men.May lower coronary heart disease.Raising blood levels of HDL.May lower risks of diabetes, arterial blockages,
Alzheimer’s
67
Alcohol Abuse and Dependence
Alcohol abuse is recurrent use that has negative consequences.
Alcohol dependence or Alcoholism more extensive problems, tolerance and withdrawal
Warning signs of alcohol abuseDrinking aloneUsing deliberately and repeatedlyFeeling uncomfortable on certain occasionsEscalating consumptionGetting drunk regularlyDrinking in the morning or unusual times
68
Alcohol Abuse and DependenceBinge Drinking
The National Institute on Alcohol Abuse and Alcoholism defines:Pattern of alcohol use that brings a person’s
BAC up to 0.08 or above (typically four drinks for a male or three for a women) within two hours.
National Survey on Drug Use and Health defines:Having five drinks in row for a man or four in a
row for a women within two hours.Frequent binge drinking in college were three to
seven times more likely than non-binge drinkers to engage in unplanned or unprotected sex
Healthy People 2010Reduce the rate of binge drinking to 20% among
college students
70
AlcoholismPatterns and Prevalence
1. Regular daily intake of large amounts2. Regular heavy drinking limited to weekends3. Long periods of sobriety interspersed with binges or
daily heavy drinking4. Heavy drinking limited to periods of stress
Health Effects DTs (delirium tremens) paranoia
Social and Psychological effectsCauses of Alcoholism
Video: http://www.youtube.com/watch?v=gTPjlN7VR7c
71
Treatment ProgramsNot one program works for everyone.
AA. 12-step program
Employee Assistance.Inpatient hospital rehabilitationPharmacological treatments.
Disulfiram (Antabuse)Inhibits the metabolic breakdown
Naltrexone (ReVia, Depade)Reduces the craving for alcohol and decreases its pleasant
effects. Injectable Naltrexone (Vivtrol) – single monthly shot Acamprosate (Campral)
Acts on brain pathways related to alcohol abuse.
Chapter 8 72
Gender and Ethnic Differences Men
White American men (excessive drinking often begins in the teens or twenties)
“Other men” (remain controlled drinkers until later in life) Women (alcoholism often occurs
later in life) African Americans (alcohol abuse
usually found in African Americans) Latinos (drinking patterns vary) Asian Americans (low rate of alcohol abuse) American Indians and Alaska Natives (excessive drinking
varies from tribe to tribe)
http://www.cbsnews.com/video/watch/?id=5024746n
Video Segment: The Effects of Drug Use on Brain Chemistry
http://www.youtube.com/watch?v=J46pvxFWNTY
http://www.aetv.com/intervention/video/?bcpid=53411497001&bclid=129113967001&bctid=115543473001
http://www.aetv.com/intervention/video/?bcpid=53411497001&bclid=64419253001&bctid=64670639001
73