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Drugs, Behavior, and Modern Society Chapter 2: Drug-Taking Behavior
Terms in this set (79)
Common Fillers added to heroin on the street
milk sugar, quinine
therapeutic index for a drug with a LD500 of 100 and ED50 of 25? possible answers: 4, .25, 2500, 50
4. Why? LD divided by ED
Based on DAWN's tracking drug related deaths, which drug is most toxic
Opiods, due to high number of deaths
________ refers to harm drug might cause right away, while ______ refers to harm drug might cause at a later date.
acute toxicity, chronicity
Situations that can cause heroin user to have a fatal overdose
High dose and unfamiliar environment
Bob uses heroin to avoid being sick. His dependence is ___________________________
Amanda uses cocaine because of the strong cravings for it. Her dependence is ________________________________
Most striking change to DSM 5 regarding substance use disorders
Substance abuse and dependence have been merged into single category of Substance Use Disorders (SUD)
A pregnant woman gives birth to a low birth weight baby who has HIV and who is having withdrawal symptoms. Is most likely pattern of drug use due to caffeine use during first month of pregnancy, cocaine use during first month of pregnancy, heroin use during final month or pot use during final month.
Heroin use during final month of pregnancy
Breaking into cars to steal cell phones or money is an example of which type of drug related violence? Systemic, economically compulsive, community or pharmacological?
Primary difference between schedule 1 and schedule 2 drugs?
Schedule 1 and 2 both have high abuse potential, but Schedule 1 drugs have NO ACCEPTED MEDICAL USE
If policy maker is looking to decrease the SUPPLY side of drugs, would he be more likely to increase research dollars, increase border patrol enforcement, decrease drinking while driving rates or fund needle exchanges?
Trying to stop the supply would involve tightening the borders with Mexico.
Which term shows the increasing probability of a certain drug effect as dose level rises?
Dose response curve
Failure to fulfill work, school or home obligations is a criteria for a:
Substance use disorder in DSM 5
Capacity of drug to produce a gradually diminished psychological or physical effect upon repeated administrations of the drug at the same does level
A needle exchange program is an example of a __________________ strategy
Harm reduction strategy
s shaped curve showing increasing probability of drug effect as dose level rises
Dose response curve
minimal dose of a particular drug necessary to produce the intended drug effect in a given % of the population
ED or Effective Dose. Has a specific effect on test population from 0 to 100 in terms of probabilities
LD50/ED50 is called the:
Program that gathers data about drug related medical emergencies in hospitals.
DAWN: Drug abuse warning network
Number of times person visits an ED OR Emergency Dept that is connected to drug use and drug related deaths are the 2 things reported by:
Drug taking behavior involving multiple drugs is
Drug abuse ED admits reported in 2011 involved which drugs:
40% cocaine, 36% marijuana, 21% heroin, 13%% meth
more males or females were admitted to ED for illicit drug related visits
Males were twice as likely
DAWN reports deaths only from
Selected metro areas
Drug deaths are more common from one or multiple drugs
Multiple drug or polydrug
According to DAWN, most reported drug related deaths in metro areas are from
Opiod Drugs cause most drug related deaths
Danger of tolerance effect is that________________________ can occur
Death from drug overdose can occur
2 factors must be looked at with drug overdoses
1. How many times the drug has been taken 2. Setting in which the drug taking occurs
Strong evidence suggests that tolerance effects are maximized when drug taking behavior occurs consistently in the same surrounding or under the same set of circumstances
This phenomenon, based on the principles of Pavlovian conditioning, explains why a heroin user may easily suffer the adverse consequences of an overdose when drug is taken in different environment or in a different manner.
Called BEHAVIORAL TOLERANCE or CONDITIONED TOLERANCE
Physical or psychological harm that a drug might cause
Possibility that short-term effects of drug will have some toxic reaction, then drug is identified as having some level of this. Measured in terms of either Therapeutic Index or Margin of Safety
Dose response curve
S shaped curve that lets us look at concept of toxicity
Effective dose (ED)
The dose of a drug that has a specific effect on a test population in terms of probabilities from 0% to 100%
Lethal dose (LD)
Amount that would cause death for a certain % of the population. The LD 50 of a drug refers to the lethal dose for 50% of the population; LD1 is dose lethal for 1% of the pop.
Ratio of LD50/ED50. Ex: LD50 is 450, and ED50 is 50, then therapeutic index is 9. So you'd have to take 9 times the dose that would be effective for half the population to incur a 50% chance of death in that population.
Margin of safety
Ratio that produces death in 1% of the population and the dose that would be effective in 99% of the population; LD1/ED99. Obviously, want it s high as possible.
Magin of safety with street drugs
Of course it doesn't exist and buyer has no way of knowing what has been bought
Fillers like milk sugar may be used or some quinine to simulate bitter taste of real heroin. Can contain animal tranquilizers, arsenic, strychnine, insecticides,etc. May also contain higher amt. than expected.
Drug abuse warning network. Reports 2 types of info: !. Number of times person visits ED for any reason connected to drug use such as suicide attempts, malicious poisoning, overmedication, adverse reactions to meds, illicit drug use, supplements, and non medical use of prescription or OTC drugs. 2. Reports number of drug related deaths as determined by coroner or med examiner.
50% of ED visits were related to what?
drug misuse or abuse. 2.5 mil in 2011 with average of 2 drugs being reported.
taking multiple drugs at a time
DAWN Report alcohol admissions
only for those under 21. Note, 1/4 of drug related ED visits involved alcohol in combo with illicit drug, prescription drug or illicit drug and a medication.
ED visits for Illicit drug use
40% coke, 36% marijuana, 21% heroin, 13% meth. Over 100% due to multiple drugs being used
ED visits for illicit drug use and Gender
2 times as many males as females
Based on DAWN 2010 stats we can see that:
More deaths were from multiple drugs, death from opioid drug is most frequently seen, alcohol often involved, meth involved death is likely underreported as Dawn stats are from large Metro areas
More heroin deaths than Cocaine deaths
underestimates the lethality of heroin since there are fewer users of it than coke.
Opioid Prescription med deaths
In 2013, over 16,000 died from them, 4 times than in 1999. Methadone, oxycodone (brand Percocet), controlled release Oxycodone (brand: OxyContin), and hydrocodone (brand Vicodin)
Negative consequences of using a drug over a long time. Alcohol and tobacco cause the most adverse effects and deaths
4 times as many deaths from TOBACCO related illnesses as from:
alcohol and illicit drug problems combined
Refers to capacity of a drug dose to have a gradually diminished effect on the user as drug is taken repeatedly. So need more to get same effect.
Strong evidence that tolerance effects are maxed when drug-taking behavior occurs consistently in same surroundings or same manner of use. Called conditioned tolerance due to it being based on Pavlovian conditioning. Explains why heroin user may suffer adverse effects when drug is taken in diff setting or in a different way. Behavioral tolerance is why former user is STRONGLY advised to avoid surroundings associated with past use.
Physical symptoms occur when drug is stopped. as if drug, previously foreign, is now part of nervous system. It's removal and absence become abnormal. So it makes sense that withdrawal produces opposite symptoms to drug being used.
Opioid withdrawal symptoms:
Runny nose, chills and fever, inability to sleep, hypersensitive to pain, diarrhea
Barbiturate withdrawal symptoms:
Anxiety, inability to sleep, sometimes lethal convulsions
Alcohol withdrawal symptoms:
Tremors, nausea, weakness, tachycardia(rapid heart rate). Severe ones are dt's, seizures, hallucinations
Possible that users take the drug not because of fear of withdrawal, but because they crave pleasurable effects of drug itself. Studies using animals who could self administer via CATHETER
Majority of users, 56-77% relapse. why? Psychological dependence
Drugs that have withdrawal vs no withdrawal symptoms demonstrated that:
Compulsive drug taking behavior is very similar, so there can be common strategies for treatment
DSM V differs from DSM-IV-TR in that:
legal difficulties has been removed and new criterion added which is craving or strong desire or urge to use; need 2 or more with 12 mo period
DSM 5 severity of symptoms
2-3 mild, 4-5 moderate, 6 or more is severe. 11 criteria. If only one drug being used, it goes by drug name as in opiod use disorder
Pregnancy concerns with drug use
4-8wks: spontaneous abortions, physical malformations.
8+ months: growth issues, neuro damage, prematurity, low birth weight
Pregnancy drug use stats: 2012-2013
20% smoked in past mo. in 1st trimester. 19% used alcohol, 5% binge drank, 8% smoked marijuana
Pregnancy drug use stats: 2012-2013
Past mo prevalence rates decline for drug use in 2nd and 3rd trimester, but then rise among women with kids under 3mo.
Pregnancy: Alcohol Use:
FETAL EFFECTS: Impairment in the supply of fetal oxygen and stimulation of excess prostaglandins possibly causing fetal malformations.
PREGNANCY EFFECTS: Risk of miscarriage during the second trimester of pregnancy if the mother consumed as few as one or two drinks a day.
NEWBORN EFFECTS: Signs of alcohol withdrawal upon birth if the mother drank heavily. Fetal alcohol syndrome involving retardation of postnatal growth and nervous system, abnormal craniofacial features, and numerous organ abnormalities.
Pregnancy: Tobacco Use:
FETAL EFFECTS: Reduced oxygen supply compounded by carbon monoxide that interferes with the blood's ability to carry oxygen throughout the body.
PREGNANCY EFFECTS: Increased frequency of spontaneous abortions and fetal death.
NEWBORN EFFECTS: Increased risk of physical defects and lower birth weight. Also a higher risk that infants born to mothers who smoke will die before their first birthday.
FETAL EFFECTS Increased carbon monoxide levels in mother's blood, particularly in the last trimester, resulting in reduced oxygen in fetal blood.
PREGNANCY EFFECTS: Inconsistent findings, although there is a tendency for more males to be conceived than females if either parent is a heavy marijuana smoker.
NEWBORN EFFECTS: Some evidence for abnormal sleep and arousal patterns if mother has used marijuana.
Pregnancy: Cocaine or Crack
FETAL EFFECTS: Constriction of blood vessels, which reduces normal fetal blood flow and causes urogenital malformations.
PREGNANCY EFFECTS: High rates of spontaneous abortion and early separation of the placenta from the uterine wall, resulting in increased numbers of stillbirths. Increased risks of early onset of labor and preterm delivery.
NEWBORN EFFECTS: Increased risk of intrauterine growth retardation: lower birth weight and smaller length and head circumference. Tendency to be jittery and easily startled. Fewer discernible withdrawal symptoms than in newborns exposed to heroin or other narcotics in utero.
FETAL EFFECTS: Unknown but likely to be similar to effects of cocaine.
PREGNANCY EFFECTS: Increased risk of premature birth, fetal distress during delivery.
NEWBORN EFFECTS: Growth retardation, lethargy, increased difficulty to arouse, and, once aroused, increased autonomic reactivity. Long-term effects largely unknown.
Pregnancy: Heroin or Morphine
FETAL EFFECTS: Reduced oxygen supply to the fetus, as well as reduced pancreatic, liver, and intestinal functioning.
PREGNANCY EFFECTS: In 10 to 15 percent of pregnant women using heroin, development of toxemia, a poisoning of the blood between the mother and the fetus.
NEWBORN EFFECTS: Retardation of intrauterine growth. Likelihood of lung problems, brain hemorrhages, and respiratory distress. Risk for perinatally transmitted HIV infection and the development of AIDS. Dramatic withdrawal symptoms usually beginning forty-eight to seventy-two hours after delivery.
Pregnancy: Prescription drugs
ACCUTANE (isoretinoin): Major birth defects associated with this antiacne medication and vitamin A derivative.
Tetracycline antibiotics: Possibility of permanent discoloration of a child's teeth.
SALICYTES (aspirin products): Possibility of bleeding in the mother or fetus and of delay in delivery if taken close to term or prior to delivery.
DILANTIN (phenytoin): Increased risk of heart malformations, cleft lip, and mental retardation associated with this and other anticonvulsants.
ANTI ANXIETY DRUGS: Possible depression of respiration in newborn when taken during labor. Fourfold increase in cleft palates and malformations of the heart and limbs when taken during early pregnancy.
PAXIL: (paroxetine): Increased risk of birth defects when this antidepressant is taken during the first trimester of pregnancy.
BARBITURATES: Birth defects resembling fetal alcohol syndrome associated with long-acting barbiturates such as phenobarbital. Withdrawal symptoms in the newborn four to seven days after delivery.
Act of violence committed by person under influence of psychoactive drug. Implies drug was responsible. Problem with it being cause is length of time drug can stay in system; pot approx 30 days
Drug most linked to violent behavior
Alcohol. More violent the crime, greater prob. that alcohol was involved
Economically Compulsive Violence
Violent act like robbery motivated by need for money to buy drugs
Violence that arises from characteristic features of drug dealing; enforcing discipline, rival dealer disputes, punishing informants
Comprehensive drug abuse prevention and control act
1970. Called controlled substances act: listed drugs under 5 classifications called schedules
Controls drug enforcement. Ended taxation when run by treasury dept.
Anti-Drug Abuse Act 1988
Penalties for money laundering when assc with drug smuggling and sales. Drug CZAR
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