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Chapter 5 Altering Consciousness through Drugs Psychoactive substances= drugs that have psychological effects such as stimulation or distortion of perceptions. Stimulant=a drug that _________ the activity of the nervous system. Stimulants elevate mood, increase feelings of well-being, and increase energy and alertness. cocaine= crack cocaine= amphetamines= Methamphetamine= nicotine= Tobacco accounts for more deaths in the U. S. than the combined total of alcohol, illicit drugs, firearms, car accidents, suicides, homicides, and AIDS combined according to a 1999 study mentioned in your textbook.
MDMA = Depressant=a drug that _______ the rate of activity of the nervous system Alcohol= Opiates= Prescription narcotics: Category I= drugs for _______ pain (Dilaudid, Demerol, Fentanyl, Methadone) Category II= drugs for ___________ pain (codeine, Percodan, Percocet, hydrocodone: Vicodin, Lortab) Category III= drugs for ______ to moderate pain (Darvon, Darvocet) Cannabis= Sedatives= Barbiturates= Solvents and inhalants= Most used drug in United States among high school seniors See chart 5. 4) pg 208 1. alcohol1. alcohol 2. marijuana 2. cigarettes 3. cigarettes 3. marijuana “Triggers” = ____________ — a sight, a sound, a smell, a feeling — that reminds someone of past drug or alcohol experiences and inspires cravings. Substance Abuse: American Psychiatric Association defines is as: a ____________consisting of persistent use of a substance even though it is causing or compounding problems in meeting the demands of life.
The Diagnostic and Statistical Manual-IV (DSM-IV) defines abuse as: A maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by ___________ of the following, occurring _____________________. (see chart on next page) Most often, abuse is diagnosed in individuals who recently began using alcohol. Over time, abuse may progress to dependence. However, some alcohol users abuse alcohol for long periods without developing dependence. Substance Dependence: is more severe, having both _________ and __________ components.
DSM-IV defines dependence as: A maladaptive pattern of substance use, leading to clinically significant impairment or distress, as manifested by ________ of the following, occurring at any time __________________: (see chart on next page) [DSM-IV, Diagnostic and Statistical Manual of Mental Disorders, ed. 4. Washington DC: American Psychiatric Association (AMA). 1994. ] Danger signs in substance use: Craving ??? A strong ____ or_____ to use Loss of control ??? Not being able to _____ use once it has begun Physical dependence ??? Withdrawal symptoms.
Tolerance ??? The need to ingest ______ amounts of drug to get achieve _____ effects ???a need for markedly _______amounts of the substance to achieve intoxication or desired effect ???markedly ________ effect with continued use of the same amount of substance Causes of Substance Abuse and Dependence: Usually begins with experimental use as a teen. The average age when youth first try alcohol is: ____ years for boys ____ years for girls. The average age at which Americans begin drinking regularly is _____ years old. | | |Dependence |Abuse | | | | |(3 or more in a 12-month period) |(1 or more in a 12-month period) | | |Symptoms must never have met criteria for substance dependence for | | |this class of substance. | | | | |Tolerance (marked increase in amount; marked decrease in effect) |Recurrent use resulting in failure to fulfill ajor role obligation at| | |work, home or school | | | | |Characteristic withdrawal symptoms; substance taken to relieve | | |withdrawal | | | |Recurrent use in physically hazardous situations | | | | |Substance taken in larger amount and for longer period than intended | | | |Recurrent substance related legal problems | | | | |Persistent desire or repeated unsuccessful attempt to quit | | | |Continued use despite persistent or recurrent social oar interpersonal| | |problems caused or exacerbated by substance | |Much time/activity to obtain, use, recover | | | | | | | | |Important social, occupational, or recreational activities given up or| | |reduced | | | | | | | | |Use continues despite knowledge of adverse consequences (e. g. failure| | |to fulfill role obligation, use when physically hazardous) | | | | | | | |In using the DSM-IV criteria, one should specify whether substance dependence is with physiologic dependence (i. e. , there is evidence of | |tolerance or withdrawal) or without physiologic dependence (i. e. , no evidence of tolerance or withdrawal). In addition, patients may be | |variously classified as currently manifesting a pattern of abuse or dependence or as in remission.
Those in remission can be divided into | |four subtypes — full, early partial, sustained, and sustained partial — on the basis of whether any of the criteria for abuse or dependence | |have been met and over what time frame. The remission category can also be used for patients receiving agonist therapy (e. g. , methadone | |maintenance) or for those living in a controlled drug-free environment. | According to research by the National Institute on Alcohol Abuse and Alcoholism, adolescents who begin drinking before age 15 are ________ more likely to develop alcohol dependence than those who begin drinking at age 21. “A child who reaches age 21 without smoking, abusing alcohol or using drugs is virtually certain never to do so. ” Joseph A. Califano, Jr. Chairman and President, National Center on Addiction and Substance Abuse at Columbia University People experiment with drugs for various reasons: Psychological views on abuse and dependence: Expectations Reinforcement Biological views on abuse and dependence: Certain people may have a __________ toward physiological dependence (addiction) on various substances including alcohol, opiates, cocaine and nicotine. An inherited tendency toward alcoholism may involve greater sensitivity to alcohol, greater enjoyment, and greater tolerance of it. Ethnicity is connected with alcohol abuse: ??? Native Americans and Irish Americans have the _______ of alcoholism in the U. S. ??? Jewish Americans have relatively ______ of alcoholism. Asian and Asian Americans are more likely to show a “flushing response” sensitivity to alcohol which inhibits heavy drinking ??? Alcohol: ??? Legal to use without a prescription ??? Dinnertime _______ ??? Bedtime _______ ??? Party __________ ??? Used to __________ ??? Asserts ________ ??? Relieves __________ ??? Relieves _____________ ??? No ___________ to ingest in public _________ million Americans are alcoholics _______ of all Americans use alcohol regularly College students binge-drink: Males = ____or more drinks in a row Females = ______or more drinks in a row Binge-drinking is connected with aggressive ______, ____ grades, sexual _______and ______ accidents. 4% of college students binge at least ______ a month and half of them binge ______ of more times every two weeks. Effects of Alcohol: Low doses are _________ because alcohol dilates blood vessels, but higher doses have a sedative effect. When alcohol intoxicates: ______ cognitive functioning ______ the speech ______ motor coordination ______ inhibitions Alcohol is involved in about half of all fatal car accidents in the U. S. Men are more likely to become alcoholics than women: Biologically women metabolize ______ of the alcohol in their stomachs. Men have _____ of the enzyme to metabolize alcohol in their stomach than women. This ______ makes women less likely to overindulge women drinking alcohol has the same effect as injecting it intravenously” (1990, Lieber) Possible complications from chronic alcoholism: ??? Pancreatitis ??? Heart muscle damage ??? Nerve damage ??? Esophageal bleeding ??? Brain degeneration ??? Cirrhosis of the liver ??? Delirium tremens (DTs) Depression ??? Erectile dysfunction ??? Fetal alcohol syndrome in the offspring of alcoholic women ??? High blood pressure ??? Increased incidence of cancer ??? Insomnia ??? Nutritional deficiencies ??? Suicide ??? Wernicke-Korsakoff syndrome o confabulation: To ________ in one’s memory with fabrications that one believes to be facts. The truth shall see you free, but first…. Alcoholics and drug addicts must “_________”
Albert Einstein once said, “The definition of _________ is doing the same thing over and over again and expecting different results”. Helping or shielding from consequences is called _________. An enabler is called _________: A “codependent” is loosely defined as someone who exhibits too much, and often inappropriate, caring for persons who depend on him or her. Treatment: Medical _________ from alcohol followed by total abstinence from all mood-altering drugs _________treatment program _________________: most widely used program. Work through 12 step program: Step 1. We admitted we were powerless over alcohol – that our lives had become unmanageable. ____________ therapy: to approach life rationally and intellectually without the crutch of alcohol. _________ treatment or ___________ Houses ____________: ** What’s the difference between an alcoholic and a drug addict? ** Opiates: (hydrocodone, OxyContin (time-released oxycodone), and heroin) ??? _______ pain ??? Strong _______ rush ??? Don’t have telltale _______ of alcohol or marijuana ??? _______ doctors to get prescriptions. Report prescriptions ______ ??? ______on the street ??? _______ out people who have medication you need Effects of Opiates: ??? Intense ________ ??? ________, drowsiness ??? ________ pupils and reduced vision ??? ________breathing ??? _______of consciousness needle or track _______ on inner arms or other parts of the body from injecting needles ??? _________perspiration, shaking, vomiting, sneezing, yawning ??? ______or possession of paraphernalia including syringes, bent spoons, bottle caps, eye droppers, rubber tubing, cotton and needles. ??? ________ mental functions ??? Complete _________ with possession = commit crimes Possible complications from chronic Opiate drug addiction: ??? Liver damage or disease ??? Withdrawal (6 to 24 hours after last dose) ??? Overdose ??? Lung damage or respiratory problems ??? Kidney damage or disease ??? Brain damage ??? Hepatitis B and C ??? HIV ??? Collapsed veins ??? Heart valve damage ??? Abscesses (boils) ??? Soft-tissue infections ??? Coma Cocaine, Methamphetamine, Crack: ??? Stimulants ??? Increase metabolism ??? Illicit substances Effects of these stimulants: ??? Feeling of __________ energy ??? Feeling of _________ _________ feeling ??? Eat _______ ??? Less _______ ??? _______ or panicky ??? Aggressive ??? Resort to crime Possible complications from chronic stimulant addiction: ??? Sores and scabs (especially meth addicts) methodically pick at their skin because they feel compelled to do so, or scratch it because they think there are bugs crawling underneath it. ??? Delusions ??? Liver, kidney, lung, heart damage ??? Awake and wired for days ??? Severe mood swings. ??? Meth rots teeth and gums ??? Snorting, leads to nose bleeds, impairs sense of smell, erodes nose septum (cartilage between nostrils) ??? Violent outbursts and psychiatric problems ??? Severe weight loss ??? Hallucinate Psychotic behavior even months after use has stopped ??? Damage the parts of brain related to feelings and memory. ??? Stroke ??? Seizures Treatment for drugs: Medical ___________ (used alone is NOT treatment) from drugs followed by: total abstinence from all mood-altering drugs because they all eventually will lead you back to your drug of choice. ___________ program= ________ Anonymous= ________________ therapy= __________ residential treatment programs. Half-way houses. Court-system (probation programs) __________= Naltrexone According to the Big Book of NA there are three life outcomes for an addict…. recovery institutionalization death Marijuana: ??? Helps people relax Elevates mood ??? Produce mild hallucinogens Effects of Marijauana: ??? _____heart rate ??? _____ response times ??? ________ the user’s perception of sounds and colors. ??? affects a user’s sense of ______, making him or her feel that time is moving slowly. ??? leads to increased hunger or thirst. ??? After initial euphoric high passes, user may feel drowsy or depressed. ??? feelings of anxiety or panic attacks. ??? impair short-term memory and slows learning capabilities ??? in higher doses, hallucinations or delusions ??? Blood vessels in the eyes dilate, making them appear red Possible complications from marijuana addiction: ??? respiratory illnesses and infection. Studies show that marijuana smoke may be more hazardous than tobacco smoke. ) ??? cancer of the respiratory tract and lungs. ??? Chronic cough ??? Prolonged heavy use of marijuana among men may reduce testosterone, the size of the testes, and sperm count. ??? Long-term use among women may lead to irregular menstrual cycles. ??? Heavy users who stop abruptly may experience jerkiness and insomnia. Treatment for marijuana: People can become _________ dependent on marijuana, but it has not been thought to lead to _________ dependence. However, tolerance may be experienced. How to raise a drug-free child: Teach Early and Often Beware of the Danger Zone Find a Hobby Plan together time Set a good example