The Use and Abuseof

Psychoactive Drugs

Nucleus accumbens The nucleus accumbens, part of the limbic

system plays a role in sexual arousal and the "high" derived from certain recreational drugs. These responses are heavily modulated by dopaminergic projections from the limbic system.

Lobotomy of Phineas Gage Ventromedial region

of both frontal lobes Personality change

◦ irreverent, profane Prefrontal cortex

functions ◦ planning, moral

judgement, and emotional control

Rats in Skinner boxes with metal electrodes implanted into their nucleus accumbens will repeatedly press a lever which activates this region, and will do so in preference over food and water, eventually dying from exhaustion. In rodent physiology, scientists reason that the medial forebrain bundle is the pleasure center of rats( and humans). If a rat is given the choice between stimulating the forebrain or eating, it will choose stimulation to the point of exhaustion.

There is a Pleasure Center!

Mainly to Become Aware of the Drug Addiction that may result from some drugs.

Why Study Drugs In Health Science?

What Constitutes Addictive Behavior?

Reinforcement- gives person pleasure Compulsion or craving- person feel need to

do it again Loss of control- Persons often denies he has

problem Escalation- person gives more time to

behavior Negative Consequences-interferes w/ life

Addictive Behavior

1. Drugs Can Be Addictive 2. Drugs Can Cause Negative Side Effects Some with Short-Term Use Most with Long-Term Use We Don’t Know All of the Long-Term

Consequences of Many of the Drugs. 3. Drugs can impair judgment; this causes

higher risk: for auto accidents; engagement in unsafe sex, violence; more likely to be involved in an accident involving drowning, falling aggression and sexual assault.

Why Teach About Drug Use?

Definition for DRUG

Chemicals, other than food, intended to affect the structure and function of the body

Anyone who has an addictive personality.◦ Habits that get out of control.◦ Negative impact on health.

Moral weakness v. brain biochemistry.◦ Actions increase tolerance. Yes, some people have

more genetic predispositions to addictions!

Who is susceptible?

How Long Have Drugs Been Around?

Purpose? Function?

Where Do Drugs Come From?

How Do We Define a Drug Anyway?

Just a Bit of Drug History…

Plants were used in early humans in either of 2 ways:

1. Religious Ceremonies ( People believed that be consuming the drug they could communicate with God)

2. A Plant or its extract was used Medicinally

The First Drugs Came from Plants

The part of the plant for pharmalogical effect is called the ACTIVE INGREDIENT

Examples: Morphine and Codeine are Active Ingredients of the plant Opium

They are NARCARTIC analgesics

Active Ingredient

Digitalis (Otherwise Known as Foxglove)The active ingredient here is Digitoxin, a

heart medicine.

TODAY…Still, most medicine comes from Plants…..Pretty Flowers Give Heart Medicine

Peyote

Known to the Aztecs , who considered this hallucinogen a divine messenger.

In 1692, Indians established the mission El Santo de Jesus Peyotes

Slice and Dry Buttons/ 4-12 are ingested At ritual…Period of meditation followed

by periods of nausea and vomiting BUT they would see>>> VISIONS of Kaleidoscopes of jewels ( Lasts 6-10 hours)

Peyote: A Trip

Best and Banting discovered they could make dogs diabetic by surgically removing their pancreases

Then curing the dogs by injecting them with extracts from the pancreas ie. Insulin.

BEEF and PORK pancreas are sources for most of insulin sold today.

Animal Sources Too

Any drug that alters your state of mind.◦ Your perceptions.◦ Your experience.

Natural or man-made

What are psychoactive drugs?

Drug Abuse involves behavior addiction as well as chemical addiction.

Psychoactive Drug- a drug that alters one’s state of consciousness or can causes intoxication.

Addictive Behavior- are behaviors that have gotten out of control , with resulting negative effects on one’s health. All psychoactive drug are addictive because of the way they work in the brain.

Drug Abuse

Tolerance- A physical adaptation of a substance that causes it to become less effective with repeated use. YOU NEED MORE EACH TIME TO GET THE SAME EFFECT!

Dependence- Occurs when person is so physically attached to drug she/he can’t live comfortably with/out it. See APA criteria in text. This person has withdrawal when drug is taken away

Withdrawal- Physical symptoms such as nausea, tremors …pain…can be dangerous.

Drug Terms

Intravenous injection, also called Mainlining (Most Effective Way)

Subcutaneous- under the skin Dermal or subdermal absorption-

(topical) can be placed on a stamp or suppository. LSD .

Swallow ( pill) Smoke it Inhale it

Different Ways To Take Drugs

1. Pharmacological Properties : of the drug its overall effects on a person. This includes how it effects the person’s body chemistry, behavior and psychology.

How Drugs Affect The Body: Drug Factors: (5)

2) Dose-response Function- Relationship between dose taken and intensity of effect.

3) Time-Action Function- How much time has elapsed and the intensity of effect.

)

Cont. of Drug Factors

4) Drug Use History- Influences the effects of and response to a drug. ( Meaning that the user may have to refrain from using a drug for a while to get the same effect from a given dosage)

5) Method of Use- Affects the strength of response ( swallow pill , inhale smoke or IV

Cont. of Drug Factors

The Neuron

STRUCTURE and FUNCTION NEURONS/ The Synaptic Cleft

Neurotransmitter - A chemical messenger released from the synaptic terminal of a neuron at a chemical synapse that diffuses across the synaptic left and binds to and stimulates the post-synaptic membrane.

Examples of neurotransmitters are

epinephrine, dopamine, seratonin and acetylcholine. 

 When in the neuron, neurontransmitters are stored in vessicles.

 

NEUROTRANSMITTERS

Most drugs of abuse seem to activate “reward” circuit(s) in the brain◦ Dopamine is a (the) principle one◦ Reward circuit(s) important for normal

functioning & learning Food, sex, & other necessary activities that are

enjoyable (interacting with others, mastering a task, etc.)

All (most) behavior is channeled through these reward circuit(s) – do not have completely difference systems for sex, hunger, etc.

Recent research suggests that it is possible to separate systems – “liking” vs. “wanting”◦ “Liking” - system responsible for pleasure◦ “Wanting” – system that drives behavior

Drugs & Reward

Most drugs, natural and synthetic , work on specific neurotransmitter systems of the brain.

Cocaine and amphetamines block reuptake of dopamine

Benzodiaepine tranquilizers work by binding and AUGMENTING the natural action of receptors for the inhibitory neurotransmitter.

SSRIs like Prozac work by inhibiting reuptake of released serotonin

So How To Drugs Work?

Different Drugs have different “receptor sites” in the Brain for the NT.

NT gives a Euphoria at the site in brain.

This is often thought of as a “reward pathway”.

From Synapse to Receptor Site

It is believed that cocaine boosts dopamine release and blocks its reuptake by dopamine transporters. This leaves more dopamine saturating synaptic clefts to overstimulate critical brain sites which cause the sensation of euphoria.

How Cocaine Causes Euphoria

How Ecstasy Works

Ecstasy affects neurons that produce the neurotransmitter called SEROTONIN.

Normally, Serotonin, stored in vesicles, is released into synapse at a “progressive rate”. The this chemical is then absorbed by receptors of the adjacent neuron which causes an electrical signal to propagate. The appropriate area of the brain is stimulated.

How Ecstasy Works

When Ecstasy is taken… 1. all of the serotonin in vesicle is released at once. This floods the synapse. 2. Then uptake serotonin receptors are blocked to that Serotonin remains in synapse. Now the NT can work longer on pleasure area of the brain.

Types◦Psychoactive – alters mood or

consciousness; affects neural functioning◦Non-psychoactive – e.g., antibacterial

Classes of psychoactive drugs◦Sedative-Hypnotics

E.g. Barbiturates, Anti-anxiety, alcohol Reduce anxiety (low), sedation (medium), anesthesia

(high)

◦Behavioral Stimulants and Consultants E.g. Amphetamines, Cocaine, Caffeine, Nicotine Increase activity (increase motor activity or counter

fatigue)

Drug Types

Classes of psychoactive drugs◦Narcotic Analgesics E.g., Opium, heroine, morphine, codeine Relieve Pain

◦Antipsychotic Agents E.g., Lithium, haloperidol, reserpine Used to treat schzophrenia

◦ Psychedelics and Hallucinogens E.g., LSD, Marijuana, MDMA (Ecstasy) Alter sensory perception and cognitive processes

Drug Types

Nutt et al. (2007) – The Lancet◦ Two sets of experts rate drugs on dimensions of

harm Physical Harm – acute, chronic, Intravenous Dependence – pleasure intensity, psychological

dependence, physical dependence Social Harm – Intoxication, other social harm, health-

care costs

Drug Harm

At low doses it acts as a stimulant, at higher doses it acts as a sedative.

does not cause a high, but rather, modulates emotions.

Stimulates the amplified release of three neurotransmitters: dopamine, epinephrine and norepinephrine.

What Kind of Drug is Nicotine?

Psychoactive substances and their potential for producing dependence

Another group of abused drugs. Amphetamines: synthetic stimulants. Effects: ALERT, less fatiqued or bored and

INCREASED motor activity. Increased heart rate and BP, decreased

appetite. Examples: Methadrine, Speed, Crack. Cocaine Dependence: Tolerance is achieved even after

moderate doses. Long-term users can suffer brain damage similar to Parkinson’s disease.

Central Nervous System Stimulants (Uppers)

 Effects:• heartbeat accelerates• blood pressure rises• blood vessels constrict• gastric & adrenal secretions increase

• greater muscular tension• increased motor activity

Stimulants

Ritalin◦ Common treatment of ADHD and ADD.

Ephedrine◦ Found in Chinese herbal tea.◦ “Herbal ecstasy”◦ Common in weight loss and driver stimulant products.

Caffeine◦ The most commonly used psychoactive drug in US.◦ Coffee, tea, cocoa, soft drinks.◦ Does sugar cause psychological disorders?

Stimulant’s (continued)

Repeated use of amphetamines leads to tolerance.

Psychosis is a possible consequence of a person of high doses; a temporary state of severe paranoia; with delusions of persecution and unprevoked violence.

Bottom Line: You can easily get hooked on uppers.

Dependence on Stimulants

How Neurotransmitter Systems Work

How Different Drugs ExertTheir Effect on NeurotransmitterSystem

Slow nervous system down• alcohol• tranquilizers• barbiturates

Effects -• reduce anxiety• mood changes• slurring of speech• drowsiness, sleep

sedatives - hypnotics

CNS Depressants:

Tranquilizers, Barbituates ( Valium, Librium…Street names..Reds, Ludes for Methaqualude)

Effects: Slow nerve activity, cause relaxation, sleep and relax muscle tension.

Tolerance is achieved quickly. Alcohol and depressants…a deadly

combination…can be.

Depressants (Downers)

A drug made from or chemically similar to opium. Opium comes from poppy plant.

Reduce pain and induce sleep and induce euphoria.

Heroin, Morphine, Darvon, and Demoral, codeine.

Heroin is usually injected and tolerance is achieved easily.

Withdrawal symptoms are severe.

Narcotics (Opiods)

Refers to a group of drugs currently used at all night dance parties

Dangerous by themselves, many are tasteless, odorless and people try to assault or sedate others in cocktails.

Ecstasy ( MDMA), Rohypnol (roofies) and LSD. See list in text.

Club Drugs

Hallucinogens are drugs that dramatically alter perceptions. Some hallucinogens are produced solely by nature. These include psilocybin, found in certain mushrooms ("magic mushrooms" or "shrooms") and mescaline, the chemical found in the peyote cactus. LSD is semi-synthetic, or artificial.

Hallucinogens

LSD Psilocybin (derived from mushroom) Mescaline (component of peyote cactus) PCP, an anesthetic used in veterinary

medicine (Also called Angel dust)

Examples of Hallucinogens

LSD (lysergic acid diethylamide) was invented by a chemist in 1938 by Albert Hofmann.

Trying to create medicine out of a fungus….AND CREATED … LSD. Five years after he created it, Hofmann accidentally ingested the drug and took the first bad trip:

"A demon had invaded me," he said. "[It] had taken possession of my body, mind, and soul."

LSD TRIP may include good experiences like SYNESTASIA and…very often….terrifying experiences….

Hallucinogens

LSD works on 2 parts on the brain the cerebral cortex involved in mood, cognition and perception and the Locus ceruleus involved in sensory perception (site of synethesia)

Hallucinogens

          Serotonin is the

NT for this drug                                                                                                    

LSD

Serotonin is the NT for this drug Hallucinogens produce “Altered States of Consciousness

PCP

Cannabis sativa

Marijuana, Hashish In a class by itself … CALLED PSYCHEDELIC:

acts as stimulant, depressant, hallucinogen, and narcotic all in one!!

Tetrahydrocannabinol (THC) (Active Ingredient): But over 400 chemicals found; 60 unique to Cannabis plant.

Effects: Relaxation, euphoria, time-perception slowed, laid-back attitude.

Cannabis sativa

THC acts on cannaboidreceptorswhich are found on neurons in many places in the brain. These brain areas are involved in memory (the hippocampus), concentration (cerebral cortex), perception (sensory portions of the cerebral cortex) and movement (the cerebellum, substantia nigra, globus pallidus). When THC activates cannabinoid receptors, it interferes with the normal functioning of these brain areas.

O

OH

tetrahydrocannabinol (THC)

Cannabis Action on the Nucleus AccumbensPromotes Dopamine Release

THC , by binding to these receptors, stimulates them to abnormally, release unusually large amounts of dopamine, a NT, into the synapse.

What Does THC DO at When it Binds to the Cannabinoid Receptor?

                       

                                                                   

Many neurons can be activated through the THC pathway.

Complex Pathway.

What Does THC DO at When it Binds to the Cannabinoid Receptor

Distorted perception (sights, sounds, time, touch)

Problems with memory and learning

Loss of coordination

Trouble with thinking and problem-solving

Increased heart rate, reduced blood pressure

Short term Effects Of Marijuana Use

WELL, you get similar addictive results ….. as most psychoaddictive Drugs

BUT BECAUSE THIS STUFF IS USUALLY SMOKED……

Let’s add a few concerns……. If you smoke too much; lots of carcinogens

more than cigarettes! Increases risk for lung cancer

UK in 2009 changed this from C to B category drug WHY???….Increases risk of Schizophrenia by 40% . Large Study done.

Long Term Effects of Marijuana Use

CLUSIONS: Long-term heavy cannabis use in healthy individuals is associated with smaller cerebellar white-matter volume similar to that observed in schizophrenia. Reduced volumes were even more pronounced in patients with schizophrenia who use cannabis. Cannabis use may alter the course of brain maturational processes associated with schizophrenia.

STUDIES SHOW…..

Anabolic steroids are MALE HORMONES.

Promote tissue growth and lead to muscle growth.

Adverse side effects including development of breasts, hair loss, and …yes, CANCER. DARE TO ASK…WHY???

Anabolic Steroids

What is the basic structure of a steroid?

What are some steroids found in nature?

Notes:

Inhalants

Cause a quick rush to the brain. Solvent, aerosols, anesthetics, nitrates. Such as

paint thinners, solvents, glue. Loss of inhibition, slurred speech, motor

coordination, loss of consciousness.Can cause serious damage to many organs

including brain, kidneys, heart and liver etc. High conc. Of inhalants can cause suffocation…death

SSD (Sudden Sniffing Death) If person inhales too long or is startled or participates in physical activity- instant death.

Inhalants

Teratogen

T Serotonin is the NT for this drug Hallucinogens produce “Altered States of

Consciousness his is a your sense of body position and movement .

Some drugs distort your sense of proprioception.

You may feel as if you are floating. It can happen with some hallucinogens. Example PCP “angel dust”

Proprioception

Seeing different colors, hearing things; Mixing of sensory messages.

Synesthesia

Increased responsiveness to same dose of drug◦ More likely with occasional drug use◦ Context is important

Sensitization seems to occur when taken in novel environments

◦ Very long lasting Evidence that sensitization may be due to dendrite

growth

Sensitization

This phenomenon may occur during use of UPPERs ( CNS stimulants).

During drug use the person is in one psychological state and information learned during that state may not be recalled when the drug user is off of the drug.

State Dependence

Perceptual distortions and hallucinations that occur days or even weeks after the drug has been eliminated from the body.

Flashbacks

This is when a person receives an INERT , That is ….no drug…no nothing…inactive ingredient… that doesn’t react with your body.. AND…… ( here’s where it becomes placebo….. YOU GET A RESPONSE from it as if it were an ACTIVE DRUG..

Placebo Effect?

Blood Brain Barrier1. Large molecules do not

pass through the BBB easily.

2. Fat Insoluble molecules do not penetrate into the brain. However, lipid soluble molecules, such as barbituate drugs, alcohol rapidly cross through into the brain.

3. Molecules that have a high electrical charge are slowed.

Allows nurishment to fetus Not Nearly as protective as Blood Brain

Barrier (BBB) as……. Fat INSOLUBLE DRUGS have an EASY

TIME PENETRATING THIS MEMBRANE!

The Placental Barrier

Teratogen- anything, but usually refers to a chemical, that causes developmental damage to a fetus.

Teratogen

Is a complex disorder associated with the idea that one is in the process of becoming addicted to a substance

There are 7 specific criteria that the APA has established for DD.

Drug Dependence

 1. Sudden withdrawal2. Rebellion or irritable behavior3. Loss of interest in usual activities4. Decline in school performance5. Sudden change in group of friends6. Changes in sleep or eating habits7. Borrowing or stealing money

Signs of drugs dependence- (in others)

Signs of drugs dependence in yourself

1) Use drug on regular basis?2) Always use it in certain situations? With certain people?3) Is it difficult to stop? 4) Do you need larger doses as time goes

by?5) Do you take it to feel normal?6) Do you go to extreme lengths to get it? Do you put yourself in dangerous

situations?7) Do you hide your use from others?8) Do you scheme to be high when you're

not?9) Do you feel bad if you stop taking it?10) Does it interfere with or guide your

life?

1) Developing TOLERANCE- When a person requires increased amounts of drug to get high.

2) Experiencing Withdrawal- Without drug, person experiences both physical and cognitive symptoms such as tremors, depression etc.

3) Taking drug in larger amounts over time4) Spending a great deal of time acquiring

drug5) Giving up or reducing an important social,

school or work due to substance abuse.6) Continuing to use the substance in spite of

recognizing that it is contributing to a psychological or physical problem.

Criteria For Drug Dependence Established by APA

STOP