7. Drugs

June 24, 2015 by Dr. Tangen Leave a Comment

Diagnosing drug abuse starts with understanding the three major types of drugs.

Drugs can be beneficial or harmful, depending on the dose, duration and drive. Clearly, the proper dose for one person can be harmful to another. And many drugs are designed to be short-term treatments.

Drive and motivation are often the most important elements in determining usage. But the drugs you take can change your brain chemistry in odd ways. What was rewarding before the drug becomes less rewarding after it. People can end up taking drugs without knowing why they started or why they continue.

Here’s what is included in this lesson:

10 most common stimulants
world’s most widely used drug
why alcohol doesn’t make you feel better
why marijuana is worse than alcohol
how psychodelics can kill you

Read chapter 4 of Kalat’s Biological Psychology

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CLUSTER

SLIDES

TERMS

adrenal medulla
aerosol spray propellant
affinity
agitation
alcohol
alcohol abuse
alcoholism
amphetamines
analeptics
angel dust
anxiety
barbituates
benzodiazepines
binding
blocking
brain damage
caffeine
chronic pain
cocaine
codeine
concentrations
deadly nightshade
deliriants
depressants
depression
dissociatives
distribution
dopamine
downer
effects
elevated mood
embalming fluid = cigarette dipped in PCP
euphoria
GABA
genetic predisposition
go pills
gradual onset
grandiose ideas
half-life
hallucinations
hallucinogenics
hangovers
heroin
inhaled
inhibit reuptake
intoxicated
ionotropic receptors
jimson weed
jitters
ketamine
laughing gas or sweet air
LSD
maintenance drug
mandrake
marijuana
methadone
morphine
natural opiates
nicotine
nicotinic receptor
nitrous oxide
NMDA receptors
nutmeg
obsessive behaviors
opioids
out of body experience
oxycodone
pain relief
paranoia
PCP
physiological addiction
psychedelics
psychological dependence
rebound depression-anxiety
risk factors
Schedule I drug
Schedule II drug
schizophrenia-like symptoms
sedatives
seizures
semi-synthetic opiates
sensation seeking
serotonin
social isolation
sons of alcoholic mothers
stimulants
street names
stupor
suicidal impulses & thoughts
suicides
synthetic opiates
tolerance
toxic levels
transcendent relaxation
treatment-resistant
Type A (Type I)
Type B (Type II)
uppers
vapor
vasoconstriction
withdrawal
withdrawal symptoms
world’s most widely used drug
xanthine

NOTES

I. Stimulants
- Mostly psychological dependence
- No physiological addiction
- Also called analeptics
- Invigorating or restorative
- Effects
  - Temporary improvement in:
  - alertness, wakefulness, endurance, productivity & motion
  - Referred to “uppers”
- Increased arousal, heart rate & blood pressure
  - Perceive less need of food-sleep
  - Improved mood, less anxiety
  - Euphoria
  - Heart failure
  - Anxiety
- Most facilitate norepinephrine
  - Increase dopamine
  - Inhibit transporter (less reuptake)
- Why Taken
  - Counteract fatigue
    - Make it through work
  - Reduce sleepiness
    - Treat narcolepsy
  - Decrease appetite
    - Weight loss
    - Treat obesity
  - Improve concentration
    - work or school; treat ADHD
  - Decrease depression
    - Treatment-resistant
    - Non-typical
10 Common Stimulants
1. Xanthine
- Mild stimulants
- Make less sleepy
- Bronchodilators (was used to treat asthma)
- Caffeine Coffee & tea
- Theobromine Chocolate
- Theophylline Tea & chocolate
- Caffeine
  - World’s most widely used drug
  - Used by 85% of US daily
  - Coffee, tea, soda & tablets
  - In some medications
  - Enhance drug
  - Reduce drowsiness
2. Nicotine
- Active chemical in tobacco
- Available in:
  - cigarettes, cigars
  - chewing tobacco
  - nicotine patches
  - nicotine gum
  - electric cigarettes
- Distribution
  - Inhaled
  - Distributed quickly thru blood
  - Crosses blood-brain barrier
  - Reaches brain 10-20 secs
  - Half-life is 2 hours
- Effects
  - Most is burned when smoked
  - Enough inhaled to cause pharmacological effects
  - Amount absorbed depends on
  - Rate of inhalation: none, fast, slow
  - Type of tobacco
  - Filter
- Nicotonic Ach receptors
  - Ganglion nicotinic receptors
  - Adrenal medulla
  - Brain
  - Nicotinic receptor
- In small concentrations
  - Increases activity of receptors
  - Impacts other neurotransmitters thru in-direct mechanisms
  - Volume control
- At toxic levels
  - Muscle contractions & respiratory paralysis
- Impacts dopamine
  - Dopamine connection is addictive
  - Relaxation
  - Euphoria
- Nicotine activates SNS (sympathetic nervous system)
  - Adrenal medulla
  - Stimulates release of epinephrine
- Affinity for melanin
  - More dependence
  - Harder to stop smoking in darker-pigmented individuals
- Like cocaine
  - Repeated use reduces dopamine response to reinforcement
  - Some find it helpful to take antidepressants when quitting
3. Amphetamines
- Schedule II drug
- High likelihood for dependence
- Used under severe restrictions
- Some accepted medical use
  - High potential for abuse
- Increase NE & dopamine
  - Inhibits reuptake
  - Direct release of nonepinephrine and dopamine from vesicles
  - Pushes dopamine into synapse
  - Uses dopamine transporter
  - Goes thru cell membrane
- Experience
  - Elevated mood & euphoria
  - Alertness & concentration
  - Increased libido
  - Higher self-esteem & confidence
  - More social interaction
  - More energy
  - More awake & focused
  - Increased weight loss
  - Decreased appetite
- Also
  - Rebound depression-anxiety
  - Dilated pupils & blood shot eyes
  - Hyperactive & restless
  - Flushing & headaches (vasoconstriction)
  - Tachycardia & tremors
  - Dry mouth & itchy skin
  - Blurred vision, dizziness
  - Insomnia
  - Fever
- Symptoms
  - Talking fast & nervousness
  - Rapid eye movements
    - “the jitters,” & shifting
  - “Munchies”
  - Obsessive behaviors
  - Grandiose ideas
  - Paranoia
  - Psychosis
  - Might not sleep for several days
  - “Crash“
    - lying down on floor, go to sleep
    - in middle of activity around them
    - in middle of a sentence
  - Eventually look thin & gaunt; starved
  - Cardiac arrest and death
- Often Abused
  - Availability
  - Fast-acting effects
- Amphetamines kill better than cocaine
  - Speed is cheaper & longer lasting
  - Cocaine is an “in” drug
  - like champagne; snob appeal
- Extremely dangerous when combined with alcohol
  - Withdrawal symptoms
  - Depression
  - Appetite
  - Fatigue
  - Deep REM sleep
  - Suicidal thoughts
  - Vivid dreams
  - Agitation
  - Can last for day or months
- Used in WWII
  - Pilots got “go pills“
II. Depressants
- Depress function or activity in the brain
  - Downer
  - Pain relief
  - Sedatives
  - Muscle relaxation
- Use different pharmacological mechanism
  - Most facilitate GABA or opioid receptors
  - Inhibit glutamate
- Common depressants
  - Alcohol
  - Opioids
  - Barbituates
  - Benzodiazepines
1. Alcohol
- Effects
  - Inhibits sodium flow across cell membrane
  - More sodium in the cells expands membrane
  - Decreases serotonin activity
  - Increases dopamine activity
  - Blocks glutamate receptors
  - Facilitates GABA
Alcoholism
- Type A (Type I)
  - Fewer genetic relatives with alcoholism
  - Men and women about equally
  - Later onset (usually after 25)
  - Generally less severe
  - Gradual onset
- Type B (Type II)
  - Earlier onset (before 25)
  - More rapid onset, more severe
  - More genetic relatives with alcoholism
  - Far more men than women
- Genetic predisposition
  - 9% of population
  - Unpredictable variables
  - Quantity, frequency & regularity
- Risk factors
  - Social environment
  - Emotional health
  - Sensation seeking
  - Genetics
    - Sons of alcoholic mothers
      - After moderate drinking
      - Feel less drunk, have less body sway
      - Show less change in EEG
      - Feel less tense
      - Smaller than normal amygdala
      - Connects emotions to senses
      - Get brain chemistry back to “normal”
  - Stress
  - Gender
    - Men 2-3 times more likely
    - Women more impacted by long-term use
  - Age = Under 16
  - Hangovers
    - 50% of Chinese-Japanese have gene that slows metabolism of acetaldehyde
    - Increases effects of hangover
    - Makes hangover immediate
    - Less alcoholics
- High rate of suicide in alcoholics & drug abusers
  - Distortion of brain chemistry
  - Social isolation
  - Intoxicated (not thinking clearly)
  - 1 in 4 teen suicides is alcohol abuse related
- More crimes
  - Abuse, rape, burglaries, assaults
- Chronic use
  - Symptoms similar to mental illness when drunk
  - When not
    - Severe anxiety
    - Depression
2. Opioids
- Types
  - Natural
    - Morphine
    - Codeine
  - Semi-synthetic opiates
    - Heroin
  - Synthetic opiates
    - Methadone
- Highly additive
  - Increases release of endorphins
  - Decreases pain
  - Inhibits GABA
  - Causes increase in dopamine
  - Blocks release of norepinephrine
- Psychological dependence
- Physical addiction
  - Withdrawal not usually fatal
  - Tolerance
- Used To Treat
  - Post-operative pain
  - Cancer pain
  - Rheumatoid arthritis
- Morphine
  - Treats acute and chronic pain
  - Heart pain
  - Labor pain
  - Lasts 3-4 hrs
  - Abusers don’t have a preference for morphine or heroin
- Codeine
  - Most widely used opiate
  - 3-methylmorphine
    - natural isomer of methylated morphine
  - Used To Treat
    - Mild-moderate pain
    - Relieve cough
    - Diarrhea & irritable bowel syndrome
  - Abused
    - Phenergam with codeine
    - Anti-nausea medication
- Semi-synthetic opiates
  - Oxycodone
  - Buprenorphine
  - Hydromorphone
  - Heroin
    - Diacetylmorphine or morphine diacetate
    - Synthesized from morphine
    - Schedule I drug
    - Effects
      - “transcendent relaxation”
    - Euphoria
    - Tolerance quickly develops
    - Users perceive it has different effects from morphine
      - Intense rush
      - Probably not physical; social
- Synthetic opiates
  - Meperidine/pethidine
  - Fentanyl
  - Methadone
  - Compared to morphine or heroin
    - Chemically different
    - Acts on same receptors
  - Use To Treat
    - Chronic pain
    - Maintenance drug for heroin reduction
III. Hallucinogenics
- Subjective perceptual changes
- Disrupt
  - Thinking, emotion, consciousness
  - Induce experiences
  - Not just enhance
1. Psychedelics
- LSD
  - Stimulates serotonin receptors
  - at inappropriate times
  - for longer than normal duration
- Marijuana
  - Leaves contain THC
    - intensify sensory experience
  - Impacts release of dopamine
  - Impairs ability to form new memories
  - Impairs ability to shift focus
  - Disrupts coordination and balance
  - Binds to receptors in cerebellum and basal ganglia
  - Impairs ability to learn new skills
    - Dance, sports or driving
  - Alters how info processed in hippocampus
  - Doesn’t affect breathing and heart rate as many substances
    - Only few receptors in medulla & brain stem
  - Limits firing of all neurons
    - Both excitatory and inhibitory
  - Hypothalamus doesn’t increase appetite when starving
  - Disrupts sense of time
  - Stays in system for 4 weeks
2. Dissociatives
- Feel detached from the environment
- Feel dream-like or unreal
  - “out of body”
- Don’t recognize self in mirror
  - Ketamine
  - DXM
  - PCP
  - angel dust
  - Schedule II drug
- Impacts ionotropic glutamate receptors
  - NMDA receptors
    - also inhibits nicotinic acetylcholine receptors
- Brain damage
  - Schizophrenia-like symptoms
  - “embalming fluid” = cigarette dipped in PCP
- Effects
  - Varies by dose
  - Loss of ego boundaries
  - Paranoia
  - Hallucinations
  - Suicidal impulses
- Nitrous Oxide
  - Colorless, sweet, non-flammable gas
  - Laughing gas or sweet air
  - Oxide of nitrogen
    - Oxidizer in rocketry
    - Aerosol spray propellant
  - Street names: whip-its, poppers or snappers
  - Vapor is “huffed“
  - Deprives body of oxygen
    - Euphoric effect
    - Seizures
3. Deliriants
- Examples
  - Deadly nightshade
  - Jimson weed
  - Mandrake
  - Nutmeg
- Effects
  - Stupor, confusion, confabulation
  - Disrobing and plucking
  - Conversation with imagined people
  - Don’t recognize self in mirror

QUIZ

1. Which produces dream-like or out-of-body experiences:
- a. dissociatives
- b. depressants
- c. stimulants
- d. alcohol
2. Alcohol is a(n):
- a. hallucinogenic
- b. depressant
- c. stimulant
- d. opioid
3. Which is a semi-synthetic opioid:
- a. methadone
- b. morphine
- c. heroin
- d. PCP
4. Which stimulates serotonin receptors at inappropriate times:
- a. caffeine
- b. alcohol
- c. heroin
- d. LSD
5. Analeptics are also called:
- a. psychodelics
- b. depressants
- c. stimulants
- d. opioids

For the answers: Click Here

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