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Substance abuse

Substance abuse. Substance abuse, dependence, withdrawal, tolerance, and demographics Substance abuse, dependence, withdrawal, tolerance, and demographics

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Substance abuse Slide 2 Substance abuse, dependence, withdrawal, tolerance, and demographics Substance abuse, dependence, withdrawal, tolerance, and demographics Definitions Definitions Substance abuse is a pattern of abnormal substance use that leads to impairment of occupational, physical, or social functioning. Substance abuse is a pattern of abnormal substance use that leads to impairment of occupational, physical, or social functioning. Slide 3 Substance dependance is substance abuse plus withdrawal symptoms, tolerance, or a pattern of repetitive use. Substance dependance is substance abuse plus withdrawal symptoms, tolerance, or a pattern of repetitive use. Withdrawal is the development of physical or psychological symptoms after the reduction or cessation of intake of a substance. Withdrawal is the development of physical or psychological symptoms after the reduction or cessation of intake of a substance. Slide 4 Tolerance is the need for increased amounts of the substance to achieve the same positive psychological effect. Tolerance is the need for increased amounts of the substance to achieve the same positive psychological effect. Cross tolerance is the development of tolerance to one substance as the result of using another substance. Cross tolerance is the development of tolerance to one substance as the result of using another substance. Epidemiology and demographics Epidemiology and demographics -caffeine, alcohol, nicotine, marijuana and to a lesser extent, cocaine, amphetamines, and heroin, are the most commonly used.--- -caffeine, alcohol, nicotine, marijuana and to a lesser extent, cocaine, amphetamines, and heroin, are the most commonly used.--- Slide 5 The use of illegal substance is more common among young adults and is three times more common in males. The use of illegal substance is more common among young adults and is three times more common in males. Classes of abused substance includes stimulants, sedatives, opiods, and hallucinogens. Classes of abused substance includes stimulants, sedatives, opiods, and hallucinogens. Slide 6 Stimulants Stimulants --overview --overview Stimulants are central nervous system activators that include caffeine, nicotine, amphetamines and cocaine.--- Stimulants are central nervous system activators that include caffeine, nicotine, amphetamines and cocaine.--- Slide 7 Caffeine is found in coffee(125mg per cup), tea (65mg\cup), cola(40mg\cup), nonprescription stimulants, and diet agents. Caffeine is found in coffee(125mg per cup), tea (65mg\cup), cola(40mg\cup), nonprescription stimulants, and diet agents. Nicotine is a toxic substance present in tobacco. Cigarette smoking decreases life expectancy more than any other substance., Nicotine is a toxic substance present in tobacco. Cigarette smoking decreases life expectancy more than any other substance., Slide 8 Amphetamines are used clinically and are also drugs of abuse. Amphetamines are used clinically and are also drugs of abuse. They are medically indicated in the treatment of attention- deficit hyperactivity disorder (adhd ) They are medically indicated in the treatment of attention- deficit hyperactivity disorder (adhd ) And narcolepsy. They are sometimes used to treat depression in the elderly and terminally ill, depression and obesity in patients who do not respond to other treatments. And narcolepsy. They are sometimes used to treat depression in the elderly and terminally ill, depression and obesity in patients who do not respond to other treatments. The most common clinically used amphetamines are dextroamphetamine, methamphetamine, and a related compound, methylphenidate. The most common clinically used amphetamines are dextroamphetamine, methamphetamine, and a related compound, methylphenidate. Slide 9 -speed, ice and ecstacy { methylene dioxy- methamphetamine are street names for amphetamine compounds. -speed, ice and ecstacy { methylene dioxy- methamphetamine are street names for amphetamine compounds. Cocaine Cocaine -crack and freebase are smokable forms of cocaine: in pure form cocaine is sniffed into the nostrils -crack and freebase are smokable forms of cocaine: in pure form cocaine is sniffed into the nostrils Slide 10 -hyperactivity and growth retardation are seen in newborns of mothers who used cocaine during pregnancy. -hyperactivity and growth retardation are seen in newborns of mothers who used cocaine during pregnancy. Tactile hallucinations of bugs crawling on the skin (fornication) is seen with use of cocaine (cocaine bugs) Tactile hallucinations of bugs crawling on the skin (fornication) is seen with use of cocaine (cocaine bugs) Slide 11 Neurotransmitter associations Neurotransmitter associations --stimulant drugs work primarily by increasing the availability of dopamine. --stimulant drugs work primarily by increasing the availability of dopamine. Amphetamine use causes the release of dopamine. Amphetamine use causes the release of dopamine. -both the release of dopamine and the block of dopamine reuptake result in increased availability of this neurotransmitter in the synapse. -both the release of dopamine and the block of dopamine reuptake result in increased availability of this neurotransmitter in the synapse. Slide 12 Increased availability of dopamine in the synapse is apparently involved in the euphoric effects of stimulates and opiates. as in schizophrenia,increased dopamine availability may also result in psychotic symptoms. Increased availability of dopamine in the synapse is apparently involved in the euphoric effects of stimulates and opiates. as in schizophrenia,increased dopamine availability may also result in psychotic symptoms. Sedatives Sedatives --overview --overview --sedatives are central nervous system depressants that include alcohol, barbiturates, and benzodiazepines. --sedatives are central nervous system depressants that include alcohol, barbiturates, and benzodiazepines. Slide 13 Sedative agents work primarily increasing gaba. Sedative agents work primarily increasing gaba. Hospitalization of patients for withdrawal from sedatives is prudent. Hospitalization of patients for withdrawal from sedatives is prudent. The withdrawal syndrome may include seizures and cardiovascular symptoms. The withdrawal syndrome may include seizures and cardiovascular symptoms. Slide 14 Alcohol Alcohol Acute associated problems Acute associated problems --traffic accidents, homicide, suicide, and rape, are correlated with the concurrent use of alcohol. --traffic accidents, homicide, suicide, and rape, are correlated with the concurrent use of alcohol. Child physical sexual abuse, spouse abuse, and elder abuse are also associated with alcohol use. Child physical sexual abuse, spouse abuse, and elder abuse are also associated with alcohol use. Chronic problems Chronic problems Slide 15 Thiamine deficiency resulting in wernicke and korsakoff syndromes is associated with long term use of alcohol. Thiamine deficiency resulting in wernicke and korsakoff syndromes is associated with long term use of alcohol. Liver dysfunction, gastrointestinal problems and reduced life expectancy are also seen. Liver dysfunction, gastrointestinal problems and reduced life expectancy are also seen. Fetal alcohol syndrome (including facial abnormalities, reduced height and weight, and mental retardation) is seen in the Fetal alcohol syndrome (including facial abnormalities, reduced height and weight, and mental retardation) is seen in the Slide 16 Offspring of women who drink during pregnancy. Offspring of women who drink during pregnancy. A childhood history of problems such as attention-deficit hyperactive disorder and conduct disorder. A childhood history of problems such as attention-deficit hyperactive disorder and conduct disorder. Intoxication Intoxication Legal intoxication is defined as 0.08-0.15 percentage blood alcohol concentration, depending on individual state laws.--- Legal intoxication is defined as 0.08-0.15 percentage blood alcohol concentration, depending on individual state laws.--- Slide 17 Coma occurs at a blood alcohol concentration of 0.40-0.50 percentage in non alcoholics. Coma occurs at a blood alcohol concentration of 0.40-0.50 percentage in non alcoholics. Delirium tremens (dts) Delirium tremens (dts) Alcohol withdrawal delirium may occur during first week of withdrawal from alcohol Alcohol withdrawal delirium may occur during first week of withdrawal from alcohol Delirium tremens is life threatening: the mortality rate is about 20 percentage. Delirium tremens is life threatening: the mortality rate is about 20 percentage. Slide 18 Barbiturates Barbiturates -used medically as sleeping pills, tranquilizers, anticonvulsants and anesthetics. -used medically as sleeping pills, tranquilizers, anticonvulsants and anesthetics. Frequently used/abused barbiturates include amobarbital, pento barbital & secobarbital. Frequently used/abused barbiturates include amobarbital, pento barbital & secobarbital. Cause respiratory depression. most commonly used for suicide Cause respiratory depression. most commonly used for suicide Slide 19 Benzodiazepines Benzodiazepines --sedatives, anticonvulsants,& anesthetics. to treat alcohol withdrawal. --sedatives, anticonvulsants,& anesthetics. to treat alcohol withdrawal. Safety margin high. Safety margin high. Opiods Opiods -agents used medically as analgesics morphine and as drugs of abuseheroin -agents used medically as analgesics morphine and as drugs of abuseheroin heroin more potent heroin more potent Slide 20 Methadone Methadone Synthetic opiod used treat heroin addiction it can be taken orally Synthetic opiod used treat heroin addiction it can be taken orally Has longer duration of action Has longer duration of action Causes less euphoria and drowsiness Causes less euphoria and drowsiness Hallucinogens Hallucinogens --include lsd, pcp, canabis and mescaline. --include lsd, pcp, canabis and mescaline. Promote altered states of consciousness Promote altered states of consciousness Increased availability of serotonin Increased availability of serotonin Slide 21 Marijuana Marijuana --tetrahydrocannabinol (thc) is the primarily active compound --tetrahydrocannabinol (thc) is the primarily active compound Marijuana increases appetite and causes relaxation Marijuana increases appetite and causes relaxation Chronic use causes lung problems and amotivational syndromes Chronic use causes lung problems and amotivational syndromes Slide 22 Lsd and pcp Lsd and pcp Lsd is ingested and is pcp is smoked Lsd is ingested and is pcp is smoked They cause altered perception They cause altered perception Er findings for pcp include hyperthermia and nystagmus Er findings for pcp include hyperthermia and nystagmus Consumption of more than 20mg of pcp may cause convulsions, coma & death Consumption of more than 20mg of pcp may cause convulsions, coma & death