Lecture 4: Substance Abuse Class Notes (Sept 23) PDF

1 2 In her own words: “Chase” “Need” “Snorting”, “inject intravenous” “Hooked” “Dope sick” 3  Addiction: Substance Use Disorder Elements to Substance Use Disorder - Euphoric “rush”...

1 2 In her own words: “Chase” “Need” “Snorting”, “inject intravenous” “Hooked” “Dope sick” 3  Addiction: Substance Use Disorder Elements to Substance Use Disorder - Euphoric “rush” - Effective delivery techniques - Potency and dose of substance - Cravings - Avoidance of withdrawal - Adaptations in neurobiology and neuropharmacology - Environment - Genetics ~ 40-60% of vulnerability to developing an addiction is due to genetics - for example D2 (autoreceptor) receptor deficiency 4  Addiction: Substance Use Disorder Historically viewed as a disease of “weak personality” - not accepted as a disease of the brain “Certain individuals use certain substances in certain ways thought at certain times to be unacceptable by certain other individuals for reasons both certain and uncertain” – Berglass and Schaefer 1984 (“Drug Abuse”) “A chronically relapsing disorder, characterized by compulsion to seek and take the drug, loss of control in limiting intake, and emergence of a negative emotional state (e.g., dysphoria, anxiety, irritability) when access to the drug is prevented” – Koob and Volkow, 2016 5  According to the American Psychiatric Association there are 10 classes of drugs linked to substance-related disorders: 1. Alcohol 2. Caffeine 3. Cannabis 4. Hallucinogens 5. Inhalants 6. Opioids 7. Sedative-hypnotic and anxiolytic 8. Stimulants 9. Tobacco 10. 0ther substances 6 7 BREAKING NEWS Schedule III doesn't legalize marijuana - means it has recognized a medical benefit - facilitates research - IR S tax deductions will exist for cannabis companies - does not legalize federally (unlike tabaco and alcohol) - possibly completed by November 8  Progression in Drug Use Gateway theory - transition from legal substances to others with higher abuse potential - alcohol, tobacco, prescriptions # of people - marijuana - cocaine, heroin, etc.. 9  Progression in Drug Use Escalation and pattern use theory - change amount taken and pattern of use over time for drugs with abuse liabilities - feeling of reward/pleasure with initial uses - preoccupation/anticipation of use - Need to take in larger amounts - periods of drug intoxication (tolerance) (potential bingeing) - Addiction can be defined by behaviors: - withdrawal and negative affect (depressed mood, irritability) Craving (strong urge to take the drug) Chronic relapsing 10  Elements of Substance Use Disorder Positive Reinforcement - the substance has to induce some sort of “reinforcing” effect to want to use again THE RUSH 1858 (invention of syringes) Factors that contribute to THE RUSH Drug properties Delivery mechanisms - purity - need “quick hit” to the brain - potency - intravenous (