Chapter13

Addictive Behavior Addictive Behavior

Chapter 13

ObjectivesObjectives Address the detrimental effects of addictive substances,

including marijuana, cocaine, methamphetamine, MDMA, heroin, and alcohol.

List the detrimental health effects of tobacco use in general.

Enumerate the reasons people smoke. Recognize cigarette smoking as the largest preventable

cause of premature illness and death in the U.S. Explain the benefits and the significance of a smoking-

cessation program. Learn how to implement a smoking-cessation program, to

help yourself (if you smoke) or someone else go through the quitting process.

Find out if you’re prone to addictive behavior. Plan for a drug-free future (including freedom from

tobacco use).

AddictionAddiction Addiction: Compulsive and

uncontrollable behavior(s) or use of substance(s) Psychotherapists describe addiction as a

problem of imbalance or unease within the body and mind

Almost anything can be addictive Most serious form is chemical dependency

on drugs such as tobacco, alcohol, cocaine, methamphetamine, MDMA, heroin, marijuana, or prescription drugs

Illicit Drug Use Among Illicit Drug Use Among Americans Aged 12 and Americans Aged 12 and Older, 2008Older, 2008

Risk Factors for AddictionRisk Factors for Addiction Common factors that predispose people to addiction

1. The behavior is reinforced.2. The addiction is an attempt to meet a basic human need.3. The addiction seems to temporarily relieve stress.4. The addiction results from peer pressure.5. The addiction can be present within the person's value

system.6. The addiction is an escape from the pain or the fear of

disfigurement.7. The addict feels pressured to perform or succeed.8. The addict has self-hate.9. Heredity may dictate susceptibility to some addictions.10. Society allows the addiction.

Most people with addictions deny their problems All forms of addiction are unhealthy

Drugs and DependenceDrugs and Dependence A drug is any substance that alters the

user’s ability to function Over-the-counter drugs Prescription medications Illegal substances

Many drugs lead to physical and psychological dependence

Drugs and DependenceDrugs and Dependence Any drug can be misused or abused

Misuse the intentional and inappropriate use of

over-the-counter or prescribed medications; for example, taking more medication than prescribed or mixing drugs

Abuse the intentional and inappropriate use of a

drug resulting in physical, emotional, financial, intellectual, social, spiritual, or occupational consequences of the abuse

The body often develops tolerance to drugs, requiring a higher dose with subsequent use

Nonmedical Use of Nonmedical Use of Prescription DrugsPrescription Drugs

Millions of Americans aged 12 or older reported nonmedical use of psychotherapeutic drugs at some point in their lifetime.

The most commonly abused prescription medications are: Opioids, prescribed to treat pain

codeine and morphine. Central nervous system depressants, used to treat

anxiety and sleep disorders Mebaral, Nembutal, Valium, and Xanax.

Stimulants, prescribed to treat the sleep disorder narcolepsy, attention-deficit hyperactivity disorder (ADHD), and obesity

Dexedrine, Adderall, Ritalin, and Concerta.

Drugs and DependenceDrugs and Dependence About 80% of federal and state inmates have

abused drugs Approximately 60% of the world’s production

of illegal drugs is consumed in the U.S. Americans spend more than $65 billion each

year on illegal drugs Today’s drugs are stronger and more addictive,

and pose a greater risk than ever before NSDUH report that 20% of the population aged

12 or older, or almost 50 million Americans, report nonmedical use of psychotherapeutic drugs

Cannabis sativaCannabis sativa Marijuana is the most

widely used illegal drug in the U.S.

Low doses yield a sedative effect

Larger doses produce physical and psychological changes

THC is the mind-altering ingredient

MarijuanaMarijuana Some short-term effects include

Tachycardia, difficulty in concentration, decreased coordination and tracking, short-term memory impairment, intermittent confusion, increased heart attack risk, and amotivational syndrome

Long-term effects include brain atrophy, less resistance to infectious

diseases, chronic bronchitis, lung cancer, possible sterility and impotence

Powdered CocainePowdered Cocaine Can be sniffed, snorted,

smoked, or injected Crack is smokable form

Popularity based on the almost immediate feeling of euphoria

At least 25% of first time users will become addicted in 4 years

Sustained snorting can lead to a constant runny nose, nasal congestion & inflammation, perforation of the nasal septum

CocaineCocaine Initial high

Alleviates fatigue, raises energy, decreases need for food and sleep

Then comes the “crash” Physiological and psychological depression leaving a desire

for more Long-term consequences include

Digestive disorders, weight loss, malnutrition, insomnia, anxiety, cocaine psychosis (“coke bugs”)

Large overdoses can cause sudden death from respiratory paralysis, cardiac arrhythmias, and severe convulsions

MethamphetamineMethamphetamine Fastest growing drug problem in the U.S. A central nervous system stimulant Primary effect

Produces a feeling of well-being, decreases appetite, increases motor activity, decreases fatigue and need for sleep

Chronic users experience Hallucinations, inflammation of the heart lining,

schizophrenia-like mental disorder, and brain cell damage Users are frequently involved in violent crime,

homicide, and suicide

MDMA (Ecstasy)MDMA (Ecstasy) A stimulant and hallucinogenic drug Users may experience faintness, blurred vision, chills,

sweating, nausea, muscle tension, and teeth-grinding The user’s risk of death is heightened at dance clubs

and raves because the crowded atmosphere combined with the stimulant effects causes dehydration

Long-term side effects include confusion, depression, sleep disorders, anxiety, aggression, paranoia, impulsive behavior

Verbal and visual memory impairment may remain for years after prolonged use due to depleted serotonin in the brain

HeroinHeroin Induces an almost immediate state of

euphoria A sedative drug Overdose can cause convulsions, coma,

death Withdrawal sets in about 4-5 hours after

taking the drug Withdrawal is painful and lasts up to 2

weeks or for several months

HeroinHeroin Short-term use symptoms include

Bone and muscle pains, muscle spasms and cramps, runny nose and eyes, drowsiness, slurred speech, nausea, and violent yawning

Long-term symptoms include Hallucinations, nightmares, constipation, sexual

difficulties, impaired vision, reduced fertility, collapsed veins, and increased risk for lung, liver, and cardiovascular diseases, including bacterial infections in blood vessels and heart valves

SIDS is more frequently seen in children born to addicted mothers

AlcoholAlcohol Alcohol is the cause of one of the

most significant health-related drug problems in the U.S. today

Alcohol intake impairs peripheral vision, decreases visual and hearing acuity, slows reaction time, reduces concentration and motor performance, and causes impaired judgment of distance and speed of moving objects

Alcohol use also lessens fear, increases risk-taking behaviors, stimulates urination, and induces sleep

Consequences of Drinking Consequences of Drinking AlcoholAlcohol

The synergistic action of alcohol when combined with other drugs, especially central nervous system depressants, is one of the most unpleasant, dangerous, and life-threatening effects of drinking

Long-term effects of alcohol abuse are serious and life-threatening cirrhosis (scarring of the liver) greater risk for oral, esophageal, and liver cancer cardiomyopathy (disease affecting the heart muscle) high blood pressure and higher risk for strokes inflammation of the esophagus, stomach, small intestine, and pancreas stomach ulcers sexual impotence birth defects Malnutrition brain cell damage causing memory loss depression, psychosis, and hallucinations

Long-term risks associated with Long-term risks associated with alcohol abusealcohol abuse

Alcohol on CampusAlcohol on Campus Alcohol is the number one drug problem

among college students Surveys found that 45% of students

engaged in binge drinking (5 or more drinks in a row)

Alcohol is a factor in about 28% of all college dropouts

Full-time college students aged 18-22 are more likely to use alcohol, binge drink, and drink heavily than part-time students

Average number of drinks by college Average number of drinks by college students per week by GPAstudents per week by GPA

Alcohol on CampusAlcohol on Campus More than 50% of students participate

in games that involve heavy drinking (5 or more drinks in one sitting)

Excessive drinking can lead to unplanned and unprotected sex (risking HIV infection), date rape, and alcohol poisoning

How to Cut Down on How to Cut Down on DrinkingDrinking

Suggestions that may help you cut down your alcohol intake Set reasonable limits - do not exceed a

certain number of drinks Learn to say “no” Drink slowly, don’t gulp your drink Dilute your drinks Do not drink on your own

Treatment of AddictionsTreatment of Addictions Recognize that there is a problem Recovery almost always requires professional help Consult a physician, counseling center, or local

mental health clinic Contact the Substance Abuse and Mental Health

Services Administration at 1-800-662-HELP for referral to 24-hour substance abuse treatment centers in your area

Information is available on the Internet at http://www.samhsa.gov

Intervention and treatment include psychotherapy, medical care, and behavior modification

Tobacco UseTobacco Use When tobacco leaves are burned, hot air and

gases containing tar and nicotine are released in the smoke More than 4,000 toxic chemicals have been

found in tobacco smoke and 69 are proven carcinogens

Harmful effects of tobacco use became known in the 1960s In 1964, the U.S. Surgeon General issued the

first major report stating that cigarettes were a major health hazard in our society, at which time more than 42% of the adult population smoked

Tobacco UseTobacco Use In 2006, 21% of adults

and 20% of high school seniors smoked cigarettes

As education increases, tobacco use declines

Morbidity and MortalityMorbidity and Mortality The World Health Organization estimates

that 10% of the 6 billion people presently living will die from smoking-related illnesses

Tobacco, a legal drug, kills 23 times as many people as all illegal drugs combined

Cigarette smoking is the largest preventable cause of illness and premature death in the U.S.

Critical ThinkingCritical Thinking Do you think the government should

outlaw the use of tobacco in all forms? Or does the individual have the right to engage in self-destructive behavior?

Morbidity and MortalityMorbidity and Mortality Smoking is the most prevalent cause of

injury and death from fire Average life expectancy for a chronic

smoker is 13-14 years shorter than for a nonsmoker

Smoking is responsible for more than 470,000 unnecessary deaths each year

Each cigarette shortens life by 7 minutes

Effects on Cardiovascular Effects on Cardiovascular SystemSystem

More than 30% of fatal heart attacks result from smoking

Risk for heart attack is 50%-100% higher for smokers than for nonsmokers

Smokers have a higher mortality rate following heart attack than nonsmokers because their heart attacks are usually more severe and they have greater risk for deadly arrhythmias

Effects on Cardiovascular Effects on Cardiovascular SystemSystem

Smoking affects the cardiovascular system by increasing heart rate, blood pressure, susceptibility to atherosclerosis, blood clots, coronary artery spasm, cardiac arrhythmia, and arteriosclerotic peripheral vascular disease

Smoking decreases HDL-cholesterol Cigarette smoke contains carbon monoxide, which reduces the

blood’s oxygen carrying capacity Carbon monoxide and nicotine can cause damage to the arterial

walls, enhancing atherosclerosis Smoking causes increased adhesiveness and clustering of blood

platelets, increasing blood thickness Any of these effects can precipitate a heart attack

Smoking and CancerSmoking and Cancer 87% of lung cancer is attributable to

smoking Lung cancer is the leading cancer killer,

accounting for about 30% of all deaths from cancer

Cigarette smoking also leads to chronic lower respiratory disease, the 3rd leading cause of death in the U.S.

Normal and Diseased Normal and Diseased Alveoli in LungsAlveoli in Lungs

Normal lung (left) is contrasted with diseased lung (right). The white growth near the top of the diseased lung is cancer; the dark appearance on the bottom half is emphysema

Smoking and CancerSmoking and Cancer The most common carcinogenic exposure

in the workplace is cigarette smoke Secondhand smoke causes an estimated

50,000 additional deaths each year in the U.S.

3,400 people die each year from lung cancer because of secondhand smoke

Data show there is no risk-free level of exposure to secondhand smoke

The health effects of smokingThe health effects of smoking

Critical ThinkingCritical Thinking You are in a designated nonsmoking

area and the person next to you lights up a cigarette. What can you say to this person to protect your right to clean air? And would you?

Smokeless TobaccoSmokeless Tobacco Use has increased during the last 15

years Average starting age is 10 years old Leads to health problems

Gingivitis and periodontitis Four times greater risk of oral cancer Increased cavities, sore gums, bad

breath, and stained teeth Diminishes smell and taste Increases heart rate and blood

pressure Just as addictive as cigarette

smoking

Health Care Costs of Tobacco Health Care Costs of Tobacco UseUse

Smokers use the health care system twice as much as nonsmokers

A smoking employee costs an employer up to an additional $5,000 annually

Almost 1,300 Americans die from smoking-related illnesses every day. How is this tolerated?

Why People SmokeWhy People Smoke The 3 fundamental instigators are

Peer pressure Desire to appear “grown up” Rebellion against authority

Smoking only 3 packs of cigarettes can lead to physiological addiction Its stimulating effect produces strong

physiological and psychological dependency. Six to eight times more powerful than the

addiction to alcohol.

““Why Do You Smoke?” Why Do You Smoke?” TestTest

The National Clearinghouse for Smoking and Health developed the “Why Do You Smoke?” Test, Lab 13B

The scores obtained on the test assess smokers for each of 6 factors that describe individuals’ feelings when they smoke

1. Stimulation2. Handling3. Pleasure/pleasurable

relaxation4. Crutch: tension reduction5. Craving: psychological

addiction6. Habit

Cigarette smoking is the single largest preventable cause of illness and premature death in the United States

Smoking CessationSmoking Cessation Annually, only about 20% of smokers who try to quit

succeed the first time Nicotine is perhaps the most addictive drug

known to humans Between 75% and 90% of all smokers would like to

quit More than 91% of successful ex-smokers have been

able to quit on their own either cold turkey or by using self-help kits

Only 6.8% of ex-smokers have quit as a result of formal cessation programs

““Do You Want to Quit?” Do You Want to Quit?” TestTest

Most important factor in quitting is the sincere desire to do so

Those who quit easily are primarily light or casual smokers

For heavy smokers, quitting will be a difficult battle

The odds of quitting are much better for those who repeatedly try to stop

Reasons for Quitting Health -quitting

because of the harmful consequences

Example - set examples for others

Aesthetics - smell, bad breath, stains on teeth, fingers

Mastery - desire for self-control

Breaking the HabitBreaking the Habit1. Decide positively that you want

to quit2. Initiate a personal diet and

exercise program3. Decide on the approach you will

use to stop smoking Cold turkey Cutting down gradually

4. Keep a daily log of your smoking habit for a few days

5. Set the target date for quitting6. Stock up on low-calorie foods7. Quit!

Starting an exercise program prior to giving up cigarettes encourages cessation and helps with weight control during the process

Breaking the HabitBreaking the Habit Many people find that quitting all at once (cold

turkey) is the easiest way Tapering off cigarettes can be done in several ways

Eliminate cigarettes you do not strongly crave Switch to a brand lower in nicotine/tar every few days Smoke less of each cigarette Smoke fewer cigarettes each day

Nicotine substitution products These products decrease the amount of nicotine used until

the person no longer craves the drug Tips on pages 468-469

Nicotine-Substitution Nicotine-Substitution Products Products

Nicotine Transdermal Patches Deliver a steady dose of 5–21 mg of

nicotine a day. A typical program lasts 3–10 weeks at a

weekly cost of about $50. A physician should be consulted if the

individual is pregnant, lactating, has heart disease, or is hypertensive.

Undesirable effects include skin redness, swelling, and rashes.

Critical ThinkingCritical Thinking If you ever smoked or now smoke

cigarettes, discuss your perceptions of how others accepted your behavior.

If you smoked and have quit, how did you accomplish the task, and has it changed the way others view you?

If you never smoked, how do perceive smokers?

Life after CigarettesLife after Cigarettes Withdrawal symptoms should be expected

Lower heart rate and blood pressure Headaches Gastrointestinal discomfort Mood changes Difficulty sleeping

Physiological addiction is broken in about 3 days following the last cigarette

Psychological addiction takes longer, possibly years to break

Life after CigarettesLife after Cigarettes Greatest early benefit is a lower risk of

sudden death Risk for illness starts to decrease the moment

you stop smoking Sore throats, sores in the mouth, hoarseness,

cigarette cough, and risk for peptic ulcers decrease

Circulation to the hands and feet improves Gastrointestinal, kidney, and bladder

functions improve Everything tastes and smells better

Real Life StoriesReal Life Stories

Real Life Stories Real Life Stories Critical Thinking Critical Thinking QuestionsQuestions

1. Describe how today’s culture contributed to Steve’s addictive behavior. How may you as an individual make a difference so that people do not develop addictive behaviors?

2. Quitting smoking is a challenging task to accomplish. If you needed to make such a change, what approach would you use to increase your chances of success?

3. Brainstorm what you may do if a friend or loved one has developed some type of addictive behavior.