Drugs Your brain is incredibly good at Psychoactive drugs ... · Marijuana Short-Term Effects ... • Impairs – memory during and between use – motor coordination – judgment

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Drugs Drug

– chemical substance that can alter structure and function of body

Psychoactive drugs

– alters behavior, thought, or perceptions

– affect nervous system, neurotransmitters

– most cross blood–brain barrier

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Your brain is incredibly good at

1. Noticing new things (“news”)

2. Adapting to these changes

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Three Laws of Drugs

1. All drugs act by changing the rate of

what’s already going on

2. All drugs have side effects

3. The brain adapts to all addictive drugs

by producing the exact opposite

effect.

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a process =

drug’s effect

b process =

brain adapts

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STATE

A

STATE

B

SETPOINT

a process =

drug’s effect

b process =

brain adapts

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STATE

A

STATE

B

SETPOINT

a process =

drug’s effect

b process =

brain adapts

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STATE

A

STATE

B

SETPOINT

2

1. Tolerance

decreased

effect with

same amount

increase

amount to get

same effect

Begin using…

continue with

same amount

ADDICTION

OVERDOSE

2. Withdrawal

Physical & psychological response when not

taking drug

– nicotine irritability

– caffeine drowsiness, headaches

– alcohol anxiety, shaking; can be fatal

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3. Abuse, Dependence, & Addiction

Addiction Dependence

•Tolerance

•Withdrawal

• Intense craving

•Use even in face

of negative

health & social

consequences

•Tolerance &

withdrawal;

normal

functioning only

when using the

drug

Abuse

•Use of the drug

continually

causes problems

Three Pillars of Addiction

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C R A V I N G

The Reward System and Addiction

Naturally occurring rewards promote survival

of self and offspring

– Food

– Water

– Sex

– Parental care

Activate brain circuits that produce dopamine

Dopamine leads to reward-seeking behavior

rewarding

on their

own

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Rat self-administers drug through needle

placed directly into brain

Needle to

reward center

3

What Is Dopamine?

Neurotransmitter, helps make pleasure very

memorable

Drives us to seek reward

Getting the reward repeatedly can lead to

addiction

dopamine

molecule

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Categories of Drugs

Depressants

Stimulants

Hallucinogens

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A. Psychoactive Drugs

1. Depressants

– Slow brain activity

– Relax and calm a user

– Cause sleep at higher doses

– examples:

• alcohol

• opioids

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Depressants Alcohol

Active ingredient = ethanol (ethyl alcohol)

In U.S., about 65% adults use alcohol

Which drink has most alcohol?

each is one

“standard drink”

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Alcohol’s Effects

arousal

inhibitions

reaction time

D

E

C

R

E

A

S

E

S

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Blood Alcohol Content (BAC)

mg alcohol per 100 mg blood

.08 = .08% of bloodstream is alcohol

Average person eliminates one standard

drink per hour

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Alcohol Usage

Moderate drinking

– Women 1 per day; men 2 per day

Heavy drinking

– Women 8+/week

– Men ≥ 15+/week

Binge drinking

– For men, 5 or more drinks in single occasion

– For women, 4 or more drinks in single

occasion 99

Alcohol Usage

• 30% don’t drink

• 30% drink <1/wk

• Top 10% drink

more than half of

all alcohol in

given year

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Alcohol: Factors Affecting Absorption

1. Food consumption

– Slows down, doesn’t prevent

2. Body weight and build

3. Gender

– Lower enzyme activity in women

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Alcohol: Biological Effects

Breathing, heartbeat

Vision

Self-control, decision making,

movement

Balance, coordination

Memory

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Alcohol: Biological Effects

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Alcohol: Biological Effects

Tolerance

– chronic use more liver enzymes to

break it down

Withdrawal

– Severe cravings

– Delirium tremens (“the DTs”)

• Shaking, hallucinations, seizures

Physical Dependence & Addiction

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5

Alcohol-Related Diseases

Heart disease

Cancer: mouth, throat, etc.

Liver diseases: cirrhosis, alcoholic hepatitis

healthy liver cirrhosis 107

1. Individual response to alcohol

2. Personality traits (e.g., impulsive)

3. Influence of social group

Alcoholism Risk Factors:

Psychological & Social

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Alcoholism Risk Factors: Genes

Alcoholism can be inherited

No evidence of one specific gene that causes alcoholism

Environmental factors work with genes to create risk

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Alcoholism Risk Factors: Genes

What is inherited?

– Break down alcohol faster

– Higher tolerance

BUT….

Most children of alcoholic parent DO NOT develop alcohol problems

Some genes may prevent alcoholism

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Opiates (Narcotics)

From opium poppy

Act on opioid receptors

Medical uses = pain relief

Psychological effects = euphoria (intense

excitement & happiness)

Natural: opium, morphine, codeine

Semi-synthetic: heroin, OxyContin

Synthetic: fentanyl

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Morphine

1803 - morphine separated from opium

1856 - development of hypodermic needle

• Use became widespread

• Used during Civil War for injuries (dependence known as “soldier’s disease”)

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Heroin

Heroin

– 1874 - first made

– 1898 - sold as cough medicine

– Why “heroin”?

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Heroin Products

An asthma medicine

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Heroin

Injected, smoked, snorted

Often “cut” with other substances

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Heroin

Short-term effects

– Euphoria, flushing of skin

Long-term effects

– Addiction

– Collapsed veins

– Organ damage

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Why is fentanyl so deadly?

On the left, a lethal dose of heroin;

on the right, a lethal dose of fentanyl 139

Stimulants

mood

alertness

blood pressure

heart rate

fatigue

appetite

– examples:

• Caffeine, nicotine, cocaine

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Stimulants

Caffeine

Found in coffee, tea, soft drinks,

chocolate, some nuts, and some medicines

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Caffeine

Found in > 60 plants

Most commonly used drug in world

Blocks adenosine (drowsiness)

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Caffeine in Selected Drinks

0

50

100

150

200

250

300

350 330

230

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54 47 47 35 18 C

AFFEIN

E I

N M

ILLIG

RA

MS

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Caffeine

500-600 mg/day probably OK

Excess anxiety, insomnia, fast heartbeat

Linked with osteoporosis, miscarriage

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2. Stimulants

Nicotine

Active ingredient in tobacco

A tobacco leaf

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Nicotine

Tobacco products

– Cigarettes, cigars,

pipes

– “Dip”

– Chewing tobacco Cans of “dip” Chewing

tobacco

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Nicotine

Rates

Adult cigarette smokers =

HS smokers =

Smoking is higher among:

– Males

– 25-64

– No HS diploma

– Below poverty level

15.1%

8%

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Chemicals in Cigarettes

More than 4000 chemicals in smoke

Some are for flavor, but also to increase

effect of nicotine

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Cancer Causing Chemicals

Identified in Cigarettes

Acetaldehyde

Acetamide

Acrylamide

Acrylonitrile

2-Amino-3,4-dimethyl-3H-imidazo[4,5-f]quinoline (MeIQ)

3-Amino-1,4-dimethyl-5H-pyrido [4,3-b]indole (Trp-P-1)

2-Amino-l-methyl-6-phenyl-1H-imidazo [4,5-b]pyridine (PhlP)

2-Amino-6-methyldipyrido[1,2-a:3',2'-d]imidazole (Glu-P-1)

3-Amino-l-methyl-5H-pyrido {4,3-b]indole (Trp-P-2

2-Amino-3-methyl-9H-pyrido[2,3-b]indole (MeAaC)

2-Amino-9H-pyrido[2,3-b]indole (AaC)

4-Aminobiphenyl

2-Aminodipyrido[1,2-a:3',2'-d]imidazole (Glu-P-2)

0-Anisidine

Arsenic

Benz[a]anthracene

Benzene

Benzo[a]pyrene

Benzo[b]fluoranthene

Benzo[j]fluoranthene

Benzo[k]fluoranthene

Benzo[b]furan

Beryllium

1,3-Butadiene

Cadmium

Catechol (1,2-benzenediol)

p-Chloroaniline

Chloroform

Cobalt

p,p'-DDT

Dibenz[a,h]acridine

Dibenz[a,j]acridine

Dibenz(a,h)anthracene

7H-Dibenzo[c,g]carbazole

Dibenzo(a,e)pyrene

Dibenzo(a,i)pyrene

Dibenzo(a,h)pyrene

Dibenzo(a,i)pyrene

Dibenzo(a,l)pyrene

3,4-Dihydroxycinnamic acid (caffeic acid)

Ethylbenzene

Ethylene oxide

Formaldehyde

Furan

Glycidol

Heptachlor

Hydrazine

Indeno[1,2,3-cd]pyrene

IQ 92-Amino-3-methyl-3H-imidazo[4,5-f]quinoline)

Isoprene

Lead

5-Methyl-chrysene

2-Naphthylamine

Nitrobenzene

Nitrogen mustard

Nitromethane

2-Nitropropane

N-Nitrosodi-n-butylamine (NDBA)

N-Nitrosodi-n-propylamine (NDPA)

N-Nitrosodiethanolamine (NDELA)

N-Nitrosodiethylamine (DEN)

N-Nitrosodimethylamine (DMN)

N-Nitrosoethylmethylamine (NEMA, MEN)

4-(N-Nitrosomethylamino)-1-(3-pyridinyl)-1-

butanone (NNK)

N'-Nitrosonornicotine (NNN)

N-Nitrosopiperidine (NPIP, NPP)

N-Nitrosopyrrolidine (NPYR, NPY)

Polonium-210 (Radon 222)

Propylene oxide

Safrole

Styrene

Tetrachloroethylene

o-Toluidine (2-methylaniline)

Trichloroethylene

Urethane (carbamic acid, ethyl ester)

Vinyl acetate

Vinyl chloride

4-Vinylcyclohexene

2,6-Xylidine (2,6-dimethylaniline)

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Smoking:

Psychological Effects

Increased alertness

Feelings of pleasure

Teen smokers:

– anxiety disorders

– depression higher rates

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Smoking: Health Effects

1 in 5 deaths in U.S. linked to smoking

(including secondhand smoke)

Life expectancy 10 years less for smokers

Thirdhand smoke

– Chemicals left on surfaces, even long

after smoking stopped

– Dangers currently being studied

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Smoking-Related Diseases

(A Partial List)

Lip Cancer

Oral Cavity Cancer

Tongue Cancer

Pharyngeal Cancer

Esophageal Cancer

Stomach Cancer

Pancreatic Cancer

Laryngeal Cancer

Tracheal Cancer

Lung Cancer

Kidney Cancer

Urinary Bladder Cancer

Cervical Cancer

Acute Myeloid Leukemia

Peripheral vascular disease

Coronary Heart Disease

Ischemic Heart Disease

Cerebrovascular Disease

Atherosclerosis

Aortic Aneurysm

Invasive Pneumococcal Disease

Chronic Obstructive Pulmonary Disease

Complications of pregnancy

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Lung Images

HEALTHY LUNG CANCER EMPHYSEMA

169

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Nicotine: Quitting Smoking

<10% able to quit on first try

Hardest = starting before age 21 (80-90% start in teens)

– Nicotine replacement therapy

• Gum, lozenge, patch

– Medication

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180 182

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BOTH DIED OF LUNG CANCER

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Stimulants

Cocaine

Coca plant

Mid-1800s

– Used as an

anesthetic

– Common ingredient

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19th Century Cocaine Products

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19th Century Cocaine Products

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Stimulants

Cocaine

Snorted, smoked, injected

crack cocaine powder cocaine 196

Stimulants

Cocaine

Short-term effects

– Intense euphoria

– Very fast-acting

– Effects short-lived urge to use more

Long-term effects

– Heart disease

– Damaged septum

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Stimulants

Amphetamines

Benzedrine®, Ritalin®, Adderall®

Increases alertness, decreases appetite

Dependence & tolerance

Altered thoughts

– Paranoia

– Similar to schizophrenia

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Amphetamine Ads

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Stimulants

Methamphetamine

Similar to amphetamines, but stronger

Street names:

speed, ice, meth, crystal meth

Made in home labs

Pills, injected, snorted, smoked

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Hallucinogens

Affect mood, thought, memory,

judgment, and perception

Effects vary depending on the user and

the particular drug

– examples:

• marijuana

• LSD

• ecstasy

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3. Hallucinogens

a. Marijuana

– Cannabis elsewhere

– Active ingredient = THC

– Most widely used illegal drug

– Usually smoked

cannabis plant

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3. Marijuana

Short-Term Effects

• Things seem more interesting

• Impairs

– memory during and between use

– motor coordination

– judgment

• High doses paranoia & psychosis

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Some Medical Uses

• Nausea

• AIDS-related wasting

• Chronic pain

210

Long-Term Effects

• Addiction

– 9% among all users

– 1 in 6 of people starting as adolescents (17%)

9%

91%

17%

83%

All Start as Adolescents 211

Long-Term Effects

• Addiction

– 25-50% of daily users

25%

50%

212

Increase in THC Potency

Across Time

216

3. Hallucinogens

b. LSD

– Lysergic acid diethylamide

– Street name “acid”

– Psychological effects are called

a “trip”, lasts 6-14 hours

– Visual and auditory changes

– Changes in time/distance perception

– Flashbacks very uncommon

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Effects of LSD on the Brain

With eyes-closed, much more of the brain contributes to the visual experience under LSD than under placebo

placebo LSD

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True or False?

LSD is stored in the body’s fat cells

long after use has stopped

Once a person has used LSD a

certain number of times, they are

considered legally insane

The US government gave LSD to

people without their knowledge

or permission

– Project MKUltra

FALSE

TRUE!

FALSE

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3. Hallucinogens

c. Ecstasy – Methylenedioxymethamphetamine

(MDMA)

– Causes massive release of serotonin in

the brain

• May lead to long-term problems

with serotonin levels

• May contribute to depression and

memory problems 224