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                                                                           DRUGS


DEFINING DRUGS

1. Drugs do not possess intrinsic properties with readily identifiable chemical  properties  or  pharmacological
    effects

    There is no property or effect inherent to or caused by substances referred to as drugs that cannot be found in substances not called drugs
     
2. Most pharmacological definitions are too broad to serve as a basis for  discriminating between chemical
    substances
Drug -- Any chemical substance, other than food that affects living processes
 
3. Drugs have both objective and subjective effects
    Objective effects -- can be perceived and measured by an outside observer

    Subjective effects -- are experienced internally by the user and can be   known too outsiders only through verbal reports
     

4. All drugs have multiple effects. Therefore, any drug could be placed in various categories depending upon which
    effects are of interest
Drug classification systems are arbitrary, selecting one set of effects over others
 
5. The term "drug abuse" is equally arbitrary
The link between illegality and harmfulness of substances is tenuous

The use level and rate of injury (illness, disability, death) from legal drugs far surpasses that of  illegal drugs

The social reaction to various drugs varies by time, place, and social location within society


6. Drugs are not independent of one another. Substances may be cross-tolerant and  cross dependent.

    Cross-dependence -- Drugs in a specific category can replace or substitute for one another in their effects.

              Heroin - Methadone

              Heroin - Morphine

    Cross-tolerance (Tolerance -- frequency and amount of use reduce drug effects) -- Inhibition of effects of drugs in the same category from taking any one in the category.

                    LSD - Mescaline



 

CENTRAL NERVOUS SYSTEM CLASSIFICATION


1. Stimulants (Speed up signals passing through the CNS)

    Caffeine, Nicotine, Amphetamines (Methedrine, Dexedrine, Benzedrine, Desoxyn), Cocaine, and Crack
     
2. Depressants (Slow down signals passing through the CNS)
    Analgesics (Inhibit the perception of pain)
    Narcotics or Opiates
     
      Opium (derivatives -- Morphine, Codeine, Heroin)

      Synthetic narcotics (Methadone, Percodan, Demerol)
       

    Non-narcotics
     
      Aspirin, Darvon, Tylenol, Ibuprophin
    General Depressants (Depress wide range of body organs and functions)
     
      Alcohol
      Sedative-Hypnotics
        PCP (Serinyl) Barbituates Minor Tranquilizers (Valium, Librium, Quaalude, Sopor, Parest)
         
3. Hallucinogens (Complex effects that cannot be reduced to stimulation/depression)
    Mescaline LSD Psilocybin MDMA (Ectasy)
     
4. Marihuana and Hashish
 
 



 

CONCEPT OF ADDICTION


Addiction is defined by

1. Tolerance -- heightened and habituated need

2. Withdrawal  -- intense suffering from discontinuation of use

3. Craving -- willingness to sacrifice all (to the point of self-destruction) for drug-taking

 
Process is thought to be
1. Inexorable

2. Universal

3. Irresistible

 
Alternative Perspective
1.  Addictive behavior is no different from all other human feeling and action in being subject to social and cognitive influences

2.  Addiction is an individual's adjustment to his/her environment. It represents a habitual style of coping, one that  the individual is capable of modifying with changing psychological and life circumstances
 




 

DISCONFIRMATION OF THE ADDICTION MODEL


1. Physician "addicts"

2. Subordination of drug use to other social demands

3. Naturalistic studies of heroin users

4. Vietnam heroin users

5. Non-narcotic substances produce craving and withdrawal symptoms
 



 

FACTORS INFLUENCING DRUG EFFECTS


1. Identity

    Many street drugs sales involve a substance sold as a different substance
     
2. Dose
    Traditions develop in every society about customary dosages of drugs
     
3. Potency and purity
    Potency --  Quantity of a drug necessary to produce a given effect. Some drugs are extremely potent (LSD)

    Purity -- Percentage of a substance taken composed of the actual drug. Some drugs traditionally have been cut continuously during production and distribution (Heroin)
     

4. Drug mixing
    Synergy -- Certain drugs have a stronger effect taken in combination

    Speedball -- Heroin and Cocaine
     

5. Route of administration
    Drug effects are significantly influenced by route of administration
     
      Intravenous Injection

      Intramuscular Injection

      Snorting

      Oral Ingestion
       

6. Habituation
    Continued use of most drugs leads to tolerance
     
7. Setting and set
    Setting -- Physical and social environment

    Set -- Psychic, mental, and emotional, and emotional state of the individual



 

NON-BIOLOGICAL FACTORS IN "ADDICTION"


1. Cultural

    Opium use in India was never proscribed but became a major social problem in China

    Displays of antisocial aggression and loss of control associated with Alcohol consumption is pronounced in some cultures (American Indians, Eskimos, Eastern Europe, United States) and absent in others (Greeks, Italians, American Jews, Chinese, Japanese)
     

2. Social
    Groups affect the pattern of use and the way that drugs are experienced

    Display of withdrawal symptoms is influenced by the context in which withdrawal occurs (prison versus therapy group)
     

3. Situational
    Drugs may be used in a particular social context and then abandoned with the situaion changes

    Most Vietnam veterans terminated Heroin use following their return to the United States
     

4. Ritualistic
    Drug use frequently occurs in a ritualized context that reinforces drug effects

    Nicotene ingested directly does not reduce cigarette smoking among habitual smokers
     

5. Developmental
    Some drug use is associated with various stages of the life course

    Heroin is most often a youthful habit
     

6. Personality
    Some types of individual become "addicted" to a variety of substances simultaneoulsy, sequentially, alternatively

    Alcohol, barbituates, and narcotics show cross-tolerance but not not act in the same way neurologically
     

7. Cognitive
    Cognitive understandings of the meaning and purpose of drugs influences their use

    Patients receiving narcotics rarely seek continued use of the drugs following treatiment

    Males become agressive and sexually aroused when told they have ingested alcohol but do not manifest those behaviors when ingesting alcohol in a disguised form



 

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