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Drugs and drug education 2 Drugs as a social problem (History (Opium act…
Drugs and drug education 2
Drugs as a social problem
Causes for law change
Substance dependence
Physical dependence
--> body changes cause of long term drug abuse
--> less receptor / excitation of neurtransitters
--> hence without drug neurtransmitters beow ormal levels
---> drug now needed jsut to feel normal
Psychological dependence
--> positive reinforcemnt for drug use
--> craving
---> both these are physiological really lol
Tolerance
--> compensatory response
--> more drugs for same effect
dependence potential
--> how addictive a drug can be
High
--> opiats (heroin, crack)
Medium / high
--> dopamine reuptake blockers (cocaine, nicotin<-- wtf lies)
Low
--> coffe, MDMA/extacy
Very low
--> LSD, mescaline
Medium
--> alcohol, Valium (depressents)
DSM V criteria
-> two or more symptoms for 12 months
Impaired center control
--> cant stop taking it
substance taken for longer than intended
wants to quit but reports many unsuccessful attempts
much time spent obtaining, using or recovering from the substance
Cravings for substance
Social impairment
Substance makes person fail obligations at home, work , school
Withdrawal from important social, work or recreational activities
takes substance even though it causes or worsens social and relationship issues
risky use
takes drugs in physically dangerous situations e.g drinking alcohol and drivign car
takes drug even though they know it causes them pyhiscal or psychologcal problems or worsens them
Pharmacological Criteria
develops drug / substance tolerance (needs more drugs to achieve same effect
Withdrawal symptoms (mostly opposite to drug effect) and they take drugs to relieve these withdrawal symptoms
Differences between DSM V and old DSM IV
old DSM IV people were classifeid either as "Substance abuse" (see 4 criteria on the right) or "Substance depended"(drug addiction/tolerance)
IN new DSM V they are unified as Substance Abuse Disorders!
because A people with substance abuse rarely progressed to Substance depended
and B because factor analysis of the criteria for both revealed they are measuring the ame thing
--> good thing because in old Dsm IV dependece took precedence over abuse so many people abused drugs for years severly impacting their lives but werent classifeid as substance abuse ..
Toxicity
--> deadliness of a drug
Categories
Acute
--> short term effects of a single dose!!
--> basically all the drugs discussed here
Behavioral
--> alcohol intoxication makes you drive shit
Physiological
---> heroin overdose makes breathing stop
Chronic
--> long term effects from repeated use
Physiological
--> liver damage through alcohol abuse
Behavioral
--> psychoactive drugs causing schizophrenia
Causes of drug toxicity
--> amount
--> how its used
--> behavior while on drug
Cost on society
#
Caused by taking drugs
Caused by law infringements
History
Opium act 1908
--> no drug regulations before
--> driven by fear of chinese immigrants
--> labor riots
--> violation of pharmacy legislation
alcohol + tobacco seen as bigger issue
to stop immigration from china / japan
opium = huge profits in trade
prohibits selling (nonmedical)
--> also cocain
--> use and possesion still ok
--> had to be labeled as ingredients
1911 Opium act replacement
--> complete ban on opiods
1909 patent medical act
--> drugs had to be approved
-->
evolved into 1920 foods and drug act
ministry of health could suspend license
1961Narcotic control act
--> Criminalisation of drugs
--> physicians treated drug addiction
1969 Le Dain Commission
--> decriminalisation of drugs
--> possesion law relaxed
-----> posessing canabis not a crime anymore
1987 Canada drug strategy
--> substance related disorders = health issue
--> approach to reduce demand and supply
1996 Controlled Drugs and Substances Act (Bill C8)
--> replaced in 2003 = more focus on harm prevention, dug education etc..
--->
turning point!
2003 Renewal of drug and substenance act (Bill C8)
-->more focus on harm prevention, dug education etc..
#
--> drugs only medical perscription
--> sharing perscribed drugs illegal
Punishment
--> conviction for: trafficking, unlawful possesion , export, import, trade
--> 100.000$
---> or both! depends if children involved or selling next to schools
Summary conviction
--> less than 30g cannabis / 1g resin
--> no criminal record
Indictable offence
--> more than 30g cannabis / 1g resin
2007 Anti drug strategy
--> reduce supply / demand for illicit drugs
Bill C10
--> bad drug crimes (selling to youth, ciminal activity.. etc )
result in mandatory JAIL TIME
--> any marihuana offence too
-
Good = drug treatment programm
-> lenience if offender takes supervised drug treatment
---> admission needs guilty plea fucked up shit
Drug awareness organizations
DAWN ( Drug Abuse Warning Network)
--> collects incidents of death and hospitalization after drug abuse
Hospitalisation
alcohol
in combination
cocaine
persciption opiods
Death
persciption opiods
(not heroin!!)
alcohol
in combination
benzodizephines (depressant)
limitations:
--> only number of ER visits/ death
--> doesnt tell us how dangerous each drug is
--> how prevalent the drugs are vs number of problems
Canadian Institute for Health Information (CIHI)
Alcohol
--> kills most in early years
--> 3% overall deaths
tobacco
--> kills mostly later in life
--> 20%over all deaths
Illicit drugs
--> third highest, declines with age
Cannabis
--> lool almost nothing hahaa xD
--> overall just 26 ppl :P and i bet cannabis wasn't the cause at all lol
Change of mind
#
Toxicity
Dependence
Crime
drugs might change personality
make people do something under influence they wouldn't normally do
may make people commit crimes to get drugs
illicit drug use is considered a crime
From Maastricht substance use disorder task
Choice or Disease model ?
Evidence = Disease !!
--> 3 parts
---> vulnerability mediated by = various genetic, environmental, and developmental factors, which influence the initial drug use, sustained drug use, and the progressive changes in the brain that characterize addiction.
.
Intoxication / Dopamin reward
Strong dopa in response to exposure to substance
.
the more exposure the more VTA firing will shift to anticipation of reward only (no more firing for reward itself!)**
The difference between a natural reward and a drug is, that dopamine stops responding to a repeated consumption of a natural reward in order to satiate it, while it keeps responding to conditioned stimuli of a drug, leading to cravings, drug-seeking, and binges.
Tolerance + withdrawal
Cause of too much dopa = less dopa receptors
leads to them having a dopa level below optimal body functioning level
normal fun activities not strong enough to even push levels to before normal baseline ---> dysphoria!!
Drugs = because of their strong dopa spike can still trigger happy response (but more of the drug is needed cause less receptors
increases craving for drug !! ---> taking drug to relieve dysphoria just to even feel normal again!
--> adaptations in amygdala caused by drugs/dopa
becomes like an
anti reward system
leads to increase in stress / negative affect when drugs wear off !
Preoccupation / anticipation
---> less dopamin reduces PFC activity = impairing executive processing (self-regulation, decision making and the monitoring of error.)!!
--------> through that also less glutamate
---> less dopa + gluata = underactivation = weakens their ability to resist strong urges or to follow through on decisions to stop taking the drug.
#
These effects explain why persons with addiction can be sincere in their desire and intention to stop using a drug and yet simultaneously impulsive and unable to follow through on their resolve
ALSO CREB changes in caudate nucleus in response to dopa !!
OLD WRONG Choice model
--> in dopamin the neural low article but fits here better
#
To overcome the addiction, a person must develop strategies to chose long-term gains over immediate rewards
Positive reinforcemtn theory
--> monkeys and littel morphine reinforced morphine taking behvior BULLSHIT !!!!
Drug development
3 phases
low dose 20-30 volunteers
few hundret ppl who could benefit
1000-5000 ppl