04/19/23 1

Graded Discussion (Out of 5) 1 person at a time (Facilitator?)

-1 Point

Everyone speaks once (1 Freebies) -1 Point

(At least) 5 subtopics related to addiction

-1 Point Time (At least 20 minutes) &

No lapse in speaking >15 seconds -1 Point

Side chatter (nada) -1 Point

04/19/23 2

Graded Discussion Hints:

Utilize your guided notes from the Movie, “Help Me, I Can’t Help Myself” as arguments.

There is no wrong answer! Feel free to disagree w/ somebody.

Start simple-Is addiction a choice or a disease?

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Graded Discussion

Comments Sub Topics

04/19/23 4

Now or never..

04/19/23 5

Essential Questions

What are the 3 best arguments for/against addiction as a disease?

What does labeling it as a disease do to the accountability

of the individual? Right/Wrong? Describe this debate as it relates to the circle of control?

How does someone become an addict?

04/19/23 6

This Week in Health Monday: Feedback on Pres, Grade Update,

Questions Regarding Drug Fair Intro to Drugs

Tuesday: Finish Intro to Drugs

Wednesday: Tobacco

Thursday: Finish Tobacco / Marijuana?

Friday: Drug Fair

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Overview of Drugs in Our Society

Page 1-Where it says at the very least I want to know before this unit is over…. Provide at least two things you’d like to learn

about regarding drugs Page 1-Where it says Give 1, Get 1….Drugs

Role in Society. Provide at least 6 ways drugs impact society

either negatively or positively….it helps to think of certain drugs like alcohol or tobacco.

Page 1-Bottom, Rank in Order Rank both-pay attention to directions on the

second one (% not rank).

04/19/23 8

04/19/23 9

The least you need to know…(TSWBAT)---------------------------------day 1----------------------------------------- Discuss the role drugs play in our society Distinguish among perceived and actual

drug use statistics. Examine pertinent questions when discussing the drug

problem in the U.S.---------------------------------day 2----------------------------------------- Identify the 4 principles of psychoactive drugs Differentiate among the reasons ‘we’

use drugs Define a psychoactive substance State the 3 classifications of psychoactive substances

and provide examples of each Distinguish between the various routes of administration

and hazards of each

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Drugs Role in Society

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What Role Do Drugs Play in Our Society?

04/19/23 12

Damaging Statistics The cost of drug abuse to the United States was $180.9

billion.($2,446 per American Family). Roughly ¼ Million US adults contract HIV from IV drug use 8.5 percent of new mothers report having used illicit drugs 90 % of identity theft cases are generated by drug users Over 6 million children live with at least one parent who

abused or was dependent upon alcohol or illegal drugs. Americans spend $64 billion to buy illegal drugs every year  Second only to alcohol, marijuana is the drug most detected

in impaired drivers, fatally injured drivers and motor crash victims.

States spent $42.89 billion on Corrections in 2005 alone Roughly ½ of all ER Visits, suicides, homicides, rapes, and

traffic fatalities

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Is there a ‘Drug Problem?’

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Place in Order by Perceived Use Alcohol Ecstasy LSD Cigarettes Marijuana OTC Steroids Inhalants Prescription Drugs

Abuse vs. Use / Regular vs. Experiment

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Social Acceptance Continuum?

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29% in vehicle w/ driver had been drinking (<30) 10% driven vehicle after drinking (<30) 20% smoked cigarettes <30 (10% frequent daily-1/2 try to

quit) 44% drink 1 or more drinks < 30 (26% binge drink) 19% smoked marijuana <30 3% used any form of cocaine <30 Lifetime Use

8% Hallucinogens 13% huffed 2 % heroin 4 % methamphetamines 4% steroids 6% ecstasy

04/19/23 17

Risk-Taking Behavior TOTALSAMPLE

Gender Grade

Category Definition M F 9 10 11 12

Alcohol Used Alcohol once or more in the last 30 days.Used Alcohol once or more in the last 30 days.

Got drunk once or more in the last two weeks.Got drunk once or more in the last two weeks.

(2000)45(2000)45(2003)46(2003)46

( (2006)39( (2006)39(2009)34(2009)34

(2000)31(2000)31(2003)30(2003)30(2006)24(2006)24(2009)23(2009)23

4747464640403535

3232343427272525

4242454538383333

2828262622222222

2929383824241919

2323232314141414

4040454533333131

2525282818182121

5252535345454141

3636373728282626

6565505058584545

4343363641413333

Tobacco Smoked cigarettes once or more in the last 30 Smoked cigarettes once or more in the last 30 days.days.

Used smokeless tobacco once or more in the last Used smokeless tobacco once or more in the last 12 months.12 months.

(2000)30(2000)30(2003)27(2003)27(2006)18(2006)18(2009)15(2009)15

(2000)8(2000)8(2003)6(2003)6(2006)5(2006)5(2009)5(2009)5

2727282819191717

1414111199

1010

3232252516161313

22221111

21212020121277

66551111

2222272712121313

99555544

3737313120201616

99886666

4545292929292525

997799

1111

Inhalants Sniffed of inhaled substances to get high once or Sniffed of inhaled substances to get high once or more in the last 12 months.more in the last 12 months.

(2000)9(2000)9(2003)9(2003)9(2006)6(2006)6(2009)6(2009)6

99997777

88996655

9913137777

99886666

77996677

99556666

Marijuana Used marijuana once or more in the last 12 Used marijuana once or more in the last 12 months.months.

(2000)29(2000)29(2003)31(2003)31(2006)22(2006)22(2009)27(2009)27

3030353526263232

2727262618182222

1414222213131111

2828323217172121

3434353527273636

4646383834344242

OtherDrug Use

Used other illicit drugs once or more in the last Used other illicit drugs once or more in the last 12 months.*12 months.*

(2000)15(2000)15(2003)13(2003)13(2006)7(2006)7(2009)7(2009)7

161615158877

131312125566

101010104433

101014144444

19191616101077

2424151510101111

Driving and Alcohol

Drove after drinking once or more in the last 12 Drove after drinking once or more in the last 12 months.months.

Rode (once or more in the last 12 months) with a Rode (once or more in the last 12 months) with a driver who had been drinking.driver who had been drinking.

(2000)16(2000)16(2003)15(2003)15(2006)12(2006)12(2009)9(2009)9

(2000)35(2000)35(2003)33(2003)33(2006)32(2006)32(2009)34(2009)34

1717161614141010

3535323231313131

161614149999

3636343432323737

55664422

2727313131313232

1010993344

3434323229293737

2121242415151111

3535343430303232

3434252527272121

2020343438383737

*Includes cocaine, LSD, PCP or angel dust, heroin, and amphetamines.

04/19/23 18

Defining the Drug Problem…

Who is taking the drug? What drug are they taking? When and where the drug is being

used. Why a person takes a drug? How the drug is taken? How much?

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4 Principles of Psychoactive Drugs

Every drug has multiple effects (virtually every drug that acts in the brain also has effects of the rest of the body)

Both the size and quality of a drug’s effect depend on the amount the individual has taken

The effect of any psychoactive drug depends on the individual’s history and expectations…

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4 Principles Continued

Drugs, per se, are not good or bad.

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“I don’t think that a drug is evil in and of itself, but just as drugs can be used

to help heal a person, they can result in destroying a life as they did to me. So it really depends on the individual-what and how he chooses, and how wisely he uses or chooses not to use medication

and drugs.”

-28 year-old recovering sedative-hypnotic abuser

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Why do people use drugs? Curiosity and Availability To Get High Self-medication Confidence Energy Pain Relief Anxiety Control Internal/External Peer Pressure Social Confidence Boredom Relief Deal w/ Isolation Competitive Edge

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The worst reason…..

How are Depression and Drug Use Related?

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Why use?

VS.

Why continue to use?

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Withdrawal

When an addictive behavior is

stopped or an addictive substance

is withdrawn from use, withdrawal

symptoms almost always follow.

Depending on the behavior or substance: sweating and fever restless behavior and anxiety abdominal and muscle cramps (even convulsions) nausea and vomiting diarrhea.

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Tolerance

Tolerance can develop with regular use. This occurs when the person becomes used to taking drugs of abuse and the drug no longer provides the same effect as it did when first taken. Tolerance can occur with regular use of most drugs of abuse.

Physiological Tolerance Vs. Psychological Tolerance

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What is the most dangerous or harmful drug?

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Harm to the individual and Society Drugs could be classified or rank ordered according to

their hazard potential to the individual and/or society.

Harm to the individual would include - significant organ or tissue damage potential for tolerance physiological or psychological addiction harm to an unborn child increased death rate from use or abuse of the substance

Harm to the society would include -increased rates of death of others (i.e. drunk driving) increased insurance rates loss of working days crimes of violence disability payments family breakdown and mental, physical, or sexual abuse from the use or abuse of the substance

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Current research has led to the formulation of the following rank ordering of drugs, in terms of degree of harm to the individual and to society:

1 and 2. Tobacco and Alcohol 3. Sedative-hypnotics 4. Cocaine 5. Heroin 6. Tranquilizers 7. Narcotic-analgesics other than heroin 8. Amphetamines 9. PCP 10. Volatile Substances 11. Hallucinogens 12. Marijuana (Cannabis sativa) 13. Antihistamines 14. Xanthines

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Table 3Drug misuse and abuse in ED visits in the U.S., by type of drug involvement: 2004

Drug involvement1 Estimatevisits

Percent

All types of drug misuse/abuse 1,254,078 100%

Illicit drugs only 379,609 30%

Alcohol only (age < 21) 98,174 8%

Pharmaceuticals only 313,125 25%

Combinations    

   Illicit drugs with alcohol4 190,747 15%

   Illicit drugs with pharmaceuticals 99,535 8%

   Alcohol with pharmaceuticals 125,374 10%

   Illicit drugs with alcohol and pharmaceuticals 47,515

04/19/23 32

Drug Abuse Warning Network (DAWN)

Other illicit drugs appeared at much lower frequencies. For 2007, DAWN estimates:

MDMA (Ecstasy) in 8,621 (CI: 5,985 to 11,257) ED visits, GHB in 2,340 (CI: 125 to 4,555) ED visits, Ketamine in 227 (CI: 109 to 345) ED visits, LSD in 1,953 (CI: 1,179 to 2,727) ED visits, PCP in 8,928 (CI: 4,920 to 12,936) ED visits, and Miscellaneous hallucinogens in 3,445 (CI: 2,202 to 4,688)

ED visits.

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What is a Psychoactive Drug?

: Any substance that directly alters the normal functioning of the CNS

The major classifications of drugs are uppers (stimulants), downers (depressants), and “all-arounders” (psychedelics or hallucinogens).

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Uppers or Stimulants

All-Arounders or Hallucinogens

Downers or Depressants

Class of DrugsEffect on the Brain

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Uppers or Stimulants Ex. Cocaine, amphetamines, diet

pills, caffeine, tobacco. Major effects: ^neural activity in

the brain = ^ sensory experience

(^ energy, feelings of confidence, ^ HR & BP)

Overuse: Jitteriness (tremor test), anger, insomnia, depletion of energy, paranoia, damage to heart, lungs, and BV’s

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These two images of the brain are positron emission tomography (PET) scans of a normal

The PET scan shows brain function by seeing how the brain uses glucose, the energy source for neurons.

In these scans, the red color shows high use of glucose, yellow shows medium use and blue shows the least use of glucose. Notice that many areas of the brain of the cocaine user do not use glucose as effectively as the brain of the normal person.

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Downers or Depressants Ex: Opiates (heroin, morphine), barbituates,

and alcohol. Major effects: Depressants work by

depressing the central nervous system. They can therefore induce a state of relaxation or sedation as well as reducing the intensity of pain and of emotions such as fear, anger or anxiety. (Depress circulatory, respiratory, & muscular systems).

Prolonged use: Numerous health problems and dependence. Reducing intellectual ability, concentrate, retain information, motivation and energy, manual dexterity (ie. the ability to operate machinery, drive, climb or swim).

04/19/23 38

Adam Drewnowski at the University of Michigan researched whether chocolate increases the production of opioids (endorphins). Opioids are chemicals, such as those found in opium,that produce a feeling of well-being (euphoria). Drewnowski found that eating chocolate causes the brain to produce natural opiates, which dull pain and increase a feeling of well-being. This may be a reason why we like to eat chocolate! And dark chocolate contains more of these compounds than milk chocolate.

Why We Love Chocolate

04/19/23 39

All-Arounders or Hallucinogens

Ex: Marijuana, LSD, PCP, psilocybin mushrooms, and peyote.

Major effects: These drugs enhance sensory perceptions - sight, sound, smell and touch.

= Illusions, hallucinations, & confused sensations.

Bad “Trip” vs. Good “Trip”

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How Drugs Get to the Brain

By definition, psychoactive drugs are substances that affect the central nervous system to cause physical and mental changes. Factors that determine the effects:

Methods of ingestion Speed of transit Affinity of the drug for nerve cells,

neurotransmitters, and other brain chemicals

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Routes of Administration

Inhaling Injecting Mucosal absorption Oral ingestion Contact absorption

04/19/23 42

Inhaling Ex. Smoking a “joint,” freebase

cocaine, “huffing” Vaporized drug enters the lungs

and is rapidly absorbed through capillaries-veins-heart-brain-body

Most addictive route of administration because it hits the brain so quickly

*Because it is inhaled, the nicotine in cigarettes takes seven to 10 seconds to reach the brain — twice as fast as intravenous drugs and three times faster than alcohol.

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Snorting & Mucosal Absorption

Ex. Snorting heroin or cocaine, chewing tobacco

Absorbed by capillaries in the mucous membranes lining nasal passages

04/19/23 44

Oral Ingestion

Ex. Swallowing alcohol, pills, etc. Onset of effect is slower…(Alcohol

Poisoning..) Absorbed through capillaries lining

digestive tract-stomach & S.I.

04/19/23 45

Contact & Transdermal Absorption

Ex. LSD, skin creams, nicotine patches.

? Speed ? Digestive system ? Dose regulation

04/19/23 46

Injection

Ex. Heroin, cocaine, methamphetaminees, by way of needles

Extremely rapid Initial absorption step is by-passed The Lancet has found that the proportion

of IV drug users that are HIV positive may exceed 40 percent in at least nine countries around the world Needle Exchange Programs???

04/19/23 47

Controversial Issue?

Injection drug users typically share needles and syringes, which frequently transmits HIV or hepatitis C.

Needle exchange programs are a strategy to reduce harm in injection drug.

In an attempt to reduce sharing of contaminated equipment, needle-exchange programs provide sterile needles and syringes to individuals in exchange for used equipment.

04/19/23 48

Harm Reduction -right or wrong-

It is a philosophy or way of thinking on drugs and many other topics.

“Individuals are going to engage in risky behaviors regardless, as a society we might as well lessen the harm associated with the behaviors.”

Do you agree or disagree?

04/19/23 49

Essential Questions Can you identify:

All 3 classes of drugs? Examples of each? Consequences of each? Tolerance vs. Withdrawal Routes of administration?

What is the worst drug? Why? What are the three worst effects of drugs on

society? Explain harm reduction in your own words (give 3

examples we discussed).