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PHAR 100 Mod 1-4
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Introduction to Pharmacology 100 notes from modules 1 to 4.
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Module 2: Drugs of Abuse Part 1Section 2: Substance Abuse and Dependence
Why do people abuse drugs?
● They gain something from their use; may be an altered feeling, benefits from
social interaction, or the thrill of experiencing something new and perhaps
risky.
● The greater the “good feeling” obtained from a drug, the more likely the use
of the drug will be repeated, a phenomenon known as reinforcement.
Substance Abuse: The Facts
Substance use disorder:
● When a person’s use of a drug leads to health issues or problems at work,
school, or home.
● It is a serious social and financial problem for many individuals and for
society.
● It occurs across all social groups, it may lead to crime to financially support
the use, and it can lead to illness and death.
Factors Influencing Substance Use Disorder
Genetic Factors:
● Can predispose an individual to substance use disorder.
● Example: it is reported that sons of alcoholic parents are at higher risk to
become alcoholics than sons of non-alcoholic parents.
Coexisting Disorders:
● Individuals with major affective disorder (depression), anxiety disorder, or
schizophrenia are at higher risk for substance use disorder than the general
population.
Environmental Factors:
● Environments that promote drug use, family, stability, work groups, and
social groups all have influences on the potential for substance use disorder.
● Stable family life and social circles can reduce the risk of substance use
disorder.
,Developmental Factors:
● Adolescence and early adulthood are the age groups primarily associated
with the initiation of substance use disorder.
I. Smoking usually begins before the age of 18.
II. 80% of alcoholics begin using before age 30.
III. Illicit drug use usually begins between 15 and 18 years of age.
The Dopamine Hypothesis
1. The dopamine hypothesis suggests that drugs of abuse increase dopamine
in the reward systems of the brain. Other neurotransmitter systems are
involved in substance abuse, but the increase in dopamine appears to be a
key component of the brain’s reward system.
2. These dopaminergic systems are also responsible for natural rewards such
as food and sex, as well as for stimulus-related rewards such as video
games and gambling. Drugs of abuse cause an exaggerated increase in
dopamine, altering communication in the brain.
Characteristics of Addictive Drugs
Increase Dopamine: a number of substances can lead to an increase in dopamine in
brain reward systems.
Substance
● Cocaine
CNS ● Amphetamines
Stimulants ● Nicotine
● Caffeine
● Morphine
Opiates ● Heroin
● Oxycontin
● Alcohol
● Cannabis
,Produce Novelty: some drugs are addictive because they produce a novel feeling in the
person taking the drug:
● LSD
● Ecstasy (MDMA)
Reduce Anxiety: some drugs are addictive because they reduce anxiety in the person
taking the drug. These drugs include CNS depressants such as:
● Benzodiazepines
● Barbiturates
Substance Abuse
● The use of addictive drugs may result in substance abuse, which can progress to
substance dependence.
Medical Perspective:
● Substance abuse is a pattern of substance use manifested by recurrent and
significant adverse consequences.
● Examples: repeated failure to fulfil obligations, repeated use in situations in
which it is physically hazardous, multiple legal problems, and repeated social
and personal problems.
Social Perspective:
● The social perspective examines permissible and non-permissible behaviour,
based on customs and tradition.
● In this definition, substance abuse refers to the use of any drug in a manner that
deviates from the approved medical or social patterns within a given culture.
● The term conveys social disapproval and does not necessarily include potential
adverse effects.
Criteria for Substance Abuse
Based on the social and medical perspectives of substance abuse, the following criteria
for substance abuse was established:
✓ The use of prohibited drugs
✓ The use of any therapeutic drug for other than its intended use
, ✓ The intentional ingestion of any therapeutic drug in amounts greater than that
prescribed, or taken by amount greater than that prescribed, or taken by routes other
than those medically approved
✓ Taking drugs in combination in order to obtain a greater pleasurable effect
✓ The excessive use of legal social drugs (alcohol, caffeine, tobacco)
✓ The use of non-therapeutic substance of abuse, including glue (sniffing), gasoline,
and solvents
Abuse Potential of a Drug
Dependence Liability:
● Refers to the tendency of the drug to cause dependence and addiction.
● It varies from drug to drug, as well as from individual to individual.
● Determined by 3 factors:
1. Nature of The Drug:
● Most drugs are natural reinforcers, much the same as food and sex.
● The pleasurable effects produced by a drug increases the probability that the
drug will be taken again.
● Heroin and cocaine produce intensely pleasurable effects, and therefore have a
high intrinsic dependence liability.
2. Route of Administration:
● Drugs that can be administered by routes that give rapid absorption, and hence
rapid effects, have a greater potential for abuse than drugs which produce the
effect more slowly.
● Drugs that are taken by sniffing, inhalation, or intravenous injection are usually
more abuse-prone than those taken orally.
3. Amount/Frequency of Use
● The greater the dose and the frequency of use, the greater the potential for
development of dependence.
Availability:
● The availability of a drug in society is a major factor in determining abuse
potential
● The more widespread a drug, the more likely it will be abused.
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