Restricted or illicitCocaine and amphetamineWidely prescribedRitalin, Adderall, etc.Readily availableCaffeine and nicotineOver the counter and supplementsPlant/herbal stimulantsMany caffeine basedStimulates Release and Blocks reuptake of neurotransmittersDopamineSerotoninNorepinephrineEpinephrineStem and seeds, leaves, buds, resinAppetite stimulation, enhanced food appealAddresses side effects of chemotherapy (cancer) and antiretroviral therapy (HIV)Chronic pain, neural painSeizuresOverarching issues addressed by addiction treatmentSkills to handle cravings (calm down the GO! System)Skills to better control impulses and prevent relapse (build up the STOP! System)Alter neurochemistry to deal with withdrawal, cravingsEnhance desire and motivation to quitAddress practical, psychological, and spiritual needs that contribute to stress, feelings of isolation, and useCognitive-behavioral interventionsCognitiveChange thoughts, expectancies, and emotions that contribute to substance use behaviorBehavioralChange the things that we do that contribute to substance usePlaces we go, people we hang with, patterns we have throughout the day that lead to increased tendency to useExam # 2 Study Guide Lectures: 8 - 14Lecture 8 DepressantsCommon depressants are opiates/opioids, sedative-hypnotics, and alcohol. These drugs slow or calm people down. Opiates/Opioids (can be used interchangeably) Examples: Vicodin, HeroinThe general effects are analgesic, which means they help relief pain. Opioids produce euphoric effects. They subdue emotional pain and create a rush of happiness or pleasure. Vicodin and Heroin are both associated with a risk of overdose. Medical uses of opiates:They are used as treatment for moderate to severe pain. Also used to treat diarrhea and coughing. Antitussive means a drug that helps prevent or reduce a cough. Opiates tend to not work as well for neurological pain such as headaches or migraines. Codeine, which is a derivative opiate, is used in cough syrup for antitussive reasons. It slows down the bodies natural responses in natural reflexes such as coughing. Opioids come from different sources. Soc Work 453 1st EditionAlkaloids are the milky substance that comes from opium poppy plants that can sometimes produce psychoactive affects. One source of opiates is naturally occurring. The naturally occurring source is deriving the opiates all from the planet that grows in Afghanistan and Australia or the opium poppy plants. This means that some opioids come directly from the opium poppy alkaloids.Another source is called derivative/semisynthetic. In the derivative source the alkaloids are taken and then are chemically manipulated.Example: MorphineMorphine is associated with a risk of overdose. In the original alkaloids there are about 20 different alkaloids in the milky substance that the plant produces. For drugs such as morphine one specific alkaloid is isolated. This then produces a specific affect such as morphine on pain relief. For semisynthetic a specific alkaloid is isolated but then also in a lab the chemical structure is manipulated. This is considered chemically manipulating a natural opiate. Example: HeroinThe final source is called synthetic. This source means that the opiate is completely manufactured from other chemicals. No actual plant is needed in this source. Example: MethadoneMethadone is given to people who have an opiate addiction to occupy the opioid receptors in the brain. This then reduces cravings and relives some withdrawal symptoms. Methadone is associated with a risk of overdose.The main risk of death that is associated with heroin and other opiates is attributed to the small difference between a lethal dose and an effective dose. Prescription drug “epidemic”An epidemic means that there is a huge increasing rate of something and that something is effecting a large segment of the population. Prescription drugs right now have become a huge epidemic in the United States.Prescription drug misuse has by public health definition reached this epidemic amount. A main concern is that overprescribing opiate drugs is a main contribution to opiate deaths. Oxycontin ExpressOxycontin is basically heroin made in a lab. Oxycontin is a semisynthetic drug. Oxycodone is the main prescription drug that people are addicted to. Oxycodone has a huge risk of overdose. In Florida there are pain clinics where people can go to different ones and get different doctors to prescribe them drugs. There was no database to determine who was getting pills or not so this enabled people to go to multiple pain clinics without doctors knowing if the patients had received pain pills or not. Doctors would sell patients a bunch of pills to make a lot of money. They would even put ad’s for the pain clinics in the newspapers. Doctor shopping: is when patients would drive around to different clinics to find different doctors to prescribe them drugsMany of these pain clinics also dispensed drugs on site. That means that people could get pills right the doctors office without having to go to pharmacy. This increased the amount of pills that patients could get since there were no pharmacists to tell them it was too much.Diversion: The actual definition of this word is an activity that diverts the mind from tedious or serious concerns. In this video we observed Doug who always felt like he needed to be high in order to feel normal. Doug was not able to get clean even after he lost his wife to drugs. Doug was always concerned about going to different pain clinics. If he couldn’t get drugs from the clinics he would go to an old woman’s house and buy some pills from her. Ways to tackle the general problem:Create a database for all doctors to see what patients are receiving in terms of drugs. Now there are databases, but they are very slow to be fully enacted. Another solution could be to get rid of the greedy doctors who sell a bunch of pills to make a lot of money. Another solution could be to realize that many people are addicted and that there should be rehabilitation offered instead of an offering of more pain medication Or another solution is to get rid of pain clinics altogether. A final solution could be to get rid of the on-site pain pill distribution. If people had to go to the pharmacy to pick up all pills, the pharmacists would know if they are being prescribed to many pills. This could help reduce addiction by reducing the amount of pills that