DREXEL PSY 310 - Drug Use as a Social Problem (5 pages)

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Drug Use as a Social Problem



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Drug Use as a Social Problem

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5
School:
Drexel University
Course:
Psy 310 - Drugs & Human Behavior
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Drug Use as a Social Problem Two Categories of Problems Problems related to taking the drug risk of developing drug dependence risk of overdose Problems related to drug use as deviant behavior arrests fines jailing expenses associated with drug prevention and treatment Changes in U S Drug Laws U S changed from a laissez faire attitude 1800s to one of tight drug restrictions Three main concerns 1 Toxicity dangerous chemicals 2 Dependence habit forming compounds 3 Crime drug users become dangerous Drug Related Toxicity Toxic poisonous deadly or dangerous Physiological versus Behavioral toxicity Acute versus Chronic toxicity Toxicity Acute Physiological Heroin overdose the user stops breathing Chronic Heart disease Lung cancer Cirrhosis Behavioral Drunk driving Intoxication that dangerously impairs behavioral functioning Deleterious lifestyle changes Strain on interpersonal relationships Drug Abuse Warning Network DAWN A system for collecting data on drug related emergency room visits and deaths Data collected at some U S metropolitan hospitals DAWN collects data on Illicit drugs Misuse of legal prescription and OTC drugs Does not determine whether drugs caused the death or ER visit ER Visits Death 1 Alcohol in combination 1 Prescription Opioids 2 Cocaine 2 Alcohol in combination 3 Prescription Opioids 3 Benzodiazepines 4 Marijuana 4 Cocaine 5 Benzodiazepines 5 Methadone Does DAWN tell us how dangerous a drug is Data are simply number of mentions in total ER visits deaths What DAWN does not tell us Relative danger of a drug o How many problems as a proportion of total drug users Cause of ER visit or death o Drugs are mentioned in every case regardless of the cause of the accident Blood Borne Diseases Specific toxicity for users who inject drugs Not due to the action of drug itself Sharing needles passes infectious agents directly into bloodstream o AIDS HIV infection and hepatitis B and C Syringe exchange programs Example of harm reduction Funded by some local governments Lowers rate of infection Problematic Drug Use What is the definition of addiction Often difficult to define Does it matter What drug is ingested How much time is spent on drug taking How much drug is ingested When does drug use go from recreational to problematic Substance Dependence Three basic processes that may occur with repeated drug use Tolerance Physical dependence Psychological dependence These processes can be defined and studied by researchers interested in understanding drug dependence Tolerance Diminished effect of the drug after repeated use Individual may need to use more of the drug to experience the desired effects The body develops ways to compensate for the chemical imbalance caused by the drug Physical Dependence Physical dependence is defined by the occurrence of a withdrawal syndrome If drug use is stopped suddenly withdrawal symptoms occur ranging from mild to severe Tolerance typically precedes physical dependence Physical dependence means the body has adapted to the presence of the drug Often characterized by High frequency of drug use Craving for the drug Tendency to relapse after stopping use Psychological Dependence Behavioral psychology contextualizes psychological or behavioral dependence as Drug taking is reinforced by consequences the drug effects Research evidence o Laboratory animals will lever press for injections of many drugs of abuse Changing Views of Dependence Early medical models before 1960 True addiction involves physical dependence Key is treatment of withdrawal symptoms But what about drugs with no clear withdrawal symptoms Positive reinforcement model 1960s Drugs can reinforce behavior without physical dependence Psychological dependence based on reinforcement is increasingly viewed as the driving force behind repeated drug use DSM IV TR Substance Use Disorders Diagnostic and Statistical Manual of Mental Disorders DSM IV TR Developed by the American Psychiatric Association Provides diagnostic criteria and definitions for multiple disorders Focuses on complex behavioral definitions DSM IV TR substance use disorders Substance Abuse Substance Dependence DSM IV TR Substance Abuse A maladaptive pattern of substance use leading to clinically significant impairment or distress as manifested by one or more of the following occurring at any time in the same 12 month period 1 Recurrent substance use resulting in failure to fulfill major role obligations at work school or home 2 Recurrent substance use in situations in which it is physically hazardous 3 Recurrent substance related legal problems 4 Continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance DSM IV TR Substance Dependence A maladaptive pattern of substance use leading to clinically significant impairment or distress as manifested by three or more of the following occurring at any time in the same 12 month period 1 Tolerance 2 Withdrawal 3 Substance often taken in larger amounts or over a period longer than intended 4 Persistent desire or unsuccessful efforts to cut down or control substance use 5 A great deal of time is spent in obtaining the substance 6 Important social occupational or recreational activities are given up or reduced because of substance use 7 Substance use continues despite knowledge of having a persistent or recurrent problem that is caused or exacerbated by the substance Note that Tolerance and Withdrawal do not have to be present for this diagnosis Is Dependence Cause by the Substance Some drugs are more likely than others to lead to dependence Heroin or crack cocaine for example But method of use or route of administration as well as other factors influence risk of dependence Is Dependence Biological Is dependence due to definable biochemical or physiological actions in the brain Many studies investigating genetic physiological and or biochemical markers Data suggest physiological consequences of drug taking But not yet useful for determining the causes of dependence Is Dependence Biological Is dependence due to definable biochemical or physiological actions in the brain Many studies investigating genetic physiological and or biochemical markers Data suggest physiological consequences of drug taking But not yet useful for determining the causes of dependence Is there an Addictive Personality No way to know if the drug or the drug use changes an individual s personality Many other factors affect


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