This is a way to address substance use, we may try to involve skills training to reduce/avoid use…Sociocultural Perspective (new material)User is largely influenced by societal pressures, stress/adversity, and the opportunity/life chances to attain goals (e.g. the “American dream”)Substance gains meaning by societal and political definitions of what is right and wrongThe substance category considers that all drugs are created equal except for the fact that in societies we accept some drugs and reject others (in terms of how we judge people for using them).The substance category takes into consideration that the acceptance of substances may change across time and across cultures. It gains meaning by what society gives it.Environment is the primary risk factor; poverty, discrimination, lack of opportunity = cumulative stressPoverty and other risk factors can contribute to substance use. They influence whether or not someone chooses to use, also they can influence the consequences that someone will take on because of their use.There are lots of reasons people use substances: could be social gathering, or wanting to relax, or using substances to cope.Response social policy changes, advocacy, legislationThink about how these are useful…Study this table about Methods and intended effects of drug policy approaches for the exam!We should know what types of programs fall into what categories:Example: Programs that prevent substance use are prevention such as drug prevention programs in schools, mass media campaigns. Prevention targets different people.Who may want to have prevention rather than treatment? –school kids. We enroll school kids in prevention rather than treatment because hopefully they haven’t started using anything yet.Prevention programs want to prevent substance use from becoming a problem.Treatment programs want to help with problems that people already have.We should be able to pick out one of the programs, know what category it fits in, and understand its goals.Iclicker question answer from last week:Teaching pro-social behavior and social skills is a drug use prevention program that appears to be successful at reducing drug use.-D.A.R.E. is not effective, yet it still raises awareness. The program doesn’t prevent drug use. Maybe D.A.R.E. has other good things that are associated with it. Maybe the raising of awareness this program does is the first step. Pulling money away from D.A.R.E would look bad in public eye for any politician.Novel drug policies1) State, country, and municipal-level shifts to decriminalizing or legalizing marijuana.Really framing this as social justice issues.Now a days, there are demonstrated medical benefits of marijuana which play a role in the debateThis is not something that we saw 10 years ago other than in CaliforniaA lot of progress being made in that area2) Federal policies to increase funding for treatmentAs a country what is our strategy in trying to reduce harm from substance use?United States Office Of National Drug Control Policy GraphGraph: The red bar is expressing Prevention and Treatment. This is the first year, since funding was established, that the prevention and treatment dollars actually exceeded the law enforcement and incarceration dollar amount.If we reduce demand for drugs, rather than supply. And we create effective treatment and prevention programs, maybe this will be a better investment that supply control (locking guys up)International bars: money to other countries to try to drop chemicals on plants that are being grown to destroy them.U.S. Law Enforcement and Incarceration: This money is mostly given to federal programs instead of states. Some of this money may be going to states. Department of Justice probably sends some money to states as well.Interdiction: trying to stop transmit of drugs in its trackThis is just money that trickles through Office of National Drug Control PolicyNow back to today’s lecture…Topics:Getting drugs to the brain and what happens thereGoals:Preparation for understandingHow people become physiologically dependent on drugsHow medications can be used to treat addiction-We need to know up to the neurotransmitter level. This level helps us learn about addiction. There has been a lot of medication development, aka many drugs by FDA to treat addiction given to patients. To understand how that works we have to know some neurobiology. This lecture will help us understand those topics.Drug metabolism and the nervous systemRoutes of Administration (how you get drugs into your body)Some will ingest orally.Some may inject the drug into vein or muscle.Others may sniff or snort something. Inter nasal route.Some folks may smoke or huff something. Another route. (inhale something)And some may use a transdermal. An example of this is a Nicotine patch; this patch will last a couple days and give slow amount of nicotine overtime.Routes of administration contribute to addiction potential. They do that at the speed in which they can get drugs into the brain.Certain routes get drugs into the brain quicker. Of routes we just discussed what is the slowest route?Transdermal is the slowest, or putting on the nicotine patch. When you put it on you won’t automatically feel nicotine and feel effects, will take some time. May need to sweat a little bit to help that transfer. Has to also get through skin and then into the blood stream. This will take the longest to get that drug into your blood stream. This will take 30 minutes to 2 days.2nd slowest: oral ingestion. If you take a shot, you may feel effects quicker than 20 minutes. But if you swallow something such as a pill this will take a while. Needs to go into stomach…Drinking or swallowing a pill will take an average of 20 to 30 minutes.Snorting/ mucosal exposure is in the middle. There are many capillaries in the nose, which can get into the blood stream more quickly. This takes an average of 3 to 5 minutes.Injecting is 2nd fastest way to get to brain. There are three different ways of injecting a substance into the body. Intravenous (injecting into veins) get into blood stream and into brain quickly. 15-20 seconds Intramuscular (injecting into muscles) can be like steroids. Takes 3-5 minutes. Subcutaneous (injecting under skin) and some other tissue. Takes usually 3-5 minutes as well.Inhaling is fastest way to get to brain. Takes 7 to 10 seconds. Why is it the fastest? When you inhale something it goes into you lungs that have a ton of