Pharmacology of Addiction

1. List and discuss four reasons why drugs are abused. There are many reasons why drugs get abused: For instance Peer Pressure, I feel it’s the leading cause. Some people will do anything to fit in with certain crowds and people that they will turn to drugs if “everyone” else is doing it. Another reason is to escape, or to forget about their problems, worries, and stress. Some drugs offer a tranquilizing effect that can make a person happy or calmer. Also, learned behavior is a big reason, if a child is growing up in an environment where drugs are all around and easy to access they may become interested in trying it and become hooked.

A fourth reason is pleasure, some drugs offer a euphoric feeling that seldom feels. Once that feeling is experienced it can be wanted more often and a continuous thing. (http://www. ehow. com/about_5427920_people-abuse-drugs. html) 2. Go to the publisher’s web site at http://health. jbpub. com/drugsandsociety/10e choosing the content links for the chapters in the unit research to find out the mission and purpose of the following governmental agencies, write a short paragraph about each agencies mission and purpose.

NIDA- The mission is to lead the nation in bringing the power of science to bear on drug abuse and addiction. Two critical components: one being strategic support and conduct of research across a range of disciplines. Also, to ensure the rapid and effective dissemination and use of the results of research to improve preventing and treatment of drug abuse and addiction. (http://www. drugabuse. gov/) Office of National Drug Control Policy- The mission is working to break the cycle of drug use, crime, and incarceration through drug courts.

Also, restore balance to U. S. drug control efforts by coordinating a government wide public health and safety approach to reduce drug use. Obama has committed over $10 billion in drug education programs along with expanding access to treatment for drug users. (http://www. whitehouse. gov/ondcp) SMAHSA- The mission is to reduce the impact of substance abuse and mental illness on America’s communities. SAMHSA has identified 8 strategic initiatives to focus on improving lives.

These 8 initiatives are: Prevention of Substance Abuse and Mental Illness, Trauma and Justice, Military Families, Recovery Support, Health Reform, Health Information Technology, Data, Outcomes, and Quality, and Public Awareness and Support. They were established in 1992, and their target is substance abuse and mental health services to people in need. (http://www. samhsa. gov/index. aspx) DEA- The mission is the enforce the controlled substances laws and regulations of the U. S. and support non-enforcement programs aimed at reducing the availability of illicit controlled substances on the domestic and international markets.

The DEA was created by Richard Nixon in 1973. It had only 1,470 special agents and a budget of less than $75 million. Today there are nearly 5,000 special agents and a budget of $2. 02 billion. (http://www. justice. gov/dea/index. htm) FDA- The FDA has 4 roles: beginning with promoting health by reviewing research and approving new products, ensure foods and drugs are safe and properly labeled, work with other nations to reduce the burden of regulation, and lastly to cooperate with scientific experts and consumers to carry out these tasks.

The FDA was established in 1862 by President Abraham Lincoln. (http://www. justice. gov/dea/index. htm) 3. Name three types of drug users and explain how they differ. –Experimenters- usually begin using drugs due to peer pressure and/or curiosity, they can set limits on the drugs they take and they know the difference between light, moderate, and chronic use. –Compulsive- devote a lot of time to drug use, recreational fun is impossible without getting high, they use drugs to escape stress and anxiety and can’t cope with out drugs.

Usually in people with problems with personal and public identity, excessive confusion about their sexual orientation, boredom, family discord, childhood sexual and/or mental abuse, and academic pressure. –Floaters or Chippers- have the desire to relieve moderate to serious psychological problems, they are on the path to drug dependence, they drift between experiment drug taking peers and chronic drug taking peers. (pg 30-31) 4. List and explain the phases of drug addiction.

–Relief phase- relief when taking a drug, usually to escape boredom, loneliness, tension, fatigue, anger, and anxiety –Increased Use phase-taking greater quantities of the drug, taking more doses than before –Preoccupation phase- always having a supply of the drug and taking the drug is perceived as “normal” behavior –Dependency phase- more of the drug is sought with no thought of the negative physical symptoms such as shortness of breath, and congested coughing –Withdrawal phase- involves symptoms of itching, chills, tension, stomach pain, or depression from the nonuse of the drug (pg 36-37)

5. Describe the FDA approval process for assessing the safety and efficacy of a newly developed drug. What are its advantages and disadvantages? Step 1- Preclinical Research and Development: must be identified as having potential value in the treatment of a particular condition or disease. Careful records must be kept of side effect, absorption, distribution, metabolism, excretion, and the dosages of the drug.

Step 2- Clinical Research and Development: Phase 1- a small number of volunteers are recruited to establish drug safety and dosage ranges for effective treatment and also to examine side effects. Phase 2-the effects of the drug is tested to determine side effects and effectiveness of the treatment. Phase 3- the drug can be offered safely to a wider group of participating clinics, the FDA usually calls for additional tests before the drug is determined safe.

Step 3- Permission to Market: the FDA can allow for marketing, it is still closely examined for adverse effects An advantage is that they closely examine the products for side effect it may have on a human being before making it public, at the same time the disadvantage is that it takes a while for a drug to pass all these steps that a perfectly good medication to become available for someone in need of it. (pg 97-98) 6. Compare and contrast supply reduction, demand reduction, and inoculation strategies for dealing with drug abuse.

Demand reduction and inoculation have a similarity were they focus on the behaviors of people, they focus more on teaching them about responsibility, and how drugs will effect a person. There is a difference in the two, inoculation is geared more towards the drug users and demand reduction is geared more towards the youths before they become drug users. Supply reduction is focused on actually trying to get the drugs off the street and not to be sold in areas that people can so easily buy them and get their hand on it. (pg 107-108) 7. List and explain Erich Goode’s four different uses of drugs.

–Legal instrumental use: taking prescribed drugs and OTC drugs to relieve or treat mental of physical symptoms –Legal recreational use: using such licit drugs as tobacco, alcohol, and caffeine to achieve a certain mental or psychic state –Illegal instrumental use: taking drugs without a prescription to accomplish a task or a goal –Illegal recreational use: taking illicit drugs for fun or pleasure to experience euphoria (pg 17) 8. List and discuss the four principle factors responsible for determining how a drug user experiences drug use.

–Biological, genetic, and pharmacological factors- pharmacology focuses on how the ingredients of a drug affect the body and nervous system and in turn the persons experience with a drug –Cultural factors-society’s view on drug use affects our initial approach to a particular drug, as determined by custom and tradition –Social factors- the belief that attitudes about drug use develop from the values and attitudes of other drug users in the community, subcultures, peer groups, and families as well as the drug uses personal experience with drug using.

–Contextual factors- Specific contexts define and determine personal dispositions toward drug use, these factors encompass the drug taking social behavior that develops from physical surroundings (pg 4) 9.

List and briefly explain at least six reasons why drug use is a more serious problem today that it was in the past. –drugs are much more potent now a days than they were years ago, for example in 1960 the drug content of marijuana was 1%to 2% and today it varies from 4% to 10%, samples seized from 1975-2007 found a 9.6% of THC –both licit and illicit drugs are being introduced and experimented with by youth, these drugs are often supplied by older siblings, friends, and/or acquaintances –through media people are more affected by TV and radio.

Especially by drug companies that are “pushing” their newest drugs –there is greater availability and wider dissemination of drug information, thousands of web sites provide information on drug usage and instructions on how to make drugs or purchase them on the Internet –drug use and drug dealing are becoming major factors in the growth of crime rates in young people, violent shootings, drive-by killings ,and car jacking –we have become highly dependent on the expertise of others and highly dependent on technology (pg 56) 10.

Explain the significance of the Pure Food and Drug Act of 1906 and why it was important in regulating drugs of abuse. The Pure Food and Drug Act require manufacturers to indicate the amounts of alcohol, morphine, opium, cocaine, heroin, and marijuana extract on the label of each product. Many medicines were labeled “no addictive” but in fact where. This Act was very important due to them enforcing labels, they made misrepresentation illegal so a potentially addicting drug could not be advertised as non-habit forming. (pg 94-95) 11.

Describe the changes in drug regulation that occurred because of the Kefauver-Harris Amendment of 1962. The Kefauver-Harris Amendment of 1962 strengthened the government’s regulation of both the introduction of new drugs and the production and sale of existing drugs. They required the manufacturers to demonstrate the efficacy as well as the safety to their drug products, they regulates and evaluated drug testing by pharmaceutical companies and mandated standards by drug manufacturing policy. (pg 96) 12. Outline the procedure used by the FDA to regulate non-prescription drugs.

The amended Federal Food, Drug, and Cosmetic Act in force today requires that all new drugs be registered with and approved by the FDA.

Because of FDA regulations all pharmaceutical companies must follow a series of steps when seeking permission to market a new drug: Step 1- Preclinical Research and Development- a chemical must be identifies as having potential value in the treatment of a particular condition or disease. Step 2- Clinical Research and Development- makes the drug available on a wide experimental basis Step 3- Permission to Market- the FDA can allow the drug to be marketed under its patented name 13.

Describe how drugs are “scheduled” and discuss each of the five schedules. There are 5 schedules, the Harrison Act of 1914 divided substances with abuse potential into categories based on the degree of their abuse potential and their chemical usefulness.

Schedule 1- substances have high abuse potential and no currently approved medicinal use, health professionals cannot prescribe them Schedule 2- drugs have high abuse potential but are approved for medical purposes and can be prescribes with restrictions Schedule 3- drug has less potential for abuse, currently accepted medical use in treatment Schedule 4- low potential for abuse, currently accepted medical use in treatment, abuse may leave to limited physical dependence Schedule 5- low potential for abuse, accepted medical use for treatment, abuse may lead to limited physical dependence (pg 104) 14.

Discuss the principal advantages and disadvantages of switching products from prescription to over the counter status. It was apparent from review that many OTC drug ingredients did not satisfy the requirements for safety and effectiveness.

With heightened public awareness, greater demand has been brought to bear on the FDA to make better drugs available to the public for self-medication. This has led to the switching policy which allows the agency to review prescription drugs and evaluate their suitability as OTC products. Advantages of this are that it will be easier and quicker to receive a drug for treatment if it is OTC rather than having to make a doctor appointment get a prescription and then wait for it to be filled by the pharmacy.

A disadvantage is that the wider access to more effective drug products will lead to increased abuse or misuse of OTC products (pg 100) 15. Explain the similarities and differences between the nervous and endocrine systems.

The nervous and endocrine systems help medicate internal and external responses to the body’s surroundings; both systems release chemical messengers to achieve their homeostatic functions, these messengers are called neurotransmitters.

These systems differ, the nervous system consists of the brain and spinal cord, it includes the basal ganglia which are primarily responsible for controlling motor activity and learned behaviors, whereas the endocrine system consists of glands that synthesize and release hormones into the blood, the blood carries these chemical messengers throughout the body and they act on specific receptors, the principal structures include the pituitary, adrenal, and gonads. (pg 133-134) 16.

Describe common unintended drug effects and why similar drug doses affect individuals differently. Some side effects of unintended drug effects are: nausea and vomiting, dependence, and allergic reaction.

Similar drug doses affect individuals differently due to many reasons, tolerance, changes in the body that decrease response to a drug, also the size of the individual, the stomach contents, acidity of urine, times of day, and also the state of a person’s health, all of these reasons can make someone react differently to the same amount of the same drug. (pg 138-139) 17. Outline the components of the autonomic and central nervous systems and explain their general functions in relation to drug use and misuse.

–The central nervous system consists of the brain and the spinal cord, which received information through the input nerves. The Reticular Activating system (RAS) is an area of the brain that receive input from all the sensory systems, the RAS is very susceptible to the effect of drugs, drugs that block the actions of another transmitter suppress RAS activity causing sleepiness.

The Basal Ganglia are the primary centers for involuntary and finely tuned motor functions, 2 important neurotransmitters are dopamine and Ach, damage to these can cause Parkinson’s disease, drugs that affect dopamine activity usually result in undesired side effects. The Limbic system includes an assortment of linked brain regions; this system regulates emotional activities and memory.

The Cerebral Cortex is a layer of gray matter made up of nerves and supporting cells that almost surround the rest of the brain and lies under the skull, it receives sensory input and initiating involuntary motor behavior, drugs can dramatically alter the perception of sensory information and cause hallucinations that result in strange behavior.

The Insula is located deep in the brain and is important for motivation; a recent finding stated that a smoker that damaged his insula no longer had the interest in tobacco. The Hypothalamus is located near the base of the brain, integrates information from many sources and serves as the “control center” many vital functions; drugs that alter its functions can have a major impact on systems that control homeostasis.

–The Autonomic Nervous System is located within the brain and spinal cord but their axons project outside the CNS to the involuntary muscles, organs, and glands and does not require conscious control. The ANS has two functional components- sympathetic and parasympathetic; both include neurons but generally have the opposite effect on an organ or its function.

They control most of the internal organs, the circulatory system, and the glandular system. Drugs that enhance the sympathetic nervous system can raise blood pressure, speeds up heart rate, slows down motility of the stomach walls and may cause pupils of the eyes to enlarge. (pg 126-130) 18. Discuss the role of the liver, kidney and lungs in drug metabolism and excretion.

Liver- the primary organ that metabolizes drugs in the body contains hundreds of enzymes that continuously synthesize, modify, and deactivate biochemical substances. After the liver enzymes metabolize the products usually pass into the urine for final elimination, can also appear in air, sweat, and saliva.

Kidney- the next most important organs for elimination, they remove metabolites and foreign substances from the body. The kidneys constantly eliminate substances from the blood, the rate of excretion of some drugs by the kidneys can be altered by making the urine more acidic. Lungs- approximately 1% of consumed alcohol is eliminated in the breath (pg 148).

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