Chapter Outline

ADDICTION

• Addiction is an abnormal relationship with an object or event. It progresses from a definite, though often unclear, beginning toward an end point. Beginning as a voluntary, pleasurable act it then becomes reflective and compulsive.

• Alcoholism and other drug use is a disease. It is characterized by using a substance or behavior repeatedly and as a disease it implies five points:
• The disease can be described
• The course of the disease is predictable and progressive
• The disease is primary
• The disease is permanent
• The disease is terminal

ADDICTIVE BEHAVIORS OTHER THAN ALCOHOL OR OTHER DRUG USE

• Addiction like behaviors, or dependencies may include objects or events such as food, gambling, sex, shoplifting, work, spending, exercise, and watching television

• Even though these objects/events have a normal, socially acceptable function. Most people have a normal, healthy relationship with these things, but dependent behavior results in an abnormal relationship.

ADDICTIVE PERSONALITY

• Many psychologists feel there is no such thing as an addictive personality.

• Others believe the addictive personality may be found in persons who don't know how to have healthy relationships, have been taught not to trust people, and have never learned to "connect" with others, community, one's emotions, and spiritual powers greater than oneself, and have dysfunctional families.

ALCOHOL

• Most misunderstood and abused drug in America

• Alcohol, ethyl alcohol or ethanol, is a central nervous system depressant, taken as a beverage, which alters your emotional and physical state.

ALCOHOL ABSORPTION

• Blood alcohol concentration (BAC) is the amount of alcohol in the blood.

• Virtually nothing speeds up liver metabolization of alcohol (such as a cold shower, coffee, cold air, etc.).

• Within minutes of entering the bloodstream alcohol reaches the brain with mind-altering effects.

SPEED OF ALCOHOL ABSORPTION

• This is based on five factors:
• your body weight
• your sex (gender)
• speed of consumption
• food intake
• what you drink

• Tolerance is the body's physical adjustment to the habitual use of a chemical. Your tolerance increases the longer you have been drinking.

IMPACT OF ALCOHOL

• It is a devastating drug.

• The most dangerous consequences of alcohol use may be that it produces a false sense of confidence, even vulnerability that often leads to disregard for the health, safety, and welfare of self and others.

HEALTH AND LONG-TERM EFFECTS OF ALCOHOL

• Alcohol is a toxin. It interrupts sleep patterns, causes brain damage, increases risk of heart disease, cancer (mouth, throat, stomach, pancreas, liver), depresses the immune system, causes liver cirrhosis.

USE, MODERATE USE, AND ABUSE

• Two-thirds of Americans use alcohol . . . no more than one or two drinks a week.

• Others use alcohol in moderation . . . no more than two drinks per day for men and no more than one drink per day for women and no more than five per week total.

• Others abuse alcohol . . . more than three drinks per day or more than five per week, uses alcohol for something other than a beverage with meals, is pregnant, drives, or binges (5 or more for men; 4 or more for women per setting).

COLLEGE BINGE DRINKING/POSITIVE NORMING AND HARM REDUCTION

• Binge drinking is defined as five or more drinks for men at one setting and four or more at one setting for women.

• Frequent binge drinkers represent 23% of the student population - not a majority by any means.

• They account for more than 3/5 of the serious alcohol-related problems on campus and consume 68% of all alcohol consumed on campus.

• Positive norming dispels the myth that "everyone" is consuming vast amounts of alcohol and causing problems for themselves and others.

• Harm reduction is learning how to drink responsibly if you choose to drink at all.

• Follow the "Zero . . . One . . . Three Rule for Lower-Risk Drinking".

• 0 = no level of drinking is recommended. Never drink and drive
• 1 = drink only one alcoholic beverage per hour if you do drink
• 3 = never drink more than three alcoholic beverages per day (or more than five per week)

ALCOHOLISM

• Alcoholism is a drug [chemical dependence]. It involves progressive preoccupation with drinking, leading to physical, mental, or social dysfunction. One in ten Americans is an alcoholic.

STRATEGIES FOR DEALING WITH ALCOHOL

• You don't have to go along with the crowd. Take charge of your decisions and learn strategies for drinking less or not at all.

• Learn how to help a friend who has consumed too much alcohol and passed out.

ALCOHOL AND THE LAW

• Drinking to any extent reduces the ability of any driver

• A tough, new standard for drunken driving has recently become law. The new law defines driving under the influence of alcohol as driving with a blood alcohol content (BAC) of 0.08 percent.

FETAL ALCOHOL SYNDROME (FAS) AND FETAL ALCOHOL EFFECT (FAE)

• This condition is caused by women drinking during pregnancy.

• Damage can range from mental retardation to physical deformity. It is totally preventable.

• It is not certain how much alcohol it takes to damage the fetus. DO NOT DRINK.

• FAE is the same but it affects a greater number of babies. Symptoms may be more subtle than FAS (impaired memory, poor judgment, reduced capacity to learn).

TOBACCO

• The U.S. Surgeon General states that smoking is the number one preventable cause of death in our society.
• Over 400,000 people die each year because they smoked.

• Smoking kills seven times the number of Americans killed in the Vietnam War. Reduces life expectancy by eight years.

SMOKING IS BECOMING SOCIALLY UNACCEPTABLE

• Smoking may have been considered glamorous once, but, today, attitudes are changing. Smoking commercials have been banned from radio/TV. Cigarette advertisements and packages carry health warnings.

• Dangers of secondhand smoke are recognized.

WHY DO PEOPLE SMOKE?

• Peer influence. The number of friends who smoke is the number one determinant.

• Powerful advertising - billboard advertising is now illegal.

• Nicotine addiction.

HEALTH RISKS OF SMOKING

• Nicotine increases heart rate, blood pressure, heart's workload, and constricts blood vessels.

• Carbon monoxide reduces oxygen in the blood stream, increases heart tissue damage, increases atherosclerosis.

• Tar contains carcinogens and lung tissue irritants. Promotes chronic bronchitis and emphysema.

• Heart disease is the number one cause of smoker's death.

SMOKELESS TOBACCO

• This is not safe: 50 times greater risk of oral cancer, decreased ability to taste and smell, stained teeth, gum damage, tooth loss, oral leukoplakia and nicotine addiction.

ARE YOU A PASSIVE SMOKER?

• Passive smoking is harmful: causes 30,000-60,000 deaths per year. Nonsmokers do not adapt to the harmful effects as do smokers so it is more damaging to them.

• Smoker's families have more respiratory illnesses, childhood asthma, and sudden infant death syndrome.

WHY SHOULD YOU QUIT?

• Health! The simple act of quitting can add years to a person's life (and quality to those years).

• Financial. Smoking is expensive.

HOW TO QUIT SMOKING

• Number one determinant of success is smoker's own desire to quit.

• Number two determinant of success is support of family and friends.

• Ways: "cold turkey," gradually reduce number smoked, nicotine patch and gum, pills.

• Learn American Cancer Society's recommendations.

THE CLOCK STRATEGY

• Assign yourself specific times of the day to smoke.

• Gradually lengthen the intervals between cigarettes.

• Cut back progressively on the number of cigarettes per week - by 1/3 each week.

PSYCHOACTIVE DRUGS

• Psychoactive drugs are mind-affecting or mind-altering drugs. They are chemical substances that change one's thinking, feelings, perceptions, and behaviors. They are classified in this text by their effect on the CNS: depressants, marijuana, narcotics or opiates, stimulants, psychedelics, and inhalants.

DEPRESSANTS

• Depressants are known as sedatives. They slow down the CNS, relax or tranquilize, and produce sleep.

• This category includes: the "date rape drugs" (gamma hydroxybutyric acid -GHB and Rohypnol - roofies).
• Of course alcohol is a CNS depressant, but it was discussed earlier in the chapter.

MARIJUANA

• America's most widely used illegal drug. Sometimes called "pot" or "grass".

• Marijuana is an intoxicating psychoactive drug that may produce both depressant and psychedelic effects.

• The main psychoactive component n marijuana is delta-9-THC.

• Usually smoked as a cigarette called a "joint".

• Has a myriad of negative effects.

• Marijuana has some medical use (treating glaucoma, epilepsy, multiple sclerosis, or nausea from cancer treatment) although not found to be better than conventional medical treatment.

NARCOTICS OR OPIATES

• These are powerful painkillers. The narcotic analgesics, often referred to as opioids, also produce pleasurable feelings (euphoria), and induce sleep, and depress breathing.

• Heroin is in this category. It is the most abused and the most rapidly acting of the opiates and is sometimes called "smack", "jink", "H," and "hard stuff".

• Heroin may be injected or sniffed. Purer and more potent heroin is available today increasing the risk of overdosing.

• Heroin has a myriad of negative effects.

STIMULANTS

• Stimulants are chemical substances that speed up the CNS, resulting in alertness and excitability.

• This category includes cocaine and crack and methamphetamine (a.k.a. crank and ice).

• Caffeine is a CNS stimulant but is discussed later in the chapter.

• Cocaine is extracted from the coco plant and is illegal.

• Cocaine may be swallowed, snorted, injected, or smoked.

• Crack is crystallized freebase cocaine sold in the form of ready-to-smoke "rocks."

• Cocaine and crack use can be deadly.

• Crank is a methamphetamine and a powerful CNS stimulant. Ice, the smokable form of crank, is called crystal meth.

• Methamphetamines are more addictive than crack cocaine.

• Methamphetamine can be made by a "cook" with readily available ingredients in a "meth" lab. Ephedrine (common over-the-counter drug) is extracted in these labs to produce the drug.

PSYCHEDELICS

• Psychedelic drugs are known as mind-expanders or hallucinogens. These drugs affect an individual's perception, awareness, and emotions and can also cause hallucinations (completely groundless, false perceptions). They can also cause illusions (misinterpretations of reality or something imagined).

• This category includes LSD and MDMA or "Ecstacy" - both are illegal.

• LSD (lysergic acid diethylamide) is illegal and commonly called "acid".

• The effects of LSD are unpredictable and may cause flashbacks (a reoccurrence of certain aspects of a person's drug experience without the user having repeated its use).

• MDMA or ecstacy is also known as "Adam", or "X-TC". It is a synthetic designer drug produced mainly by underground chemists.

• Ecstacy can be found at raves (all-night dance parties), rock concerts, night clubs, and even at schools.

INHALANTS

• Inhalants are volatile non-drug substances (often ordinary household products) that have druglike effects when inhaled. A few of these substances do have some medical uses specifically, amyl nitrite and nitrous oxide.

• Inhalants are a diverse group of breathable chemicals that produce mind-altering vapors. They are classified into three major groups, all potentially hazardous to users: commercial solvents, aerosols, and anesthetics.

DRUGS AFFECTING PHYSICAL PERFORMANCE

• These are drugs used by athletes looking for an edge over the competition. All of these can adversely affect your health.

• This category includes: anabolic steroids, amphetamines, diuretics, and caffeine.

• Anabolic steroids are an artificial form of the male hormone testosterone. Use may cause uncontrollable, aggressive behavior, or 'roid rage.

• Amphetamines ("speed") are powerful CNS stimulants. This drug is taken by athletes, truck drivers, pilots, and entertainers to mask fatigue.

• Diuretics cause the body to pass water by increasing urine output and are used by athletes to mask anabolic steroid use.

• Caffeine is the most common drug used by our society and may be used by athletes to improve performance in endurance activities (little or no benefit for highly trained athletes) and to mask fatigue.

OVER-THE-COUNTER (OTC) AND PRESCRIPTION DRUGS

• OTCs are legal drugs which may produce adverse effects or dependence or be abused.

• Aspirin most commonly used OTC drug.

• Nasal sprays, laxatives, eye drops, alcohol/codeine cough syrups, and stimulants (herbal energizers, etc.) which contain ephedrine, pseudoephedrine, and PPA (phenylpropanolamine) all may cause adverse effects or dependence.
• Some prescription drugs may be abused. This includes amphetamines, barbiturates, narcotics, tranquilizers, and stimulants.