Key Terms

• Drug: any chemical substance that affects the structure or function of the body
• Psychoactive drug: a drug that can alter a person’s state of mind or consciousness
• Intoxication: a state in which a person’s normal functioning is impaired, usually by alcohol or drugs
• Substance misuse or abuse: use of any substance despite adverse social, psychological, or medical consequences; the use may be intermittent and with or without tolerance and physical dependence

What is Addiction?

Addiction: psychological or physical dependence on a substance or behavior, which causes harm to the individual or society

Dependence: result of physiological or psychological adaptation that occurs in response to frequent use of a substance (which includes behaviors such as gambling); typically associated with tolerance and withdrawal

Tolerance: lower sensitivity to a drug, so that a given dose no longer exerts the usual effect and larger doses are needed

Withdrawal: physical and psychological symptoms resulting from the interrupted use of a drug on which a user is physically dependent; symptoms may be mild or life threatening

American Psychological Association (APA) Substance Use Disorder Criteria

• Developing tolerance to the substance
• Experiencing withdrawal
• Taking the substance in larger amounts or over a longer period than originally intended
• Expressing the desire to cut down or regulate substance abuse
• Spending a great deal of time getting the substance, using the substance, or recovering from its effects
• Giving up or reducing important school, work, or recreational activities because of substance use
• Continuing to use the substance despite the knowledge that it is contributing to a psychological or physical problem
• Craving or an intense desire or urge for a specific substance
• Use in situations that are physically hazardous
• Unsuccessful efforts at reducing amounts
• Failure to fulfill major obligations

Types of Drugs

Opioids

What: heroin, opium, morphine, oxycodone, codeine, hydrocodone

How it’s used: injected, smoked, snorted, swallowed

Short-term effects:

• Relief of anxiety/pain
• Lethargy
• Drowsiness
• Confusion
• Respiratory depression
• Constipation
• Nausea

Central Nervous System (CNS) Depressants

What: barbiturates, Xanax, Valium

How it’s used: swallowed, injected

Short-term effects:

• Reduced anxiety
• Reduced pulse rate
• Impaired muscle coordination
• Loss of consciousness
• Drowsiness
• Lowered inhibitions

Central Nervous System (CNS) Stimulants

What: amphetamine, Cocaine, Ritalin

How it’s used: injected, swallowed, smoked, snorted

Short-term effects:

• Increased and irregular heart rate, blood pressure, metabolism
• Increased mental alertness/energy
• Nervousness
• Insomnia
• Reduced appetite

Cannabis Products

What: marijuana, Hashish

How it’s used: smoked, swallowed, eaten (edibles)

Short-term effects:

• Slowed thinking and reaction time
• Euphoria
• Confusion
• Impaired balance and coordination

Hallucinogens

What: LSD, Ecstasy, PCP, MDMA, Psilocybin

How it’s used: swallowed, smoked, injected, snorted, absorbed through mouth

Short-term effects:

• Altered states of perception and feeling
• Increased heart rate, blood pressure
• Delirium
• Impaired motor function
• Weakness and numbness

Overview of Psychoactive Drugs

A Drug’s Potential for Substance Abuse and Addiction

Alcohol

In the following sections, we will describe how alcohol works in body, as well as the short and long term effects of alcohol use and misuse.

What is a Standard Drink? What is “one drink”?

A “standard” drink is any drink that contains about 0.6 fluid ounces or 14 grams of pure alcohol. Below are different drink sizes, each containing approximately the same amount of alcohol and counting as a single standard drink. The examples serve as starting point for comparison.

Citation: https://alcohol.stanford.edu/faq/count-your-drinks

But What About the “Red Cup”?

Knowing the measurements associated with the lines on the cup can help you get a better idea of how many drinks you are consuming. You may want to consider mixing your own drinks, so you can control how much alcohol you are realistically consuming. See this web site for great information on the alcohol that is typically served at social functions on and off college campuses.

Red Cup Measurements

Citation: https://wellness.uncc.edu/sites/wellness.uncc.edu/files/media/red%20solo%20cup%20%28website%29_1.jpg

Blood Alcohol Concentration (BAC)

• Amount of alcohol in the blood in terms of weight per unit volume; used as a measure of intoxication
• If a person drinks slowly, blood alcohol concentration (BAC) remains low
• Consuming more than is metabolized causes BAC to rise and results in intoxication
• Legal limit for BAC in all states is 0.08%
• Many states have “zero tolerance” laws for drivers under age 21
• Alcohol impairs the user even at much lower BACs than 0.08%
• Blood Alcohol Content (BAC) Calculator

Effects of Alcohol

• Brain: Alcohol interferes with the brain’s communication pathways and can affect the way the brain looks and works. These disruptions can change mood and behavior and make it harder to think clearly and move with coordination.
• Heart: Drinking a lot over a long time or too much on a single occasion can damage the heart, causing problems such as stroke, high blood pressure, and arrhythmia.
• Liver: Heavy drinking takes a toll on the liver and can lead to a variety of problems such as alcoholic hepatitis, fibrosis, and cirrhosis
• Pancreas: Alcohol causes the pancreas to produce toxic substances that can eventually lead to pancreatitis, a dangerous inflammation and swelling of the blood vessels in the pancreas that prevents proper digestion.
• Cancer: Drinking too much alcohol can increase your risk of developing certain cancers, including cancers of the mouth, esophagus, throat, liver, and breast.
• Immune system: Drinking too much can weaken your immune system, making your body a much easier target for disease. Chronic drinkers are more liable to contract diseases like pneumonia and tuberculosis than people who do not drink too much. Drinking a lot on a single occasion slows your body’s ability to ward off infections—even up to twenty-hour hours after getting drunk.

Binge Drinking

• Binge Drinking is defined by the National Institute on Alcohol Abuse and Alcoholism as a pattern of alcohol consumption that brings blood alcohol concentration (BAC) to 0.08% or higher within about 2 hours.
• 5 drinks in a row for men or 4 drinks in a row for women within 2 hours
• 2013 survey: 23% of people over age of 12 were binge drinkers

Alcohol Misuse

• Use of alcohol to a degree that causes physical damage, impairs functioning, or results in behavior harmful to others
• Warning signs for alcohol use disorder:
  • Drinking alone or secretively
  • Using alcohol to get through difficult situations
  • Using alcohol as a way to self-medicate
  • Discomfort at social events without alcohol
  • Drinking more than usual
  • Heavy drinking in risky situations
  • Getting drunk regularly or more frequently
  • Drinking in the morning or at unusual times

Alcohol Use Disorder

• Chronic psychological disorder characterized by excessive and compulsive drinking, and measured as mild, moderate, or severe
• Usually involves developing a physical tolerance to alcohol and symptoms of withdrawal when drinking stops.
• When alcoholics stop drinking, they experience withdrawal symptoms that can be life-threatening
  • DTs (delirium tremens): state of confusion brought on by the reduction of alcohol intake in an alcohol-dependent person

Practical/Safe Tips For When You Choose to Drink

• Pace and space-sip your drink instead of chugging; alternate alcoholic drinks with non-alcoholic options (water or soda) and consume no more than one alcoholic beverage per hour. It generally takes 3 hours for most people to eliminate the alcohol in 3 drinks.
• Eat before and while drinking-food, especially protein, helps slow the absorption of alcohol into the bloodstream.
• Avoid mixing alcohol with other drugs, even over the counter medications and caffeine.
• Use caution when sick or tired-fatigue and illness cause alcohol to be metabolized more slowly.
• Use the buddy system-if you’re headed to a party, or bar, go with an accountable and trustworthy group of friends that can keep an eye out for you and vice versa. Have a plan in place for transportation and what you’ll do if your friends had too much.

Tobacco

Facts

• U.S. Surgeon General: smoking is the leading preventable cause of illness and death in the U.S.
• 480,000 Americans die prematurely from smoking-related causes
• All forms of tobacco are unsafe, including pipes, chewing tobacco, and clove cigarettes

Nicotine Addiction

• Nicotine: poisonous, addictive substance found in tobacco and responsible for many of the effects of tobacco
• If an addicted tobacco user does not have a steady amount of nicotine circulating in the body and going to the brain, s/he experiences such withdrawal symptoms as muscular pain, nausea, insomnia, and headaches

Nicotine Health Hazards

• Smoking has profound negative effects
• Chemicals in tobacco include carcinogens, cocarcinogens, agents that irritate respiratory tissue, and carbon monoxide
• Nicotine can either excite or tranquilize the nervous system
• Smokers lose about 14 years of life on average
• Smoking is linked to:
  • CVD
  • Lung disease
  • Cancer
  • Tooth decay and gum disease
  • Menstrual disorders
  • Motor vehicle crashes

Other Forms of Tobacco Use

• Cigars and pipes
  • Cigar and pipe smokers are at risk for many health problems faced by cigarette smokers
  • Cigars contain more nicotine and tar than do cigarettes
  • Cigar smokers who don’t inhale have a six-times greater risk of throat cancer than nonsmokers
• Spit (smokeless) tobacco
  • Spit tobacco can be used as snuff or chewing tobacco
  • Chewing tobacco increases the risk of oral cancer
  • Snuff increases the risk of cheek and gum cancer
  • Both lead to nicotine addiction
• Hookahs
  • Smoking flavored tobacco through a waterpipe has increased in popularity
  • Smoke from these pipes contains 10 times more carbon dioxide than the smoke from a single cigarette
  • Hookah smokers take an average of 100 puffs per session and each one delivers approximately the same amount of smoke as a single cigarette
• E-cigarettes, or e-cigs
  • Battery-powered devices that resemble real cigarettes
  • Use changeable filter that contains one or more chemicals, such as nicotine and flavorings
  • FDA warns consumers that the same carcinogens are present in these products

Environmental Tobacco Smoke

• Environmental tobacco smoke (ETS): smoke from the burning end of a cigarette, cigar, or pipe, and smoke exhaled by smokers; also called secondhand smoke
• Mainstream smoke: smoke inhaled by a smoker and exhaled into the atmosphere
• Side stream smoke: smoke from the burning end of a cigarette, cigar, or pipe
• Known human carcinogen
  • Causes 7,000 lung cancer deaths annually
• Contributes to heart disease and aggravates such respiratory conditions as allergies and asthma

Treatment for Substance Use Disorder and Addiction

• There is no single best method
• Treatment must:
  • Deal with the reasons behind the abuse
  • Help individuals change their attitudes and behaviors and develop a social support system
  • The best solution is prevention

References

• TED. (2015, Jul 9). Everything you think you know about addiction is wrong-Johann Hari [Video]. YouTube. https://www.youtube.com/watch?v=PY9DcIMGxMs
• TED-Ed. (2020, May 7). What causes opioid addiction and why is it so tough to combat?-Mike Davis [Video]. YouTube. https://www.youtube.com/watch?v=V0CdS128-q4
• Khan Academy. Overview of Psychoactive Drugs [Video]. https://www.khanacademy.org/science/in-in-class-12-biology-india/xc09ed98f7a9e671b:in-in-human-health-and-disease/xc09ed98f7a9e671b:in-in-addiction-and-dependence/v/substance-use-disorders
• Stanford University. (2021). The red cup. https://alcohol.stanford.edu/alcohol-drug-info/i-bet-you-didnt-know/red-cup
• Responsibility.org. (2021). BAC calculator: the virtual bar. https://www.responsibility.org/drink-responsibly/bac-calculator/