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Drug Use, Abuse and Misuse
in the
United States
Health 11 – Principles of Healthful Living
Categories of Drugs
1. Prescription Drugs (need doctor approval)
2. Over-the-counter (OTC) drugs (self-diagnose)
3. Recreational Drugs (alcohol, tobacco, caffeine)
4. Illicit (illegal) drugs (stimulants, depressants,
hallucinogens, designer drugs, marijuana & oils)
5. Herbal preparation (lack of FDA regulations)
6. Commercial preparations (cleansers, tar, nail
polish, industrial by-products)
Public Health Campaign on
Drugs
 The “War on Drugs”, “Just Say No”, “Hugs Not Drugs”
 “DARE”, “Mothers Against Drunk Drivers”, “Drug Czar”
 When you have politicians serving the public as “health
educators” this is the result. The cost to benefit ratio is
outrageous and We – the taxpayers – are paying for it. We
spend 500 million each year for a “drug-free” America. It’s
time to let everyone do their own jobs. Health educators
should be educating the public and the politicians should be
serving in the best interest of the public.
Routes of Administration
1. Oral ingestion
2. Injection (intravenous, intramuscular,
subcutaneous)
3. Inhalation
4. Inunction
5. Suppositories
The Effects of Drugs
1. Physiological Factors – chemical effects
based on type of drug – stimulants vs.
depressants vs. hallucinogens– effects
on central nervous system
2. Psychological Factors – environmental
effects (Set vs. Setting)
Receptor Site Theory
 The Receptor Site Theory answers the question as to how
chemicals are utilized by the body. The cells in your body
maintain your existence. Cells utilize nutrients, oxygen, hormones
and neurotransmitters to provide for your energy and repair. Cells
are also specialized – meaning that they have different functions,
“job titles” in the body that they are responsible for completing.
The receptor sites on the cells provide the “toll-booth” for cells.
Thereby only allowing certain chemicals to enter the cell. Once
these chemicals enter the cell they are metabolized and
eventually the waste products of their metabolism is excreted.
The analogy of putting together pieces of a puzzle or the “lock and
key” example describes how receptors only allow certain
nutrients, drugs, hormones, neurotransmitters, etc. to enter the
cell.
Main Effects of Drug Use
Depending on your drug of choice: Stimulant, Depressant,
Hallucinogenic (Your personality has a lot to do with this)
 The “positive” effect that your are looking for from the drug
(the high, the low, the gone, the flow, the here, the there,
the happy, the sad).
 Once you develop a tolerance, the body will need more for
the same effect. This contributes to the escalating need for
more drug, more often, more time spent using, more money
and obviously more energy spent involved with this
addicting habit.
 An addiction takes time from your schedule. Addictions
leave less time for work, school, travel, reading, learning,
meeting new people, going to parties, conferences, leisure
activities.
Side Effects of Drugs
 Chronic diseases (CVD, Cancer, COPD)
 Mood instability
 Nausea, Vomiting, Coughing
 More colds, flu, absent from work, school
 Lower GPA in school
 Family problems, divorce, violence, rape
 Accelerates the aging process
 Eventually will lose independent living
 We do not use drugs for these reasons – but
these are the consequences of our decisions.
Drugs are immediate!
Everything else takes time. Such
as exercise, relaxing to music,
calming effects of candles, sex.
History of Alcohol in U.S.
 1600’s – 1700’s – no alcohol problem
 1700’s – 1800’s – alcohol problems begin –
family violence on the rise
 1800’s – 1900’s – Doctor’s begin to define
alcoholism – see problems in society
There are approximately 295
million Americans in the U.S.
Who is at risk for becoming an alcoholic?
1. 1 in 10 Americans
2. 1 in 4 if one parent is an alcoholic
3. 1 in 2 if dad or grandfather
Alcohol and All Other Drugs
do Two Things:
 They are agents of change.
1. They change the way you think (mental).
2. They change the way you feel (emotional).
By default – you will behave differently.
Successful Treatment for Drug
Use, Abuse and Misuse
1. The Individual – 5 levels
 Mental, Physical, Emotional, Social, Moral
2. The Environment (Society)
 Hetero-, Homo-, Politics, Economics, Religion,
Culture
3. Genetics – enzymes, genes
Do you send people to jail if they
drink alcohol or if they smoke
tobacco or use marijuana?
Why do we put people in jail?
What is an addiction versus a
habit?
 Addiction
An unhealthy continued involvement with a mood-altering
object or activity that creates harmful consequences.
Signs of an addiction are (1) obsession/compulsion (2)
loss of control (3) negative consequences (4) denial (5)
escalation (6) tolerance (7) withdrawal symptoms.
 Habit
A healthy continued involvement with an object or activity
that contributes to your growth in all six dimensions of
wellness.
Risk Factors
for Addiction
 Your
Personality
1. Low self-esteem
2. External focus of
control
3. Passivity
4. Post-traumatic stress
disorder
 Your
Environment
1. Access
2. Abusive home
3. Peer norms
4. Life events
/oppression
 Your Biology
1. Early exposure
2. ADD/Learning
disabilities
3. Neurotransmitter
imbalance
4. Genetic predisposition
Signs of Work Addiction
 Time urgency
 Need to control
 Perfectionism
 Difficulty with
relationships
 Work binges
 Difficulty relaxing and
having fun
 Irritability
 Memory loss due to
preoccupation with
work
 Low self-esteem
 Health problems
Alcohol Key Terms
 History of Alcohol
 Perception
 Schedule 1-5
 Rehab
 Risk factors
 Physical effects
 Statistics
 Tolerance
 Withdrawal
 Dependence
 Set and Setting
 Binge drinking
 Proof/Percentage
 Cirrhosis,fatty liver
 FAS, FAE,
DT’STolerance
Perception of Alcohol Use &
Abuse
 Behavior – before prohibition
 Substance – during prohibition
 Person – after prohibition
History of Drug Control
 Tax it
 Prohibit it – 18th
amendment (1919-1933)
 Where’s the education?
 1933 21st
amendment – repealed prohibition –
Franklin D. Roosevelt trying to boost economy
after the Depression 1929-1933.
Alcoholics Anonymous (AA)
1935 – AA formed by Dr. Bob and Bill W.
Dr. Jellinek defines alcoholism as a disease
for the first time!
The “Abstract” Brain
1. Think
2. Feel
3. Vital functions
We have 20 billion brain cells
1. Cells communicate electrically and
chemically
What is one drink?
1. Beer – 12 oz. (4-6%)
2. Wine – 3-4 oz. (12-15%)
3. Distilled liquors – 1 oz. (50-75%)
Proof = twice the percentage
How Alcohol Passes through
the Body
1. Mouth – Esophagus – Stomach –
Duodenum – Blood stream – circulates
through all the organs – brain, heart,
pancreas, liver, kidneys, adrenal glands,
genitals, breast
2. The body can remove approximately 1
drink per hour.
Effects of Alcohol
 Immediate
effects
1. Loss of inhibitions
2. Flushing/dizziness
3. Impaired
coordination
4. Slow reactions
5. High blood pressure
6. Memory impairment
 Long Term Effects
1. Vitamin/nutritional
deficiencies
2. Skin problems
3. Loss of muscle tissue
4. Sexual impotence
5. Frequent infections
6. Heart, lung, liver and
brain disfunctions
How Drugs Are Scheduled
 Schedule I – high potential for abuse and addiction, no
accepted medical use (amphetamine, heroin, PCP, marijuana)
 Schedule II – high potential for abuse and addiction, restricted
medical use (cocaine, methadone, morphine, opium)
 Schedule III – some potential for abuse and addiction,
currently accepted medical use (prescription drugs and over the
counter drugs)
 Schedule IV – low potential for abuse and addiction, current
medical use (anti-seizure meds, minor tranquilizers)
 Schedule V – lowest potential for abuse and addiction,
medical use (over-the counter drugs)
Polydrug Use
1. Synergism
2. Antagonism
3. Inhibition
4. Intolerance
5. Cross tolerance
Prescription / OTC Drugs
 Prescription
Drugs:
1. Antibiotics
2. Anti-depressants
3. Sedatives/
4. Tranquilizers
5. Diuretics
 OTC Drugs:
1. Analgesics
2. Laxatives
3. Prostaglandin
inhibitors
4. Anti-inflammatory
drugs - ibuprophen
When do prescription drugs
become over-the-counter drugs:
1. Doctors feel they are safe without a
prescription
2. The drug(s) have been on the market
for at least 3 years and are on the safe
and effective list (GRAS/GRAE)
3. There appears to be a high demand for
drugs to be over-the-counter
Tolerance
1. Weight (size)
2. Gender
3. Percent concentration
4. Amount consumed
5. Empty stomach
6. Polydrug use
7. Enzyme action
Withdrawal
 Detox
 The first 3 days presents the greatest
risk for death
Dependence
 Physiological and psychological issues
 Not as easy as saying “Just Say No”
 In fact, with some drugs if you stop
suddenly there may be severe side
effects – even death. Careful when you
try to give advise to others.
How do you feel?
Depressed Normal Bliss
Unhappy Euphoric
Bottom line…We have needs!
 We want to be happy
 We want to feel good
 We want to be successful
 We want to be loved
 We want to feel
motivated
 We want to have energy
 We want friends
 We want to be
recognized
 We want to be relaxed
 We want to feel “high” –
stimulated
 We want to relieve
depression
 We want to be less
inhibited
 We want to try something
new, take risks – be
adventurous
 We want to discover the
meaning of life
If your needs are not being met…
You will self-medicate!

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Drug Use, Abuse And Misuse 2004

  • 1. Drug Use, Abuse and Misuse in the United States Health 11 – Principles of Healthful Living
  • 2. Categories of Drugs 1. Prescription Drugs (need doctor approval) 2. Over-the-counter (OTC) drugs (self-diagnose) 3. Recreational Drugs (alcohol, tobacco, caffeine) 4. Illicit (illegal) drugs (stimulants, depressants, hallucinogens, designer drugs, marijuana & oils) 5. Herbal preparation (lack of FDA regulations) 6. Commercial preparations (cleansers, tar, nail polish, industrial by-products)
  • 3. Public Health Campaign on Drugs  The “War on Drugs”, “Just Say No”, “Hugs Not Drugs”  “DARE”, “Mothers Against Drunk Drivers”, “Drug Czar”  When you have politicians serving the public as “health educators” this is the result. The cost to benefit ratio is outrageous and We – the taxpayers – are paying for it. We spend 500 million each year for a “drug-free” America. It’s time to let everyone do their own jobs. Health educators should be educating the public and the politicians should be serving in the best interest of the public.
  • 4. Routes of Administration 1. Oral ingestion 2. Injection (intravenous, intramuscular, subcutaneous) 3. Inhalation 4. Inunction 5. Suppositories
  • 5. The Effects of Drugs 1. Physiological Factors – chemical effects based on type of drug – stimulants vs. depressants vs. hallucinogens– effects on central nervous system 2. Psychological Factors – environmental effects (Set vs. Setting)
  • 6. Receptor Site Theory  The Receptor Site Theory answers the question as to how chemicals are utilized by the body. The cells in your body maintain your existence. Cells utilize nutrients, oxygen, hormones and neurotransmitters to provide for your energy and repair. Cells are also specialized – meaning that they have different functions, “job titles” in the body that they are responsible for completing. The receptor sites on the cells provide the “toll-booth” for cells. Thereby only allowing certain chemicals to enter the cell. Once these chemicals enter the cell they are metabolized and eventually the waste products of their metabolism is excreted. The analogy of putting together pieces of a puzzle or the “lock and key” example describes how receptors only allow certain nutrients, drugs, hormones, neurotransmitters, etc. to enter the cell.
  • 7. Main Effects of Drug Use Depending on your drug of choice: Stimulant, Depressant, Hallucinogenic (Your personality has a lot to do with this)  The “positive” effect that your are looking for from the drug (the high, the low, the gone, the flow, the here, the there, the happy, the sad).  Once you develop a tolerance, the body will need more for the same effect. This contributes to the escalating need for more drug, more often, more time spent using, more money and obviously more energy spent involved with this addicting habit.  An addiction takes time from your schedule. Addictions leave less time for work, school, travel, reading, learning, meeting new people, going to parties, conferences, leisure activities.
  • 8. Side Effects of Drugs  Chronic diseases (CVD, Cancer, COPD)  Mood instability  Nausea, Vomiting, Coughing  More colds, flu, absent from work, school  Lower GPA in school  Family problems, divorce, violence, rape  Accelerates the aging process  Eventually will lose independent living  We do not use drugs for these reasons – but these are the consequences of our decisions.
  • 9. Drugs are immediate! Everything else takes time. Such as exercise, relaxing to music, calming effects of candles, sex.
  • 10. History of Alcohol in U.S.  1600’s – 1700’s – no alcohol problem  1700’s – 1800’s – alcohol problems begin – family violence on the rise  1800’s – 1900’s – Doctor’s begin to define alcoholism – see problems in society
  • 11. There are approximately 295 million Americans in the U.S. Who is at risk for becoming an alcoholic? 1. 1 in 10 Americans 2. 1 in 4 if one parent is an alcoholic 3. 1 in 2 if dad or grandfather
  • 12. Alcohol and All Other Drugs do Two Things:  They are agents of change. 1. They change the way you think (mental). 2. They change the way you feel (emotional). By default – you will behave differently.
  • 13. Successful Treatment for Drug Use, Abuse and Misuse 1. The Individual – 5 levels  Mental, Physical, Emotional, Social, Moral 2. The Environment (Society)  Hetero-, Homo-, Politics, Economics, Religion, Culture 3. Genetics – enzymes, genes
  • 14. Do you send people to jail if they drink alcohol or if they smoke tobacco or use marijuana? Why do we put people in jail?
  • 15. What is an addiction versus a habit?  Addiction An unhealthy continued involvement with a mood-altering object or activity that creates harmful consequences. Signs of an addiction are (1) obsession/compulsion (2) loss of control (3) negative consequences (4) denial (5) escalation (6) tolerance (7) withdrawal symptoms.  Habit A healthy continued involvement with an object or activity that contributes to your growth in all six dimensions of wellness.
  • 16. Risk Factors for Addiction  Your Personality 1. Low self-esteem 2. External focus of control 3. Passivity 4. Post-traumatic stress disorder  Your Environment 1. Access 2. Abusive home 3. Peer norms 4. Life events /oppression  Your Biology 1. Early exposure 2. ADD/Learning disabilities 3. Neurotransmitter imbalance 4. Genetic predisposition
  • 17. Signs of Work Addiction  Time urgency  Need to control  Perfectionism  Difficulty with relationships  Work binges  Difficulty relaxing and having fun  Irritability  Memory loss due to preoccupation with work  Low self-esteem  Health problems
  • 18. Alcohol Key Terms  History of Alcohol  Perception  Schedule 1-5  Rehab  Risk factors  Physical effects  Statistics  Tolerance  Withdrawal  Dependence  Set and Setting  Binge drinking  Proof/Percentage  Cirrhosis,fatty liver  FAS, FAE, DT’STolerance
  • 19. Perception of Alcohol Use & Abuse  Behavior – before prohibition  Substance – during prohibition  Person – after prohibition
  • 20. History of Drug Control  Tax it  Prohibit it – 18th amendment (1919-1933)  Where’s the education?  1933 21st amendment – repealed prohibition – Franklin D. Roosevelt trying to boost economy after the Depression 1929-1933.
  • 21. Alcoholics Anonymous (AA) 1935 – AA formed by Dr. Bob and Bill W. Dr. Jellinek defines alcoholism as a disease for the first time!
  • 22. The “Abstract” Brain 1. Think 2. Feel 3. Vital functions
  • 23. We have 20 billion brain cells 1. Cells communicate electrically and chemically
  • 24. What is one drink? 1. Beer – 12 oz. (4-6%) 2. Wine – 3-4 oz. (12-15%) 3. Distilled liquors – 1 oz. (50-75%) Proof = twice the percentage
  • 25. How Alcohol Passes through the Body 1. Mouth – Esophagus – Stomach – Duodenum – Blood stream – circulates through all the organs – brain, heart, pancreas, liver, kidneys, adrenal glands, genitals, breast 2. The body can remove approximately 1 drink per hour.
  • 26. Effects of Alcohol  Immediate effects 1. Loss of inhibitions 2. Flushing/dizziness 3. Impaired coordination 4. Slow reactions 5. High blood pressure 6. Memory impairment  Long Term Effects 1. Vitamin/nutritional deficiencies 2. Skin problems 3. Loss of muscle tissue 4. Sexual impotence 5. Frequent infections 6. Heart, lung, liver and brain disfunctions
  • 27. How Drugs Are Scheduled  Schedule I – high potential for abuse and addiction, no accepted medical use (amphetamine, heroin, PCP, marijuana)  Schedule II – high potential for abuse and addiction, restricted medical use (cocaine, methadone, morphine, opium)  Schedule III – some potential for abuse and addiction, currently accepted medical use (prescription drugs and over the counter drugs)  Schedule IV – low potential for abuse and addiction, current medical use (anti-seizure meds, minor tranquilizers)  Schedule V – lowest potential for abuse and addiction, medical use (over-the counter drugs)
  • 28. Polydrug Use 1. Synergism 2. Antagonism 3. Inhibition 4. Intolerance 5. Cross tolerance
  • 29. Prescription / OTC Drugs  Prescription Drugs: 1. Antibiotics 2. Anti-depressants 3. Sedatives/ 4. Tranquilizers 5. Diuretics  OTC Drugs: 1. Analgesics 2. Laxatives 3. Prostaglandin inhibitors 4. Anti-inflammatory drugs - ibuprophen
  • 30. When do prescription drugs become over-the-counter drugs: 1. Doctors feel they are safe without a prescription 2. The drug(s) have been on the market for at least 3 years and are on the safe and effective list (GRAS/GRAE) 3. There appears to be a high demand for drugs to be over-the-counter
  • 31. Tolerance 1. Weight (size) 2. Gender 3. Percent concentration 4. Amount consumed 5. Empty stomach 6. Polydrug use 7. Enzyme action
  • 32. Withdrawal  Detox  The first 3 days presents the greatest risk for death
  • 33. Dependence  Physiological and psychological issues  Not as easy as saying “Just Say No”  In fact, with some drugs if you stop suddenly there may be severe side effects – even death. Careful when you try to give advise to others.
  • 34. How do you feel? Depressed Normal Bliss Unhappy Euphoric
  • 35. Bottom line…We have needs!  We want to be happy  We want to feel good  We want to be successful  We want to be loved  We want to feel motivated  We want to have energy  We want friends  We want to be recognized  We want to be relaxed  We want to feel “high” – stimulated  We want to relieve depression  We want to be less inhibited  We want to try something new, take risks – be adventurous  We want to discover the meaning of life
  • 36. If your needs are not being met… You will self-medicate!

Editor's Notes

  1. Today - our biggest problem with drugs are our legal drugs.