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PSY 320 - Study Guide for Exam #2

by: Elliana

PSY 320 - Study Guide for Exam #2 PSY 320

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Includes combined class lecture & textbook notes, notes on the supplemental videos & articles, & vocabulary terms.
Drugs & Behavior
Dr. Marc Gellman
Study Guide
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This 28 page Study Guide was uploaded by Elliana on Thursday February 25, 2016. The Study Guide belongs to PSY 320 at University of Miami taught by Dr. Marc Gellman in Spring 2015. Since its upload, it has received 252 views. For similar materials see Drugs & Behavior in Psychlogy at University of Miami.

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Date Created: 02/25/16
PSY 320 Drugs & Behavior Exam #2 Study Guide Tobacco Educa▯on is the single biggest influence on smoking rates ◦ Men: 25% • High school diploma only: 28% • Undergraduate degree: 11% 02 : nem W • Non-college students: 19% • Full-▯me college students: 5% Mechanisms of ac▯on • Nico▯ne ◦ Ac▯ve ingredient to tobacco ◦ Naturally occurring liquid alkaloid that is colorless & vola▯le • Lungs: ◦ Inhala▯on very effec▯ve ◦ 90% of inhaled nico▯ne is absorbed ◦ Enters brain in 7 seconds, peak absorp▯on at 7 minutes • 80-90% of nico▯ne is deac▯vated in the liver, then excreted via kidneys ◦ Nico▯ne increases ac▯vity of liver enzymes responsible for nico▯ne deac▯va▯on ◦ Metabolized by CYP450 enzymes: CYP2A6 & CYP2B6 • Contributes to tolerance • May decrease effects of medica▯ons ◦ Major metabolite is co▯nine • Byproduct which remains in the bood for up to 2 days • Tar (tobacco byproduct) adheres to ▯ssues in mouth, nose, throat, lungs, & skin • Nico▯ne acts on: ◦ Nico▯ne acts on nico▯nic acetylcholine receptors ◦ Receptors present in drenal medulla ◦ Mimics acetylcholine • First s▯mulates then blocks receptor sites • Indirect sympopathomime▯c effect Effects • Increases levels of: ◦ Dopamine in reward circuits of CNS ◦ Flows of adrenaline (by binding to nico▯nic receptors) ◦ Release of epinephrine • Increase in heart rate, blood pressure, respira▯on, blood glucose levels • Nico▯ne poisoning: : l eve l w o L • Beginning smokers • Nausea, dizziness, general weakness 1 PSY 320 Drugs & Behavior ◦ Higher level/acute: • Tremors, convulsions, paralysis of breathing muscles, death • CNS & Circulatory System effects: ◦ Increases dopamine release in nucleus accumbens ◦ Influences acetylcholine, glutamate, GABA, norepinephrine, serotonin, & vasopressin ◦ Increased heart rate/blood pressure ◦ Increased oxygen need of the heart ◦ Decreased oxygen-carrying ability of blood • Shortness of breath ◦ Increased platelet adhesiveness (s▯cky blood platelets) ◦ Increased electrical ac▯vity in the cortex r egnu h decud ◦ R • Inhibi▯on of hunger contrac▯ons • Increased blood sugar • Deadening of taste buds • Peripheral nervous system: ◦ Increases sympathe▯c nervous system ac▯vity • Release of adrenaline from adrenal glands & other sympathe▯c sites ◦ S▯mulates & blocks various sensory receptors • Behavioral effects: ◦ Nico▯ne has s▯mulant & calming effects ◦ User expecta▯on plays important role cnednep ◦ D no▯c i d ◦ A gn i va◦r C ◦ Irritability ◦ Anxiety ◦ Hos▯lity ◦ Concentra▯on difficul▯es ◦ Impa▯ence ◦ Insomnia 2 PSY 320 Drugs & Behavior Harms • Lung cancer • Cardiovascular disease • Chronic obstruc▯ve lung diseases (emphysema, etc.) • Emphysema: • Chronic lung disease characterized by difficulty breathing & shortness of breath • Risk increases for those who: ◦ Start young ◦ Smoke many cigare▯es ◦ Con▯nue for a long ▯me • Dead ▯ssues inside the body & organs ◦ Ischemic ▯ssue in the heart causes heart a▯acks • Leukoplakia Whitening/thickening of mucous ▯ssue in the mouth, precancerous ▯ssue damage • • Other issues: ◦ Causes fires ◦ Pollu▯on by toxins released & discarded bu▯s ◦ Social isola▯on ro◦ O ◦ Cosme▯c concerns (wrinkles, balding, etc.) ◦ Financial expenses ◦ Secondhand smoke • Pregnancy: ◦ Miscarriage ◦ Low birth weight 3 PSY 320 Drugs & Behavior ◦ SIDS (Sudden Infant Death Syndrome) ◦ Neurological problems ◦ Hyperac▯vity ◦ Learning disabili▯es The Health Consequences of Smoking (ar▯cle notes) • Smoking remains the leading preventable cause of premature disease & death in the U.S. • 2004 report concludes that smoking affects nearly every organ in the body • Ac▯ve smoking is causally associated with: ◦ Age-related macular degenera▯on ◦ Diabetes ◦ Colorectal cancer ◦ Liver cancer s i so l uc r eb ◦u T no▯cnu f s yd e l ▯ce◦r E ◦ Orofacial cle▯s in infants ◦ Ectopic pregnancy ◦ Rheumatoid arthri▯s ◦ Inflamma▯on ◦ Impaired immune func▯on • Exposure to secondhand smoke causally associated w. increased risk for stroke • What works: ◦ Media campaigns ◦ Smokefree air policies ◦ Op▯mal tobacco excise taxes ◦ Barrier-free cessa▯on treatment ◦ Comprehensive statewide tobacco control programs ◦ Greater restric▯on on sales • History: ◦ Over 20 million Americans died from cigare▯es since the first Surgeon General's report in 1964 • 2.5 million were non-smokers dying of hear diseases/lung cancer from exposure to secondhand smoke • 100,000 babies from SIDS or complica▯ons (prematurity, low birth weight, parental smoking) ◦ More than 10 ▯mes as many U.S. ci▯zens did from smoking than from all the wars combined in U.S. history ◦ Prevalence of smoking has declined, but men & women have a higher risk for lung cancer & pulmonary disease than in 1964 despite smoking fewer cigare▯es • Research: ◦ 2006 reports conclude there are no risk-free levels of exposure to secondhand smoke ◦ Results of an▯-smoking measures: • Text-only pack warnings • Control programs • Indoor smoking bans • Support for cessa▯on • Restric▯ons on adver▯sements/promo▯ons 4 PSY 320 Drugs & Behavior • Tax hikes den i l c ed ev ah s e t a r gn i ko m S ▪ Mortality rates declined for heart disease & lung cancer ◦ 2005-2009: Smoking & secondhand accounts for: • Over 87% of lung cancer deaths • 61% of pulmonary disease deaths • 32% of all deaths from coronary heart disease ◦ The rela▯ve risk for dying from coronary heart disease among women 35 years + is now higher than for men ◦ Women who smoke have the same high risk of death from lung cancer as men • Na▯onal financial costs: ◦ Produc▯vity losses from premature death alone exceeds $150 billion per year • Value of produc▯vity loss from premature deaths by secondhand exposure is ~ $5.6 billion per year ◦ Annual costs of direct medical care a▯ributable to smoking are over $130 billion • Summary: ◦ Epidemic of cigare▯e smoking is a public health tragedy ◦ Epidemic ini▯ated & sustained by aggressive strategies of the tobacco industry • Deliberately misled the public on risks of smoking cigare▯es ◦ Secondhand smoke causally linked to cancer, respiratory & cardiovascular diseases, & adverse health effects on the health of infants & children ◦ Large dispari▯es in tobacco use remain across groups according to: • Race • Ethnicity • Educa▯onal level • Socioeconomic status • Region ◦ Comprehensive tobacco control programs & policies since 1964 have been proven effec▯ve for controlling use Addic▯on Inc. Trailer Notes - Scien▯sts were hired to research how to make less harmful cigare▯es (maybe even free of tobacco) - Companies ended up researching how to make cigare▯es more addic▯ng - Scien▯sts blew the whistle on company secrets - Researchers were pursued & harassed by companies for leaking their secrets that brought companies to court The Real Cost of Cigare▯es Commercial Notes - Commercials featured teenagers purchasing cigare▯es - They had to make sacrifices like ripping the skin off their cheeks or pulling their teeth out to purchase - Represented consequences such as damaging your skin or teeth whenever you smoke 5 PSY 320 Drugs & Behavior Caffeine Caffeine • ^Psychos▯mulant compound; member of xanthine chemical class ◦ Greatest effect upon CNS & skeletal muscles • Approx. 90% of Americans consume caffeine on a regular basis • Caffeine & related compounds in plants ◦ Found in kola nuts, cocoa tree nuts, & coffee beans • Most widely used psychoac▯ve drug in the world ◦ Average North American intake: 200-250 mgday ◦ Some ppl regularly consume much more • Can cause dependence & interfere with func▯oning • Belongs to a class of chemicals known as xanthines • Xanthines - The class of chemicals to which caffeine belongs en i l l yhpoe ◦h T - A xanthine found in tea • High doses used in asthma medica▯on • Effects relax bronchial smooth muscle in the respiratory system - improves breathing e n imorboe ◦h T - A xanthine found in chocolate • More potent agent in CV system ◦ Adenosine - An inhibitory neurotransmi▯er through which caffeine acts • Caffeinism - Excessive use of caffeine Pharmacology: Absorp▯on & Metabolism • Rapid oral absorp▯on • Peak plasma levels reached within 30-60 min of inges▯on • Metabolized by hepa▯c P450 enzymes 1E2PYC & 2A1P ◦Y C ◦ Into ac▯ve metabolites - theophylline & theobromine • Half-life about 3-4 hours ◦ Significantly increased in women pregnant or taking oral contracep▯ves Mechanism of Ac▯on • Caffeine & other xanthines antagonize Adenosine ◦ Adenosine - neuromodulator, normally produces seda▯on behaviors • Receptors present in almost all brain regions, highest concentra▯ons being in the: ▪ Hippocampus, cerebral cortex, cerebellum, thalamus ▪ Found in dopaminergic cells within the striatum ◦ Has inhibitory effects on: • Cholinergic neurons in cerebral cortex • Dopamine neurons in basal ganglia • Caffeine binds to adenosine receptors & inhibits adenosine effects, producing a s▯mulant effect Physiological Effects • Arousal EEG pa▯erns - eleva▯ng mood, alertness • Fa▯gue decreases 6 PSY 320 Drugs & Behavior • Insomnia • Dila▯on of vascular muscles (waking) • Constric▯on of blood vessels in brain • Increased heart & respiratory rates • Increased diure▯c effect - increases urinary output • S▯mulates skeletal muscle Effects of Xanthine s • CNS effects: ◦ Enhances alertness, causes arousal, diminishes fa▯gue • Adverse CNS effects: ◦ Insomnia, anxiety, muscle twitches ◦ Over 500 mg - panic sensa▯ons, chills, nausea, clumsiness ◦ Extreme high doses (5-10 grams) - seizures, respiratory failure, death • Cardiovascular effects: ◦ Low doses - heart ac▯vity increases, decreases, or does nothing ◦ High doses - rate of heart contrac▯ons increases, minor vasodila▯on in most of the body, cerebral blood vessels vasoconstricted ◦ Respiratory system effect ◦ Can cause air passages to open & facilitate breathing Behavioral Effects • S▯mula▯on ◦ Par▯ally offsets fa▯gue on both mental & physical tasks • May not improve performance in well-rested individuals ◦ High caffeine consump▯on among college students associated w. lower academic performance • Headache treatment - helps relieve both migraine & nonmigraine headaches • Hyperac▯vity treatment - high doses may decrease hyperac▯vity • Sobering up - caffeine does NOT lower blood alcohol concentra▯on, does not help individuals "sober up" ◦ Double dehydra▯ng effects of alcohol & caffeine Risk Factors • Cancer: not a risk factor in human cancer • Teratogens: ◦ High consump▯on reduces women's chances of becoming pregnant ◦ Slows/stunts growth in fetus ◦ Mixed research on whether caffeine increases risk of miscarriage • Heart disease: ◦ High intake may increase risk of heart a▯ack ◦ Par▯cularly in ppl w. other risk factors Harms • Dependence: ◦ Caffeine can func▯on as reinforcer ◦ Withdrawal symptoms include headache & fa▯gue • Readily crosses placental barrier ◦ Reaches comparable levels in fetus ◦ Leads to significant blood levels in infants of mothers drinking caffeine while breas▯eeding 7 PSY 320 Drugs & Behavior • Distribu▯on: ◦ Water solubility ◦ Freely distributed thru all body fluids Lawsuit on Monster Drink - A man overdrank mul▯ple cans of Monster a day - Died from consump▯on - Company sued for falsely adver▯sing Monster as a “safe drink” and not clearly labeling harms & products Your Brain on Coffee Youtube Notes - Caffeine travels from your stomach to the blood stream to reach your brain - Adenosine chemical in the brain a▯aches to a nerve cell - Slows cells down - Makes you sleepy - Caffeine chemical resembles adenosine & is picked up by receptors - Blocks adenosine recep▯on & inhibits sensa▯ons of sleepiness - Produces caffeine “high” that lasts for a couple of hours Dietary Supplements & Over-the-Counter Drugs Dietary Supplements: Food or Drug? • Legally classified as a food product • Drugs & food are similar in some respects • Both contain chemicals that interact w. the body's physiology • Drugs are defined as: ◦ A product intended for use in diagnosis, cure, mi▯ga▯on, treatment, or preven▯on of a disease • Drugs must be shown to be: ◦ Safe when used as directed esu dedne t n i ro f ev▯ce ◦ E • These requirements do not apply to supplements! OTC vs. Prescrip▯on Drug s • 1938 Food, Drug, & Cosme▯c Act ◦ Established a classifica▯on of drugs that can be sold only by prescrip▯on • Possible differences btwn OTC & prescrip▯on drugs: ◦ Dosage: • OTC version of a drug may come in smaller doses ◦ Chemicals: • A prescrip▯on drug may contain a chemical not allowed for OTC sale due to poten▯al toxicity History • 1994 Dietary Supplement Health & Educa▯on Act (DSHEA) ◦ Passed in part due to pressure on congress from supplement industry ◦ Industry wanted to limit FDA regula▯on ◦ Redefined which substances could be "dietary supplements" 8 PSY 320 Drugs & Behavior ◦ Redefini▯on of presumed safety ◦ Vague health claims w.o proof were allowed • Sellers do not have to prove claims • Only have to provide evidence that claims are not false or misleading • Essen▯ally: DSHEA expanded the defini▯on of supplements to include a variety of substances ◦ Vitamins & minerals ◦ Herbs (whole, concentrates, extracts) ◦ Amino acids • Congress's priority in payments from the industry over safety/health of consumers • Ingredients already on the market at the ▯me of the Act: ◦ Considered safe enough to be sold unless the FDA can demonstrate a risk • FDA can declare a dietary supplement to be unsafe or unadulterated ◦ Only if it presents a significant or unreasonable risk of illness/injury • Recent rules emphasizing safety: ◦ Good manufacturing prac▯ces rules ◦ Adverse Events Repor▯ng process ◦ But rules much more lenient than for drugs • *Dietary supplements cannot claim to be a treatment for a disorder ◦ Labels must carry a disclaimer: "This statement has not been evaluated by the Food & Drug Administra▯on. This product is not intended to diagnose, treat, cure, or prevent any disease." • DSEA: Boon or Threat to consumers? : no◦o B • Many more supplements on the market • Consumers have more op▯ons : sn◦o C • Much less research available on safety & effec▯veness • Supplements remain on the market un▯l the FDA presents clear evidence of risk ▪ Basically someone has to die to raise concerns • Case Study: Ephedra ◦ S▯mulant for weight loss ◦ 1994: First evidence of safety concerns published by FDA • Took more than 10 yrs for FDA to compile evidence (cases of death) to get ephedra off the market • Consumers complained there were not enough regula▯ons protec▯ng them • 2010 Dietary Supplement Act ◦ Senator John McCain introduced bill • All manufacturers would have to register with FDA • Manufacturers would have to provide a complete list of ingredients • FDA could recall any ingredient they found to be unsafe : emoc t◦u O • Dietary supplement industry mounted campaign against regula▯on • McCain withdrew bill FDA Regula▯on of OTC Products • 1962 Kefauver-Harris amendment ◦ Required that all drugs be evaluated for safety & efficacy ◦ FDA charged w. reviewing all OTC drugs currently on the market 9 PSY 320 Drugs & Behavior • Approximately 300,000 products • Impossible task? : no▯u l◦ o S • Only ac▯ve ingredients reviewed • 300,000 individual products contain fewer than 1,000 total ac▯ve ingredients • OTC Regula▯on: 3 Standards ◦ GRAS • Generally Recognized as Safe ▪ Given currently available info, the ingredient is considered safe ▪ Safe = "low incidence of adverse reac▯ons" ▪ Note that no drug is en▯rely sage ◦ GRAE • Generally Recognized as Effec▯ve ▪ Reasonable expecta▯on that the pharmacological effect of the drug will provide clinically significant relief ◦ GRAHL • Generally Recognized as Honestly Labeled • OTC drug labeling: ◦ Uniform labeling standards adopted in 1997 • To avoid confusion • Layout, headings, topics consistent • Language made clear & concise • Less medical terminology ◦ Consistent labels make it easier for consumer to compare products • OTC drug review process: ◦ FDA reviews products & may switch drugs to OTC status : CTO o t dehc t i ws s gu ◦r D • Ibuprofen (Advil: analgesic) • Iansoprazole (Prevacid: heartburn) • Fexofenadine (Allegra: an▯histamine) Psychoac▯ve OTC Drugs • S▯mulants ◦ FDA allows s▯mulants to be sold to "help restore mental alertness/wakefulness when experiencing fa▯gue or drowsiness) • Only legal OTC ingredient is caffeine • I.E. Vivarin • Combina▯ons of caffeine & other ingredients (ephedrine) not allowed • Seda▯ves & Sleep Aids ◦ Early OTC seda▯ves & sleep aids • Combina▯on of scopolamine (acetylcholine receptor blocker) & methapyrilene (an▯histamine) • Found to be unsafe ◦ Brands changed ac▯ve ingredients frequently • Currently diphenhydramine is the only an▯histamine legally sold as a sleep aid • Weight-Control Products ◦ 1970s phenylpropanolamine (PPA) legal in OTC ◦ 2000 FDA requested all companies to seek marke▯ng PPA products 10 PSY 320 Drugs & Behavior • Concerns over safety & effec▯veness ◦ Currently, 1 FDA approved weight-control OTC drug: • Orlistat (Alli) ◦ Weight-control market shi▯ed largely from OTC drugs to less well regulated dietary supplements • Analgesics: Pain-killers ◦ Anesthe▯cs reduce all types of sensa▯on or block consciousness completely • General: blocks consciousness completely • Local: injected at site of injury to numb area ◦ Analgesics reduce pain selec▯vely w.o causing loss of other sensa▯ons ◦ Types of pain based on place of origin: • Visceral pain from non-skeletal por▯ons of body s d i o i po yb deve i l▪ e R • Soma▯c pain from muscle or bone ▪ Relieved by OTC analgesics • Aspirin • Acetaminophen • Ibuprofen ◦ About 35% of pa▯ents obtain pain relief from placebo OTC Analgesics: Aspirin • Long historical use of teas & extracts of willow & poplar bark for pain relief ◦ Used for pain-relief of arthri▯s in inhabitants of damp climates • 19th century: ac▯ve ingredient salicylic acid iden▯fied, synthesized, & mass-produced • 1989: Acetylsalicylic acid (less acidic product) synthesized by Bayer Labs chemist - had fewer side effects • 1899: Patented & released ini▯ally from prescrip▯on sale as white powder ◦ Consumed as powder mixed in water • 1915: Aspirin sold OTC in tablet form • Aspirin: Therapeu▯c Use ◦ Analgesic • Effec▯vely blocks mild-to-moderate soma▯c pain • Especially effec▯ve for headache & musculoskeletal pain c▯e r yp▯ ◦n A • Reduces fever • Causes vasodila▯on of peripheral blood vessels & increases swea▯ng ◦ An▯-Inflammatory • Reduces swelling, inflamma▯on, & soreness • Used extensively for arthri▯s treatment • Mechanism of Ac▯on ◦ Prostaglandins - local hormones manufactured & released when cell membranes are distorted or damaged (injured) ◦ Aspirin blocks synthesis of prostaglandins by inhibi▯ng enzymes COX-1 & COX-2 ◦ Blocks synthesis in the anterior hypothalamus • Effects & Risks ◦ Inhibits blood platelet aggrega▯on (clo▯ng) • Can cause bleeding problems for surgical pa▯ents • May prevent heart a▯acks & strokes by preven▯ng clots in high-risk pa▯ents 11 PSY 320 Drugs & Behavior ◦ Induces gastrointes▯nal bleeding emo rdny S s ' ey◦e R • Rare but serious disease • Symptoms include: disorienta▯on, personality changes, lethargy, coma, death • Almost all cases occurred in ppl under 20 y.o who have had a viral illness such as influenza or chicken pox • Prostaglandins ◦ Local-ac▯ng, pain-causing hormones • Released when cell membranes are injured • Mediate pain in injured areas by sensi▯zing neurons to s▯mula▯on ◦ Analgesic ac▯on: • Aspirin inhibits synthesis of prostaglandins by effec▯ng 2 forms of cyclooxygenase (COX) enzyme • Thereby blocking synthesis of pain-causing prostaglandins ◦ An▯pyre▯c ac▯on: • Aspirin acts on prostaglandins involved in heat regula▯on • Reduces heat OTC Analgesics: Acetaminophen (Tylenol) • Compared to Aspirin: ◦ As effec▯ve in analgesic & an▯pyre▯c effects ◦ Less useful as an▯-inflammatory drug • Risks: ◦ Overuse can cause serious liver disorders ◦ DAWN data: Acetaminophens far surpassed Aspirin for ER visits & deaths ◦ FDA has limited maximum single capsule amount to 650 mg for OTC products OTC Analgesics: Ibuprofen & other NSAIDS • Class of drugs known as Nonsteroidal An▯-Inflammatory Drugs (NSAIDs) ◦ Originally available by prescrip▯on, now also available OTC • Ibuprofen is an NSAID ◦ Effec▯ve as an analgesic & an▯-inflammatory ◦ Like aspirin, inhibits COX enzymes • Poten▯al side effects: ◦ Nausea & stomach pain ◦ Liver damage (if consumed in large amounts) OTC Cold & Allergy Products • Cold symptoms can be treated, not cured • Modern cold remedies contain 3 common types of ingredients: ◦ An▯histamines: for temporary relief of runny nose & sneezing • Also for relief of allergy symptoms ◦ Nasal decongestants: for temporary relief of swollen nasal membranes ◦ Analgesic-an▯pyre▯cs: for temporary relief of aches & pains & fever reduc▯on 12 PSY 320 Drugs & Behavior Alcohol History • Humans have been consuming alcohol da▯ng back to hominids (ancestors to homo sapiens) ◦ Perhaps as far back as 8000 BC • Second most widely consumed beverage ◦ According to surveys, more than half of US individuals 12 yrs + have consumed alcohol within the last 30 days • Dis▯lla▯on process discovered in Arabia around AD 800 • Introduced into Europe in about 10th century • U.S. began on a large scale at the end of 18th century Before American Revolu▯on • Ppl drank more alcohol than water ◦ Water from clean sources was rare ◦ Drunkenness viewed as misuse of posi▯ve product A▯er American Revolu▯on • Alcohol demonized & viewed as the cause of problems • First psychoac▯ve substance to become demonized in American culture ◦ Crime associated w. increasing influx of immigrants Temperance Movement • Benjamin Rush (1745 - 1813) ◦ Founding father : deve i l◦e B • Heavy drinking = health problems • Alcohol use damages morality • Alcohol addic▯on = a disease • Temperance socie▯es ◦ Ini▯ally promoted moderate consump▯on of beer/wine & abs▯nence from dis▯lled spirits ◦ Later promoted total abs▯nence ◦ Became fashionable to "take the pledge" • Grass-Roots temperance movements traveled coast to coast • States began passing prohibi▯on laws in 1851 ◦ Banning sale of alcohol • 18th Amendment (1919) banned sale of alcohol ◦ Went into effect 1920 ◦ Only lasted 13 yrs ◦ Ppl s▯ll drank illegally in speakeasies & private clubs ◦ Legally thru purchase of patent medicines containing alcohol ◦ Enforcement difficult & expensive ◦ Hospital admissions & deaths from alcohol sharply declined ◦ Alcohol dependence & related deaths remained lower than before prohibi▯on • Huge increases in racketeering & smuggling alcohol (criminal ac▯vity) • Thousands poisoned by homemade alcohol • Support for prohibi▯on dwindled • Prohibi▯on repealed by 21st Amendment (1933) 13 PSY 320 Drugs & Behavior ◦ Alcohol taxes major source of revenue ◦ Concerns that widespread disrespect for Prohibi▯on laws encouraged general sense of lawlessness ◦ Alcohol sales & consump▯on increased, returned to pre-Prohibi▯on levels a▯er WW2 ◦ Major boost to American economy Regula▯on a▯er 1933 • Laws slowly relaxed un▯l last dry state, Mississippi, became "wet" in 1966 • 1970s drinking age lowered to 18-19 in 30 states ◦ Raised back up to 21 following concerns over increased drinking rates & alcohol-related traffic accidents • Taxa▯on: ◦ Federal & state taxes, licensing fees = about half the price of an alcohol beverage ◦ When taxes increase, consump▯on slightly decreases News • Consump▯on pa▯erns are influenced by cultural factors • Trends in US alcohol consump▯on: ◦ Similar to other drug use, alcohol use peaked in 1981 & then declined • Mirrors pa▯erns of illicit drug use ◦ Decline par▯cularly significant for dis▯lled spirits ◦ 1/3rd of Americans abstain ◦ Avg consump▯on among drinkers: ~3 drinks/day, most Americans drink far less • Half of all alcohol consumed in the US consumed by about 10% of the drinkers • Regional differences in US: ◦ Stress Index - Drinking rates higher in states where ppl experience a great deal of social stress/tension ◦ Drinking Norms - Drinking rates higher in states where ppl tend to approve of use of alcohol to relieve stress • Gender differences: ◦ Males more likely to drink than females ◦ More likely to drink larger amounts • College students: ◦ College students drink more than their nonstudent peers ◦ Many campuses have banned sale/adver▯sing of alcohol & keg par▯es ◦ Alcohol use has not changed significantly • Sight increase in binge drinking & driving a▯er drinking Plant • Class of chemical: Ethyl Alcohol ◦ Body can tolerate specific amounts Alcohol Pharmacology • Alcohol is water & fat soluble ◦ Readily diffuses across all cell membranes • Absorp▯on ◦ Most absorbed in the small intes▯ne ◦ Some absorbed through oral ▯ssues when drinking ◦ Some absorbed in the stomach • Absorp▯on is slower if there is food or water in the stomach 14 PSY 320 Drugs & Behavior • Absorp▯on is faster in the presence of carbonated beverages (beer) Pharmacokine▯c Factors • BAC (Blood Alcohol Concentra▯on) = # of grams of alcohol in a 100-ml volume of blood (percentage) ◦ A measure of the concentra▯on of alcohol in blood • Alcohol dehydrogenase - enzyme that metabolizes alcohol • Acetaldehyde - metabolite produced from enzyma▯c conversion of alcohol w. alcohol dehydrogenase • Alcohol distributed thru body fluids & can be measured from any ▯ssue ◦ Most common method of measuring BAC from expired air (breathalyzer) • Alcohol less distributed in fa▯y ▯ssues ◦ Lean person will have a lower BAC than a fa▯er person ◦ Since fat doesn't absorb much alcohol, a fa▯er person will have less lean body mass to absorb it, hence there is a smaller "tank" to accommodate the alcohol & they get drunker Metabolism • 90% of alcohol metabolized in the liver ◦ About 2% is excreted unchanged (breath, skin, urine) • 90-95% of ingested alcohol is metabolized by the enzyme alcohol dehydrogenase ◦ Remainder excreted or metabolized by P450 • Liver metabolizes about 0.25 oz/hour ◦ If rate of intake = rate of metabolism, BAC is stable ◦ If rate of intake exceeds rate of metabolism, BAC increases • Liver responds to chronic intake of alcohol by increasing enzyme ac▯vity 15 PSY 320 Drugs & Behavior ◦ Contributes to tolerance in heavy users Mechanisms of Ac▯on • Ac▯ons of alcohol involve mul▯ple transmi▯er systems: A◦ G ◦ Glutamate d i o i po s uonegod ◦ E ◦ Dopamine n i no t o e S ◦ Endocannabinoid systems ◦ Acetylcholine neurons • CNS depressant ◦ Primarily enhances inhibitory effect of GABA @ GABA-A receptor • Depressant: cortex, hippocampus, thalamus • Reinforcing: nucleus accumbens, VTA ◦ Also blocks glutamate • Inhibits excitatory glutamate NMDA receptors ◦ Inhibits calcium channels • Reduces neurotransmi▯er release from axon terminals • Inhibi▯on of vasopressin release leads to: ▪ Increased urina▯on ▪ Impaired cogni▯on ▪ Disrupted circadian rhythm e r u s s r p doo l b de r ew o L ▪ Enhanced aggression • Chronic alcohol administra▯on: ABAG secud ◦ R A receptor levels/sensi▯vity ◦ Lowers increases in B-endorphin levels ◦ Increases # of NMDA receptors • Contributes to greater risk of seizure • Used as anesthe▯c un▯l late 19th century • Increases opioid ac▯vity in several brain regions • Mul▯ple mechanisms at work Gender Differences • Women tend to be more suscep▯ble than men to the effects of alcohol a▯er consuming the same amount ◦ Gastric alcohol dehydrogenase is less ac▯ve in women • Women generally have a smaller amount of this enzyme available to break down alcohol ◦ Women absorb a greater propor▯on of the alcohol they drink • Women tend to weigh less & have a higher propor▯on of body fat ◦ "Tank" into which alcohol added is smaller (generally) 16 PSY 320 Drugs & Behavior Effects • Vary depending on concentra▯on in the body ◦ Higher concentra▯ons: depressant effects ◦ Lower concentra▯ons: pseudo-excitatory effects • Alcohol readily passes thru blood-brain barrier • Allows neural ▯ssues to reach BALs quickly • Peak blood levels reach 30-60 min depending upon concentra▯on & what else is in the diges▯ve tract • Alcohol readily absorbed by all ▯ssues, pregnant women expose fetus to same blood level as she has • Exercise, coffee, & other strategies DO NOT speed up rate of metabolism ◦ Exercise/swea▯ng/hot showers only aggravate drunkenness thru heat & dehydra▯on Behavioral Effects • BAC determines effects es ruoc em ▯ no dnep◦e D ◦ I.E. Effects greater when BAC rises rapidly • Influenced by individual's alcohol experience 17 PSY 320 Drugs & Behavior ◦ Effects influenced by expecta▯ons • Disinhibi▯on: Weakening of behavioral control that displays as: ◦ Poor risk assessment ◦ Engagement in dangerous behavior ◦ Impulsivity (decision making w.o reflec▯ng adequately on the consequences) ◦ Reduces anxiety • A▯er consuming 1-2 drinks, users develop an urge to consume more alcohol, known as alcohol priming • Sexual behavior: ◦ Alcohol use enhances interest in sex but impairs physiological arousal xes e f asnu o t dekn◦ i L • Blackouts: ◦ Danger sign of excessive alcohol use ◦ Reversible, alcohol-induced demen▯a, stupor (dulled senses, poor cogni▯ve func▯on) anterograde amnesia (inability to form new memories) • Crime & violence: ◦ Alcohol use sta▯s▯cally related to violence ◦ Homicide ◦ Assault, family violence, sexual assault, date rape ed i c i◦ u S Physiological Effects • Peripheral circula▯on ◦ Dila▯on of peripheral blood vessels ◦ Drinkers lose body heat but feel warm 18 PSY 320 Drugs & Behavior • Fluid balance ◦ Alcohol has diure▯c effect that: • Increases urine output • Lowers blood pressure in some ppl • Hormonal effects ◦ Chronic abusers can develop a variety of hormone-related disorders Harms Acute Physiological Toxicity • Alcohol overdose (poisoning) common & dangerous • If someone drinks enough to pass out: ◦ Place the person on their side (if they're on their back they could vomit & choke) ◦ Do not leave the person alone • If someone drinks enough to vomit: gn i kn i rd po t s d l u ohs ye◦h T ◦ Vomi▯ng reflex is suppressed at BAC above 0.20 % & can quickly reach lethal levels • Inhibits sexual performance ◦ Men with high BACs unable to a▯ain or maintain erec▯ons DUI • 1/3rd of all traffic crash fatali▯es linked to alcohol use • Risk of a fatal crash is dose-related • Single-vehicle fatali▯es more likely to involve alcohol than mul▯ple-vehicle fatali▯es • Alcohol related fatali▯es: more likely to occur during dark hours & weekends • Men more likely than women to be involved in alcohol related fatal crash (men drive more) • Safe BAC for driving is below 0.05% Hangover • Drinking ~250ml of alcohol causes the body to expel 80-1,000 ml of water ◦ 4x the amount of liquid lost as gained ◦ Diure▯c effect decreases as alcohol in the bloodstream decreases ◦ A▯ereffects create a hangover • Symptoms: Upset stomach, fa▯gue, headache, thirst, depression, anxiety, & general malaise • Possible causes: Withdrawal, congeners exposure, cellular dehydra▯on, gastric irrita▯on, reduced blood sugar, accumula▯on of acetaldehyde • Moderate drinking (the night before) is the only way to avoid a hangover Fetal Alcohol Syndrome • Collec▯on of physical & behavioral abnormali▯es associated w. mother's alcohol use during pregnancy ◦ Rela▯ve to peak BAC & dura▯on of alcohol exposure ◦ Prevalence: 0.2-1.5 (80-200) per 1,000 births • Diagnos▯c criteria: ◦ Growth retarda▯on before/a▯er birth (small baby, slow growth) ◦ Pa▯ern of abnormal head & facial features ◦ Evidence of central nervous system abnormality • Trouble developing skills in speaking, walking, cogni▯ve func▯oning, etc. ◦ Mental retarda▯on • Drinking during pregnancy increases risk of spontaneous abor▯on • Data DO NOT prove that low levels of alcohol use during pregnancy are safe or unsafe Long Term/Chronic Effects (Organs Effected) • Brain ▯ssue loss & cogni▯ve impairment 19 PSY 320 Drugs & Behavior ◦ Wernicke-Korsakoff Syndrome • Confusion, ataxia (impaired walking coordina▯on), abnormal eye movements ◦ Alcoholic demen▯a - global decline of intellect • Heart disease: ◦ Cardiomyopathy, cell ischemia, heart a▯ack, hypertension, stroke ◦ Alcohol's beneficial effects on HDL may reduce heart a▯ack risk among moderate drinkers (1 or 2 drinks every day or every other day), therefore considered cardioprotec▯ve • Liver disease: hepa▯▯s, fa▯y liver, cirrhosis ◦ Cirrhosis - death of liver cells, accumula▯on of collagen, decreased blood flow, inability to func▯on properly, infec▯ons, cancers ◦ Irreversible liver disorder • Cancer ◦ Mouth, tongue, pharynx, larynx, esophagus, stomach, liver, lung, pancreas, colon, rectum • Suppression of immune system, suscep▯bility to infec▯ons • Chronic alcohol intake increases ac▯vity of metabolic enzymes ◦ Slows metabolism of other drugs while body is concentra▯ng on alcohol intake ◦ High enzyme ac▯vity remains for 4-8 weeks a▯er cessa▯on of drinking • During this ▯me other drugs are metabolized more rapidly • Impotence in men, tes▯cular atrophy • Impaired reproduc▯ve func▯oning in women Alcoholism, Problem Drinking & Binge Drinking • Alcoholism - Chronic & o▯en progressive disease that includes problems controlling your drinking, being preoccupied w. alcohol, con▯nuing to use alcohol even when it causes problems, having to drink more to get the same effect (physical dependence), or having withdrawal symptoms ◦ If you have alcoholism: You can't consistently predict how much you'll drink, how long you'll drink, or what consequences will occur from drinking ◦ It's possible to have a problem with alcohol even when it has not progressed to the point of alcoholism • Problem drinking - You drink too much at ▯mes, causing repeated problems in life, even without complete dependence on alcohol • Binge drinking - A pa▯ern of drinking where a male consumes 5 or more drinks in a row, or a female drinks at least 4 or more drinks in a row ◦ Can lead to same health risks & social problems associated w. alcoholism ◦ Binge drinking in young adults or teenagers may lead to faster development of alcoholism • Michigan Alcohol Screening Test (MAST) ◦ One of the most widely used measures for assessing alcohol abuse ◦ 25-item ques▯onnaire to rapidly screen for life▯me alcohol-related problems & alcoholism Dependent Behaviors • Alcoholics Anonymous view ◦ Dependence as a progressive disease characterized by loss of control over drinking ◦ Only treatment is abs▯nence 20 PSY 320 Drugs & Behavior ◦ Disease model: alcohol dependence is the primary disease & not the result of another underlying cause • DSM ◦ Defines substance abuse & dependence & includes alcohol as psychoac▯ve substances ◦ Alcohol abuse - Maladap▯ve pa▯ern indicated by con▯nued use despite knowledge of having persistent problems caused by alcohol ◦ Alcohol dependence - Involves more serious psychosocial characteris▯cs & includes physiological factors of tolerance & withdrawal among the possible symptoms • Cogni▯ve & gene▯c factors are poten▯al underlying causes of dependence Dependence: Withdrawal Syndrome • Abs▯nence syndrome more medically severe & deadly than opioid withdrawal • Abs▯nence syndrome occurs in stages: ◦ Stage 1 - Tremors, rapid heartbeat, hypertension, heavy swea▯ng, loss of appe▯te, insomnia ◦ Stage 2 - Hallucina▯ons (auditory, visual, or tac▯le) ◦ Stage 3 - Delusions, disorienta▯on, delirium ◦ Stage 4 - Seizures • Mortality of cases may be as high as 1 in 7 • Detoxifica▯on should be carried out in an inpa▯ent medical se▯ng ◦ Seda▯ve given in stages 1 or 2 to prevent stages 3 or 4 ◦ Some symptoms can last up to several weeks Treatmen t • Alcoholics Anonymous ◦ Voluntary, worldwide fellowship who meet together to a▯ain/maintain sobriety ◦ Only requirement for membership is a desire to stop drinking ◦ Program of total abs▯nence ◦ Sobriety maintained thru sharing experience & 12-step recovery from alcoholism Binge Drinking on America's Campuses (ar▯cle) • Harvard School of Public Health College Alcohol Study (CAS) • Binge drinking: ◦ Men: 5 drinks or more in a row ◦ Women: 4 drinks or more in a row • At least once in a 2 week period • Frequent binge drinker: Binging 3 or more ▯mes in a 2 week period • Frequent binge drinkers significantly more at risk for: ◦ Educa▯onal problems ◦ Psychological problems ◦ An▯-social behaviors ◦ High-risk sex gn i v i rd & gn i kn i◦r D • 2nd hand effects: ◦ Automobile-related fatali▯es se i ru j n i suo i r◦ e S ◦ Vandalism ◦ Physical assaults 21 PSY 320 Drugs & Behavior ◦ Sexual assaults • Deaths: ◦ Acute alcohol poisonings ◦ Car accidents s gn i nw◦r D ◦ Falls ◦ Fights • The majority (56%) of students do not binge drink • Frequent binge drinkers consume 72% of all alcohol that college students drink • Frequent binge drinkers increased from 20% in 1993 to 23% in 1999 • More students drink than use cocaine, MJ, or cigare▯es combined • Strongest predictors of binge drinking: e ti W ◦ Male d l o s r y 42 r ◦n U ◦ Fraternity or sorority membership • Least likely to binge drink: ◦ African American or Asian r ed l o r o s r y ◦ 2 ◦ Married Alcohol’s Hold on Campus Ar▯cle Notes Why colleges haven’t stopped students from binge drinking: - Colleges focus on preven▯on & counseling, but don’t target environmental factors: - Cheap & easy access to alcohol - Football tailgates - Greek life system - Fake ID industries - Inconsistent enforcement - Colleges con▯nue to treat alcohol abuse as an individual problem - Only try to solve it thru educa▯on - Limited enforcement of actual laws - Administrators o▯en aren’t equipped w/ the community-organizing skills for preven▯on - Colleges encounter resistance from local bars & spor▯ng events looking to profit - Bars use discounts & promo▯ons to lure students - Happy hours 22 PSY 320 Drugs & Behavior - Businesses unite to ba▯le laws & regula▯ons - Half of students start binge drinking before college Performance Enhancing Drugs History Ancient Times: • Early concoc▯ons ◦ I.E. Consuming horse hoof powder to make one run as fast • May not have provided any true physical performance enhancement • Could have placebo value for boos▯ng confidence • Ancient Greek Olympians & Aztec athletes used plant-based s▯mulants ◦ Herbs, mushrooms, cactus-based strychnine s▯mulants S▯mulants some of the earliest used drugs • Beginning in 1800s ◦ Coca wine used by French cycling team • Athletes later used pure cocaine ◦ Caffeine in coffee • Or straight up caffeine tablets ◦ Amphetamines in 1930s • Use of "pep pills" by pro soccer players, boxers, & cyclists • 1960 Cyclist died from use during race in Rome ▪ Combina▯on of amphetamines & sun stroke Strychnine • Famous as a rat poison • Low doses = CNS s▯mulant • High doses = Convulsions & death • Use reported in boxers, possibly to make them more aggressive & reduce fa▯gue • 1904 St. Louis Olympic marathon winner ◦ Mixed brandy & strychnine ◦


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