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Pure Food and Drug Act
- Enacted in 1906
- Regulated labeling of patent medicines and created the FDA
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Harrison Act
- Enacted in 1914
- Regulated dispensing and use of opioid drugs and cocaine
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18th Constitutional Amendment
- Enacted in 1920
- Prohibition; banned alcohol sales except for medicinal use
- Repealed in 1933
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Marijuana Tax Act
- Enacted in 1937
- Banned nonmedical use of cannabis
- Overturned by Supreme Court in 1969
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Controlled Substances Act
- Enacted in 1970
- Established the schedule of controlled substances and created the DEA
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Schedule of controlled substances
- Established as part of the Controlled Substances Act of 1970
- Five schedules of controlled substances
- Schedule I cannot be prescribed at all (heroin, LSD, marijuana)
- Schedule II-V can be prescribed
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Substance abuse
- One or more of the following:
- Role impairment
- Hazardous use
- Legal issues
- Social issues
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Substance dependence
- 3 or more of the following:
- Tolerance
- Withdrawal
- Larger amounts over longer periods of time
- Desire to quit/cut down
- Great deal of time spent related to the substance
- Reduced social, occupational, or recreational activities
- Continued use despite major health problems
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Tolerance
Needing more of the drug to get the same effect
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Withdrawal
When you stop or cut down drug use, significant physical and psychological symptoms
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More severe: substance abuse or substance dependence?
Dependence
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Two Disease Models of Addiction
- Susceptibility models: Initial drug use + inherited susceptibility to uncontrolled drug use --> repeated drug use --> loss of control
- Exposure models: Initial drug use --> repeated drug use --> altered brain function --> loss of control
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4 models of drug addiction: physical dependence model, positive reinforcement model, incentive-sensitization model, opponent-process model
- Physical dependence model: focus on withdrawal symtpoms
- Positive reinforcement model: focus on rewarding properties of drugs/craving; rat experiments where they keep self-administering drugs
- Incentive-sensitization model: focus on distinction between "wanting" (incentive salience) and "liking" (euphoria)
- Opponent-process model: who cares
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Nutt studies
- Harm to self: Heroin most dangerous, then cocaine, alcohol pretty high
- Harm to self + Harm to others: Alcohol most dangerous
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Homeostasis vs. Allostasis
- Homeostasis: normal set point, equilibrium, etc...
- Allostasis: when you become addicted, you shift to allostasis; changing set point, compromised equilibrium, etc...
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Panskepp's SEEKING system
- Includes the dopaminergic central reward system (pleasure)
- Also includes curiosity and motivation
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Three Components of Addiction
- Binge/Intoxication
- Withdrawal/Negative Affect
- Preoccupation/Anticipation/Craving
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HPA Axis, Cortisol, and Drugs
When you don't have the drug, it leads to release of glucocorticoids from the adrenal gland, which leads to stress
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