Pharmacology: Drugs of Abuse 1
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Use of an illicit drug causing harm to individual and/or society
Action of the drug in the Central Nervous System (CNS) causing alterations in perception
- Pharmacological/medical context: a drug that causes stupor and loss of sensibility or dulling of the senses (eg morphine)
- Legal context: any illicit and habit forming drug
Promotes the compulsive use of a drug (eg euphoria, withdrawal signs)
Rate at which a drug reaches its receptors in the CNS and exerts its effects. The faster this occurs, the greater the drug’s reinforcing effects and abuse potential.
A decrease in the drug’s effect as a consequence of repeated administration. More drug is required to produce the same effect that a smaller dose once produced
Evidenced by the appearance of a withdrawal syndrome when chronic administration of a drug is halted.
Psychological Dependence or Addiction
An abusive pattern of drug use, characterized by an overwhelming involvement with the use of a drug, the securing of its supply, and a high tendency to relapse after withdrawal.
Compulsive Drug Use
Obsession that takes form of a motor act.
What are the opioids?
Heroin, Morphine, Meperdine and Fentanyl
What are the psychomotor stimulants?
Cocaine and Amphetamines (Adderall or Ritalin)
What are the sedative hypnotics?
Barbibiturates and Benzodiazepines
What are the Hallucigens?
Lysergic and Diethylamide (LSD)
What are the inhalant?
Nitrous Oxide, Amyl Nitrite and Toluene
Subjective behavioral effects of opioids:
- Intravenous/inhaled opioids cause euphoria characterized by:
- Rapid rush of warmth in skin and lower extremities often likened to orgasm, lasting several minutes
- Followed by period of contentment, sedation, relaxation and tranquility (nodding) lasting 3 - 5 hours
Examples of opioids:
Heroin, Morphine, Meperidine, Oxycodone
Effects of IV/inhaled opioids like, a warm rush followed by sedation reinforce what?
- Psychological dependence
- Positively reinforce drug taking
What are the negative physical-physiological effects of opioids relevant to drug abuse?
Respiratory depression, miosis, nausea, constipation and vomiting
The Degree of tolerance to opioids is related to:
Dose and frequency of use
What interval of exposures/doses of opioids causing euphoria results in rapid tolerance?
Several daily doses for a few days
What are effects of opioids that tolerance can develop to?
Euphoria, respiratory depression, emesis and sedation
What are effects of opioids that tolerance cannot develop to?
Miosis and constipation
- Physiological state that develops as a result of the adaptation (tolerance) in response to repeated drug use
- Upon cessation (withdrawal), a drug-class-specific abstinence syndrome appears which is typically opposite to the acute effects of that drug-class
Is tolerance reversible?
Is dependence usually reversible?
If a person is tolerant to a drug are they also addicted?
Degree of dependence is related to what characteristic?
Dose and frequency
The Appearance and severity of abstinence syndrome depends on what charactertistics?
Degree of dependence
Signs/Symptoms of withdrawal include:
- Opioid craving
- Increased sensation of pain
- Dysphoric mood
- Pupillary dilation
- Sweating, piloerection, tachycardia, vomiting, diarrhea, increased blood pressure, yawning and fever
The severity of withdrawal is related to what specific characteristics?
Dose, time, exposure, dependence and DOA of the drug you are dependent on
Will a drug with a short or long DOA have a less intense withdrawal?
Long DOA will have less intense withdrawal
The development of physical dependence is reinforced mainly by what?
- Treatment of psychological dependence through maintenance on orally available, long-acting agonist exhibiting cross-tolerance with abused agonist
- Non-sedating doses suppress opioid craving, block heroin's effects and promote positive behaviors.
What drugs are used for maintenance therapy in detoxification?
- Levomethadyl acetate hydrochloride
As you drive physical dependence with escalating dose, you are more prone to experience severe withdrawal, which drives ______________.
Drug seeking behavior
The greater the _________________, the more you have to manage pharmacologically with methadone or buprenorphine.
What is the triad of symptoms for opioid toxicity?
Respiratory depression, miosis and coma
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