Objectives Address the detrimental effects of addictive substances, including marijuana, cocaine, methamphetamine, MDMA, heroin, and alcohol. List the detrimental health effects of tobacco use in general. Enumerate the reasons people smoke. Recognize cigarette smoking as the largest preventable cause of premature illness and death in the U.S. Explain the benefits and the significance of a smoking-cessation program. Learn how to implement a smoking-cessation program, to help yourself (if you smoke) or someone else go through the quitting process. Find out if you’re prone to addictive behavior. Plan for a drug-free future (including freedom from tobacco use).
Addiction Addiction: Compulsive and uncontrollable behavior(s) or use of substance(s) Psychotherapists describe addiction as a problem of imbalance or unease within the body and mind Almost anything can be addictive Most serious form is chemical dependency on drugs such as tobacco, alcohol, cocaine, methamphetamine, MDMA, heroin, marijuana, or prescription drugs
Illicit Drug Use Among AmericansAged 12 and Older, 2008
Risk Factors for Addiction Common factors that predispose people to addiction 1. The behavior is reinforced. 2. The addiction is an attempt to meet a basic human need. 3. The addiction seems to temporarily relieve stress. 4. The addiction results from peer pressure. 5. The addiction can be present within the persons value system. 6. The addiction is an escape from the pain or the fear of disfigurement. 7. The addict feels pressured to perform or succeed. 8. The addict has self-hate. 9. Heredity may dictate susceptibility to some addictions. 10. Society allows the addiction. Most people with addictions deny their problems All forms of addiction are unhealthy
Drugs and Dependence A drug is any substance that alters the user’s ability to function Over-the-counter drugs Prescription medications Illegal substances Many drugs lead to physical and psychological dependence
Drugs and Dependence Any drug can be misused or abused Misuse the intentional and inappropriate use of over-the- counter or prescribed medications; for example, taking more medication than prescribed or mixing drugs Abuse the intentional and inappropriate use of a drug resulting in physical, emotional, financial, intellectual, social, spiritual, or occupational consequences of the abuse The body often develops tolerance to drugs, requiring a higher dose with subsequent use
Nonmedical Use of Prescription Drugs Millions of Americans aged 12 or older reported nonmedical use of psychotherapeutic drugs at some point in their lifetime. The most commonly abused prescription medications are: Opioids, prescribed to treat pain codeine and morphine. Central nervous system depressants, used to treat anxiety and sleep disorders Mebaral, Nembutal, Valium, and Xanax. Stimulants, prescribed to treat the sleep disorder narcolepsy, attention-deficit hyperactivity disorder (ADHD), and obesity Dexedrine, Adderall, Ritalin, and Concerta.
Drugs and Dependence About 80% of federal and state inmates have abused drugs Approximately 60% of the world’s production of illegal drugs is consumed in the U.S. Americans spend more than $65 billion each year on illegal drugs Today’s drugs are stronger and more addictive, and pose a greater risk than ever before NSDUH report that 20% of the population aged 12 or older, or almost 50 million Americans, report nonmedical use of psychotherapeutic drugs
Cannabis sativa Marijuana is the most widely used illegal drug in the U.S. Low doses yield a sedative effect Larger doses produce physical and psychological changes THC is the mind-altering ingredient
Marijuana Some short-term effects include Tachycardia, difficulty in concentration, decreased coordination and tracking, short- term memory impairment, intermittent confusion, increased heart attack risk, and amotivational syndrome Long-term effects include brain atrophy, less resistance to infectious diseases, chronic bronchitis, lung cancer, possible sterility and impotence
Powdered Cocaine Can be sniffed, snorted, smoked, or injected Crack is smokable form Popularity based on the almost immediate feeling of euphoria At least 25% of first time users will become addicted in 4 years Sustained snorting can lead to a constant runny nose, nasal congestion & inflammation, perforation of the nasal septum
Cocaine Initial high Alleviates fatigue, raises energy, decreases need for food and sleep Then comes the “crash” Physiological and psychological depression leaving a desire for more Long-term consequences include Digestive disorders, weight loss, malnutrition, insomnia, anxiety, cocaine psychosis (“coke bugs”) Large overdoses can cause sudden death from respiratory paralysis, cardiac arrhythmias, and severe convulsions
Methamphetamine Fastest growing drug problem in the U.S. A central nervous system stimulant Primary effect Produces a feeling of well-being, decreases appetite, increases motor activity, decreases fatigue and need for sleep Chronic users experience Hallucinations, inflammation of the heart lining, schizophrenia-like mental disorder, and brain cell damage Users are frequently involved in violent crime, homicide, and suicide
MDMA (Ecstasy) A stimulant and hallucinogenic drug Users may experience faintness, blurred vision, chills, sweating, nausea, muscle tension, and teeth-grinding The user’s risk of death is heightened at dance clubs and raves because the crowded atmosphere combined with the stimulant effects causes dehydration Long-term side effects include confusion, depression, sleep disorders, anxiety, aggression, paranoia, impulsive behavior Verbal and visual memory impairment may remain for years after prolonged use due to depleted serotonin in the brain
Heroin Induces an almost immediate state of euphoria A sedative drug Overdose can cause convulsions, coma, death Withdrawal sets in about 4-5 hours after taking the drug Withdrawal is painful and lasts up to 2 weeks or for several months
Heroin Short-term use symptoms include Bone and muscle pains, muscle spasms and cramps, runny nose and eyes, drowsiness, slurred speech, nausea, and violent yawning Long-term symptoms include Hallucinations, nightmares, constipation, sexual difficulties, impaired vision, reduced fertility, collapsed veins, and increased risk for lung, liver, and cardiovascular diseases, including bacterial infections in blood vessels and heart valves SIDS is more frequently seen in children born to addicted mothers
Alcohol Alcohol is the cause of one of the most significant health-related drug problems in the U.S. today Alcohol intake impairs peripheral vision, decreases visual and hearing acuity, slows reaction time, reduces concentration and motor performance, and causes impaired judgment of distance and speed of moving objects Alcohol use also lessens fear, increases risk-taking behaviors, stimulates urination, and induces sleep
Consequences of Drinking Alcohol The synergistic action of alcohol when combined with other drugs, especially central nervous system depressants, is one of the most unpleasant, dangerous, and life-threatening effects of drinking Long-term effects of alcohol abuse are serious and life-threatening cirrhosis (scarring of the liver) greater risk for oral, esophageal, and liver cancer cardiomyopathy (disease affecting the heart muscle) high blood pressure and higher risk for strokes inflammation of the esophagus, stomach, small intestine, and pancreas stomach ulcers sexual impotence birth defects Malnutrition brain cell damage causing memory loss depression, psychosis, and hallucinations
Long-term risks associated with alcoholabuse
Alcohol on Campus Alcohol is the number one drug problem among college students Surveys found that 45% of students engaged in binge drinking (5 or more drinks in a row) Alcohol is a factor in about 28% of all college dropouts Full-time college students aged 18-22 are more likely to use alcohol, binge drink, and drink heavily than part-time students
Average number of drinks by collegestudents per week by GPA
Alcohol on Campus More than 50% of students participate in games that involve heavy drinking (5 or more drinks in one sitting) Excessive drinking can lead to unplanned and unprotected sex (risking HIV infection), date rape, and alcohol poisoning
How to Cut Down on Drinking Suggestions that may help you cut down your alcohol intake Set reasonable limits - do not exceed a certain number of drinks Learn to say “no” Drink slowly, don’t gulp your drink Dilute your drinks Do not drink on your own
Treatment of Addictions Recognize that there is a problem Recovery almost always requires professional help Consult a physician, counseling center, or local mental health clinic Contact the Substance Abuse and Mental Health Services Administration at 1-800-662-HELP for referral to 24-hour substance abuse treatment centers in your area Information is available on the Internet at http://www.samhsa.gov Intervention and treatment include psychotherapy, medical care, and behavior modification
Tobacco Use When tobacco leaves are burned, hot air and gases containing tar and nicotine are released in the smoke More than 4,000 toxic chemicals have been found in tobacco smoke and 69 are proven carcinogens Harmful effects of tobacco use became known in the 1960s In 1964, the U.S. Surgeon General issued the first major report stating that cigarettes were a major health hazard in our society, at which time more than 42% of the adult population smoked
Tobacco Use In 2006, 21% of adults and 20% of high school seniors smoked cigarettes As education increases, tobacco use declines
Morbidity and Mortality The World Health Organization estimates that 10% of the 6 billion people presently living will die from smoking-related illnesses Tobacco, a legal drug, kills 23 times as many people as all illegal drugs combined Cigarette smoking is the largest preventable cause of illness and premature death in the U.S.
Critical Thinking Do you think the government should outlaw the use of tobacco in all forms? Or does the individual have the right to engage in self- destructive behavior?
Morbidity and Mortality Smoking is the most prevalent cause of injury and death from fire Average life expectancy for a chronic smoker is 13-14 years shorter than for a nonsmoker Smoking is responsible for more than 470,000 unnecessary deaths each year Each cigarette shortens life by 7 minutes
Effects on Cardiovascular System More than 30% of fatal heart attacks result from smoking Risk for heart attack is 50%-100% higher for smokers than for nonsmokers Smokers have a higher mortality rate following heart attack than nonsmokers because their heart attacks are usually more severe and they have greater risk for deadly arrhythmias
Effects on Cardiovascular System Smoking affects the cardiovascular system by increasing heart rate, blood pressure, susceptibility to atherosclerosis, blood clots, coronary artery spasm, cardiac arrhythmia, and arteriosclerotic peripheral vascular disease Smoking decreases HDL-cholesterol Cigarette smoke contains carbon monoxide, which reduces the blood’s oxygen carrying capacity Carbon monoxide and nicotine can cause damage to the arterial walls, enhancing atherosclerosis Smoking causes increased adhesiveness and clustering of blood platelets, increasing blood thickness Any of these effects can precipitate a heart attack
Smoking and Cancer 87% of lung cancer is attributable to smoking Lung cancer is the leading cancer killer, accounting for about 30% of all deaths from cancer Cigarette smoking also leads to chronic lower respiratory disease, the 3rd leading cause of death in the U.S.
Normal and Diseased Alveoliin Lungs
Normal lung (left) is contrasted with diseased lung (right). The white growth near the top of the diseased lung is cancer; the dark appearance on the bottom half is emphysema
Smoking and Cancer The most common carcinogenic exposure in the workplace is cigarette smoke Secondhand smoke causes an estimated 50,000 additional deaths each year in the U.S. 3,400 people die each year from lung cancer because of secondhand smoke Data show there is no risk-free level of exposure to secondhand smoke
The health effects of smoking
Critical Thinking You are in a designated nonsmoking area and the person next to you lights up a cigarette. What can you say to this person to protect your right to clean air? And would you?
Smokeless Tobacco Use has increased during the last 15 years Average starting age is 10 years old Leads to health problems Gingivitis and periodontitis Four times greater risk of oral cancer Increased cavities, sore gums, bad breath, and stained teeth Diminishes smell and taste Increases heart rate and blood pressure Just as addictive as cigarette smoking
Health Care Costs of Tobacco Use Smokers use the health care system twice as much as nonsmokers A smoking employee costs an employer up to an additional $5,000 annually Almost 1,300 Americans die from smoking-related illnesses every day. How is this tolerated?
Why People Smoke The 3 fundamental instigators are Peer pressure Desire to appear “grown up” Rebellion against authority Smoking only 3 packs of cigarettes can lead to physiological addiction Its stimulating effect produces strong physiological and psychological dependency. Six to eight times more powerful than the addiction to alcohol.
“Why Do You Smoke?” TestCigarette smoking is the single The National Clearinghouse forlargest preventable cause of illness Smoking and Health developedand premature death in the United the “Why Do You Smoke?” Test,States Lab 13B The scores obtained on the test assess smokers for each of 6 factors that describe individuals’ feelings when they smoke 1. Stimulation 2. Handling 3. Pleasure/pleasurable relaxation 4. Crutch: tension reduction 5. Craving: psychological addiction 6. Habit
Smoking Cessation Annually, only about 20% of smokers who try to quit succeed the first time Nicotine is perhaps the most addictive drug known to humans Between 75% and 90% of all smokers would like to quit More than 91% of successful ex-smokers have been able to quit on their own either cold turkey or by using self-help kits Only 6.8% of ex-smokers have quit as a result of formal cessation programs
“Do You Want to Quit?” Test Most important factor in Reasons for Quitting quitting is the sincere desire to Health -quitting because of do so the harmful consequences Those who quit easily are Example - set examples for primarily light or casual others smokers Aesthetics - smell, bad For heavy smokers, quitting breath, stains on teeth, will be a difficult battle fingers The odds of quitting are much Mastery - desire for self- better for those who repeatedly control try to stop
Breaking the HabitStarting an exercise program 1. Decide positively that you want to quitprior to giving up cigarettesencourages cessation and 2. Initiate a personal diet and exercisehelps with weight controlduring the process program 3. Decide on the approach you will use to stop smoking Cold turkey Cutting down gradually 4. Keep a daily log of your smoking habit for a few days 5. Set the target date for quitting 6. Stock up on low-calorie foods 7. Quit!
Breaking the Habit Many people find that quitting all at once (cold turkey) is the easiest way Tapering off cigarettes can be done in several ways Eliminate cigarettes you do not strongly crave Switch to a brand lower in nicotine/tar every few days Smoke less of each cigarette Smoke fewer cigarettes each day Nicotine substitution products These products decrease the amount of nicotine used until the person no longer craves the drug Tips on pages 468-469
Nicotine-Substitution Products Nicotine Transdermal Patches Deliver a steady dose of 5–21 mg of nicotine a day. A typical program lasts 3–10 weeks at a weekly cost of about $50. A physician should be consulted if the individual is pregnant, lactating, has heart disease, or is hypertensive. Undesirable effects include skin redness, swelling, and rashes.
Critical Thinking If you ever smoked or now smoke cigarettes, discuss your perceptions of how others accepted your behavior. If you smoked and have quit, how did you accomplish the task, and has it changed the way others view you? If you never smoked, how do perceive smokers?
Life after Cigarettes Withdrawal symptoms should be expected Lower heart rate and blood pressure Headaches Gastrointestinal discomfort Mood changes Difficulty sleeping Physiological addiction is broken in about 3 days following the last cigarette Psychological addiction takes longer, possibly years to break
Life after Cigarettes Greatest early benefit is a lower risk of sudden death Risk for illness starts to decrease the moment you stop smoking Sore throats, sores in the mouth, hoarseness, cigarette cough, and risk for peptic ulcers decrease Circulation to the hands and feet improves Gastrointestinal, kidney, and bladder functions improve Everything tastes and smells better
Real Life Stories
Real Life Stories Critical Thinking Questions 1. Describe how today’s culture contributed to Steve’s addictive behavior. How may you as an individual make a difference so that people do not develop addictive behaviors? 2. Quitting smoking is a challenging task to accomplish. If you needed to make such a change, what approach would you use to increase your chances of success? 3. Brainstorm what you may do if a friend or loved one has developed some type of addictive behavior.