drugs

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drugs

• Controversy, danger, tradition

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Controversy and confusion

• Uneasy boundary between legal and illegal,
  beneficial and harmful
• Many legal drugs injure in high amounts
• Many are addictive
• Many illegal drugs have medical uses
• Gateway drugs?
• Misinformation often causes people to ignore
  real risks

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background

• Humans use, and abuse, a wide variety of drugs
  which exert widely ranging effects
• Genetics play a role in our differing
  sensitivities to drugs
• Also, behavioral tendencies like impulsivity,
  novelty-seeking, hyperactivity, and variations in
  tolerance of stress, are important

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Focus on the brain

• The release of dopamine and the pleasure which
  follows, tells us what we like
• This nudges us into eating, drinking, and other
  beneficial behaviors
• Years of research has revealed that ingesting
  many drugs also causes dopamine to be released,
  hi-jacking this natural reward system - to our
  peril

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Underlying neurology

• The dopamine circuit begins in the ventral
  tegmental area (found at the top of the brain
  stem) which synthesizes dopamine which it passes
  to the
• Nucleus accumbens which then connects through its
  axons to areas of the frontal lobes
• Continued use of some drugs (opiates) causes
  neurons to shrink or otherwise work less
  effectively, forcing the user to rely on the drug
  for pleasure

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but there is more

• Two other key brain structures are also involved
• The amygdala adds an emotional overtone to the
  desire for this manipulation of the reward
  circuit
• Even more importantly, the hippocampus makes sure
  that we remember the fun times associated with
  the drug, and the surroundings which accompany it

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perspectives

• Many drugs decrease our ability to experience
  pleasure normally
• We then need them to make-up for what they have
  taken from us
• But these changes to our natural reward system
  can also be effected by other things such as
  gambling, video games, even sweets

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alcohol

• World-wide and ancient use
• Part of many of our customs and traditions
• At the most basic level, simply a class of
  molecules
• We are concerned with ethanol the type which
  people drink

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Alcohol the depressant that makes us act out

• While we typically link drinking alcohol with
  wild, reckless behavior, it is actually a
  depressant
• Thats because it, especially in high amounts,
  lessens our inhibitions by turning off our
  frontal lobes, increasing impulsivity/risk-
  taking behavior
• Excessive use leads to physical damage

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tranquilizers

• Another type of depressant
• Help us relax, fall asleep and decrease muscle
  tension
• Barbiturates formerly commonly prescribed, now
  out of favor addiction and other risks
• Benzodiazepines, such as valium, now hold sway
  less addictive

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bennies

• Great danger mixing them with alcohol
• Both stimulate production of the neurotransmitter
  GABA, which can inhibit the function of the
  medulla disrupting our breathing and heartbeat
  a truly fatal mix
• Another aspect of these drugs is their use as
  date rape drugs very inconspicuous
• Flunitrazepam/Rohypnol, or roofies
• Induce euphoria, lack of inhibitions, amnesia

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narcotics

• Produce drowsiness, insensitivity to pain and
  indifference to events
• Most commonly opiates
• Natural substances derived from the opium poppy
• Also synthetic compounds with similar chemical
  structures - methadone

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Opiates - why they wreak such havoc

• Give users a warm, happy, contented feeling
• Heroin, morphine, methadone (synthetic)
• Virtually eliminate pain and anxiety but at the
  cost of apathy and fast addiction
• When the unnatural production of dopamine ceases
  the body cries out for it
• If denied, chemical withdrawal begins

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Withdrawal from opiates

• During withdrawal all of the pleasant effects of
  the drug are reversed
• While before there was contentment now there is
  anxiety, before happiness now pain
• Worse yet, we need more - tolerance
• Need for a fix causes desperate actions
• theft, burglary, prostitution, shattered lives,
  criminal prosecution

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Long term effects

• Longitudinal studies paint a very bleak picture
• Of 581 users followed from 1962, nearly half were
  dead by 1997
• Survivors self-medicated, including cigarettes
  (67)
• They also faced many health problems, including
  hypertension, liver and lung ills, etc.

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stimulants

• Drugs which boost energy, alertness, activity and
  pleasant feelings
• Caffeine perhaps the most widely used drug?
  90!
• Delivered through coffee, chocolate, soda, energy
  drinks, tea
• Can lead to dependency headaches and drowsiness
  if denied

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cocaine

• The drug of choice in the 80s and beyond
• Derived from the leaves of the coca plant
• Creates a euphoric sense of happiness and
  increased activity
• Considered a stimulant because it turns off
  inhibitors, leading to an increase in behaviors
• But its use decreases over-all brain activity

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More cocaine

• Very powerful, with many effects
• Works by preventing a terminal buttons synaptic
  vesicles from reabsorbing dopamine (reuptake)
  thus increasing its effects
• Also, kicks up norepinephrine and serotonin
  levels
• Works as an anesthetic ( as does lidocaine and
  Novocain) by stopping action potentials

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Cocaine and addiction

• Usually taken in powder form with euphoria coming
  on within minutes and lasting for up to an hour
• If smoked through free basing, its effects
  emerge even faster
• The faster the pleasure, the quicker the addiction

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Crack addiction squared

• Crack cocaine, first developed in the mid- 80s,
  provides even quicker, virtually instantaneous,
  pleasure
• Addictive after only a few uses
• Very expensive, readily addictive and quick to
  lose its effects
• It takes over lives, ruining careers and families

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Long term

• While coke-triggered heart attacks and strokes
  strike occasionally, its residual damage is
  harder to assess
• Many who started to use it in the 80s are now
  well into their 50s and the number of addicts
  over 50 is set to explode, perhaps to over 4
  million
• Effects are often worsened by overall neglect

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marijuana

• CONTROVERSY
• Intensifies sensory experiences, induces
  euphoria, distorts time perception, also can lead
  to feelings of anxiety
• Formally known as Cannabis sativa
• Main psychoactive chemical is called THC
• Cultivated for at least 3000 years

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The neurochemistry of marijuana

• Mimics a neurotransmitter called anandamide
• They attach to receptors which affect short term
  memory (on the hippocampus) which can make it
  difficult to remember events and learn
• Also they impact our muscle coordination by
  altering the normal functions of the cerebellum

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Medical benefits

• Research shows that marijuana aids some medical
  conditions
• Chemotherapy problems decreases vomiting,
  nausea, and anxiety
• Aids-related wasting improves appetite
• Pain and muscle spasms decreases these
  plus depression
• Glaucoma decreases pressure on eye

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Why pot?

• It is so easy to administer
• Puff by puff, the user can simply stop when
  acceptable levels have been reached
• Low toxicity
• Plus, its effects last no longer than 2 3 hours
  and no chance of overdose
• But, since it is fat soluble, it can be detected
  for 28-30 days after ingestion

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The debate

• Life threatening?
• Harmless?
• Probably neither.
• A gateway drug? (millions spent)
• very few move on to cocaine or heroin
• most used tobacco and alcohol first
• if marijuana disappeared would cocaine and
  heroin?

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withdrawal

• Is pot addictive?
• tolerance doesnt seem to develop
• nothing compared to opiates, alcohol, or
  nicotine
• very little proof of any residual effects
• 99 discontinue use without any withdrawal
  effects

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Other risks

• Evidence is building of a relationship between
  early pot use and the development of psychosis
• Use before the age of 15 can make vulnerable
  teens much more likely to eventually develop
  serious mental illness
• Genetic predispositions activated by
  environmental conditions

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A real danger?

• Amotivational syndrome
• Putting off important things till tomorrow
  because you got high today
• Coupled with well established barriers to
  learning, pot smoking can cause people to waste a
  lot of time and money
• Fact of fiction?

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Long term

• A 2003 study stated that even among regular users
  there is no proof of irreversible cognitive
  damage
• Uncertain as to long range pulmonary disease and
  cancers though pot does contain carcinogens

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hallucinogens

• Drugs which induce sensory distortions
• Can come from plants mushrooms (psilocybin) or
  cactus (peyote)
• Also produced synthetically LSD
• Famous for amazing intensification of sensations
  and experiences from dream-like states to
  transcendent mystical events

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Mescaline and psilocybin

• Mescaline, better known as peyote, is derived
  from a Chihuahan cactus found in Texas and Mexico
• It has been used medicinally and sacramentally
  for thousands of years
• US government allows its use in Native American
  religions
• Initial focus of Carlos Castenadas quest

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More peyote

• Users consume it in buttons
• Many initially experience nausea which is
  followed by feelings of physical energy (small
  doses) or visionary experiences which they view
  as a spiritual and physical blessing
• A recent study of regular Native American users
  found no harmful cognitive or psychological
  effects, and some gains!

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Magic mushrooms

• Psilocybin, an active chemical compound in
  hundreds of mushrooms that causes hallucinogenic
  experiences
• Used world-wide especially by the Aztecs
• Can be smoked or simply eaten
• Castenada, and many others, sampled
• Most common natural hallucinogenic

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lsd

• Officially lysergic acid diethylamide
• Accidentally discovered by a Swiss chemist,
  Albert Hoffman, in 1943
• Somehow ingesting it, he experienced an amazing
  shift in consciousness
• An uninterrupted stream of fantastic images of
  extraordinary vividness and plasticity passed
  before his eyes accompanied by an intense
  kaleidoscopic play of colors

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Further research

• Hoffman went on to try LSD on many more occasions
  
• These experiences were invariably pleasant except
  once, when tired, he mixed it with amphetamines
  and experienced historys first bad trip
• Recently turned 100, he still considers LSD
  medicine for the soul

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Then things got weird

• The word slowly spread until in the early 60s it
  reached Timothy Leary, a maverick Harvard
  psychologist with extensive work with psilocybin
• Leary experimented with his graduate students and
  raved about LSDs effects reporting profound
  mystical and spiritual experiences
• Turn on. Tune in. Drop out.
• The most dangerous man in America.?

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The serotonin connection

• LSD attaches to receptors usually used by
  serotonin
• It apparently stimulates the receptors in strange
  ways
• Change our typical perceptual filtering?
• Bad trips largely arise from the setting
• In secure environments, very unlikely
• Some suffer flashbacks, but still rare

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ecstasy

• Also known as MDA or MDMA
• Synthetic compounds which resemble
  neurotransmitters and stimulate serotonin
  receptors
• Users report heightened intimacy and insight into
  relationships
• Many negative effects confusion, anxiety
• Evidence points towards damage to axons devoted
  to serotonin

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Crystal meth

• Also known as methamphetamine
• Causes extensive production of dopamine
• Ingestion leads to an almost instant tingly rush
  of sexiness, confidence and alertness
• But eventually, dopamine receptors are depleted
  and users feel unable to experience pleasure
  without more and more

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A hurricane of shattered bodies and lives

• Addiction often follows with devastated families,
  lost jobs, ruined health, crime, etc
• Horrible physical aftermath premature aging,
  skin sores, ruined teeth, wasting
• Burns victims overwhelm rural counties
• But for the Bush administration pot is still
  enemy 1 Local governments disagree