Drug abuse and drug dependence

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Drug abuse and drug dependence

• Zhou Yanqiong

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• Broad definition of drug abuse
• Unreasonable administration

(drug abuse)
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• Narrow definition of drug abuse
• psychological dependence
• physiological dependence
• mental disorder
• aberrant behavior

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definition of drug dependence

• Unusual mental state
• Constraint
• Continuity or regularity
• mental effect
• to avoid malaise
• toleration

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Key Concepts and Terms

• physical dependence/ physiological dependence
• psychic dependence/ psychological dependence
• cross-dependence

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poppy flower of California (1998.5)
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opium poppy
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marijuana
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drug tolerance

• Definition
• Repeated medication
• Characteristic
• Different tolerance
• Reversability
• Cross resistance
• analogic chemcial constitution
• mechanism of action
• drug dependence toleration

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Classification of drug to cause dependence

• narcotic drug
• psychotropic drug

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Narcotic drug

• Consecutive application to bring about
  physiological dependence and addiction
• Including
• opioids, cocaine, cannabis

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psychotropic drug

• Definition
• Repeated medication,
• Affect C.N.S excited/inhibited
• to bring about psychological dependence
• (1) Sedativehypnotics / antianxietic
• Barbiturates, benzodiazepines
• (2) psychostimulant
• Amphetamines, ritalin, caffeine
• (3)psychodelic
• Cannabinol, cannabidiol

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WHO classification

• Suppressant of central nerve
• Nicotine or tobacco
• Opioid
• antimelancholic
• cannabis
• hallucinogenic drug
• Fugitive compound

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Appearance of drug dependence

• Craving re-medication
• Constraint drug seeking behavior
• Withdrawal reaction

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Characteristic of drug dependence

• Opioid
• discontinuation 8-16h, 24-36h
• Suppressant of central nerve
• Benzodiazepine withdrawal 36h
• Barbiturates withdrawal 12-24h
• Cannabis
• Antimelancholic
• phenamine
• Cocaine

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Disservice of drug abuse

• Individual
• physical and mental health
• Intoxation death
• immunity infection
• Society
• Common family life destroy
• Criminality
• hold-back development

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Control of drug abuse

• International
• 1961 convention
• 1971 convention
• 1981 strategy
• National
• institute system
• Education
• medical establishment of withdrawal

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prevention and cure
Insulate to withdrawal Substitution
therapy BarbituratesPhenobarbital Alcoholclormet
hiazoleclorazepate Opioidmethadone
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Substitution therapy of methadone

• pharmacologic action of methadone
• methadone 1mg
• morphine 4mg heroin 2mg dolantin 20mg
• ? detoxification
• ?convalescent care

replace
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Therapy of clonidine

• pharmacologic action of clonidine
• Excitomotor ofa2 adrenoceptor
• Inhibit NC excitation of NE nucleus ceruleus
• to control abstinent symptom
• therapy
• ? detoxification
• ?convalescent care

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Therapy of the drug abuse

• Detoxification
• to prevent relapse
• Return to social life

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Chronopharmacology

• Definition of chronopharmacology
• Definition of Bioperiodicity
• Definition of circadian
• Definition of circannual rhythm
• E? F(a,C,S)

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• oral administration effect
• Pharmaceutics
• pharmacokinetics
• pharmacodynamics
• pharmacotherapeutics
• Chronopharmacokinetics
• Chronopharmacodynamics

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Rhythmicity and pharmacokinetics

• Rhythmicity and drug absorption
• Diazepam
• Theophylline
• amitriptyline
• Rhythmicity and drug disposition, protein binding
• Diazepam protein binding 99

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Rhythmicity and pharmacokinetics

• Rhythmicity and drug metabolism
• Methexenyl metabolic enzyme
• Rhythmicity and drug excretion
• urinary volume cidomycin
• urinary pHsulfacetic acid
• Rhythmicity and repeat administration

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Rhythmicity and pharmacodynamics

• Rhythmicity and drug effect
• HMG-CoA reductase inhibitor
• Pravastatin?lovastatin
• Avoiding hypotensive drug or diuretic at bedtime

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Chronopharmacology in-service use

• Chronotherapy
• Chronotherapeutic
• cardiovascular drugs
• Nifedipine

myocardial ischemia
day-night rhythm
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Cardiovascular drugs

• Acenterine prevent
• myocardial infarction,
• Cardiogenic sudden death

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Cardiovascular drugs

• Antihypertensive
• labetalol
• nifedipine
• verapamil

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Antasthmatic

• Terbutaline 5mg 8Am, 10mg 8Pm
• Salbutamol retard tablets POHS
• Theophylline
• 250mg 8Am, 500mg 8Pm

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Glucocorticoid and insulinum

• adrenal cortical hormone
• 810 Am 450nmol/L
• 4Pm 110nmol/L
• alternate day therapy
• Prednisonum,prednisolone

obvious
day-night rhythm
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Antitumor drug

• reproductive cycle of the tumour cell
• CyclophosphamideVESP
• Cisplatin man.pr
• Adriamycin12Am
• Arabinosylcytosin sinusoidal administration

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Rhythmicity and Drug toxicity

• Theophylline
• Strophanral
• Phenobarbital
• E600(paraoxon)