1. Classes of phychoactive substances
    • 1) alcohol
    • 2) amphetamines
    • 3) caffeine
    • 4) cocaine
    • 5) cannabis
    • 6) hallucinogens
    • 7) inhalants
    • 8) nicotine
    • 9) opioids
    • 10) Phencyclidine (PCP) 
    • 11) sedatives, hypnotics, anxiolytics
  2. Cultural aspects
    • Spain and italy:  alcohol dependency and acute intoxication is uncommon
    • Native americans: High incidence of dependency
    • Northern and Southern Europeans: High dependency
    • Asians: Unpleasant symptoms due to a missing isoenzyme leads to low alcohol dependency
  3. Alcohol content
    • Beer: 3 to 6 percent
    • Wine: 10 to 20 percent
    • Distilled: 40 to 50 percent
  4. Phases of alcoholism
    • 1) Prealcoholic phase
    •        drinks to releive stress, tolerance begins to develop
    • 2) Early alcoholic phase
    •         begins with blackouts...secret drinking....preoccupation with drinking...rapid gulping...further blackouts...enourmous guilt...very defensive
    • 3) Crucial phase
    •         physiological dependence is clearly evident...inability to choose to drink or not...anger and agression are common...may have experienced loss of job, marriage, family member or friends or self asteem due to drinking
    • 4) Chronic phase
    •         emotional and physical disintegration... intoxicated more than sober... profound helplessness and self-pity
  5. Effects on the body
    •  about 20% of the alcohol is absorbed directly into the blood stream via the stomache 
    •  80% is absorbed only slightly slower via the upper intestinal tract
    •  moments after consumption it can be found in all organs, tissues and secretions
    •  absorption is delayed when:
    •         -the alcohol is sipped rather than gulped, the stomache contains food, the alcohol is beer or wine rather than distilled
  6. Chronic abuse may cause:
    • -Peripheral neuropathy
    •       Pain, burning, or tingling in the extremities
    •       May be from lack of vit. B particularly thiamine and nutritional deficiencies 
    •       Is reversable
    • -Alcoholic myopathy
    •       acute:  sudden onset of muscle pain, swelling, and weakness; reddish tinge in urine caused by myoglobin, a breakdown product of muscle excreted in the urine; and a rapid rise in muscle enzymes in the blood; higher elevations of CPK, LDH, aldolase, and AST
    •       chronic:  gradual muscle wasting and weakness, no pain or elevated muscle enzymes, thought to be the result of vit. B defiency

    • Improvement with alcohol abstinence and nutritious diet is seen
    • -Wernickes encephalopathy
    •       Most serious form of thiamine defeciency in alcoholics;  paralysis of the ocular muscles, diplopia, ataxia, somnolence, and stupor.  death will ensue w/o thiamine replacement
    • -Esophagitis
    • -Gastritis
    • -Pancreatitis
    • -Alcoholic hepatitis
    • -Cirrhosis of the Liver: give lactulose to excrete the amonia that's built up in the body, end-stage of alcoholic liver disease.. liver cells are replaced with fibrous scar tissue
    • -Leukopenia
    • -Thrombocytopenia; platelet production and survival are impaired.... risk for hemorrhage
    • -Sexual dysfunction
  7. Intoxication occurs at what blood alcohol level?
    100 and 200 mg/dL

    death occurs at 400 to 700 mg/dL
  8. Symptoms of alcohol withdrawal
    • within 4 to 12hrs:  coarse tremor of hands, tongue, or eyelids; nausea or vomiting; malaise or weakness; tachycardia; sweating; elevated blood pressure; anxiety depressed mood or irritability; transient hallucinations or illusions; headache; and insomnia
    • May progress to alcohol delirium
  9. Barbituates/CNS depressants
    • Pentobarbital (Nembutal); yellow jackets, yellow birds
    • Secobarbital (Seconal); GB's, red birds, red devils
    • Amobarbital ( Amytal); Blue birds, blue angels
    • Secobarbital/amobarbital (Tuinal); Tooies, jelly beans
    • Phenobarbital
    • Butabarbital
  10. Nonbarbituate hypnotics/CNS depressants
    • Chloral hydrate (Noctec); Peter, Micky 
    • Triazolam (Halcion); Sleepers
    • Flurazepam (Dalmane); Sleepers
    • Temazepam (Restoril); Sleepers
    • Quazepam (Doral); Sleepers
  11. Antianxiety agents/CNS depressants
    • Dazepam (Valium);Vs (color designates strength)
    • Chlordiazepoxide (Librium); Green and whites, roaches
    • Meprobamate (Miltown); Dolls, dollies
    • Oxazepam (Serax); Candy,downers (the benzodiazepines)
    • Alprazolam (Xanax); 
    • Larazepam (Ativan);
    • Clorazepate (Tranxene);
  12. Club drugs/CNS depressants
    • Flunitrazepam (Rohypnol); Date rape drug: roofies,R-2, rope 
    • Gamma hydroxybutyric acid (gamma hydroxybutyrate; GHB); G, liquid X, grievous bodily harm, easy lay
  13. apply to all CNS depressants
    • 1) Affects are additive with one another and with state of mind
    • 2) Capable of producing physiological dependency; withdrawal could lead to convulsions and death
    • 3) Capable of producing phycological dependence
    • 4) Cross tolerance: one drug results in a lessened response to another drug
    •     Cross dependance: one drug can prevent withdrawal symptoms assoc. with physical dependence on a different drug
Card Set
substance related disorders Townsend ch. 13