What are opioids? - ANS Opioids:
• Street use - not for physical pain states.
• Patients (signalling in pain pathways) - used in presence of pain. Presence of opioid in presence of pain
does not have same effect as recreational use.
• Self administration and access, but patient controlled...
• Patients (signalling in pain pathways) - used in presence of pain. Presence of opioid in presence of pain
does not have same effect as recreational use.
• Self administration and access, but patient controlled analgesia (PCA) also involves
self administration.
• Animals and patients pick doses.
• Heroin vs morphine - same drug.
• Pain must counter reinforcement.
• Patients become physically dependent.
• SM - control of the pain.
What are the changes in opioid use? - ANS Changes in opioid use:
• Kratom - mitraygnine - herbal opioid used by middle aged mid-income users for pain and anxiety.
,• Opiophobia - fears of addiction in pain patients.
• Based on oxycodone - widely prescribed in the US, in poor area, diversion widespread - 30,000 deaths
per annum from overdose.
• Fentanyl is a synthetic opioid that is highly potent and mixed with heroin.
Pain may block dopamine and reward: - ANS IMAGE
How do individuals get their drugs in the UK? - ANS How individuals get their drugs:
• 65% of individuals say they receive drugs from their friends.
• 25% of individuals say they known their dealer.
• 10% of individuals say the do not know their dealer.
How much do individuals spend on drugs? - ANS 0 = 39%
< 40 = 31%
40-100 = 16%
100-200 = 5%
> 200 = 8%
Drugs and me - UCL study: - ANS IMAGE
What is the current drug use in Europe? - ANS IMAGE
,Drug use study in the UK from 2014 - 1080 individuals: - ANS IMAGE
How has the purity of drugs changed? - ANS IMAGE
What are examples of drugs that have appeared more recently? - ANS IMAGE
What are the pharmacoeconomics of various drugs? - ANS IMAGE
Difference between alcohol and cannabis? - ANS • Drug on the left (alcohol) is legal, drug on the right
(cannabis) is illegal.
University of Essex cannabis research - if cannabis was legalised: - ANS IMAGE
What are the effects of prohibition - making a drug illegal (alcohol)? - ANS IMAGE
What is drug dependence? - ANS Drug dependence:
Drug dependence = a physical or psychological state, resulting from an interaction between a drug and
organism, characterised by a compulsion to take the drug on a periodic or continuous basis to
experience its psychic effects and/or avoid the discomfort of its absence.
• Wish, need, desire, craving - psychological (all drugs).
• Physical withdrawal - only depressant drugs (opioids, alcohol).
, How do inhibitory and excitatory drugs use different mechanisms to increase the levels of dopamine
within the brain? - ANS • Inhibitory and excitatory drugs use different mechanisms to increase the
levels of dopamine within the brain.
What are reward dependence systems? - ANS Reward dependence systems:
IMAGE
20% of individuals that go through withdrawal stay clean: - ANS • If the reason and incentive for use is
still present, most individuals will go back to the drug.
• However, binge drinking in young adults is down to 18% from 29% a decade ago - resorted to trying
new drugs?
Example - Vietnam war:
• The Vietnam war shows that the environment and circumstances for drug use was a very powerful
drive for the majority of soldiers.
What treatment is available for individuals that are dependent? - ANS Treatment for dependence:
• 20-30 years ago aversion therapy was used (chemicals that interacted with drugs). Antabuse was used
for alcohol, which made consuming alcohol a very unpleasant experience.
• Most successful treatment for opioid use is substitution drug therapy. Methadone is an opioid that can
be prescribed, is a liquid, and is long lasting. It also takes individuals away from the environment they
were using drugs in.
• Clinics are extremely expensive facilities where many celebrities go to undergo drug rehabilitation.
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