At the end of the session, participants should be able to: understand the complexity of drugs and classification of the drugs, define the society and understand the relation between drugs and society, understand the various interventions that can be used to mediate the impact of drugs on society.
AMBIENT/
Chủ đề:
Nội dung Text: Introduction of drug and society - Hanoi Medical University
- INTRODUCTION OF
DRUG AND SOCIETY
Hanoi Medical University
11-12 December 2012
Substance Abuse and Mental Health Services Administration
(SAMHSA)
HCMC, 7 September 2011
Session overview
• At the end of the session, participants
should be able to:
– understand the complexity of drugs and
classification of the drugs
– Define the society and understand the relation
between drugs and society
– understand the various interventions that can
be used to mediate the impact of drugs on
society
- What are drugs?
• There is no single definition of a ‘drug’
• The World Health Organization (WHO)
defines a drug as:
– “any substance which, when taken into the
body alters its function physically and
physiologically”
– Source: WHO, 1989
- Classification of drugs
• Medical versus non-medical
• Legal versus illegal
– US Drug Enforcement Agency drug schedules
– UN conventions on drugs control
• Effect on the central nervous system (CNS)
– Depressants
– Stimulants
– Hallucinogenic
Can we classify drugs?
• There is no perfect way to group or classify drugs
• Many people use multiple drugs at one time
• Many drugs have multiple effects on the CNS
Why is it important to classify drugs?
- What is a society?
“A society is a group of individuals,
generally seen as a community. Human
societies are characterized by patterns of
relationships between individuals that
share a distinctive culture”
A history of drugs
• 5000 B.C. Ancient Sumerians
produce an ideogram for the
poppy and medicinal ‘recipes’
carved on stone
• 3500 B.C. Earliest historical
record of the production of
alcohol: the description of a
brewery on Egyptian papyrus
(paper)
- A history of drug (cont.)
• Drug use in ancient
cultures
– Hashish was reveled as
a spiritual drug in
Hinduism
– Shamanism in South
America
– The role of alcohol in
European culture
Beer Street and Gin Lane
- Drugs are apart of our everyday lives
• Almost everyone uses drugs
• Drugs are always in the media
– Representations in popular culture
– Stories in the media
– On public announcement speakers
Like it or not, they are here to stay!
How are drugs controlled?
• Long history of drug control
– Religious control
• Alcohol prohibition – Qu’ran
• Catholic prohibited coffee consumption in Ethiopia
until 1880’s
– Social control
• Social festivals
• Temperance movement
• Local market
- International drug control
• Three UN Drug Conventions govern international drug
policy
– Single Convention on Narcotic Drugs, 1961 (Single
Convention) as amended by the Protocol Amending the
Single Convention on Narcotic Drugs, 1961
– Convention on Psychotropic Substances (Psychotropics
Convention, 1971)
– Convention against Illicit Traffic in Narcotic Drugs and
Psychotropic Substances (Trafficking Convention, 1988)
Review
• Drugs have always been a part of society
• Society has many ways of regulating
drugs
• Drugs lead to both benefits and harms to
society
• When thinking about drugs and society,
consider it is more than just about drug
use
- Biological Foundation
for Addiction
An Over-riding PRINCIPLE
IN ADDICTION
Drug use is a voluntary,
preventable behavior
- but...
Drug addiction is not just
“a lot of drug use.”
Drug Addiction is..
Compulsive drug seeking
and use, even when
knowing about the negative
health and social
consequences
- Science of Addiction
Advances in medicine and scientific
techniques have given researchers a
clearer idea of what addiction is:
– Magnetic resonance imaging (MRI)
– Positron emission tomography (PET) scan
– Advanced genetic research
- IMAGING THE
BRAIN
PET
MRI
SPECT
The addicted brain is distinctly,
biologically different from the
non-addicted brain:
• Cell receptor function and availability
• Metabolic activity
• Responsiveness to environmental
cues
• Gene expression
- 1.2
- Virtually all drugs of abuse
have common effects on the
dopamine mesolimbic reward
system in the brain
• Ventral tegmental area
• Nucleus accumbens
• Limbic system
• Orbitofrontal cortex
- Addiction and the Reward Pathway
The brain’s reward pathway is
critical to the development of
addiction
- Addiction and the Reward Pathway
Our brains are wired to ensure that we
repeat life-essential activities by
associating those activities with pleasure
or reward
- Addiction and the Reward Pathway
The over-stimulation of this pathway,
which rewards our life essential
behaviours (eating, drinking, sexual
behaviour), produces the euphoric effects
sought by people who abuse drugs and
teaches them to repeat the behavior
The addicted brain is fooled into believing
drugs are essential for life
Brain Communication
The brain is a communications center
consisting of billions of nerve cells
- Nerve cell
Brain Communication
Networks of nerve cells pass messages
back and forth to different structures
within the brain, the spinal column, and
the peripheral nervous system
- Brain Communication
A neurotransmitter and its receptor
operate like a key and lock
- Drugs and Dopamine
• Psychostimulants, (e.g.cocaine and
amphetamines) directly increase available
dopamine for post-synaptic signalling
– increase release or
– reduce reuptake (block dopamine agonist transporter)
• Alcohol, opioids, cannabis and nicotine increase
dopamine activity indirectly
– stimulating neurons that influence dopamine neurons
• Nicotine is a typical addictive drug
– does not increase dopamine as much as
psychostimulants and opiates
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