SOC 204 Chapter 8 Narcotics
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Transcript of SOC 204 Chapter 8 Narcotics
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SOC 204 Drugs & Society
Goldberg Chapter 8 Narcotics
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We have completed one third of this entire class. How are you doing in this class?
Michelle’s office hour:10:30-11:30 M-FEmail through CanvasCall 509-524-4791 Andrea here.
8%
42%
50% A. Awesome!B. I’m keeping up.C. I’m lost…help!
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Narcotics
OpioidsOpiates
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Do you know someone who has used opioids recreationally in the last 30 days?
39%
17%
43% A. NoB. Yes, one personC. Yes, more than one person
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Opium
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Morphine Codeine Heroin
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At one time, heroin was given to morphine addicts to help them break their addiction to morphine.
9%
91% A. TrueB. False
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1914 Harrison ActMade opioids difficult to obtainOral use declinedCost and risk increasedView of addicts changed
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Vietnam
Use among troops was about 10-15%Most users stopped upon returning to US
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Review: Which two compounds are in the opium plant resin?
A. Oxycontin and heroin
B. Morphine and heroinC. Morphine and
codeineD. Hydrocodone and
codeine
Oxyco
ntin and heroin
Morphine and heroin
Morphine and codeine
Hydroco
done and codeine
0% 0%
77%
23%
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Review: What impact did the Harrison Act have on opium use?
A. Opium use increased
B. Opium was no longer readily available
C. Illegal IV use decreased
D. Oral use increasedOpium use
incre
ased
Opium was n
o longer r
ea...
Illegal IV
use decre
ased
Oral use in
crease
d
0% 0%0%0%
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Review: Upon returning to the US, soldiers who used opiates in Vietnam:
A. 70% were arrested for illegal drug use
B. 67% became homeless
C. 95% stopped using the drug
70% were arre
sted fo
r ill...
67% became homeless
95% stopped usin
g the drug
0%
95%
5%
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Synthetic Prescription NarcoticsOxycodone (OxyContin, Percodan, Percocet)Hydrocodone (Vicodin, Lortab, Lorcet)Diphenoxylate (Lomotil)Fentanyl (Duragesic)Propoxyphene (Darvon)Hydromorphone (Dilaudid)Meperidine (Demerol)Methadone
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Narcotic Doses
Drug Therapeutic Dose Tolerant Dose Lethal DoseMorphine 15-30 mg 100 mg 500 mg
Heroin 10-15 mg 60 mg 200 mg
Fentanyl 25 micrograms 2 mg
OxyContin 10 mg 40 mg 160 mg
1 mg = 1000 micrograms
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Pharmacology
Raw opium is about 10% morphine, smaller amount of codeine
Heroin is made by adding two acetyl groupsAllows passing through blood-brain barrier faster
Mouse Party Enkephalins – adrenal gland Endorphins – pituitary gland
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Medical UsesPain reliefTreatment of intestinal disorders
Cough suppressant
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Physical Effects
Drowsiness (nodding out), vomiting, nausea, and difficulty concentrating
EuphoriaGradually anesthetizing sensationsDifficulty urinating, constipationConstricted pupils
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Emotional EffectsRelief from anxiety, hostility, feelings of inadequacy, and aggression
Difficulty regulating inhibitions and frequently make risky decisions
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Social EffectsAlienated from and hostile toward friends and family
Correlated with criminal behavior, unemployment, and violence
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Review: Heroin’s effects do not include:
0%
76%
10%
14% A. SleepinessB. EuphoriaC. AgitationD. Pain relief
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Review: which of the following is NOT a medical use for narcotics?
A. Cough suppressant
B. Stop diarrheaC. Induce sleepD. Pain relief
Cough su
ppressant
Stop diarrhea
Induce sle
ep
Pain re
lief
9% 5%
64%
23%
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DependencyAbout half of narcotic abusers become dependent:TolerancePositive reinforcementNegative reinforcementCan develop in less than two weeksAverage addiction is six to eight years (aging out)
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Acute ToxicityBehavioral
Respiratory depression can be fatalSynergistic effect when combined with
depressants
Opioid Triad Coma Depressed respiration Pinpoint pupils
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Chronic ToxicityBlood borne pathogensContaminantsInfections
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Which is an example of chronic physiologic toxicity?
A. Making bad decisions while high
B. Committing crimes to obtain the drug
C. Acquiring an HIV infection through use of unclean needles
D. Depressed respiration
Making bad decisions w
h...
Committing c
rimes t
o ob...
Acquirin
g an HIV in
fecti..
Depressed re
spira
tion
13% 13%
65%
9%
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WithdrawalFactors affecting the difficulty of withdrawal:
Social support networkDesire to stopPhysical environment during withdrawalAlternative opiates
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Signs Heroin orMorphine
Methadone
Craving for drugs, anxiety 6 24
Yawning, perspiration, running nose, teary eyes 14 34-48
Increase in above signs plus pupil dilation, goose bumps, tremors, hot and cold flashes, aching bones and muscles, loss of appetite
16 48-72
Increased intensity of above, plus insomnia; raised blood pressure; increased temperature, pulse rate, respiratory rate and depth; restlessness; nausea
24-36
Increased intensity of above, plus curled-up position, vomiting, diarrhea, weight loss, spontaneous ejaculation or orgasm, hemoconcentration, increased blood sugar
36-48
(hours after last dose)
Narcotic Withdrawal
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Opioid Antagonists/AgonistsNaloxone - NarcanSuboxone
Naloxone & BuprenorphineMethadone
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Opinion: Do you agree with the use of suboxone or methadone to help a person quit using opioids?
11%
89% A. YesB. No
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Which drug has the most dangerous withdrawal syndrome?
A. HeroinB. MorphineC. LSDD. Alcohol
Heroin
MorphineLSD
Alcohol
45%
55%
0%0%
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I think Needle Exchange Programs are a good idea.
A. TrueB. False
TrueFa
lse
0%0%