NOTE: These are not exact notes from class and should not be used to substitute coming to class. The notes posted on these pages are supplemental and/or contain information needed for exams but not contained in the text.
As in any field, items need to be defined to facilitate communication. Also, as in any field, few of these definitions are universally accepted.
Definition of "drug":
If you look through different textbooks or online, you'll find many different definitions for "drug." Some of these are more restrictive, some broader, than the one presented in your text. We'll use this definition (acknowledging that it isn't perfect):
Natural or synthetic substances used in order to have a specific effect on how the body functions because of their chemical nature.
In day-to-day language, we tend to use "drug" more narrowly. Some of the following help narrow the term down....
Definitions related to how or why drugs are used:
Medicine vs. pleasure (diagnosis, cure, treatment, etc. v. for fun, escape, etc.) The focus is on the intended purpose for the drug. This can get murky-- pain pills can be used simultaneously for both medicinal and pleasure purposes.
Misuse vs. Abuse--
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Misuse = inappropriate use of prescribed or non- prescribed medicine, but not for “pleasure” or other non-medicinal purposes. A common example is "more will work better." Another is to stop taking an antibiotic before the pills have been completely taken. |
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Abuse = repeatedly and willfully using a drug in a way other than prescribed or socially sanctioned. This means that whether or not use of a drug is labeled "abuse" is, in part, a matter of social context. In our society, drinking heavily and repeatedly will be considered differently if done by someone under age 17 v. someone over 21. It also would be looked at differently if the person were pregnant. This also would include using one's prescribed medications in ways not socially sanctioned (i.e., not how prescribed). |
Both misuse and abuse are said to occur when physical, psychological and/or social impairment occur.
The misuse v. abuse definitions relate to a drug's use and the intent behind its use and are therefore not easily identified just by watching what someone is taking. A drug of abuse, on the other hand, is generally thought of as one with reinforcing properties and ability to do harm to self and/or others). The drugs we'll discuss this term mostly fall in this category. Also, most of these are "psychoactive" -- that is, ones that affect thoughts, feelings, or perceptions.
Beyond these terms, you need to be familiar with the following defined in your text:
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Addiction |
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Substance
abuse |
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Substance
dependence |
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Psychic
dependence |
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Physiological
dependence |
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Tolerance |
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Withdrawal
symptoms |
After studying the text's definitions related to drugs and addiction, try the following matching exercise:
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NOTE: If a warning bar appears stating that "Internet Explorer has restricted this file from showing active content...," be sure to click the bar and choose to "Allow Blocked Content." |
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In order to talk about drugs, we need to be able to classify the various types. There are numerous schemes for doing this. The most common type would reflect aspects of the drug's pharmacological nature-- either by its chemical structure or by the effects on the body. In addition to classifications that focus on the chemical, drugs are commonly classified by their impact on the individual or society as a function of their use. In class, the following classification schemes for psychoactive drugs were highlighted:
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Effects on the central nervous system (CNS),
After studying the different types of drugs, try the following matching exercise:
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Legal status as defined by the U.S. Congress (through the
Controlled Substances Act (CSA),
After studying the CSA
definitions, try the
following exercise:
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Effects on one's personal well-being-- personal or social hazards associated with a drug's use.
Be sure to think about the implications of each way we classify drugs.
For your reference, I have put together a table based on information in the Drug Enforcement Agency's publication, Drugs of Abuse, which was available online at the DEA's web site. The table summarizes information and provides examples for each of the major drug classes.
Click on the button below to go to the classification summary table:
Controlled Substances-- Uses, effects, and
classifications
Drug Use Statistics |
Keeping track of statistics related to drug use is kind of like counting the red cars passing on a busy freeway-- as soon as you have a count, it's obsolete. Probably more important than the count of the day is consideration of relative use (which drugs are used by more people more often?), changes over time (which drugs have shown increases or decreases in use over time?), and relative health impacts (for which drugs have there been increased emergency room visits?)
Accordingly, I won't ask you about exact % usage rates of, say, methamphetamine use, but I will want you to know how meth used has changed and how it compares to, say, heroin or marijuana use.
With that in mind, having completed the pre-quiz and looked through the answers, I'm sure you noticed some trends in the information. For one, it's clear that alcohol and nicotine/cigarettes represent a markedly larger "drug problem" than all other drugs combined. This observation will be a recurring part of our discussions.
Pages 27-34 of the textbook give you updated information about drug use patterns in the U.S.
These first days of the course were to provide an idea of what "drugs" are (e.g., definitions and classification strategies). In part, these lectures and readings were also intended to demystify the topic of drug use, acknowledging that drug use has been inherent in human history, and to bring various myths and misconceptions about different substances to the fore (e.g., the misperception that legal drugs have less impact on individual and societal health than do illegal drugs.)
Some points to have gotten out of the discussions include the fact that patterns of use, social context/culture, and opinion play as much a role in the categorization and definition of drugs as does a drug's pharmacological effect. Legal categorizations, for example, by ignoring alcohol and cigarette use, differ greatly from categorizations based on personal or societal risk. Additionally, categorizations are not absolutes nor should one expect the same breakdowns to appear across individuals or cultures.
The categorizations based on personal and societal risk placed alcohol in "very high" risk levels whereas drugs often thought of as being "hard" drugs, such as PCP and LSD, were listed lower. Patterns of use account for much of that. Clearly, alcohol is used to excess more frequently by more people than are the other drugs. Why is that? Is it only because alcohol is legal and the others are not? If LSD and PCP were legal would they be used to the same extent? We as a country know from experience that making alcohol illegal is very difficult.
Be sure to take a close look at the criteria used for drug categorizations (especially the legal Schedules). Know why a drug would be a Schedule I or a Schedule II. Also, because drugs from those two categories represent the ones with greatest abuse potential, know examples of ones that fit into either of those categories.
Regarding the use patterns, be aware of relative levels of use (e.g., what illegal drug has been used by a majority of the U.S. population at least once? (none-- marijuana is closest with about 1/3 of the population claiming to have used at least once.)) Also be aware of changes in patterns over time (e.g., is drug use greater or lesser than during the late '70's?-- (less. 1978 was the peak.)) I will not ask you to repeat exact percentages (or even to guess between close options.
Also, note the material in Chapter 1 of the Biopsychosocial text. If you have any questions about that material be sure to ask! Note what's listed in the chapter summary, page 41 for an outline of important points from the text, and the end of chapter questions as a self-test.
Check yourself with the questions at the end of the chapter and the following ones taken from an earlier exam in this course:
