Fluent Essays

the documents With the instructions and articles are linked.Basically a critical response on the effects of drugs and how it affects the brain. the second is a essay/project on how marijuana is so controversial and it’s effects on humans. (Supporting articles on marijuana effects on the brain is provided),The third is an leadership interview I did with my local librarian. Simply typing out the answers to the questions. critical_respone__3.pdf marijuana_project_.pdf naadac_position_on_marjiuana.pdf barger_handout_of_marijuana___what_the_internet_wont_tell.pdf marijuana_volkow_article.pdf leadership_interview_reflection.pdf Unformatted Attachment Preview Module 3: Substances Commonly Abused Module Objectives​: Demonstrate an understanding of the history of opiates/opioids use, identify the types and effects of opioids, understand the origin and use of Opioid Replacement Therapies, understand the interactions between opioids (synthetic & non-synthetic) and other psychotropic substances (both licit & illicit), and become familiar with the new ORT’s such as Buprenorphine). Demonstrate an understanding of the history of stimulant use, identify types of stimulants (both licit and illicit), understand the interactions between stimulants and other substances, and become familiar with pharmacological therapies available for stimulant users . Demonstrate an understanding of the history of alcohol and sedative use, the types and effects of sedatives, the detoxification process for alcohol and sedatives, interactions between alcohol and sedatives with other psychotropic substances, understand the impact of alcohol on physiological systems. Demonstrate an understanding of the history of hallucinogens, identify the types & effects of hallucinogens as well as the interactions between hallucinogens & other psychoactive substances. Module Readings​: Just skim all of them: Links for NIAAA/NIDA information on various substances: Alcohol: RethinkingDrinking.niaaa.nih.gov Marijuana: http://www.drugabuse.gov/publications/drugfacts/marijuana Heroin: http://www.drugabuse.gov/publications/drugfacts/heroin Prescription Drugs I: http://www.drugabuse.gov/publications/drugfacts/prescription-over-counter-medications Prescription Drugs II: http://www.drugabuse.gov/publications/research-reports/prescription-drugs Cocaine: http://www.drugabuse.gov/publications/research-reports/cocaine-abuse-addiction Stimulants: http://www.drugabuse.gov/publications/drugfacts/stimulant-adhd-medications-methylphenidateamphetamines Vignette​: Your sister has come to you concerned because she just found out that her daughter has been using prescription drugs over the past year. Your sister found out from the school and when she confronted your niece this was the story given in response: Last year when your sister’s partner had back surgery there was medication left over that your niece started taking from the medicine cabinet in the bathroom. Once that supply ran out your niece started buying similar prescription drugs from a kid at school, but when that became too expensive your niece switched to an illicit drug that had similar effects. Now your niece is using this illicit drug on a daily basis in increasing amounts and has begun to steal from your sister and her partner to support her habit. Your niece was also caught stealing from neighbors and friends. When your sister asked your niece why not just stop, her reply was “I am afraid of the withdrawal symptoms.” Your sister feels horribly guilty about your niece’s substance misuse problem since she divorced your niece’s father. However, you reassure your sister that she has provided a stable home for your niece, has her engaged in religious services, lives in a tight community, and your niece attends a good school. Your sister feels like although your niece’s father in absent from her life due to his alcoholism, it was for your niece’s own good, as he saw no problem with his alcoholism and disruptive argumentative behavior. She also feels she and her partner are very close with your niece. However, your sister has been concerned over the past year that your niece’s friends have changed, and your niece seems to have distanced herself from your sister. Your sister is also disappointed because your niece used to be on the volleyball team and hang out with other girls from the team, but she was cut from the team after missing several practices and games. Response:​ Given the scenario, what type of prescription drugs do you think your niece started using, and what illicit drugs do you think your niece is using now? Provide evidence for your answer. What are the effects of these two types of substances on your niece’s body and brain? Include how the substances are experienced by the body and the long-term effects of using these substances on the body. -Numerous groups have advocated for various positions on the legalization of marijuana. However, each position on legalization depends on the vantage point of the various stakeholders world view and interests. This assignment will explore these different viewpoints. -Each student will represent the world view and interests of the stakeholder group it chooses. The stakeholders include: law enforcement, public health officials, marijuana users, parents of both marijuana users and adolescents in general, pain management/palliative care advocates. -First, read the resources I have posted on marijuana legalization under Module 3. Then search for additional resources regarding federal marijuana policy examples in the United States and other countries. Marijuana Risks (SAMHSA): ​https://www.samhsa.gov/marijuana -Next, you will determine what policy the United States should adopt that is in the best interest of your chosen stakeholders. You will then produce a position paper detailing your marijuana policy and why it is not only in the best interest of your stakeholders, but also why it should be adopted for all Americans. Please use the template provided below. -Length limit is 3-4 double spaced typed pages, in 12 pt font. Use APA Style throughout. -Make sure you cite the course readings to support your claims. MARIJUANA POLICY PROJECT OUTLINE Stakeholder Group: __________________________________________________ How does your stakeholder group view the issue of marijuana legalization? Give background, history and context, of the problem from your stakeholder position. Write a short policy thesis (a paragraph or less). Provide evidence to support your policy position. Evidence must come from sources, statistics, facts, studies, data, other countries, etc. Write three reasons of support for your claim and provide the required evidence making a clear and convincing argument that is fully fleshed out with examples. 1. 2. 3. Explain three opposing arguments, explain how and why there may be value in them, and disagree with the parts you believe to be invalid from your stakeholder position. Establish common ground. 1. 2. 3. How would the future of this country be different by adopting your marijuana policy? And how would the policy that is in the best interest of your group impact others? Marijuana: What the Internet Won’t Tell You Allan Barger, MSW Copyright © 2013, Prevention Research Institute – All rights reserved. Before we start… 1. What is our role? 2. How can we assist change? Copyright © 2013, Prevention Research Institute – All rights reserved. Reframe Your Role Life is a banquet… 1. Reframe Your Role  Life is a banquet! 2. How can we assist change? Copyright © 2013, Prevention Research Institute – All rights reserved. Stages of Change are a set of labels Copyright © 2013, Prevention Research Institute – All rights reserved. Our Clinical Work • Meet people where they are in their attitudes, beliefs and behaviors… • to help them overcome barriers they do not know they have… • to adopting behaviors they do not know they need… • and, once they learn they need, may not want! Copyright © 2013, Prevention Research Institute – All rights reserved. Client’s Tasks of Change • Precontemplation  Develop concern  Envision change • Contemplation  Resolve ambivalence  Make a decision Copyright © 2013, Prevention Research Institute – All rights reserved. Client’s Tasks of Change • Preparation  Make a plan  Identify skills/resources • Action  Implement the plan  Revise as needed • Maintenance  Integrate throughout Copyright © 2013, Prevention Research Institute – All rights reserved. Cannabis Use – Five Risks 1. Acute Impairment 2. Lingering Effects 3. Psychosis 4. Dependence & Addiction 5. Life Outcomes Copyright © 2013, Prevention Research Institute – All rights reserved. Risk 1. Impairment “Getting high is just harmless fun and a great way to relax.” Seed of Truth: Marijuana can be fun and relaxing. Copyright © 2013, Prevention Research Institute – All rights reserved. Risk 1. Impairment Cannabis is the most commonly used illegal substance in DUI.  DUI reports on adults 18 and older: • 17,876,000 DUIs - with alcohol • 13,124,000 DUIs - with cannabis (73.4\% of all DUI other than alcohol) • 2,900,000 DUIs - with cocaine (16.2\% of all DUI other than alcohol) NOTE: Cocaine is the 2nd largest drug using/driving group Copyright © 2013, Prevention Research Institute – All rights reserved. (Source: NSDUH, 2006) Risk 1. Impairment Impact of THC Impairment on Fatal Crashes • Any level THC – 2.7 increased odds of causing a fatal crash • > 5 ng/ml THC – 6.6 increased odds of causing a fatal crash THC mostly impairs automated driving skills. Copyright © 2013, Prevention Research Institute – All rights reserved. Risk 1. Impairment Research on Cannabis and Driving • Past use of THC (24 hours earlier) – no effect on crash risks • Recent use of THC (past 2-4 hours) - increases risks for motor vehicle accidents • THC alone increases risk • Synergistic effect of alcohol & THC - greater impairment than either alone Copyright © 2013, Prevention Research Institute – All rights reserved. Risk 1. Impairment The New View • Those using cannabis do injure themselves and others. • Cannabis use decreases the ability to shift attention among multiple tasks. • Cannabis use is not harmless. Copyright © 2013, Prevention Research Institute – All rights reserved. Risk 2 – Lingering Effects “It’s better than alcohol. I don’t have a hangover; I get high, I come down. Everything is fine.” Seed of Truth: • People don’t have obvious hangovers from using marijuana. Copyright © 2013, Prevention Research Institute – All rights reserved. Risk 2 – Lingering Effects Multiple studies find deficits in:  Short-term memory  Attention  Executive brain functions • Planning • Organizing • Focused attention • Persistence to task Copyright © 2013, Prevention Research Institute – All rights reserved. Risk 2 – Lingering Effects Do cannabis users do better at school or work while using? • Acute effect is decreased ability to shift attention, i.e. more focus on one thing. • Rebound effect is decreased ability to focus on one thing while not using, increasing the felt need to use to function. • Rebound effect increases with duration of use. Copyright © 2013, Prevention Research Institute – All rights reserved. Risk 2 – Lingering Effects Summary The New View • Those using cannabis over time develop subtle, but significant, cognitive problems. • Cannabis use can increase attention problems as a rebound effect, increasing psychological dependence. • Marijuana is different from alcohol, but that doesn’t make it “safe.” Copyright © 2013, Prevention Research Institute – All rights reserved. Risk 3 – Psychosis Disorder “Marijuana doesn’t cause real mental health problems.” Seed of Truth: • Many long-term marijuana users seem pretty normal. Copyright © 2013, Prevention Research Institute – All rights reserved. Risk 3 – Psychosis Disorder Studies show cannabis use linked to development of schizophrenia • Swedish conscript study (n=50,087 males) • Cannabis use associated with dose-response curve • Persisted after controlling for stimulant use Cannabis Use Dose-Response Curve and \% Developing Schizophrenia 5-10 times 1.1\% Developed Schizophrenia 11-50 times 1.9\% Developed Schizophrenia 2.2 increased odds > 50 times 3.8\% Developed Schizophrenia 3.1 increased odds • Similar findings from other research Copyright © 2013, Prevention Research Institute – All rights reserved. Odds Ratios Risk 3 – Psychosis Disorder Subthreshold psychosis can also be a problem: • Becoming more asocial • Loss of motivation/energy/concentration • Drop in functioning • Increased suspicion and/or exaggerated beliefs • Odd behaviors Copyright © 2013, Prevention Research Institute – All rights reserved. Risk 3- Psychosis Disorder Summary The New View  Most people using marijuana will not develop a psychosis disorder, but risk is there for some.  Long-term or high-potency use may cause subthreshold psychosis symptoms.  Predictors of psychosis disorders: • family history of psychosis, • daily use in adolescence • episodes of toxic psychosis. Copyright © 2013, Prevention Research Institute – All rights reserved. Risk 4 – Dependence & Addiction “Cannabis is not addictive. Or if it is, it’s so mild it doesn’t matter.” Seed of Truth: • Many people who smoked marijuana were not addicted and quit easily. Copyright © 2013, Prevention Research Institute – All rights reserved. Risk 4 - Dependence & Addiction Is Marijuana Addictive?  A New Understanding – Addiction is centered in brain  Can marijuana use meet criteria for dependence and addiction? • Withdrawal • Loss of control Copyright © 2013, Prevention Research Institute – All rights reserved. Risk 4 - Dependence & Addiction What we do know: • Addiction is not just defined by physical dependence leading to withdrawal. • Medical withdrawal does not lead to loss of control. • Withdrawal may play a role in continued use and relapse. Copyright © 2013, Prevention Research Institute – All rights reserved. Risk 4 - Dependence & Addiction Three Biological Symptoms  Tolerance • increased amounts or diminished effect  Withdrawal • Typical substance withdrawal syndrome or • Substance or analog taken to relieve or avoid withdrawal  Craving • strong desire or urge to use a specific substance Copyright © 2013, Prevention Research Institute – All rights reserved. Risk 4 - Dependence & Addiction Eight Behavioral Symptoms  Failure to fulfill major role obligations (family, school, work)  Use in potentially hazardous situations  Continued Use despite social or interpersonal problem caused or made worse  Using more or longer than intended  Persistent Desire or Unsuccessful Efforts to cut down or control use  Spend a lot of time obtaining, using, or recovering  Decrease or give up other important activities  Continued use despite knowing of a persistent or recurring physical or psychological problem cause or made worse by the substance Copyright © 2013, Prevention Research Institute – All rights reserved. Risk 4 - Dependence & Addiction 2nd View of Addiction: Homeostasis to Allostasis  High blood pressure is an allostatic state.  Drug-driven brain changes lead to addiction as the brain tries to maintain stability in the brain’s reward systems.  Persistent vulnerability to relapse and addiction  Addiction is an allostatic state characterized by the • Compulsion to seek and take drug • Loss of control in limiting intake • Emergence of a negative emotional state when access is blocked Koob & Le Moal, 2008 Copyright © 2013, Prevention Research Institute – All rights reserved. Risk 4 - Dependence & Addiction Addiction - A New Understanding from the Latest Brain Research  group of behaviors arising from an altered brain  characterized by • A compulsion to seek and take drug • The loss of control in limiting intake • The emergence of a negative emotional state when access to the drug is blocked Koob & Le Moal, 2008 Copyright © 2013, Prevention Research Institute – All rights reserved. Risk 4 - Dependence & Addiction Neurobiological View of Addiction Loss of Executive Control Chronic Elevation of Reward Threshold Compulsive Drug Seeking/Using Recruitment of Anti-reward Systems Enhanced StimulusResponse Links Copyright © 2013, Prevention Research Institute – All rights reserved. Koob & Le Moal, 2008 Risk 4 - Dependence & Addiction Loss of Executive Control Lingering Deficits in Executive brain functions • Planning • Organizing • Focused attention • Persistence to task Copyright © 2013, Prevention Research Institute – All rights reserved. Risk 4 - Dependence & Addiction Loss of Executive Control Chronic Elevation of Reward Threshold Let’s explore the second brain change… Copyright © 2013, Prevention Research Institute – All rights reserved. Risk 4 - Dependence & Addiction Reward Threshold Lowered Reward Threshold  While “buzzed,” drunk or high, the brain’s reward threshold is lowered: Reward Stimuli  Normal pleasures enhanced  Friends feel friendlier  Humor is funnier Copyright © 2013, Prevention Research Institute – All rights reserved. Risk 4 - Dependence & Addiction Reward Rebound • While “buzzed,” drunk or high, the brain’s reward threshold is temporarily lowered. • Following the “high,” the reward threshold is temporarily raised. Reward Stimuli Copyright © 2013, Prevention Research Institute – All rights reserved. Risk 4 - Dependence & Addiction Chronic Elevation of Reward Threshold Recruitment of Anti-reward Systems The second reason for reward rebound is activation of the anti-reward system. Copyright © 2013, Prevention Research Institute – All rights reserved. Risk 4 - Dependence & Addiction Reward Rebound  Many anti-reward chemicals help moderate and shut down the reward system.  Loss of reward response leads to a: • Shift in values • Shift in behaviors  Flip side of reward is stress. Copyright © 2013, Prevention Research Institute – All rights reserved. Risk 4 - Dependence & Addiction During and after the “high” After the “High” “High” Stress Threshold Stress & Reward Baseline Reward Threshold Reward Stimuli Stress Copyright © 2013, Prevention Research Stimuli Institute – All rights reserved. Stress Stimuli Reward Stimuli Risk 4 – Cannabis Dependence & Addiction Does marijuana use acutely RAISE the stress threshold (reduce stress)? Multiple studies report: • Cannabis stimulates the production and release of opioids, calming the brain and reducing pain (emotional or physical). • Marijuana users state enhanced relaxation as the #1 reason they use. Copyright © 2013, Prevention Research Institute – All rights reserved. Risk 4 – Cannabis Dependence & Addiction A LOWER stress threshold after a marijuana “high”? Multiple studies report: • Irritability (87\%) • Nervousness (80\%) • Depression (76\%) • Restlessness (76\%) • Anger (74\%) Copyright © 2013, Prevention Research Institute – All rights reserved. Risk 4 – Cannabis Dependence & Addiction A LOWER stress threshold after a marijuana “high”? Multiple studies find: • More aggressive responses during times of abstinence Copyright © 2013, Prevention Research Institute – All rights reserved. Risk 4 – Cannabis Dependence & Addiction Does marijuana use acutely LOWER reward threshold (more pleasure)?  Lowered reward threshold by ∆9-THC has been demonstrated by: • Rate-frequency paradigm • Reward-threshold paradigm  Similar to all other abused drugs  Cannabis produces conditioned place preference in lab animals.  Self-administration studies find both animals and humans will self administer cannabis. Copyright © 2013, Prevention Research Institute – All rights reserved. Risk 4 - Dependence & Addiction Chronic Elevation of Reward Threshold Recruitment of Anti-reward Systems Let’s see the outcomes of these two chronic brain changes Copyright © 2013, Prevention Research Institute – All rights reserved. Risk 4 - Dependence & Addiction Altered Reward & Stress Systems  Loss of reward leads to a shift ... Purchase answer to see full attachment