PSYC324 Week 6 Notes

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PSYC324 | LESSON 6 Enhancers and Depressants Questions to consider.  How did the use and development of performance-enhancing drugs evolve over time and in societies?  How do anabolic steroids work?  What are some of the physical and psychological symptoms and side effects of anabolic steroid use in men and women?  What are the major distinctions between barbiturates and benzodiazepines?  What makes the use of inhalants appealing to children and teenagers? There are three disparate groups of widely used drugs in our society: performance-enhancing drugs, depressants, and inhalants. How did the use and development of performance-enhancing drugs evolve over time and societies? Start by checking out this entertaining and informative nine-minute overview video from SciShow.com. Performance-Enhancing Drugs As you read the chapter on performance-enhancing drugs, it is likely that you may think this area of drug abuse represents a tangent from your previous week’s studies and is a relatively new and esoteric realm of drug abuse. However, quite to the contrary, the abuse of drugs for the explicit purpose of gaining a physical performance advantage in competition and battle has been in existence and documented since at least 300 B.C. and the first Olympic games. By the end of the 19th century, recorded accounts were archived of professional athletes consuming a wide variety of drugs for the purposes of enhancing their physical prowess, including caffeine, alcohol, cocaine, opioids, and amphetamines. However, over the centuries, not all attempts to enhance performance through the ingestion of chemicals and drugs were successful; strychnine and nitroglycerin were two examples of substances that ended up causing more harm than help to those who used them. Occasional deaths were reported as a direct result of overdosing on some of these powerful drugs; the first recorded death of a professional athlete in such a manner occurred in the late 1800s with the collapse of a

cyclist who was discovered to have used a combination of cocaine and heroin, commonly known as a “speedball,” in a race to deleterious effect. The advent of modern-day performance-enhancing drug use began in the 1930s with the manufacture of anabolic steroids, patterned after the male sex hormone testosterone. This class of drugs was noticeably different from its predecessors in that this drug actually changed (often permanently) aspects of an individual’s physiology rather than simply their experience or behaviors for a period of time. These effects were long-lasting and often generalizable across a wider range of activities. Anabolic steroids were originally designed to help address the effects of severe anemia, malnutrition, and starvation in soldiers, victims of war, and other patients whose bodies were severely degraded. However, it quickly became apparent that the gains seen when administering these drugs to waylaid individuals could also be used to magnify the prowess and abilities of healthy individuals as well. It wasn’t long before coaches and athletes began to experiment with these drugs as a way to enhance performance or produce ergogenic effects, across a variety of sports and competitive events. How do Anabolic Steroids Work? Testosterone serves two fundamental purposes in the body: promoting the development of male sex characteristics and the development of muscle tissue. In typically developing males, a higher level of testosterone found in the bloodstream helps explain, in part, the larger muscles and sheer mass of men compared to their female counterparts. Anabolic steroids, which are developed through manipulation of the testosterone molecule, produce similar effects, but in a more rapid manner, when taken by any individual. For much of the modern Olympic games, it was quite common for many athletes to use performance-enhancing drugs, including anabolic steroids. Their use was most prominent and acknowledged from the 1960s to the 1980s. While some athletes were placed on protocols of anabolic steroids secretly under the supervision of their coach and a physician, other athletes were part of large, systematic programs of drug use and performance measurement within their country. It wasn’t until the 2000 Olympic games that stringent restrictions were placed on the use of performance-enhancing drugs and all athletes had to attest that they were not using drugs or otherwise “doping” to enhance their performance. While the increase in regulations, restrictions, and sanctions has lessened the overt use of performance-enhancing drugs, there continues to be a dynamic, and well-financed, amount of covert use in professional competition. By 2004, the World Anti-Doping Code was created, which codified the specific rules and regulations regarding performance-enhancing

drugs and their use in sporting events. Since that time, and with the advent of better testing to identify cases in which athletes have violated the Code, there have been many high-profile cases in the media that highlight the ongoing concern with performance-enhancing drugs. It should be noted that the sanctions received for violations have increased quite significantly in the last 15 years. In addition, legislation was passed in 1990, designating anabolic steroids as a Schedule III controlled substance, which makes them subject to criminal penalties if inappropriately manufactured, distributed, or used. Some individuals may argue that the stakes in modern sports are higher than they have ever been in human history as a means for justifying, excusing, or explaining the use of performance-enhancing drugs. However, while the records in sports that exist today are higher than they have been in the past, individual athletes still have to struggle to make a living and support their families, much like their predecessors. In addition, there was less revenue from multiple sources (e.g., commercial endorsements) available to athletes in the past, so making a living as a full-time professional athlete was even more precarious during past generations. In other words, the life of a professional athlete has always been difficult and always requires sacrifice. Temptations to cheat and “game the system” have existed in various forms since the beginning of organized competition. What has changed is the manner of sophistication and subtlety in which drugs can be used to enhance one’s performance. Certainly, what passes as a standard for masculinity in our society has changed over time and this, in part, could be one source of cultural influence in today’s current climate of performance-enhancing drug use. In our modern society, the images that are portrayed in terms of masculinity, femininity, athletic prowess, and endurance can potentially influence individuals in terms of behaviors that they might engage in to meet or exceed an imagined cultural standard. Physical and Psychological Symptoms and Side Effects of Anabolic What are some of the physical and psychological symptoms and side effects of anabolic steroid use in men and women? There are several well-documented hazards associated with the use of anabolic steroids. One confound in determining the effects of various dose– response relationships is the fact that many individuals illegally abusing anabolic steroids take anywhere from 5 to 500 times the recommended dose. Because of this high degree of variance, it can be hard to gauge the relative risk from individual to individual. However, some generalizations can be

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made. As these synthetic hormones enter the bloodstream and systemically flood the body with testosterone, changes occur across a wide variety of organ systems, and not all with an efficacious outcome. Given that the liver’s function is to help clear toxins and unnatural substances from the body, it should come as no surprise that this organ can suffer greatly from prolonged anabolic steroid use in both men and women. This is typically seen through the increased risk for tumors, the increase in lifetime risk for liver failure and, when they rupture, the need for emergency liver surgery. An increased risk for cardiovascular disease has also been noted with chronic anabolic steroid use. One notable change in men with prolonged use is that an individual’s own testes glands begin to produce less testosterone in the body as the body becomes acclimated to having it artificially introduced into the system at higher-than-normal levels. This not only causes male function to decrease (shrinking testicles, lower sperm count, enlarged prostrate) but the low, natural production level also results in less inhibition of naturally occurring estrogen which can result in an increase in feminine, secondary sex characteristics (e.g., enlarged breasts or gynecomastia). Some of these effects are reversible when hormone supplementation is stopped, while others are not. For women, the sustained use of anabolic steroids, and the introduction of a large amount of testosterone into their bodily systems, has an overall tendency to accentuate stereotypically male characteristics in them, including a lower voice, increased facial hair, increased aggressiveness, decreased body fat, diminished or stopped menstruation, increased acne, and decreased breast size. Again, some of these symptoms are reversible with discontinuation of anabolic steroids, while others continue to persist. Anecdotally, psychological problems in men and women who abuse anabolic steroids have included severe mood swings and a lower threshold for aggressive behavior, commonly referred to as “’roid rage.” However, more systematic research needs to be conducted in this area to determine more clearly the propensity of these symptoms for different individuals. In short, a variety of other, possibly confounding variables, come into play that can moderate the resultant mood changes with anabolic steroid abuse, such as an individual’s temperament, personality, and the social context within which a person lives and trains. In terms of dependence on anabolic steroids, there is evidence to support the phenomenon of psychological dependence on the drug and associated drug- taking behaviors. Many athletes engage in drug use in a cyclic fashion, incrementally increasing the doses (whether taken orally, intramuscularly, or both) and then tapering down for a period of time, usually at the point when they suspect they will be tested for the presence of illegal drugs in their

system. Some muscle atrophy or shrinkage has been noted with the lessening or cessation of anabolic steroids and this, when coupled with an individual who is inordinately preoccupied with their physical appearance, leads to concerns about losing physical appearance and prowess and a higher likelihood to continue to use the drug. From a perceptual standpoint, some individuals who chronically abuse anabolic steroids develop “muscle dysmorphia,” which is a disturbance in their perception of their bodies, much like what is seen with some people who have eating disorders, where the individual believes that their bodies are weak and insufficient (thereby requiring more anabolic steroids), even in the face of physical evidence to the contrary. Unfortunately, it does not appear that our dominant culture in the United States, with its focus on youth, attractiveness, and physical prowess, will be helping to ameliorate this social problem anytime in the near future. Depressants You will now shift your study from performance-enhancing drugs to the class of medications that are collectively known as depressants. As classified, these medications collectively bring one “down” and create symptoms in individuals that are the antithesis of the stimulant class of medications (e.g., amphetamines, cocaine, caffeine) that you have previously covered in this course. Keep in mind that these drugs are manufactured in the laboratory and don’t naturally occur in the environment as many classes of drugs that you have previously studied in this course. What are the major distinctions between barbiturates and benzodiazepines? One of the original and major classes of depressants is that of barbiturates. They are tasteless and odorless and historically were prescribed as a sleep aid. Compared to benzodiazepines, which will be discussed shortly, barbiturates pose a greater health risk because of their broader, systemic effect on the body. Depending on the dose taken, the effects of the barbiturates can range from mild relaxation to coma and death. As such, the threat of a lethal overdose is a significant concern. In and of itself, the effects of barbiturates are positively reinforcing; animal studies have shown how consistently they will respond in an operant learning environment to receive a continuous infusion of barbiturates into their system. Barbiturates are also known to have a synergistic, or additive, effect when taken with alcohol; one can take a non-lethal dose of it, but when taken together, they can be a lethal combination to the unsuspecting user.

Individuals who take barbiturates at relatively low doses report feeling a sense of relaxation and euphoria. As the dose level of barbiturates increases, more primitive areas of the brain are subsequently affected, including those that control autonomic functions like consciousness and respiration. At these higher doses, people report feeling heavily sedated and drowsy. While initially used as a sleep aid, researchers demonstrated that this class of drugs is typically not well suited for that purpose. Specifically, it has been noted that Rapid Eye Movement (REM) sleep is inhibited during the periods when barbiturates have been taken. REM sleep is generally thought of as being one of the deepest stages of sleep and highly restorative to bodily functions. As such, individuals taking barbiturates often report feeling tired upon waking and describe their sleep as not very restful. Further, upon discontinuation of barbiturates, many individuals experience a sleep “rebound” effect in terms of REM sleep in that they experience inordinately longer cycles of REM sleep than typical and these periods of sleep are characterized by highly vivid and often disturbing dreams. Using barbiturates as a primary treatment for sleep problems can certainly lead to symptoms of dependence. Physiologically, the body builds up dependence on the drug with regards to effects on sleep, requiring progressively larger amounts of the drug to achieve sleep-inducing effects. Compared to other classes of drugs, the withdrawal from barbiturates can be very dangerous if attempted without medical supervision. Symptoms of withdrawal include tremors, vomiting, perspiration, nausea, convulsions, confusion, and high fever. Individuals are negatively reinforced to continue taking the drug in an attempt to avoid these undesirable symptoms. As a result, the use of barbiturates as a sleep aid has largely been discontinued in the United States because of these risks. Another important and more modern class of depressants is benzodiazepines. Compared to barbiturates, these are the next generations of depressants – they focus more selectively on the concerning symptoms of anxiety without causing global sedation across all bodily systems as its predecessor, barbiturates, do. This is preferred because the risk of a lethal overdose by shutting down the respiratory center in the brain is greatly reduced. In addition, benzodiazepines are absorbed more slowly into the bloodstream, avoiding any reinforcing “rush” effect where the resultant symptoms of relaxation more slowly with a longer duration of effect. As a result, this drug is a poor reinforcer of drug-using behavior. Benzodiazepines work by increasing the activity of the neurotransmitter GABA, which produces an inhibitory effect on the central nervous system. It is interesting to note that one of the primary uses for depressants in our society over the years has been to aid and sleep and to lessen symptoms of anxiety. While these drugs have been used with varying degrees of success in treating these ailments, it should be noted that there are a wide variety of

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cognitive-behavioral interventions that have been supported in research studies to address these problems without the use of drugs. For example, there is a whole body of research on sleep hygiene and the appropriate behavioral habits, routines, and nighttime rituals that can help promote and sustain healthy, natural sleeping patterns in individuals. Similarly, the available psychological literature on cognitive-behavioral treatments to address symptoms of anxiety has been well documented. For a quick overview of anxiety disorders and how they can disrupt aspects of daily functioning like sleep, check out this 11-minute CrashCourse.com video . Unfortunately, many individuals in our society as well as healthcare professionals espousing the medical model often look to pharmaceutical interventions as a first-line solution for many problems in living. While it certainly takes fewer appointments and less effort on the part of the individual and care provider to simply prescribe medication to an individual, as you have learned in reviewing the reading materials and this lesson for the week, it is not without its own risks in terms of health and symptoms of dependence. Other avenues of non-pharmaceutical intervention should be actively explored; often, those strategies can be generalized broadly and have longer-lasting effects for individuals without the risks associated with overreliance on drugs to ameliorate their symptoms. Inhalants Inhalants, like most of the other drugs you have studied in this course, have been used throughout societies and cultures for thousands of years in an attempt to obtain mind-altering effects. These drugs also fall into the general category of depressants in that brain activity (as measured by EEG) is significantly slowed down with their use. The first readily documented accounts occurred in the late 1700s with the use of nitrous oxide and ether as pain-relieving analgesics that also produced a mild sense of euphoria, a sense of well-being, and a period of sedation. The aftermath of their use, however, can include nausea, vomiting, and sensory confusion. Another significant concern with inhalants is that they dilute the amount of available oxygen for respiration when individuals cover their mouths and inhale other, noxious substances. Ether also has the dubious distinction of being highly flammable. Beginning in the 1950s, other substances, including glue and aerosol solvent chemicals, began to be abused, heralding in the modern area of what we typically know as common inhalants. What makes the use of inhalants appealing to children and teenagers?

Most substances used as inhalants are inexpensive, readily available and because they are found in common household products, don’t need to be hidden covertly from others like other illicit drugs. Unfortunately, because these substances are absorbed rapidly through the lungs, inhaling these substances produces a quick “high” which can be very reinforcing to the user and lasts about an hour with withdrawal symptoms that are relatively mild when compared to other drugs such as alcohol. Because of the ease of purchase and accessibility, this form of drug abuse is most commonly found in children and teenagers, and chronic abuse, when it does occur, is most likely to be found among poor and disadvantaged children who are experiencing significant psychosocial problems. Perhaps the best outcome research that we have to date on inhalants is that many individuals stop using them after a period of time and that their use appears to be developmental and peer-influenced in nature. The long-term physical effects are not readily understood.