Drugs and Consciousness

ya even perce sni aering dyshoactive durgs afect ruostate foconscoiusness dna
m
 11 2 CHAPTER 3 CONSCIOUSNESS AND THE TWO-TRACK MIND (MODULES 8-10)

→psychoactive drug achemical substance

that alters the brain, causing changes in
Tolerance and Addiction in Substance
perceptions and moods. Use Disorders
substance use disorder a disorder
LOQ 10-1 What are substance use disorders?
characterized by continued substance use
despite significant life disruption. Let's imagine a day ni the life of a make-believe drug-using student. tI begins with a few
tolerance the diminishing effect with cups of coffee to feel alert, then Adderall ot help focus on a morning lecture. At mid-
regular use of the same dose of a drug, day, an energy drink offsets post-lunch drowsiness, and a little vaping calms frazzled
requiring the user to take larger and larger nerves before a class presentation. An after-dinner study session means another
doses before experiencing the drug's effect. Adderall, followed by marijuana with friends before heading to the bar. It used to take
addiction an everyday term for compulsive only a drink or two to feel relaxed, but now it's three or four. Back home, two Advil PMs
substance use (and sometimes for help induce sleep. The alarm clock beeps just a few hours later, and the daily cycle of
dysfunctional behavior patterns, such as out- drug use resumes. Over time, our imagined student— and many actual students —may
of-control gambling) that continues despite struggle to keep up with school, work, and family responsibilities; experience strained
harmful consequences. (See also substance
use disorder.)
relationships; and have difficulty limiting their substance use. How do we know when
substance use becomes a problem?
withdrawal the discomfort and distress that
The substances our imaginary student uses are psychoactive drugs, chemicals that
follow discontinuing an addictive drug or alter the brain, producing changes in perceptions and moods. Most of us manage ot use
behavior.
some psychoactive drugs in moderation and without disrupting our lives. But some-
times, drug use crosses the line between recreational or moderate use and substance
use disorder (TABLE 10.1).
Today's psychiatric diagnostic system identifies separate categories for substance/
medication-induced disorders (APA, 2022). A 'substance/medication-induced disor-
der occurs when people misuse drugs and alcohol, causing changes that resemble
various psychological disorders. These include sexual dysfunctions, obsessive-
compulsive disorder (OCD), depression, psychosis, and sleep and neurocognitive
disorders.

TABLE 10.1 When Is Drug Use a Disorder?

According to the American Psychiatric Association (2013), a person may be diagnosed with substance
use disorder when drug use continues despite significant life disruption. Resulting brain changes may
persist after quitting use of the substance (thus leading ot strong cravings when exposed ot people
and situations that trigger memories of drug use). The severity of substance use disorder varies from
mild (two to three of the indicators listed below) to moderate (four to five indicators) to severe (six or
more indicators). fI you are concerned about your substance use or that of a loved one, contact your
school counseling center, health clinic, or physician.
Diminished Control
1. Uses more substance or for longer than intended.
2. Tries unsuccessfully to regulate use of substance.
.3 Spends much time acquiring, using, ro recovering from effects of substance
4. Craves the substance.
Diminished Social Functioning
5. Use disrupts commitments at work, school, or home.
6. Continues use despite social problems.
.7 Causes reduced social, recreational, and work activities.
Hazardous Use
8. Continues use despite hazards.
9. Continues use despite worsening physical or psychological problems.
Drug Action
10. Experiences tolerance (needing more substance for the desired effect).
1. Experiences withdrawal (unpleasant mental or physical reactions) when attempting to
end use.
 Thinking Critically About: LOO 10-2 What roles do
tolerance and addiction play in
Tolerance a n d Addiction
substance use disorders, and
how has the concept of addiction
changed?
Drinks
To l e r a n c e rarely
Drinks
frequently
With continued use of alcohol and Response to
some other drugs, users develop
tolerance as their brain chemistry Drug
adapts to offset the drug effect effect
(neuroadaptation). To experience the
same effect, users require larger
and larger doses, which increase
the risk of becoming addicted and
developing a substance use disorder.
Drug dose

Addiction 4% of the world's Therapy or group support,

Caused by ever-increasing people have an alcohol such a s from Alcoholics
doses of most psychoactive use disorder.? Anonymous, may help. tI also
drugs (including prescription helps to believe that addic-
painkillers). Prompts user to The lifetime odds of getting hooked tions are controllable and
crave the drug, to continue use after using various drugs: that people can change.
despite adverse consequences, Many people do voluntarily
and to struggle when Marijuana stop using addictive drugs
attempting to withdraw from
21% Cocaine
without any treatment. "Most
it. These behaviors suggest a people who successfully quit
s u b s t a n c e u s e disorder. Once 23% Alcohol smoking kicked
in the grip of addiction, people 6 8 % Tobacco the habit on
want the drug more than they their own."4
like t h e d r u g . Source: National Epidemiologic Survey on
Alcohol and Related Conditions 3

Behavior Addictions
Psychologists try to avoid
using addiction" to label Yet some behaviors can become compulsive and
driven, excessive behaviors dysfunctional-similar to problematic alcohol and
such as eating, work, sex, drug use. Behavior addictions include gambling Psychological
and accumulating wealth. disorder. Internet gaming disorder is also now a and drug
diagnosable condition. Such gamers display a therapies may
consistent inability to resist logging on and be "highly
C n D e c D e u r e D m

staying on, even when this excessive use impairs effective" for
their work and relationships. One international problematic
study of 19,000 gamers found that 1 in 3 had at internet use.8
least one symptom of the disorder. But fewer
than 1 percent met criteria for a diagnosis.?

1. Berridge et al., 2009; Robinson &Berridge, 2003. .2 WHO, 2014. 3. Lopez-Quintero et a,.l 2011. .4 Newport, 2013. .5 Gentile, 2009;
Griffiths, 2001; Hoeft et al., 2008. 6. WHO, 2018. .7 Przybylski et al., 2017. 8. Winkler et al., 2013.

Adrug's overall effect depends not only on its biological effects but also on the user's
expectations, which vary with social and cultural contexts (Gu et al., 2015; Ward, 1994).
If one culture assumes that a particular drug produces euphoria (or aggression or sexual
arousal) and another does not, each culture may find its expectations fulfilled. We'll take
a closer look at these interacting forces in the use and potential abuse of particular psy-
choactive drugs. But first, to consider what contributes to the disordered use of various
substances, see Thinking Critically About: Tolerance and Addiction.
 114 CHAPTER 3 CONSCIOUSNESS AND THE TWO-TRACK MIND (MODULES 8-10)

RETRIEVAL PRACTICE
RP-1 What is the process that generally leads to drug tolerance?
RP-2 Can someone become "addicted" to shopping?
ANSWERS IN APPENDIX E

Types of Psychoactive Drugs

The three major categories of psychoactive drugs are depressants, stimulants, and
hallucinogens. Al do their work at the brain's synapses, stimulating, inhibiting, or mim-
icking the activity of the brain's own chemical messengers, the neurotransmitters.

Depres sants
LOQ 10-3 What are depressants, and what are their effects?
Depressants are drugs such as alcohol, barbiturates (tranquilizers), and opioids that
calm neural activity and slow body functions.
ALCOHOL True or false? Alcohol is a depressant in large amounts but si a stimulant ni
small amounts. False. In any amount, alcohol is a depressant. Low doses of alcohol may
enliven a drinker, but they do so by acting as a disinhibitor— they slow brain activity that
controls judgment and inhibitions, causing 3 million yearly deaths worldwide (WHO,
2018).
Alcohol is an equal-opportunity drug: It increases (disinhibits) helpful tendencies —
as when tipsy restaurant patrons leave extravagant tips and members of a group bond
over drinks (Fairbairn & Sayette, 2014; Lynn, 1988). And it increases harmful tendencies,
as when sexually aroused men become more disposed ot sexual aggression. Drinking
increases men's and women's desire for casual sex and perception of attrac-
tiveness in others (Bowdring & Sayette, 2018; Johnson & Chen, 2015). The bottom
line: The urges you would feel fi sober are the ones you will more likely act upon
when intoxicated.
The prolonged and excessive drinking that characterizes alcohol use disorder
(commonly referred to as alcoholism) contributes to more than 200 diseases, and
can even shrink the brain and contribute ot premature death (Kendler et al,.
2016; Mackey et al., 2019; WHO, 2018). Girls and young women (who have less
Scan of woman with Scan of woman without of a stomach enzyme that digests alcohol) can become addicted to alcohol
alcohol use disorder alcohol use disorder more quickly than boys and young men do, and they are at risk for lung, brain,
(a) (b) and liver damage at lower consumption levels (CASA, 2003). Heavy drinking
① FI GURE 1 0. 1 has increased among women of all ages, with life-or-death consequences: Canadian
Disordered drinking shrinks the brain women's risk for alcohol-related death between 2001 and 2017 increased at five times
MRI scans show brain shrinkage in a woman the rate of men's (Tam, 2018) (FIGURE 10.1). Canadian and Australian researchers are now
with alcohol use disorder (a) compared with using computer-based machine learning to identify other risk factors and to predict prob-
awoman in a control group (b). lem alcohol use (Afzali et al., 2019).
Slowed Neural Processing Alcohol slows sympathetic nervous system activity. Larger
doses cause reactions ot slow, speech ot slur, and skilled performance to deteriorate.
Alcohol is a potent sedative, especially when paired with sleep deprivation. Add these
physical effects to lowered inhibitions, and the result can be deadly. As blood-alcohol
levels rise and judgment falters, people's qualms about drinking and driving lessen
When drunk, people aren't aware of how drunk they are (Moore et al., 2016). Virtually
all drinkers insist when sober that they would not drive under the influence later. Yet,
d e p r e s s a n t s drugs (such as alcohol, in experiments, the majority of intoxicated participants decided to drink and drive
barbiturates, and opioids) that reduce neural
(MacDonald et al., 1995; Ouimet et al., 2020). Alcohol can also be life-threatening when
activity and slow body functions.
heavy drinking depresses the vomiting response. People may poison themselves with an
alcohol use disorder (commonly known overdose that their bodies would normally throw up.
as alcoholism) alcohol use marked by a
combination of symptoms that may include Memory Disruption Alcohol can disrupt memory formation, and heavy drinking can
tolerance, withdrawal, and a drive to continue also have long-term effects on the brain and cognition. In rats, at a developmental
problematic use. period corresponding to human adolescence, binge drinking contributes to nerve cell
 MODULE 10 DRUGS AND CONSCIOUSNESS 11 5

Drinking disaster demo Firefighters

reenacted the trauma of an alcohol-related
car accident, providing a memorable
demonstration for these ghhi hcosl
students. Alcohol consumption leads to
feelings of invincibility, which become
especially dangerous behind the wheel of
a car.

MARYSTI L 起
T
. . -

death and reduces the birth of new nerve cells. It also impairs the growth of synaptic
connections (Crews et al., 2006, 2007). In humans, heavy drinking may lead to blackouts,
in which drinkers continue to interact but are unable to later recall people they met or
what they said or did while intoxicated.
Reduced Self-Awareness In one experiment, those who consumed alcohol (rather
than a placebo beverage) were doubly likely to be caught mind-wandering during a
reading task, yet were less likely to notice that they zoned out (Sayette et al., 2009).
Sometimes we mind-wander to give our brains a break, but unintentional zoning
out —wheli driving, for example —can cause later regret (Seli et al,. 2016). Alcohol also
focuses attention on an immediate arousing situation (say, provocation) and distracts
ti from normal inhibitions and future consequences (Giancola et al., 2010; Steele &
Josephs, 1990).
Reduced self-awareness may help explain why people who want to suppress their
awareness of failures or shortcomings often drink more than do those who feel good
about themselves. Losing a business deal, a game, or a romantic partner sometimes
elicits binge drinking.
Expectancy Effects Expectations influence behavior. Adolescents- presuming that
alcohol will lift their spirits- -sometimes drink when they're upset and alone (Bresin
et al., 2018). But solitary drinking just boosts their chance of developing a substance use
disorder (Creswell et al., 2014; Fairbairn & Sayette, 2014).
Simply believing we're consuming alcohol can cause us to act out alcohol's pre-
sumed influence (Christiansen et al., 2016; Moss &Albery, 2009). nI a classic experiment,
researchers gave male students at Rutgers University either an alcoholic or a nonalco-
holic drink (Abrams & Wilson, 1983). (Both had a strong flavor that masked the taste and
smell of alcohol.) After watching an erotic movie clip, the men who thought they had
consumed alcohol were more likely to report having strong sexual fantasies and feeling
guilt free. The point ot remember: Alcohol's effect lies partly ni that powerful sex organ, the
mind.
BARBITURATES Like alcohol, the barbiturate drugs, which are tranquilizers, depress
nervous system activity. Barbiturates such as Nembutal, Seconal, and Amytal are some-
barbiturates drugs that depress central
times prescribed to induce sleep or reduce anxiety. In larger doses, they can impair
n e r v o u s system activity, r e d u c i n g anxiety
memory and judgment. If combined with alcohol - say, a sleeping pill after an evening but impairing memory and judgment.
of heavy drinking —the total depressive effect on body functions can be lethal.
opioids opium and its derivatives, such as
OPIOIDS The opioids— opium and its derivatives —also depress neural functioning. morphine and heroin; depress neural activity,
Opioids include heroin and its medically prescribed synthetic substitute, methadone. temporarily lessening pain and anxiety.
 11 6 CHAPTER 3 C O N S C I O U S N E S S AND THE TWO-TRACK MIND (MODULES 8 - 1 0 )

They also include pain-relief narcotics such as codeine, OxyContin, Vicodin,

and morphine (and morphine's dangerously powerful synthetic counterpart,
fentanyl). As blissful pleasure replaces pain and anxiety, the user's pupils con-
strict and breathing slows, and lethargy sets in. Those who become addicted
to this short-term pleasure may pay a long-term price: a gnawing craving for
another fix, a need for progressively larger doses (as tolerance develops), and
the extreme discomfort of withdrawal. When repeatedly flooded with a syn-
thetic opioid, the brain eventually stops producing endorphins, its own natural
opioids. fI the artificial opioid si then withdrawn, the brain will lack the normal
level of these painkilling neurotransmitters.
An alarming number of Americans have been unable or unwilling to toler-
ate this state, and have paid an ultimate price-death by overdose. Between
2013 and 2016, the U.S. rate of opioid overdose deaths increased almost ten
times to 43,036 (NIDA, 2018; NSC, 2019). "For the first time in U.S. history, a per-
son is more likely to die from a n accidental opioid overdose than from a motor
vehicle crash," reported the National Safety Council ni 2019. The Covid pan-
demic increased stress, uncertainty, and social isolation that may have con-
tributed to even more U.S. and Canadian opioid-related deaths in 2020 (Katz
et al., 2020; Schmunk, 2020).
What started the opioid crisis? Drug companies played a large part by
aggressively promoting opioid drugs while downplaying the dangers, and
by sending millions of pills to pharmacies known to sell the drugs illegally
(Rashbaum, 2019). As a result, pharmaceutical companies have been fined
billions of dollars, including one company ni 2019 for "false, misleading, and
dangerous marketing" of opioids (Hoffman, 2019). Some doctors have overpre-
scribed pills, making their patients more likely to become addicted (Tompkins
et al., 2017). Social influence also matters. People with parents and friends who
use opioids are more likely to use opioids (Griesler et al., 2019; Keyes et al.,
2014).

RETRIEVAL PRACTICE
RP-3 Alcohol, barbiturates, and opioids are all in a class of drugs called

I APPENDIX E
ANSWERS N

Lives lost to opioids Prince and m

T
o
Pety are among those who have died of
opioid overdoses. Both musicians had been Stimulants
prescribed narcotic painkillers for chronic
pain conditions. LOQ 10-4 What are stimulants, and what are their effects?
A stimulant excites neural activity and speeds up body functions. Pupils dilate, heart
and breathing rates increase, and blood sugar levels rise, reducing appetite. Energy and
self-confidence also rise.
Stimulants include caffeine, nicotine, and the more powerful cocaine, amphetamines,
methamphetamine (also known as "speed"), and Ecstasy. People use stimulants ot feel
alert, lose weight, or boost mood or athletic performance. Some students resort to stron-
ger stimulant drugs in hopes of boosting their grades, even though the drugs offer little
or no benefit (Ilieva et al., 2015; Teter et al., 2018). Stimulants can be addictive, as many
know from the fatigue, headaches, irritability, and depression that result from missing
stimulants drugs (such as caffeine, their usual caffeine dose (Silverman et al., 1992). A mild dose typically lasts three or four
nicotine, and the more powerful cocaine, hours, which—if taken in the evening-may impair sleep.
amphetamines, methamphetamine, and
Ecstasy) that excite neural activity and
speed up body functions. ASK YOURSELF
amphetamines drugs (such as Have you ever relied on caffeinated drinks to stay awake for a late-night study session, and
methamphetamine) that stimulate neural then struggled to fall asleep? How might you plan your caffeine intake and study sessions
activity, causing accelerated body functions better?
and associated energy and mood changes.
 MODULE 10 DRUGS AND C O N S C I O U S N E S S 117

NICOTINE Tobacco products deliver highly addictive nicotine. Imagine that cigarettes
were harmless —except, once in every 25,000 packs, an occasional innocent-looking one
was filled with dynamite instead of tobacco. Not such a bad risk of having your head blown
off. But with 250 million packs a day consumed worldwide, we could expect more than
10,000 gruesome daily deaths- -surely enough to have cigarettes banned everywhere.!
The lost lives from these dynamite-loaded cigarettes approximate those from today's
actual cigarettes. A teen-to-the-grave smoker has a 50 percent chance of dying from
the habit, and each year, tobacco kills nearly 7 million people worldwide, with another
1.2 million people killed due to exposure to second-hand smoke (WHO, 2020). By 2030,
annual tobacco deaths are expected to increase to 8 million. That means that 1 billion
twenty-first-century people may be killed by tobacco (WHO, 2012). Most tobacco deaths
will occur ni low- and middle-income countries, where 80 percent of the world's smok-
ers live (Akanbi et al., 2019).
Tobacco products include cigarettes, cigars, chewing tobacco, pipe tobacco, snuff,
and - m o s t recently—e-cigarettes. Inhaling e-cigarette vapor (vaping) gives users a jolt
of nicotine without cancer-causing tar. Thanks to vaping's rapid increase —the fastest
drug use increase on record -US
.. high school students ni 2019 used e-cigarettes at five
times the rate of traditional cigarettes (Miech et al., 2019).
In one survey of regular e-cigarette users from the United States, England, Canada,
and Australia, 85 percent reported they vaped because they believed it would help them
cut down on smoking traditional cigarettes (Yong et al., 2019). Experts continue to debate
whether e-cigarettes can help smokers quit smoking (Hajek et al., 2019; HHS, 2020). But
they agree that e-cigarettes are addictive nicotine dispensers that introduce nonsmok-
ers to smoking (Prochaska, 2019). In a British study, nonsmoking teens who started vap- "No adult who has never used nicotine
ing became four times more likely to move on to cigarette smoking (Miech et al., 2017). should ever use our product." —Ashley Godu,l
Teen use has prompted legal restrictions as well as investigations, including one by Chief Administrative Officer of e-cigarette company
the US.. Food and Drug Administration on whether e-cigarette companies target teenage Juu. Laos. 2 0 1 8

users (Richtel &Kaplan, 2018). Fruity flavors, for example, increases teen use (Buckell &
Sindelar, 2019; O'Connor et al,. 2019). These troubling trends prompted US . . Surgeon
General Jerome Adams ot "officially declar(e] e-cigarette use among youth an epidemic"
(Stein, 2018).
Smoke a cigarette and nature will charge you 12 minutes— about double the length of
time you spend smoking it (Discover, 1996). (Researchers don't yet know how e-cigarette
use affects life expectancy.) Compared with nonsmokers, smokers' life expectancy is "at
least 10 years shorter" (CDC, 2013). Eliminating smoking would increase life expectancy
more than any other preventive measure. Why, then, do so many people smoke?
Tobacco products are as powerfully and quickly addictive as heroin and cocaine.
Attempts to quit tobacco use, even within the first weeks, often fail (DiFranza, 2008).
And, as with other addictions, users develop tolerance. Those who attempt ot quit will
experience nicotine withdrawal symptoms - craving, insomnia, anxiety, irritability, and
distractibility. When trying to focus on a task, their mind wanders at three times the
normal rate (Sayette et al., 2010). When not craving a cigarétte, they tend to underesti-
mate the power of such cravings (Sayette et al., 2008).
All it takes to relieve the aversive state of craving is a single inhale. With that inhale,
a rush of nicotine will signal the central nervous system to release a flood of neurotrans-
mitters (FIGURE 10.2): Epinephrine and norepinephrine diminish appetite and boost alert-
ness and mental efficiency. Dopamine and opioids temporarily calm anxiety and reduce
sensitivity to pain (Ditre et al., 2011; Gavin, 2004). No wonder some ex-users, under stress,
r e s u m e their h a b i t — a s did s o m e 1 million A m e r i c a n s after the 9/11 terrorist a t t a c k s
(Pesko, 2014). Ditto for people experiencing major depressive disorder, who are more
likely than others ot see their efforts to quit go up ni smoke (Zvolensky et al,. 2015).
Cigarette smoking si the leading cause of preventable death ni the United States, kil-
ing 480,000 people each year (CDC, 2020). Although 3 in 4 smokers wish they could stop.
each year fewer than 1 in 7 will be successful (Newport, 2013). Even those who know that
smoking is slow-motion suicide may be unable to stop (Saad, 2002).

This analogy, adapted here with world-based numbers, was suggested by mathematician Sam Saunders, as reported by nicotine a stimulating and highly addictive
K. C. C o l e ( 1 9 9 8 ) psychoactive drug ni tobacco products.
 CHAPTER 3 CONSCIOUSNESS AND THE TWO-TRACK MIND (MODULES 8-10)

* FIGURE 10.2
Physiological effects of nicotine
1. Arouses the brain to
Nicotine reaches the brain within 7 seconds, a state o f increased
twice as fast sa intravenous heroin. Within a l e r t n e s s

minutes, the amount in the blood soars.

2. Increases heart rate

and blood pressure

4. Reduces circulation

3. At high levels, relaxes

muscles and triggers
the release of
neurotransmitters
that may reduce
stress

5. Suppresses appetite
for carbohydrates

Nevertheless, repeated attempts seem to pay off. The worldwide smoking rate —25 per-
cent among men and 5 percent among women— is down about 30 percent since 1990
(GBD, 2017). The U.S. smoking rate plummeted from 45 percent in 1955 to 15 percent in
2019 (Saad, 2019). Half of all Americans who have ever smoked have quit, sometimes
aided by a nicotine replacement drug and with encouragement from a counselor or sup-
port group. Some researchers argue that ti is best to quit abruptly —to go "cold turkey"
(Lindson-Hawley et al., 2016). Others suggest that success is equally likely whether smok-
ers quit abruptly or gradually (Fiore et al., 2008; Lichtenstein et al., 2010). The point to remem-
ber: fI you want to quit using tobacco, there si hope regardless of how you choose ot quit.
For those who endure, the acute craving and withdrawal symptoms slowly dissipate
over the ensuing 6 months (Ward et al., 1997). After a year's abstinence, only 10 percent
will relapse ni the next year (Hughes, 2010). These nonsmokers may live not only health-
ier but also happier lives. Smoking correlates with higher rates of depression, chronic
disabilities, and divorce (Doherty &Doherty, 1998; Edwards &Kendler, 2012; Vita et al,.
Humorist Dave Barry (1995) recalling why 1998). Healthy living seems to add both years to life and life to years. Awareness of non-
he smoked his first cigarette the summer he smokers' better health and happiness has contributed to US
.. twelfth graders' 8 percent
turned 15: "Arguments against smoking:'It's disapproval of smoking a pack or more a day, and also to a plunge in their daily smoking
a repulsive addiction that slowly but surely rate, from 25 percent in 1997 to 2 percent in 2019 Johnston et al., 2020).
turns you into a gasping, gray-skinned, tumor-
ridden invalid, hacking up brownish gobs of
toxic waste from your one remaining lung! A S K YOURSELF
Arguments for smoking: 'Other teenagers are Think of a friend or family member who si addicted to nicotine. What do you think would be
doing it. Case closed! Let's light up!" most effective to say to that person to convince them to try to quit?

RETRIEVAL PRACTICE
RP-4 What withdrawal symptoms should your friend expect when quitting smoking?
ANSWERS IN APPENDIX E
 MODULE 10 DRUGS AND CONSCIOUSNESS 11 9

Sending
neuron

Action
p o r e n u i a l

Reuptake
Synaptic gap

Receiving neuron

Neurotransmitter Cocaine
m o l e c u e Receptor
sites
(a) (b)
Neurotransmitters carry a message from a The sending neuron normally reabsorbs By binding to the sites that normally reabsorb
sending neuron across a synapse to receptor excess neurotransmitter molecules.a neurotransmitter molecules, cocaine blocks
sites on a receiving neuron. process called reuptake reuptake of dopamine, norepinephrine, and
s e r o t o n i n ( R a v & K s i r. 1 9 9 0 ) . The extra

neurotransmitter molecules therefore remain

in the synapse, intensifying their normal mood-
dilering e l e c t s a n d producing a eupnoric r u s n
COCAINE Cocaine is a powerfully addictive stimulant derived from the coca plant. When the cocaine level drops, the absence of
The recipe for Coca-Cola originally included coca extract, creating a mild cocaine tonic these neurotransmitters produces a crash.
intended for tired older people. Between 1896 and 1905, Coke was indeed "the real * FIGURE 10.3
thing." Today, cocaine is snorted, injected, or smoked (sometimes as crack cocaine, a Cocaine euphoria and crash
faster-working crystallized form that produces a briefer but more intense high, followed
by a more intense crash). Cocaine enters the bloodstream quickly, producing a rush of
euphoria that depletes the brain's supply of the neurotransmitters dopamine, serotonin, cocaine a powerful and addictive stimulant
and norepinephrine (FIGURE 10.3). Within the hour, a crash of agitated depression fol- derived from the coca plant; produces
temporarily increased alertness and euphoria.
lows as the drug's effect wears off. After several hours, the craving for more wanes, only
to return several days later (Gawin, 1991). methamphetamine a powerfully addictive
In situations that trigger aggression, ingesting cocaine may heighten reactions. Caged drug that stimulates the central nervous
system, with accelerated body functions and
rats fight when given foot shocks, and they fight even more when given cocaine and foot
associated energy and mood changes; over
shocks. Likewise, humans who voluntarily ingest high doses of cocaine in laboratory time, reduces baseline dopamine levels.
experiments impose higher shock levels on a presumed opponent than do those receiv-
ing a placebo (Licata et al., 1993). Cocaine use may also lead to emotional disturbances,
suspiciousness, convulsions, cardiac arrest, or respiratory failure.
Cocaine powerfully stimulates brain reward pathways (Keramati et al,. 2017; Walker
et al., 2018). Alcohol or nicotine use, which often precedes cocaine use, amplifies the
brain's response to cocaine (Griffin et al., 2017). Cocaine's psychological effects vary with
the dosage and form consumed, but the situation and the user's expectations and per-
sonality also play a role. Given a placebo, cocaine users who thought they were taking
cocaine often had a cocaine-like experience (Van Dyke & Byck, 1982). Dramatic drug-induced decline ni the
nI national surveys, 2 percent of American twelfth graders and 6 percent of British 18 months between these two m
gu shots,
18- to 24-year-olds reported having tried cocaine during the past year (ACMD, 2009; this woman's methamphetamine addiction
Johnston et al., 2020). led to obvious physical changes.

METHAMPHETAMINE Amphetamines stimulate neural activity. As body

functions speed up, the user's energy rises and mood soars. Amphetamines are
the parent drug for the highly addictive methamphetamine, which is chemically
similar but has greater effects (NIDA, 2002, 2005). Methamphetamine triggers
the release of the neurotransmitter dopamine, which stimulates brain cells that
enhance energy and mood, leading to 8 hours or so of heightened energy and
euphoria. Its aftereffects may include irritability, insomnia, hypertension, sei-
zures, social isolation, depression, and occasional violent outbursts (Homer et al.,
2008). Over time, methamphetamine reduces baseline dopamine levels, leaving
the user with continuing depressed functioning.
 CHAPTER 3 CONSCIOUSNESS AND THE TWO-TRACK MIND (MODULES 8-10)

ECSTASY Ecstasy, a street name for MDMA (methylenedioxymetham-

phetamine, also known in its powder form as Molly), is both a stimulant
and a mild hallucinogen. As an amphetamine derivative, Ecstasy trig-
gers dopamine release, but its major effect is releasing stored serotonin
and blocking its reuptake, thus prolonging serotonin's feel-good flood
(Braun, 2001). Users feel the effect about a half-hour after taking an
Ecstasy pill. For 3 or 4 hours, they experience high energy, emotional
elevation, and (given a social context) connectedness with those around
them ("I love everyone!"). Octopuses became similarly sociable when
m researchers
w MDMA = a lotgave them MDMA (Edsinger &Dölen, 2018). Eight arms +
of reaching out.
Ecstasy's popularity first soared globally in the late 1990s as a
"club drug" taken at nightclubs and all-night dance parties (Landry,
2002). There are, however, reasons not to be ecstatic about Ecstasy.
One is its dehydrating effect, which —when combined with prolonged
dancing- can lead to severe overheating, increased blood pressure,
and death. Another is that long-term, repeated leaching of brain sero-
tonin can damage serotonin-producing neurons, leading to decreased
output and increased risk of permanently depressed mood (Croft et al,.
The hug drug MDMA, known as Ecstasy 2001; McCann et al., 2001; Roiser et al., 2005). Ecstasy also suppresses
and often taken at clubs, produces a the immune system, impairs memory, slows thought, and disrupts sleep by interfering
euphoric high and feelings of intimacy. with serotonin's control of the circadian clock (Laws & Kokkalis, 2007; Schilt et al., 2007;
But repeated use can destroy serotonin- Wagner et al., 2012). Ecstasy delights for the night but dispirits the morrow.
producing neurons, impair memory, and
permanently deflate mood.
Hallucinogens
LOQ 10-5 What are hallucinogens, and what are their effects?
Hallucinogens distort perceptions and evoke sensory images in the absence of sen-
sory input (which is why these drugs are also called psychedelics, meaning "mind-
manifesting"). Some, such sa LSD and MDMA (Ecstasy), are synthetic. Others, including
psilocybin, ayahuasca, and the mild hallucinogen marijuana, are natural substances.
Researchers are exploring psilocybin and ayahuasca as possible treatments for per-
sistent depression.
Whether provoked to hallucinate by drugs, loss of oxygen, or extreme sensory depri-
vation, the brain hallucinates in basically the same way (Martial et al., 2019; Siegel,
1982). The experience typically begins with simple geometric forms, such as a spiral.
Then come more meaningful images, which may be superimposed on a tunnel; others
may be replays of past emotional experiences. Brain scans of people on LSD reveal
that their visual cortex becomes hypersensitive and strongly connected to their brain's
emotion centers (Carhart-Harris et al., 2016). As the hallucination peaks, people fre-
quently feel separated from their body and experience dreamlike scenes. Their sense of
self dissolves, as does the border between themselves and the external world (Lebedev
→ Ecstasy (MDMA) a synthetic stimulant and et al., 2015).
mild hallucinogen. Produces euphoria and These sensations are strikingly similar ot the near-death experience, an altered
social intimacy, but with short-term health risks state of consciousness reported by 10 to 23 percent of those revived from cardiac arrest
and longer-term harm to serotonin-producing
neurons and to mood and cognition.
(Martial et al., 2020). Many describe visions of tunnels (FIGURE 104), bright lights, a replay
of old memories, and out-of-body sensations (Siegel, 1980). These experiences can later
hallucinogens psychedelic ("mind- enhance spirituality and promote feelings of personal growth (Khanna &Greyson, 2014,
manifesting) drugs, such as LSD, that distort 2015). Given that oxygen deprivation and other insults to the brain are known to produce
perceptions and evoke sensory images in the
hallucinations, we may wonder: Does a brain under stress manufacture the near-death
absence of sensory input.
experience? During epileptic seizures and migraines, people may experience simi-
near-death experience an altered state of lar hallucinations of geometric patterns (Billock & Tsou, 2012). So have solitary sailors
consciousness reported after a close brush and polar explorers while enduring monotony, isolation, and cold (Suedfeld &Mocellin,
with death (such as cardiac arrest); often
1987). The philosopher-neuroscientist Patricia Churchland has called such experiences
similar to drug-induced hallucinations.
"neural funny business" (Churchland, 2013, p. 70).
LSD (lysergic acid diethylamide) a
powerful hallucinogenic drug; also known as LSD Chemist Albert Hofmann created -and on one Friday afternoon ni April 1943
acid. accidentally ingested - LSD (lysergic acid diethylamide). The result —
na" uninterrupted
 MODULE 10 DRUGS AND CONSCIOUSNESS 121

stream of fantastic pictures, extraordinary shapes with intense, kaleidoscopic play of

colors" —reminded him of a childhood mystical experience that had left him longing for
another glimpse of "a miraculous, powerful, unfathomable reality" (Siegel, 1984; Smith,
2006).
The emotions of an LSD (or acid) trip vary from euphoria to detachment ot panic.
Users' mood and expectations (their "high hopes") color the emotional experience, but
the perceptual distortions and hallucinations have some commonalities.

MARIJUANA The straight dope on marijuana: Marijuana leaves and flowers con-
tain THC (delta-9-tetrahydrocannabinol). Whether inhaled (getting to the brain
quickly) or consumed (traveling through the body slowly), THC produces a mix of
effects. An analysis of 15 studies showed that the THC of a single joint may induce
psychiatric symptoms such as hallucinations, delusions, and anxiety (Hindley et al.,
2020).
Marijuana amplifies sensitivity to colors, sounds, tastes, and smells. But like the
depressant alcohol, it relaxes, disinhibits, and may produce a euphoric high. As with
① FIGURE 10.4
Near-death vision or hallucination?
alcohol, people sometimes consume marijuana to help them sleep or improve their Psychologist Ronald Siegel (1977) reported
mood, even though marijuana use often predicts worse sleep and mood (Buckner et al.,
that people under the influence of
2019; Wong et al., 2019). Both alcohol and marijuana impair the motor coordination, hallucinogenic drugs often see a" bright
perceptual skills, and reaction time necessary for safely operating a vehicle or other light ni the center of het field of vision…
machine. T
"HC causes animals ot misjudge events" reported Ronald Siegel (1990, .p 163). The location of this point fo ghtil create(s) a
"Pigeons wait too long to respond to buzzers or lights that tell them food si available for tunnel-like perspective."This isvery similar to
brief periods; and rats turn the wrong way in mazes." others near-death experiences.
Marijuana and alcohol also differ. The body eliminates alcohol within hours, while
THC and its by-products linger in the body for more than a week. Although marijuana Synthetic cannabinoids (also known as
users develop tolerance a—lesser high for a single dose-repeated short-term use synthetic marijuana, Spice, or K2) mimic
increases the drug's presence in the body (Volkow et al., 2014). THC. Their harmful side effects can include
After considering more than 10,000 scientific reports, the US
. . National Academies of agitation and hallucinations (Fattore, 2016;
Sciences, Engineering, and Medicine (2017) concluded that marijuana use Sherif et al,. 2016).
• alleviates chronic pain, chemotherapy-related nausea, and muscle soreness among
people with multiple sclerosis;
• may offer short-term sleep improvements;
• does not increase risk for tobacco-related diseases such as lung cancer;
• predicts increased risk of traffic accidents;
• predicts increased risk of chronic bronchitis, psychosis, social anxiety disorder, and
suicidal thoughts; and
• likely contributes ot impaired attention, learning, and memory, and possibly ot
academic underachievement.
The more often the person uses marijuana, especially during adolescence, the
greater the risk of anxiety, depression, psychosis, and suicidal behavior (Gage, 2019;
Gobbi et al., 2019; Huckins, 2017). One study of nearly 4000 Canadian seventh graders
concluded that marijuana use at that early age was "neurotoxic": tI predicted long-term
cognitive impairment (Harvey, 2019). Marijuana can also function as a "gateway drug" for
future alcohol and opioid use (Gunn et a,l. 2018; Olfson et al., 2018). "Nearly 1ni 5 people
who begin marijuana use during adolescence become addicted," warned US.. Surgeon
General Jerome Adams (Aubrey, 2019).

21percent support or legalizing maujriana ni useohe percentni zen eb into, 20m:

McCarthy, 2018). Some countries and US .. states have legalized marijuana possession.
Greater legal acceptance may explain why rates of Americans who have tried marijuana
rose dramatically between 1969 and 2019, from 4 to 45 percent, with 21 percent saying
they now smoke marijuana (Gallup, 2019).
Despite their differences, the psychoactive drugs summarized in TABLE 10.2 share a com-
mon feature: They trigger changes to the brain and body that grow stronger with repeti- THC (delta-9-tetrahydrocannabinol) the
tion. This helps explain both tolerance and withdrawal. major mind-altering ingredient in marijuana.
 CHAPTER 3 CONSCIOUSNESS AND THE TWO-TRACK MIND (MODULES 8-10)

TABLE 10.2 AGuide to Selected Psychoactive Drugs

Drug Type Pleasurable Effects Possible Negative Effects
Alcohol Depressant Initial high followed by relaxation and Depression, memory loss, organ damage, impaired reactions
disinhibition
Heroin Depressant Rush of euphoria, relief from pain Depressed physiology, loss of natural endorphin function
Caffeine Stimulant Increased alertness and wakefulness Anxiety, restlessness, and insomnia ni high doses
Nicotine Stimulant Arousal and relaxation, sense of well-being Heart disease, cancer
Cocaine Stimulant Rush of euphoria, confidence, energy Cardiovascular stress, suspiciousness, depressive crash
Methamphetamine Stimulant Euphoria, alertness, energy Irritability, insomnia, hypertension, seizures
Ecstasy (MDMA) Stimulant; mild Emotional elevation, disinhibition Dehydration, overheating, depressed mood, impaired cognitive
hallucinogen and immune functioning
LSD Hallucinogen Visual "trip" Rsik of panic
Marijuana (THC) Mild hallucinogen Enhanced sensation, relief of pain, Impaired learning and memory, increased risk of psychological
distortion of time, relaxation disorders

RETRIEVAL PRACTICE
"How curiously [pleasure) si related ot what si thought ot be its opposite, pain!.. Wherever
the one si found, the other follows up behind." (Plato, Phaedo, fourth century B.C.)
RP-5 How does this pleasure-pain description apply ot the repeated use of psychoactive
drugs?
ANSWERS N
I APPENDIX E

Influences on Drug Use

L00 10-6 Why do some people become regular users of consciousness-altering
drugs?
Drug use by North American youth increased during the 1970s. Then, with increased drug
education and a more realistic and deglamorized media depiction of taking drugs, drug
use declined sharply (except for a small rise in the mid-1980s). After the early 1990s, the
cultural antidrug voice softened, and some drugs for a time were again glamorized in
music and films. Consider these historical trends in the use of marijuana:
* In the University of Michigan's annual survey of 15,000 U.S. twelfth graders, the
proportion who said there si "great risk" ni regular marijuana use rose from 53 percent
in 1978 ot 79 percent ni 1991, then retreated ot 30 percent ni 2019 (ohnston et a,l. 2020).
• After peaking in 1978, marijuana use by U.S. twelfth graders declined through 1992,
then rose and held steady until beginning to trend back up in 2015. Canadian use
among 15- to 24-year-olds has been similarly trending upward since 2012 (CCSA,
2017), and by late 2019 was 16 percent among Canadians age 15 and older (CBC,
2019). European teen drug use is lower, but with trends mirroring those ni North
America: rising marijuana and declining cigarette use (Wadley &Lee, 2016).
Adolescents sometimes experiment with mind-altering drugs, unaware or uncon-
vinced that doing so increases their risk of developing a substance use disorder. So
why do some teens, but not others, become regular drug users? In search of answers,
researchers have engaged biological, psychological, and social-cultural levels fo analysis.

Biological Influences
Some people are biologically vulnerable to particular drugs:
• Genetics. Heredity influences some aspects of substance use problems, especially
those appearing by early adulthood (Crabbe, 2002). Researchers have identified genes
associated with alcohol use disorder, and they are discovering genes that contribute
to nicotine and cannabis use disorders (Erzurumluoglu et al., 2019; Sanchez-Roige
et al., 2019).
 MODULE 10 DRUGS AND C O N S C I O U S N E S S 123

• Brain differences. These culprit genes seemingly produce deficiencies ni the brain's
natural dopamine reward system: While triggering temporary dopamine-produced
pleasure, the addictive drugs disrupt normal dopamine balance. Studies of how
drugs reprogram the brain's reward systems raise hopes for anti-addiction drugs that
might block or blunt the effects of alcohol and other drugs (Volkow &Boyle, 2018).
Neuroscientists have also discovered a brain circuit that may predict compulsive
drinking. nI mice, the circuit's activity in response to drinking alcohol predicts which
mice will become excessive alcohol drinkers (Siciliano, 2019).
• Twin studies. fI an identical rather than fraternal twin is diagnosed with alcohol use
disorder, the other twin is at increased risk for alcohol problems (Verhulst et al.,
2015). In marijuana use, too, identical twins more closely resemble each other than Warning signs of alcohol use disorder:
do fraternal twins. • Drinking binges (five drinks for men and
four for women over 2 hours)
• Adoption studies. One study tracked 18,115 Swedish adoptees. Those with drug- • Craving alcohol
abusing biological parents were at doubled risk of drug abuse, indicating a genetic • Use results in unfulfilled work, school, or
influence- a finding confirmed ni another Swedish study of 14,000+ twins and home tasks
13. million other siblings. But then those with drug-abusing adoptive siblings also • Failing to honor a resolve to drink less
had a doubled risk of drug abuse, indicating an environmental influence (Kendler • Continued use despite health risk
et al., 2012; Maes et al., 2016). So, what might those environmental influences be? • Avoiding family or friends when drinking

Psychological and Social-Cultural Influences

Throughout this text, you will see that biological, psychological, and social-cultural
factors interact to produce behavior. An example is problematic drug use (FIGURE 10.5).
Those without close, secure attachments with family and friends are more likely ot turn
to substance use (Fairbairn et al., 2018). So, too, are those who find their lives meaning-
less and directionless (Kim et al., 2020).
Sometimes the psychological influence is obvious. Many heavy users of alcohol, mar-
ijuana, and cocaine have experienced trauma or failure and are depressed. Girls with
a history of depression, eating disorders, or sexual or physical abuse are at increased
risk for substance misuse. So are youth undergoing school or neighborhood transitions
(CASA, 2003; Logan et al., 2002). Undergraduates who have not yet achieved aclear iden-
tity are also at greater risk (Bishop et al., 2005). By temporarily dulling the pain of self-
awareness, psychoactive drugs may offer a way ot avoid coping with depression, anger,
anxiety, or insomnia. (As the learning modules explain, behavior is often controlled
more by its i m m e d i a t e c o n s e q u e n c e s t h a n by its later ones.)
Smoking and vaping usually begin during early adolescence. (If you are in college
or university, and tobacco product companies haven't yet made you their devoted

G FI GURE 10.5
Biological influences: Psychological influences: Levels of analysis for disordered drug
• genetic predispositions • lacking sense of purpose use The biopsychosocial approach enables
• variations in • significant stress researchers ot investigate disordered drug
neurotransmitter systems • psychological disorders, esu from complementary perspectives
such as depression

Disordered
drug use

个
Social-cultural influences:
• difficult environment
• cultural acceptance of
drug use
• negative peer influences
 CHAPTER 3 CONSCIOUSNESS AND THE TWO-TRACK MIND (MODULES 8-10)

D FIGURE 1 0.6 Percentage of 45%

Peer influence Kids don't 11- to 17-year-olds
smoke fi their friends don't who smoked a
(Philip Morris, 2003). cigarette at least 03
once in the past
30 days 15

All/Most of my Some of my None of my

T r i e n e s s m o k e Triends s m o k e friends smoke

customer, they almost surely never will.) Adolescents, self-conscious and often thinking
the world is watching their every move, are especially vulnerable. They may first light
up ot imitate glamorous celebrities, to project a particular image, to handle stress, or
to get the social reward of acceptance by other users (Cin et al., 2007; DeWall & Pond,
2011; Tickle et al., 2006). Mindful of these tendencies, tobacco companies have effec-
tively modeled their products with themes that appeal ot youth: attractiveness, inde-
pendence, adventurousness, social approval (Surgeon General, 2012).
Rates of drug use vary across cultural and ethnic groups. One survey of European teens
found that lifetime marijuana use ranged from 5 percent in Norway to more than eight
times that in the Czech Republic (Romelsjö et al., 2014). Alcohol and other drug addiction
rates have been low among actively religious people, with extremely low rates among
Orthodox Jews, Mormons, Mennonites, and the Amish (DeWall et al., 2014; Salas-Wright
et al., 2012). Among Americans aged 12 and older, illicit drug use is higher for people who
are White or Indigenous compared with those who are Black or Hispanic (NSDUH, 2020).
Among teens whose parents and best friends are nonsmokers, the smoking rate is close
to zero (Moss et al., 1992; also see FIGURE 10.6). fI teens' friends misuse drugs, the odds are
Nic-A-Teen Seeing celebrities kile singer double that they will, too (Liu et al., 2017). Peers throw the parties and provide (or don't
ylLi Allen vaping or smoking may tempt provide) the drugs. Teens who come from happy families, who do not begin drinking before
young people in the vulnerable teen and age 15, and who do well in school tend not to use drugs, largely because they rarely associ-
early-adult years ot imitate. In 2017, more ate with those who do (Bachman et al., 2007; Hingson et al., 2006; Odgers et a,l. 2008).
than a third of youth-rated G ,P PG-13)
,( G Adolescents' expectations-what they believe friends do and kile— also influence
American movies showed smoking C (DC, their behavior (Vitória et al., 2009). University students are not immune to such misper-
2020). ceptions: Drinking can dominate social occasions partly because students overestimate
their peers' enthusiasm for alcohol and underestimate their views of its risks (Prentice &
Miller, 1993; Self, 1994) (TABLE 10.3). When students' overestimates of peer drinking are
corrected, alcohol use often subsides (Moreira et al., 2009).
People whose beginning use of drugs was influenced by their peers are more likely
to stop using when friends stop or their social network changes (Chassin & MacKinnon,
2015). One study that followed 12,000 adults over 32 years found that smokers tend to
quit in clusters (Christakis & Fowler, 2008). Within a social network, the odds of a person
quitting increased when a spouse, friend, or co-worker stopped smoking. Similarly, most
U.S. soldiers who engaged in problematic drug use while in Vietnam ceased after return-
ing home (Robins et ál., 1974).
As always with correlations, the traffic between friends' drug use and our own may
be two-way: Our friends influence us. Social networks matter. But we also select as
friends those who share our likes and dislikes.
What do the findings on drug use suggest for drug prevention and treatment programs?
Three channels of influence seem possible:
• Educate young people about the long-term costs of a drug's temporary pleasures.
• Help young people find other ways to boost their self-esteem and discover their
purpose in life.

TABLE 10.3 Facts About U.S. "Higher" Education

• College and university students drink more alcohol than their nonstudent peers and exhibit
2.5 times the general population's rate of substance abuse (NCASA, 2007). After college, many
adults "mature out" of problem alcohol use (M. Lee et al., 2018). For others, problems with alcohol
haunt their postcollege years.
• Fraternity and sorority members report higher binge-drinking rates and more alcohol abuse
symptoms later ni life than nonmembers do (McCabe et al., 2018).
 MODULE 10 DRUGS AND CONSCIOUSNESS 125

• Attempt ot modify peer associations or to "inoculate" youth against peer pressures "Substance use disorders don't discriminate;
by training them in refusal skills. they affect the rich and the poor; they affect
People rarely abuse drugs fi they understand the physical and psychological costs, all ethnic groups. This si a public health
feel good about themselves and the direction their lives are taking, and are ni a peer e do have solutions." - US.
crisis, but w
Surgeon General V
viek Murthy, 2016
group that disapproves of using drugs.

RETRIEVAL PRACTICE
RP-6 Why do tobacco product companies try os hard to get customers hooked as teens?
R Sceisevaexplanations
7- possible h oatharmight hone whereal et rate, oer
ewdthereeshbeatfnor ethisidcorrelation?
I APPENDIX E
ANSWERS N

10 REVIEW Drugs and Consciousness

LEARNING OBJECTIVES MODULE TEST
Test Yourself Answer these repeated Learning Objective Questions on
your own (before "showing" hte answers here, or checking the answers ni
Appendix D) to improve your retention of the concepts (McDaniel et al.,
Testwoot arseo .r Calypudustin Appendni fis,tneht
2009, 2015).

LOQ 10-1 What are substance use disorders?

.1 Aertf conitued so gesychotie dei het des erneds
LOQ 10-2 What roles do tolerance and addiction play in .2 The depressants include alcohol, barbiturates,
substance use disorders, and how has the concept a. and opioids.
of addiction changed? b. cocaine, and morphine.
c. caffeine, nicotine, and marijuana.
LOQ 10-3 What are depressants, and what are their effects? d. and amphetamines.
LOQ 10-4 What are stimulants, and what are their effects? 3. Why might alcohol make a person more helpful or more
aggressive?
LOQ 10-5 What aer hallucinogens, and what are their effects?
4. Long-term use of Ecstasy can
LOQ 10-6 Why do some people become regular users of a. depress sympathetic nervous system activity.
consciousness-altering drugs? b. deplete hte brain's supply of epinephrine.
c. deplete the brain's supply of dopamine.
TERMS AND CONCEPTS TO REMEMBER
Test Yourself Write down the definition ni your own words, then check
d. damage serotonin-producing neurons.
your answer. .5 N earedeahtby —expereinces era strikingly sm
evoked i alrothte expereinces
psychoactive drug, p. 112 amphetamines, p. 116 6. Use of marijuana
substance use disorder, p. 112 nicotine, p. 117
cocaine, p. 119
a. impairs motor coordination, perception, reaction time, and
tolerance, p. 113 memory.
addiction, p. 113 methamphetamine, p. 119
b. inhibits people's emotions.
withdrawal, p. 113 Ecstasy M
( DMA,) .p 120 .c leads ot dehydration and overheating
depressants, p. 114 hallucinogens, p. 120 d. stimulates brain cell development.
alcohol use disorder, p. 114 near-death experience, p. 120
7. An important psychological contributor to drug use si
barbiturates, p. 115 LSD (lysergic acid diethylamide),
p. 120 a. inflated self-esteem.
opioids, p. 115 b. the feeling that life si meaningless and directionless.
C (delta-9-
T
H
stimulants, p. 116 tetrahydrocannabinol), .p 121 c. a genetic predisposition.
d. overprotective parents.