Drug Taking Behaviour: Personal and

Social Issues
Chapter 2
Drug Toxicity
A drug’s harmful effects are referred to as its toxicity.

The quantity of a drug that is taken into the body is known as the dose.

Dose:
Typically measured in terms of milligrams (mg) or micrograms (µg)
Drug Toxicity

Dose-response curve:

An S-shaped graph showing the biological or behavioural response

due to specific concentrations (doses) of a drug
Drug Toxicity
Effective dose (ED):

The minimal dose of a particular drug necessary to produce the intended

drug effect in a given percentage of the population

Lethal dose (LD):

The minimal dose of a particular drug capable of producing death in a

given percentage of the animal population studied
Drug Toxicity

Acute toxicity:

Can be measured in terms of either:

A drug’s therapeutic index

Its margin of safety

Each of which can be computed from its effective dose response and
lethal dose-response curves
Drug Toxicity
Therapeutic index:

A measure of a drug’s relative safety for use

Computed as the ratio of the lethal dose or toxic dose for 50% of the population
to the effective dose for 50% of the population

The higher the therapeutic index, the safer the drug is.
Drug Toxicity
Toxic dose (TD):

The minimal dose of a particular drug capable of producing toxicity in

a given percentage of humans

Margin of safety:

The ratio of a lethal dose for 1% of the population to the effective

dose for 99% of the population
Drug Toxicity
The Canadian Centre on Substance Abuse (CCSA)

A federal program
Routinely gathers data concerning:
Drug-related medical emergencies
Health care related to substance abuse
The Centre for Addictions Research of British Columbia

Keeps statistics on mortality rates due to alcohol, tobacco, and illicit

drugs

Polydrug use:
Drug-taking behaviour involving multiple drugs
Drug Toxicity
Judging Drug Toxicity From Drug
Related Deaths
The number of people who die each year as a result of drinking
alcohol or smoking tobacco

Far outnumbers the fatalities from the abuse of illicit drugs

Chronic toxicity:
Examples can be found in a wide range of psychoactive drugs.

Ironically, however, chronic use of alcohol and tobacco (both legally available) cause
by far the greatest adverse health effects.
Diagnosing Drug Related Problems
Diagnostic and Statistical Manual of Mental Disorders (referred to as the
“DSM”)

Is used by health care professionals in Canada

Issued by American Psychiatric Association

Is the official standard for defining and diagnosing a wide range of

psychological problems
Diagnosing Drug Related Problems
Substance Use Disorder:

A diagnostic term used in the DSM-5 for clinical psychiatrists and other health care
professionals to identify an individual with significant problems that are associated with
some form of drug-taking behaviour
Diagnosing Drug Related Problems
A new revision of the Diagnostic and Statistical Manual of Mental Disorders
(the DSM-5), was issued in 2013:

Included two major changes involving the diagnosis of drug-taking

behaviour
Substance Use Disorder

A minimum of two criteria has been established for an individual to be identified as

having a substance use disorder

DSM-5 now has set a severity-of-symptoms scale for this condition

Substance Use:
Is a broader term used instead of “drug use”
This term clarifies the confusion in the public mind about what is defined as a drug
and what is not.
Special Circumstances in Drug Abuse
Pregnant Women:

Increasing attention has been directed toward the harmful effects that drug
abuse has on:

Pregnancy
The neural development of the fetus
Special Circumstances in Drug Abuse
Drug Abuse and HIV Infection

Concern with drug use by injection, and the spread of disease when needles
are shared

To reduce risk of HIV infection among injecting drug users, needle-

exchange programs have been established

It’s been estimated that these programs can reduce new cases of HIV infection by 1/3,
without increasing the use of illicit drugs.
Special Circumstances in Drug Abuse

Needle-exchange programs

The Ontario Needle Exchange Coordination Committee recommends the following steps:

Give clients as many sterile needles as they wish

Do not require the users to give back their used needles

Do not deny users large numbers of needles if requested

Strongly suggest that users do bring back their used needles

Whenever possible discuss the harms associated with using non-sterile needles
Drugs, Violence, and Crime
Do illicit drugs cause violence and crime?

How is this complicated question answered?

Two Canadian statistical sources are used:

Statistics Canada reporting on trends in police-reported drug offences; this report

combines:

The Uniform Crime Reporting Survey

The Adult Criminal Court Survey

The Youth Court Survey

Drugs, Violence, and Crime
There is an overall association between the taking of illicit drugs
and crime

Analysis indicates that the drug with the closest connection to social
violence is alcohol.

Heroin and marijuana cause the user to be less inclined toward violent
behaviour, rather than more so.
Drugs, Violence, and Crime
Drug abuse prompts many drug users to commit criminal acts.

Generally, they are property theft crimes to support the user’s drug habit.

However, there is a high level of social violence and criminal behaviour

inherent in the trafficking and distribution of illicit drugs.
Drugs, Violence, and Crime
Drugs, Violence, and Crime
Drugs, Violence, and Crime
Pharmacological violence:

Violent acts committed while under the influence of a particular

psychoactive drug, with the implication that the drug caused the
violence to occur

Economically compulsive violence:

Violent acts that are committed by a drug abuser to secure money to buy
drugs
Systemic violence:

Violence that arises from the traditionally aggressive patterns of

behaviour within a network of illicit drug trafficking and distribution