Objectives

– Discuss the meaning of the term “drug abuse”; Legal and

illegal drugs.
– Distinguish between psychological and physical
dependence;
– Describe the short-term and long-term consequences of
alcohol consumption on the nervous system and the liver;
– Discuss the social consequences of excess alcohol use;
– Describe the effects of the components of cigarette smoke
on the respiratory and cardiovascular systems;
 Substance Abuse
A drug is a substance that alters the body’s psychology

Any substance or product that is used or intended to be used to modify or explore

the physiological system or pathological state in the benefit of the recipient. WHO
Legal : pain killers e.g asprin , paracetemol
Illegal drugs Heroin, morphine ( opiates ) pain killers . Mimic the enkephalins
(neorotransmitter)

Drug Use
Used for therapy in medicine : therapeutic drug
Used to change mood (recreation) e.g caffeine , alcohol nicotine, cannabis,
heroin. No health effect .

Drugs affect what happens at the synapse:

-Mimic the transmitter substance
-Prevent its breakdown (inhibition of enzymes)
-Block transmitter receptors at postsynaptic neuron
 Substance Abuse
Tolerance
more drug is required for the same effect . An indicator of dependence on the
drug

Drug Abuse
over use / miss uses of drugs such that it causes harm . There is damage to the
health of the individual as well persons around them.

Drug Dependence
There is changes to the body due to drug use . The person cannot survive
without it.
• Physical: withdrawal or abstinence symptoms. Neurons structure and physiology
has changed
• Psychological : mental effects eg cravings etc
Substance Abuse
 Alcohol
DAL (Daily Alcohol Limit):
Guidelines on alcohol consumption?
The U.S. Dietary Guidelines recommends that for healthy adults who choose to drink
recommends:
• For women—1 drink or less in a day
• For men—2 drinks or less in a day

The NHS recommends that men should not regularly drink more
than between 3 and 4 units of alcohol a day. Women, meanwhile, should
not regularly exceed 2 to 3 units. A unit of alcohol is roughly equivalent to a
third of a pint of beer, a single whisky, or half a glass of red wine.

These amounts are not intended as an average but rather a daily limit.

2-3 units women

3-4 units men
# of units = Vol of drink X ABV ( alcohol by vol.) /1000

A unit of alcohol is defined as 10ml (millilitres) or 8g (grams) of pure alcohol.

 Alcohol
Calculating units
Using units is a simpler way of representing a drink's alcohol content –
usually expressed by the standard measure alcohol by volume (ABV).
ABV is a measure of the amount of pure alcohol as a percentage of the total
volume of liquid in a drink.
You can find the ABV on the labels of cans and bottles, sometimes written as
"vol" or "alcohol volume", or you can ask bar staff about particular drinks.
For example, wine that says "12% ABV" or "alcohol volume 12%" means 12%
of the volume of that drink is pure alcohol.
You can work out how many units there are in any drink by multiplying the
total volume of a drink (in ml) by its ABV (measured as a percentage) and
dividing the result by 1,000.
• strength (ABV) x volume (ml) ÷ 1,000 = units
For example, to work out the number of units in a pint (568ml) of strong
lager (ABV 5.2%):
• 5.2 (%) x 568 (ml) ÷ 1,000 = 2.95 units
 Alcohol
s and units
bottle of red, white or rosé wine (ABV 13.5%) contains 10 units.

guide shows how many units on average are in your favourite drink.
n, rum, vodka, whisky, tequila and sambuca. Large (35ml) single measures of spi
Units of alcohol in drinks

Type of drink Number of alcohol units

Single small shot of spirits* (25ml, ABV 40%) 1 unit

Alcopop (275ml, ABV 4.6%) 1.3 units

Small glass of red/white/rosé wine (125ml, ABV 12%) 1.5 units

Bottle of lager/beer/cider (330ml, ABV 5%) 1.7 units

Can of lager/beer/cider (440ml, ABV 5.5%) 2.4 units

Pint of lower-strength lager/beer/cider (ABV 3.6%) 2 units

Standard glass of red/white/rosé wine (175ml, ABV 12%) 2.1 units

Pint of higher-strength lager/beer/cider (ABV 5.2%) 3 units

Large glass of red/white/rosé wine (250ml, ABV 12%) 3 units

 Alcohol
History:
http://www.drugfreeworld.org/drugfacts/alcohol/a-short-history.html

DAL (Daily Alcohol Limit):

2-3 units women
3-4 units men
# of units = Vol of drink X ABV ( alcohol by vol.) /1000

One unit = 8g alcohol

In the United States, a "standard drink" or "alcoholic drink equivalent" is any

drink containing 14 grams, or about 0.6 fluid ounces, of “pure” ethanol. As
shown in the illustration, this amount is found in 12 ounces of regular beer
(with 5% alcohol by volume or alc/vol), 5 ounces of table wine (with 12%
alc/vol), or 1.5 ounces of 80-proof distilled spirits (with 40% alc/vol).

In the United States, a "standard drink" or "alcoholic drink equivalent" is any

drink containing 14 grams, or about 0.6 fluid ounces, of “pure” ethanol. As
shown in the illustration, this amount is found in 12 ounces of regular beer
(with 5% alcohol by volume or alc/vol), 5 ounces of table wine (with 12%
alc/vol), or 1.5 ounces of 80-proof distilled spirits (with 40% alc/vol).
 Alcohol
Heavy drinking thresholds for women are lower because after
consumption, alcohol distributes itself evenly in body water, and
pound for pound, women have proportionally less water in their
bodies than men do. This means that after a woman and a man of
the same weight drink the same amount of alcohol, the woman’s
blood alcohol concentration (BAC) will tend to be higher, putting her
at greater risk for harm.

For men and women, the risk for alcohol-related harm depends on a
combination of how much, how fast, and how often they drink:
• Too much, too fast. When a woman has 4 or more drinks—or a
man has 5 or more—in about 2 hours, this typically raises the BAC to
0.08% and meets the definition of binge drinking. It increases the
risk of falls, burns, car crashes, memory blackouts, medication
interactions, assaults, drownings, and overdose deaths18
• Too much, too often. - Heavy drinking
• For women—4 or more drinks on any day or 8 or more per week
• For men—5 or more drinks on any day or 15 or more per week
 Alcohol
Blood alcohol concentration
• Binge drinking is defined as reaching a
BAC of 0.08% (0.08 grams of alcohol
per deciliter of blood) or higher.
• A typical adult reaches this BAC after
consuming 4 or more drinks (women)
or 5 or more drinks (men), in about 2
hours
Alcohol
 Alcohol
When is having any alcohol too much?

It is safest for patients to avoid alcohol altogether if they:

• Take medications that interact with alcohol (
• Have a medical condition caused or exacerbated by drinking,
such as liver disease, bipolar disorder, abnormal heart rhythm,
diabetes, hypertension, or chronic pain, among others.
• If you are pregnant or plant to get pregnant
• Experience facial flushing and dizziness when drinking
alcohol. Between 30% and 45% of people of East Asian heritage
inherit gene variants responsible for an enzyme deficiency that
causes these symptoms and amplifies the risk of alcohol-related
cancers, particularly head and neck cancer and esophageal
cancer, even if they drink at light or moderate levels.5 People of
other races and ethnicities can carry similar variants.6
 Alcohol Effects
• Alcohol molecules dissolve very easily in the fatty acid tails of
phospholipids that make up cell surface membranes. This distorts the
proteins that form channels in the membranes. In particular, it affects the
shape of receptors in the membranes of neurons in the brain that respond
to a neurotransmitter called GABA, which inhibits the formation of action
potentials. Alcohol increases and prolongs the eff ects of GABA.

• Alcohol also affects another, stimulatory, neurotransmitter called

glutamate. This is the commonest neurotransmitter in the brain, and is
responsible for much of the interaction between neurones. Alcohol blocks
the receptors on cell membranes that glutamate would normally bind to.
So, alcohol increases the effect of the inhibitory neurotransmitter GABA
and reduces the effect of the stimulatory neurotransmitter glutamate.
Both of these actions reduce or depress the activity of the brain, so
alcohol is a depressant. The effects are especially great in the cortex of the
cerebrum and in the cerebellum.
 Alcohol Effects
• As the activity of the cortex is depressed, the person
becomes less able to think clearly and logically and to
make decisions. Inhibitions are reduced, and this helps
some people to relax and interact socially. Depression of
the activity of the cerebellum inhibits coordination of
movements.

• If drunk in large amounts, alcohol can kill. Inhibition of

various areas of the brain causes drowsiness and
eventually unconsciousness. It can cause coma. When the
nervous stimulation of the muscles used in breathing is
inhibited by alcohol, breathing movements stop and the
person may die.
 Alcohol
Breakdown occurs in the liver :
1.Enzyme: Alcohol ( ethanol) dehydrogenase
Alcohol (Ethanol) to ethanal ( acetaldehyde)

2.Enzyme: Aldehyde dehydrogenase

Ethanal ( acetaldehyde) to ethanoate (acetate
enters the Kreb cycle)
Alcohol
 Alcohol
Effects on the Body
Short term effects on the Nervous system :
Acts as a depressant : retard action potentials making individuals less responsive to
thinking , focusing , logical decisions, relax. NB(inhibition at cerebellum affects
movement and coordination )
– Alcohol enhances the effect of the inhibitory neurotransmitter GABA
– Alcohol inhibits stimulatory neurotransmitters glutamate
Can be fatal in large quantities (inhibition of certain centers of the brain may cause
drowsiness and unconsciousness or coma

Long term effects on the nervous system :

-Impaired nervous transmission
-Demyelination neurons of some brain cells
-Dehydration: especially of brain cells results in shrinkage
Alcohol acts as a diuretic. It inhibits the release of ADH causing water loss in urine
which results in dehydration
-Korsakoff’s psychosis
-Wernickle encepholpathy
http://www.alz.org/dementia/wernicke-korsakoff-syndrome-symptoms.asp
 Alcohol
Effects On the Body
Short term effects on the Liver:

Fatty Liver
– NADH is made in each reaction
– This uses up NAD+ required for the oxidation of fatty acids in the liver.
– If NAD+ is not available, fatty acids accumulate and deposit as fats in the liver.
– Liver is swollen
– Reversible if stop drinking

Hepatitis
– Damaged cells die
– Inflammation of liver cells due to alcohol over use leads to hepatitis
– Cells are swollen with fatty tissue
– If severe it may give rise to jaundice (yellowing of eye and skin-inability of liver to excrete bile
pigments)
– Reversible if stop drinking
 Alcohol
Effects on the Body
Long term Effects on the Liver:
Excess storage of fat cause hepatocytes to die
Blood flow into the liver is obstructed. Blood is diverted past
the hepatic portal vein into the hepatic vein to arteries
around the esophagus . This causes internal bleeding ,
vomiting blood.
Replacement of fatty tissue by fibrous tissue called cirrhosis.
The Liver cannot fulfill its function adequately See p.g 665-
666
Not reversible
 Alcohol
Effects on the Body
 Alcohol
Effects on the Body
 Alcohol
Effects on the Body
 Alcohol
Effects on the Body
Blood flow in a normal Liver
Blood flow in a normal Liver
Blood flow in a Cirrhotic Liver
Blood flow in a Normal and Cirrhotic Liver
 Alcohol
Long term effects on the Body
Long term effects on the body
Long term effects include hypertention which in
turn increase the risk of Heart attacks and
Stroke
Increases the risk of Cancer of the oesophagus,
mouth, breast ,bowels
 Alcohol
Effect on the Body
Features of Alcohol dependence:
Daily consumption >10units
Increased tolerance
BAC of 150mg 100cm 3 with no signs of
drunkenness
Compulsion to drink
Alcohol d dominant in the person’s life
 Alcohol
Social Consequences
Drinking and driving: Increase road accidents
– Alcohol increases reaction time and impairs judgment.
– Laws limit drivers blood alcohol levels. Tis is a safe unit for driving.
• Most Caribbean countries the limit is 0.08% i.e 80mg per 100cm 3 blood
• Jamaica’s limit is 0 .35%
• In Barbados and Cuba the limit is 0
Increased Violence
– Aggressive behaviour,
– intra-family violence,
– family breakdown

Increase in Crime petty crime etc.

Breathing & Gaseous Exchange
Breathing & Gaseous Exchange
Breathing & Gaseous Exchange
Breathing & Gaseous Exchange
Respiratory Epithelium
Respiratory Epithelium
 Breathing & Gaseous Exchange
Factors affecting efficiency of gaseous exchange
• Presence of Surfactant: lowers surface tension reducing effort
needed to breathe in and inflate the lungs
• Large surface Area to Volume ratio
• Respiratory Epithelia ( ciliated epithelia with goblet cells)
• Blood air Barrier ( blood alveolar barrier) diffusion is efficient:
– Alveoli : large surface area and elastic fibres ( stretch during breathing)
– Short distance
– Steep diffusion gradient
– Good blood supply
– Surfactant

Pg287 Biological Science

 Smoking
Contents of Tobacco Smoke:

Tar: mixture of substances that may cause cancer (carcinogens)

Nicotine:
-Addictive substance .
-Affects the brain , nervous system and cardiovascular system
-Mimics neurotransmitter acetylcholine(Ach)on some post synaptic receptors
( Nicotine receptors typically at neuromuscular junctions)

-Nicotine causes vasoconstriction in abdominal organs and limbs

-Parasympathetic effects e.g increased gastrointestinal activity , slowing the heart
rate.
- Stimulate dopamine release thus triggering pleasure sensors
 Smoking
Carbon monoxide:
-reduces oxygen carrying capacity of the blood. HB as higher affinity
for CO than O2.
-Forms caroxyhaemoglobin
Some smokers compensate by increase erythropoietin in from the
kidney which stimulates RBC production. However this may have
side effects such as joint pain.

Particles:
Irritants to the respiratory epithelium lining the lungs and airways
e.g hydrogen cyanide, hydrocarbons, nitrous oxides, organic acids,
phenols and oxidising agents.
 Smoking
These substances cause the following effects on your vascular
system:
Narrowing of Blood Vessels: Nicotine causes blood vessels to
constrict, reducing the amount of oxygen-rich blood that can
flow to your tissues. This narrowing increases your risk of high
blood pressure and restricts circulation, especially to your
limbs.

Damage to the Arteries: Smoking damages the lining of your

blood vessels, making them more prone to plaque buildup.
Over time, this can lead to atherosclerosis, where arteries
 Smoking
Increased Risk of Blood Clots: Smoking thickens the blood and makes it stickier, increasing the
chances of clot formation. Blood clots can block blood flow to vital organs, leading to life-
threatening conditions like heart attacks, strokes, and deep vein thrombosis (DVT).Long-Term
Impact of Smoking on Vascular Health

Atherosclerosis (Hardening of the Arteries): As the walls of the arteries become

damaged from smoking, cholesterol and other substances form plaque. This plaque
buildup narrows the arteries, restricting blood flow and increasing the risk of
cardiovascular diseases.

Peripheral Artery Disease (PAD): Smoking is a leading cause of PAD, a condition where
plaque builds up in the arteries that supply blood to your limbs. Symptoms include pain,
numbness, and even ulcers or infections in the legs and feet due to poor circulation.

Hypertension (High Blood Pressure): Smoking can raise your blood pressure because of
the constriction of the blood vessels. Over time, this extra pressure weakens the
arteries and the heart, leading to serious vascular problems.
 Smoking
Smoking causes atherosclerosis through several mechanisms:

• Chemical Damage: The chemicals in tobacco smoke damage the heart and blood
vessels, leading to plaque buildup in the arteries.

• Increased Clotting: Smoking makes blood cells stickier, promoting clot formation
and increasing the risk of coronary artery disease.

• Arterial Hardening: It causes arteries to harden and narrow by raising levels of LDL
cholesterol and oxidative stress, which contributes to fatty plaque buildup.

• Inflammation: Smoking increases inflammation in the body and thickens the blood,
making it more likely to clot and damaging blood vessel linings.

• Narrowing of Arteries: Overall, smoking leads to the narrowing and clogging of

arteries, reducing blood supply and oxygen availability throughout the body.
 Smoking
Smoking also:
• Reduces “good” HDL cholesterol levels
• Fosters plaque buildup in blood vessels
• Elevates triglycerides to unhealthy levels

- These injurious mechanisms make smoking a major

risk factor for every form of CVD, from atherosclerosis
and peripheral vascular disease (PVD) to coronary heart
disease, stroke, and abdominal aortic aneurysm (AAA).
They also make smoking a significant risk factor for DVT.
 Smoking
• Many of the carcinogens and co-carcinogens
present in tobacco smoke are also present in
smoke from marijuana.

• Marijuana smoking does cause inflammation and

cell damage, and it has been associated with pre-
cancerous changes in lung tissue.

• Marijuana has been shown to cause immune

system dysfunction, which could theoretically
 Smoking and Respiration
Cigarette-induced bronchitis is a form of chronic bronchitis, which is one of the
conditions that falls under Chronic Obstructive Pulmonary Disease (COPD). It
occurs when the airways (bronchi) in the lungs become inflamed due to long-term
exposure to the harmful substances in cigarette smoke. Here's a step-by-step
breakdown of how cigarette-induced bronchitis occurs:
1. Inhalation of Cigarette Smoke:
• When a person smokes a cigarette, they inhale smoke that contains harmful
chemicals, including tar, carbon monoxide, and various irritants like nicotine and
formaldehyde.
• These chemicals irritate the lining of the airways and the lungs, triggering an
immune response.
2. Inflammation of the Bronchi:
• The irritation caused by the cigarette smoke leads to inflammation of the bronchi,
which are the large airways that carry air into the lungs.
• The body's immune system recognizes the smoke as a harmful substance and
releases white blood cells to fight the irritants, which causes the tissues in the
bronchi to swell.
 Smoking and Respiration
3. Mucus Production:
• In response to the irritation, the goblet cells in the lining of the bronchi produce
excess mucus as a protective mechanism.
• While mucus helps to trap and remove harmful particles, too much mucus can clog
the airways, making it harder to breathe and leading to chronic coughing.
4. Thickening and Scarring of Bronchial Walls:
• Over time, the chronic inflammation and constant irritation from cigarette smoke
lead to thickening of the walls of the bronchi.
• The lining of the bronchi becomes scarred and less flexible, narrowing the airways
and restricting airflow. This is a key characteristic of chronic bronchitis.
5. Decreased Ability to Clear Mucus:
• Normally, tiny hair-like structures called cilia in the airways help to move mucus
and trapped particles up and out of the lungs. However, cigarette smoke damages
and paralyzes these cilia, impairing the ability to clear mucus from the lungs.
• This further increases the buildup of mucus, making it difficult to breathe and
leading to more frequent coughing and wheezing.
 Smoking and Respiration
6. Chronic Symptoms Develop:
• With continued exposure to cigarette smoke, the inflammation and mucus
production become chronic, resulting in the hallmark symptoms of chronic
bronchitis:
• Persistent cough (especially in the morning)
• Excessive mucus production (phlegm)
• Wheezing and difficulty breathing, especially during physical activity
• Frequent respiratory infections due to impaired lung defense mechanisms
7. Progression to COPD:
• If cigarette smoking continues, chronic bronchitis can progress into more severe
stages of COPD.
• The persistent inflammation and narrowing of the airways lead to increasingly poor
lung function. Over time, it can result in more severe symptoms and an increased risk
of complications, such as lung infections, respiratory failure, or even heart problems.
8. Permanent Damage:
• If the person continues smoking, the damage to the bronchi and lungs becomes
irreversible. The inflammation and scarring of the airways continue to worsen, and
lung function is permanently reduced.
 Smoking and Respiration
Lung Disease
Chronic Obstructive Pulmonary Disease (COPD) e,g
Emphysema , Bronchitis
– Blockage of small airways
– Destruction of alveoli
– Blood is not oxygenated
– Hyperplasia of goblet cells
– More blood is pumped to the lungs (Blood pressure in
pulmonary artery increases)
– Right side of the heart enlarges
 Smoking and Respiration
Chronic Bronchitis: usually induced due to a pathogen
Tar in tobacco smoke:
– stimulate goblet cells to secrete more mucus this
inhibits and destroy the sweeping action of the cilia
– Mucus accumulate in bronchioles obstructing the airways
trapping dirt , bacteria etc causing a “Smokers cough”
– Infections become common leading to inflammation
– Damaged Epithelia are replaced by scar tissue
Bronchitis
 Smoking and Respiration
Emphysema is a type of chronic obstructive pulmonary disease (COPD) that primarily affects
the lungs' ability to exchange oxygen and carbon dioxide. Here’s a step-by-step
explanation of how emphysema occurs:
1. Inhalation of Irritants:
• The primary cause of emphysema is prolonged exposure to irritants, such as cigarette
smoke, air pollution, chemical fumes, or dust. These irritants damage the lungs over
time.
2. Inflammation and Immune Response:
• When the lungs are exposed to harmful particles or gases, the immune system triggers
an inflammatory response to fight the perceived infection or injury.
• This leads to the release of enzymes like proteases, which can begin to break down lung
tissue.
3. Damage to Alveolar Walls:
• The alveoli are tiny air sacs in the lungs where gas exchange (oxygen and carbon dioxide)
happens. Chronic inflammation causes the walls of the alveoli to weaken and break
down.
• As the alveolar walls rupture, the surface area available for gas exchange decreases. This
damages the delicate structure of the lungs.
 Smoking and Respiration
4. Loss of Elasticity:
• Healthy lungs are elastic, meaning they can expand and contract effectively. The breakdown
of alveolar walls and surrounding tissue results in a loss of elasticity, making it harder for
the lungs to expand and contract normally.
• This leads to difficulty breathing, particularly when exhaling.
5. Formation of Larger Air Spaces (Bullae):
• As the alveoli collapse and merge into larger air spaces called bullae, the lungs become less
efficient at oxygenating blood and removing carbon dioxide.
• Bullae are pockets of air that form where the alveolar walls have been destroyed, and these
areas do not participate in gas exchange.
6. Impaired Oxygen and Carbon Dioxide Exchange:
• With fewer healthy alveoli, the lung’s capacity to exchange gases (oxygen and carbon
dioxide) is severely reduced. This leads to shortness of breath and low blood oxygen levels
(hypoxemia).
7. Chronic Symptoms Develop:
• Over time, the damage worsens, and people with emphysema experience increasing
difficulty breathing, a chronic cough, and other symptoms like wheezing and chest
tightness.
• The reduced lung function may lead to more frequent respiratory infections, increased
 Smoking and Respiration
Emphysema (irreversible) - Summary
• Phagocytes e.g neutrophils release the protein digesting enzymes elastase which
destroy the elastin in the connective tissue in the surface of the alveoli.
• Alveoli are not capable of stretch and recoil when breathing in and out
• Bronchioles collapse during exhalation trapping air in the alveoli
• Cells in alveoli release elastase inhibitor to reduce the effects of the phagocytes but
in smokers this is not efficient (The ratio of elastase to inhibitor is greater).
• The air remain in the lungs not refreshed ( dead air )
• Surface area for gaseous exchange is reduced as walls of the alveoli are broken down
• The lungs is filled with large air spaces increasing the diffusion distance between air
and the capillary
• Progressive damage cause lungs to loose elasticity
• Blood is not well oxygenated
• Rapid breathing rate
• Wheezing occurs
Emphysema
Emphysema
 Tobacco Smoking
Lung Cancer
• Tar in cigarette smoke contains several
substances called carcinogens
– Produce mutation which lead to development of
malignant tumors
 The Smoking Epidemic

The effects of smoking on the:

Respiratory system
Circulatory system
Immune system
Musculoskeletal system
Sex organs

http://www.cdc.gov/tobacco/data_statistics/fact_sheets/health_e
ffects/effects_cig_smoking/

https://www.betterhealth.vic.gov.au/health/healthyliving/smoking
-effects-on-your-body