Clinical research

1. Clinical research Cranfield University

2. Drug abuse & Drug dependence Shovan K B ICRI, Cranfield University.

3. Drug !? • Early 14th century, old French word “Drouge”. • May be from old/middle Dutch “Droog”= dry, arid. • association with "poisons" is 1500s. • Application to "narcotics and opiates" is 1883. • NO EXACT DEFINITIONS: • A chemical substance used in the treatment, cure, prevention, or diagnosis of disease or used to otherwise enhance physical or mental well-being.

4. No exact definitions: • Federal law states: a. any substance recognized in the official pharmacopoeia or formulary of the nation. b. any substance intended for use in the diagnosis, cure, mitigation, treatment, or prevention of disease in humans or other animals. c. any article, other than food, intended to affect the structure or any function of the body of humans or other animals. d. any substance intended for use as a component of such a drug, but not a device or a part of a device

5. Simply! • It just a catalyzing agent! • It can take you to heaven. • It can take you to hell.

6. The difference in relation! • Medicine! • Latin- medicina > old French> medicin> medicine. • the healing art, medicine, a physician's shop, a remedy.

7. Difference between drugs and medicines • A drug is a single chemical substance in a medicine that alters the structure or function of some of the body's biological processes. • A medicine is drug (or combination of drugs) that is intended to prevent illness, cure decease and pain relievers. • Not all drugs are medicines, for example Alcohol and nicotine.

8. The problem starts with! • Recreational drug use. • The usage of drug with the intention of creating or enhancing recreational experience. • Usually involves; self medication, performance enhancement and entheogenic. • Other independent types in recreational use are Alcohol and tobacco.

9. Understanding the thin line. • Drugs are escapist and dangerous, unpredictable and sometimes addictive, and have negative and profound effects in not only in individuals but also in society. • The thin line can be balanced by understanding the term called responsibility. • Medical literature says that, responsible drug use only becomes drug abuse when the use of the substance significantly interferes with the user's daily life.

10. Other wise! • Addiction and hence abuse. • Drug addiction is a complex brain disease. • It is characterized by compulsive, at times uncontrollable, drug craving, seeking, and use that persist even in the face of extremely negative consequences. • Drug seeking becomes compulsive, in large part as a result of the effects of prolonged drug use on brain functioning and, thus, on behavior. • For many people, drug addiction becomes chronic, with relapses possible even after long periods of abstinence.

11. Anything can be used a drug of probable abuse. • Mostly abused drugs are: • Psychoactives. • Depressants: • Antihistamines. • Analgesics. • Tranquilizers. • Hallucinogens. • Stimulants. • Inhalants. • Psychedelics.

12. Classification: • CNS depressants. • Alcohol. • Barbiturates. • Non barbiturate sedatives and ant anxiety drugs. • CNS stimulants: • Amphetamines. • Anorectics. • Cocaine.

13. Narcotics. • Heroin. • Morphine. • Codeine. • Psychotomimetics. • LSD, DOM, DMT. • Psilocybins. • Mescaline. • Phencyclidine (PCP)

14. Volatile inhalants: • Acetone. • Benzene. • Trichloromethane, • Toluene, • Paint thinner, • Amyl nitrate, • Petrol.

15. Your assignment! • Find more details of the above classes. and try to find a association with clinical research.

16. Drug dependence: • A state either Psychic and sometimes physical, resulting from the interaction between a living organism and a drug characterized by behavioral and other responses that always include a compulsion to take drug on a continuous or periodic basis to experience its Psychic effects and to avoid discomfort of its absence. • A person may be dependent for more than one drug.

17. In short! • Drug dependence produced by repeated consumption of a natural or synthetic drug is characterized by • An overpowering desire or need (compulsion) for drug intake. • A tendency to increase the dose. • A psychic or physical dependence. • Appearance of a characteristics withdrawal syndrome, on withholding the drug. • And a general detrimental effect on the patient and society.

18. When a potential addict start and continue taking a dependence drug ? • Following its medicinal use throughly. • To achieve sense of relaxation. • As curiosity of drug and its effects. • To escape from reality. • Factors which facilitate initiation of drug abuse. • Ready availability of drugs as in case of doctors and medical students. • Public acceptance of use of mood modifiers such as alcohol. • Group pressure. • An abundance information about drug effect and its sources. • Lack of adequate publicity given to harmful effects of these drugs. • Unstable or broken homes, socio-cultural pressures and social ills.

19. Mechanism of action: • Alteration of cellular metabolism of the CNS is a prime factor in the development of drug dependence. • Other system-tolerant to drug but the CNS is only capable of producing physical dependence. • Drug dependent, once developed, is difficult to treat. • Success=complete co-operation of individual is vital.

20. LSD effect:

21. Neurotransmitters and hormones • Understanding the difference.

22. Serotonin. • Serotonin (5-hydroxytryptamine, 5HT) , a monoamine neurotransmitter. • It plays an important role in many behaviors including sleep, appetite, memory, sexual behavior, neuroendocrine function, and mood. • In the brain, the highest level of serotonin is found in the dorsal and median raphe nuclear complex. • There are also many serotonergic neurons found in the reticular region of the lower brain stem.

23. Serotonin is synthesized from the amino acid precursor tryptophan, packaged into vesicles, and released into the synapse following an action potential. • Once in the synapse, serotonin can interact with both the pre- and postsynaptic receptors. • However, immediately after reacting with the pre- and postsynaptic receptors, it is critically important that serotonin be removed from the synapse.

24. Treatment of Drug Dependence • Hospitalization • Gradual or sudden withdrawal of the drug. • Substitution therapy • Specific drug therapy like disulfiram in alcohol etc. • Correction of nutritional deficiencies • Community treatment and rehabilitation

25. Drug education • The best way to make people understand and lessen curiosity.

26. Nootropics • Nootropics, also commonly referred to as "smart drugs", are drugs that are claimed to improve human cognitive abilities. • Nootropicsare used to improve memory, concentration, thought, mood, learning, and many other things. • Some nootropics are now beginning to be used to treat certain diseases such as attention-deficit hyperactivity disorder, Parkinson's disease, and Alzheimer's disease. They are also commonly used to regain brain function lost during aging.

27. Terminologies: • Drug dependence, • Drug dependence; (psychological and physical dependence), • Habituation, • Tolerance, • Addiction, • Drug misuse, • Drug abuse. • Lifestyle drug

28. If you think you can, you can! ICRI (Mumbai)