Requisites- None, recommended preparation: Eligibility for ENGL 100 and READ 100

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1 HSERV 162- Physiology and Pharmacology (aka, Foundations in Behavioral Pharmacology) Section: Room: HW2214 Date/Time: Monday, 6:10-9:15 p.m. Instructor: Mark Stanford Website: DrNeurosci.com Phone: ext Office: HW2215 Office Hours: Monday 5-6 p.m. Pharmacology is the science of understanding how drugs act on the body and conversely, how the body acts on drugs. This is not to be confused with pharmacy, which deals with the preparation and dispensing of drugs. Drugs can be defined as chemical compounds with a specific therapeutic function, such as aspirin. Pharmacology focuses on how a drug gets into the body, where in the body the drug acts, and how the body gets rid of a drug. Behavioral pharmacology is the scientific study of the effects that drugs have on human behavior. Behavioral pharmacology includes addiction research which tries to understand why people become addicted to drugs like alcohol, methamphetamine or opioids. This course is designed to provide non-medical professionals a working knowledge of licit and illicit psychoactive drugs; pharmacokinetics (how drugs move through the body), pharmacodynamics (the mechanism of action of how drugs act in the body), as well as the most current evidence on the biobehavioral effects of substance use disorders. The course utilizes lectures, video training, group discussion, reading and written essay assignments This course will explore the neurochemical, physical and mental effects of commonly used psychoactive substances on the human biological system. Emphasis is placed on the basic pharmacology of psychoactive drugs, the medical consequences of compulsive illicit use, and therapeutic approaches for managing substance use disorders. This course will also review the four major classes of drugs that are of clinical significance in treating four major categories of psychiatric disorders: anxiety, depression, bi-polar illness, and schizophrenia. Requisites- None, recommended preparation: Eligibility for ENGL 100 and READ 100 Core Cabrillo Competencies: Communication Critical Thinking and Information Competency Global Awareness Personal Responsibility and Professional Development Learning Outcomes 1. Analyze the physiological and pharmacological (bio/psycho/social) impacts of alcohol and other drug use, abuse, addiction, and recovery.. 2. Investigate medical concepts, terminologies, and technologies used in the field of 1

2 Alcohol and Drug abuse treatment. 3. Evaluate the physiological symptoms of alcohol and other drug use, abuse, addiction, withdrawal, relapse, and recovery. Content 1. Fundamental Organization of the Human biological systems with an emphasis on the nervous system 2. Study of brain anatomy and function the neuron, synaptic transmission and neurotransmitters 3. Basic pharmacokinetics and pharmacodynamics. A drug s mechanism of action 4. Sedative hypnotics: Drugs that depress brain function 5. Stimulants: Drugs that stimulate brain function: 6. Opioid and nonopioid analgesics: Drugs that relieve pain 7. Psychedelics: Drugs that possess hallucinogenic properties 8. Cannabinoids: Drugs that affect the human endocannabinoid system 9. Drugs used to treat substance use disorders 10. Drug used to treat mental health disorders Evaluation- Requirements for passing the course include: 1. Attendance and classroom discussion participation (10 points per class; total of 140 points possible)- You are expected to attend all regularly scheduled class meetings and participate in classroom discussions and activities. Absences or failure to participate in class will greatly reduce your ability to pass this course. Students leaving class before class is dismissed must have instructor permission or 50% attendance credit for that class will be deducted. See the instructor if you have more than 2 absences. 2. Complete 4 in-class assignments (25 points each; total of 100 points)--these will be handed out by the instructor in class sessions (some will be completed in class, others may be completed at home). 3. Participate in a "Research and Present" Panel Discussion (60 points)--students will form into groups of 3-4 individuals: each group will choose a drug to research from a list presented by the instructor. The group is to write up a brief research findings paper (directions given by instructor) and present their findings as an oral panel to the class. by the instructor at intervals during the course.. 4. Exams (200 points): There will be a total of 4 Exams, (25 points each; total of 100 points) and a Final Comprehensive Exam (100 points Total). These exams are made up of multiple choice and true/false questions constructed from the reading and classroom discussion materials. Grading- Letter Grade or CR/NC. You can take this course for credit or on a pass/fail basis whereby upon successful completion of the course you will receive the appropriate number of credits with no grade attached. Grading will be as follows: Total of 500 points possible % - A (450+ points) 80-89% - B ( points) 70-79% - C ( points) 2

3 60-69% - D ( points) 0-59% - F (299 or less) Required Reading Text- Stanford, Mark, Ph.D., Foundations in Behavioral Pharmacology, 3rd Ed., Lightway Centre Publishers, Santa Cruz, CA., NOTE: Books sold in class or you can order through Amazon. Books are not available in the bookstore. Additional Reading Various publications provided by the instructor in-class. Incudes articles from professional journals, literature reviews and national health agencies (i.e. SAMHSA; NIDA; NIMH; Institute of Medicine; National Quality Forum, etc.) Accommodations/Additional Assistance Students needing accommodations should contact the instructor ASAP. As required by the Americans with Disabilities Act (ADA), accommodations are provided to ensure equal opportunity for students with verified disabilities. If you need assistance with an accommodation, please contact the Accessibility Support Center (formerly Disabled Student Services) in room 1073, , or Learning Skills Program, room 1073, above the library. Your success in this class and in this program is important to me and to the college. Pass/No Pass Option With the instructor s approval, students may opt for a P/NP by the end of the fifth week of class per Title V Should you decide to take the class CR/NC you will not be issued a letter grade for your overall class performance. Your final grade will be a P if your work is satisfactory or a NP is your work is unsatisfactory. It is the student s responsibility to drop this class in Web-Advisor if you choose not to stay in this class. Regarding classroom management, for student behavior expectations and progressive consequences go to the following link and if there any questions regarding classroom management please contact Michelle Donahue Ext. 6525: Week-By-Week Class Topics and Assignments Week 1: 1/26 Introduction to Course: Syllabus and Text Review What research science says about substance abuse. American Society of Addiction Medicine. Research-based Best Practice Standards in Treatment. Evidence Based Practices (EBP). Reading assignment for next week s class: Section 1, Introduction and Chapter 1 3

4 Week 2: 2/2 Behavioral Pharmacology: Basic Principles Drug administration, absorption, distribution, metabolism and excretion. Hepatic mechanisms in drug metabolism: The Function of the liver. Dose-response relationships. Drug classification by shared mechanism of action. Tolerance, withdrawal syndromes, and environmental triggers (cued reactivity). Reading assignment for next week s class: Chapters 2 and 3 Week 3: 2/9 An Overview of the Functional Nervous System The Central Nervous System (CNS). Brain-Behavior relationships. Gross anatomical features of the brain. The Peripheral Nervous System (PNS) and substructures. Autonomic processes. Central and peripheral actions of drugs. Brain mapping exercise. Reading assignment for next week s class: Chapter 4 and the Section II Introduction Week 4: 2/16: HOLIDAY - NO CLASS Week 5: 2/23 Neurophysiology Neurophysiology and the dynamic process of neurotransmission. Critical synaptic defenses and neural stabilizing mechanisms. Neurotransmitters: Types, function, amino precursors, pathology, and drugs related to transmitter substances. Receptor subtypes and relative functions. Week 6: 3/2 Neurophysiology (con t) Week 7: 3/9 Pharmacology of Alcohol and Sedative Hypnotic Drugs A discussion of the mechanism of action for alcohol and CNS depressants. Overview of the pharmacology of alcohol. Biogenetic markers. Ethnic and gender differences in metabolism. Withdrawal syndromes and medical detox protocols. Cooccurring medical conditions in chronic alcoholism. Review of the pharmacotherapy for alcohol use disorders: naltrexone, acamprosate, disulfiram, topiramate, neurontin. Review assessment protocol for determining severity of alcohol withdrawal. Reading assignment for next week s class: Chapter 7 Week 7: 3/10 Pharmacology of Stimulant Drugs A discussion of the mechanism of action for psychostimulants. 4

5 Overview of stimulant drugs: medical use and illicit abuse. Methamphetamine and cocaine: pharmacological aspects. Other stimulants including MDMA, methylphenidate, and over-the-counter (OTC s) including ephedrine and pseudoephedrine. Behavioral toxicity and drug induced organic syndromes Withdrawal syndromes and special treatment considerations. Review of the pharmacotherapy research for stimulant use disorders. Reading assignment for next week s class: Chapter 8 and read Drug Use and Infectious Diseases and also HIV/AIDS in the Appendix section. Week 8: 3/16 Pharmacology of narcotics and non-narcotic analgesics A discussion of the mechanism of action for opioids. Overview of opioid pharmacology including synthetic opioid derivatives. Narcotic withdrawal syndrome and clinical interventions. IV drug use and related medical concerns including HIV, AIDS, and hepatitis and their pharmacotherapy treatments. Review of the pharmacotherapy for opioid use disorders: methadone, buprenorphine, and naltrexone. Review assessment protocol for determining severity of narcotic withdrawal. Reading assignment for next week s class: Chapter 9 and read the Principles of Drug Addiction Treatment: A Research-Based Guide in the Appendix section. Week 9: 3/23 Pharmacology of Cannabinoids A discussion of the mechanism of action for cannabinoids. Overview of the cannabinoids: pharmacologic and biobehavioral issues. Treatment considerations for cannabis abuse disorder. The human endocannabinoid system, ligands and receptor subtypes: Review the pharmacotherapy for cannabis use disorders including neurontin, Reading assignment for next week s class: Chapters 14 and 15 Week 10: 3/30 SPRING BREAK Week 11: 4/6 Pharmacology of Medicines for Mental Health A discussion of the mechanism of action for antidepressant, antipsychotic and anti-mania medications. The evolution of antipsychotic medications. New generation antipsychotics including aripirazole (Abilify) and paliperidone (Invega). The evolution of antidepressant medications. New generation antidepressants including duloxetine (Cymbalta) and selegeline (Emsam). Overview of anti-mania drugs - how and why they work in the treatment of Bipolar Disorder. Predictable medication side effects - risk/benefit analysis. Treatment considerations in co-occurring disorders. Review the pharmacotherapy for mental health including antidepressants., anti-psychotics, antianxiety and mood stabilizer drugs. 5

6 Reading assignment for next week s class: Overview of prescription drugs abuse and selected articles to be determined Week 12: 4/13 Pharmacology of Medicines for Mental Health (con t) Week 13: 4/20 Prescription Drug Abuse: Community Responses and Health System Revisions In recent years, there has been a dramatic increase in prescription drug misuse or abuse. This increase has led to a corresponding increase in ER visits because of accidental overdoses as well as admissions to drug treatment programs for drug addictions. Review the 3 major classes of prescription drugs that are often abused, according to the National Institute on Drug Abuse. These include: Opioids; depressants, such as benzodiazepines (Xanax, Valium, Ativan, Klonopin), used to treat anxiety and sleep disorders and; stimulants, such as Adderall or Ritalin, used to treat attention deficit disorder and narcolepsy. Review opioid overdose prevention protocols using naloxone. Week 14: 4/27 Methods of Drug Testing Urine, blood, hair, saliva, sweat, and nails (toenails and fingernails) are some biological specimens used to perform laboratory drug testing, and they provide different levels of specificity, sensitivity, and accuracy. Urine is most often the preferred test substance because of ease of collection. Concentrations of drugs and metabolites also tend to be high in the urine, allowing longer detection times than concentrations in the serum allow. Review the principle methods of drug testing and discuss the strengths and weaknesses of each technique including false negative and false positive results. Week 15: 5/4 Summary Review Review the acute and post-acute symptoms of the major drugs of abuse as well as withdrawal syndromes and withdrawal management approaches. A review of behavioral health medicines currently in use to manage drug craving and withdrawal as well as those used in the treatment of mental health disorders. Review evidence-based screening instruments, assessment tools and the principles of developing effective care plans for persons with behavioral health conditions. Week 16: 5/11- Panel Presentations of Research Papers. Must get prior topic approval from instructor. Week 17: 5/18 - Scheduled Final Exam About the Instructor Mark Stanford, Ph.D has been in the behavioral health treatment profession since 1976 and has direct clinical experience within the modalities of inpatient, day treatment, outpatient and medication-assisted treatment programs. He is the past Director of Addiction Medicine and Therapy services for a large County 6

7 Health & Hospital System in California. Currently, he is the Senior Director of Quality Improvement and Integrated Behavioral Health Services at a large community-based organization in Santa Cruz. Dr. Stanford has been a Clinical Associate Professor (affiliated) at Stanford University School of Medicine in Psychiatry, Behavioral and Addiction Medicine. He has taught Integrated Behavioral Pharmacology of Substance Use and Mental Health Disorders for over 25 years through the UC Berkeley Extension program, and San Jose State University School of Social Work. Dr. Stanford is the author of over 30 articles and 3 books including the text, Behavioral Pharmacology of Substance Use and Mental Health Disorders, used by colleges and universities around the nation. He is also the Chief Editor and contributor of the Integrated Behavioral Health Grand Rounds newsletter with a readership of over 50,000 people. His website is 7