Addiction: Biology, Psychology, and Society

An Emerging Model

Dr. Shree Dhawale, Associate Professor, Biology, Honors Program Director; Dr. Jeannie DiClimenti, Assistant Professor, Psychology; Dr. Ahmed Mustafa,Assistant Professor, Biology, Indiana University Purdue University Fort Wayne (IPFW), Fort Wayne, IN 46805

Abstract

Addiction to alcohol and other drugs is a social, economic, and health problem that affects people in every age group and income bracket. This course teaches principles of biology and chemistry through four of the most commonly used addictive substances: alcohol, nicotine, marijuana, and psychostimulants (such as cocaine and methamphetamine). The basic science covered includes the biology of the brain and nervous systems, metabolism, genes, toxicity, the chemistry of enzymes and alcohols, and the biochemistry behind intoxication, tolerance, and addiction.

While learning the science behind addiction students explore the social, political, economic, and psychological problems that are associated with specific forms of addiction. Questions addressed include the moral vs. the medical understanding of addiction and their impact on public policy, the ethics of using genetic or neurological screening for pre-dispositions to addiction, the relationship between alcohol abuse and other social ills, such as domestic violence, high-risk behavior, fetal alcohol syndrome and suicide, the validity of medical marijuana use, and the legitimacy of using nicotine as a memory enhancer.

In addition to mid-term and final exams, students integrate their learning by working in pairs to produce a literature review on a topic of their own choosing. They must use peer-reviewed articles in three disciplines-biology, psychology, and nutritional chemistry, for this project. All students present their work orally to the class at the end of the semester. Additionally, 10% of the course grade derives from a service learning component where students use their research to develop educational programming for the campus community.

Learning Goals

Addiction to alcohol and other drugs is a serious global problem that has major impact on Society. In American society, the socioeconomic impact is huge, and despite the availability of many social services, addiction is increasing at alarming rates. The problem is not limited to any age group or ethnic background. Using addiction to four compounds that have different modes of action and are among the most commonly abused substances, the course will provide introduction to understanding the biological, psychological, and psychosocial functioning of the human system. We will present conceptual understanding of the mechanisms of action upon body and mind and how addiction affects individuals, communities and society. We will not only use evidence-based principles, we will also teach how such knowledge is acquired, focusing on scientific methodology and critical thinking. Collaborative learning and service learning will also be utilized.

Course Objectives:

  1. Teach scientific methods to non-science majors
  2. Increase science literacy and critical thinking
  3. Improve science related attitudes in non-science majors
  4. Teach the application of scientific knowledge to social problems
  5. Increase student involvement in civic engagement
  6. Increase students’ ability to engage in increasingly complex tasks during the course

Course Goals:

  1. To learn basic biological and biochemical processes in the context of human body
  2. To explain the basics of, learning theory, sensation and perception, neurological and neuropsychological functioning
  3. To describe and explain the structures and functions of the brain, involvement of genes, the effect of nutrition and the role of environment in the development of addiction
  4. To explain the scientific method as applied in each of the sciences
  5. To apply knowledge of psychological and biological processes to social problems.
  6. To connect knowledge and skills with civic engagement

Linking Science and Social Issues

Science topics covered and their link to civic or policy issues

Civic, socioeconomic, legal and policy issues that are associated with addiction are many and the course attempts to integrate various issues that were relevant to the science topic being covered. The following table shows the breadth of coverage of civic and policy issues. The idea is to expose students to various aspects of impact of addiction instead of limiting the coverage to a single narrow theme. The attempt is to bring attention to controversies associated with substance use and abuse. Both sides of a given issue were brought to the attention of students and the students were allowed to form informed opinions and discuss the issue in class. If they took a position, they were expected to be able to defend it based on the science and scholarly work.

Science Topic Civic or Policy Issues
An overview of human organ systems and life processes including homeostasis; integration and control of human body (nervous system); biological basis of addiction, dependence and tolerance, drugs and alteration of communication Should addiction be considered a disability?
Is addiction a brain disease or is it a mere lack of self control?
Alcohol absorption, distribution and elimination
Alcohol, central nervous system and health
How successful are current treatment programs?
Discussion of moral vs. medical models of addiction and their impact on policies
Cognitive theories of alcohol use and abuse
Psychological basis of tolerance and dependence
Effects of alcohol on behavior: cognition and mood
Relationship between alcohol addiction and other social problems such as domestic violence, crime, child abuse and neglect, fetal alcohol syndrome and suicide
Antioxidants, their role in human health and metabolism, and antioxidants in alcoholic beverages Is alcohol good for your health?
Basic concepts in genetics: gene, gene expression, pedigree analysis
Is there a genetic basis for alcohol addiction?
Are there pleasure seeking genes?
Should genetic screening for addiction be used to prevent socioeconomic costs of alcohol addiction?
Interaction of genes and environment: twin and adoption studies Privacy and insurance issue related to genetic and neurological tests for addiction. Should having susceptibility genes be considered by insurance industry?
Smoking and health Is it wrong to use nicotine as a memory enhancement tool?
Nicotine and behavior & mood
Smoking cessation and the reinforcing effects of nicotine use
Is the money spent on cessation programs a waste?
Biochemical basis of nicotine addiction
Effects of second hand smoke
Smokers’ rights vs. non-smokers’ rights
Should it be legal to discriminate against addicts?
Central nervous system and marijuana
Marijuana metabolism
Should medicinal use of marijuana be legalized?
Medico-legal issues of addiction
Behavioral and neuropsychological effects of marijuana, intoxication, tolerance, and dependence A motivational syndrome reduces productivity of persons in the workforce and in school, creating burdens on society
Psychostimulants and augmentation of neurotransmitters Rights and responsibilities of health professionals dealing with addiction
Psychosis, violence, and aggression Domestic violence, crime and mental disorders

The Course

Course Syllabus (Acrobat (PDF) 199kB Jul15 08)

Course Syllabus

Download (PDF, 199KB)

 

Course Design

This interdisciplinary team-taught course focuses on using the processes of addiction to alcohol, marijuana, nicotine, and psychomotor stimulants to teach the basics of biological and psychological science. Example topic areas include neurological/brain function, impact on cognitive function, biochemistry, genetics, emotion and motivation, learning and memory, physiology and pharmacology, and the psychosocial aspects of addictions. The course also integrates relevant current issues with basic science and encourages students to actively participate and critically analyze various aspects of those issues.

Course Management and Strategies

Our approach to teaching this course is to start with simple and basic introduction to human organ systems, life processes and homeostasis. This is followed by the details on various systems and integration of physiology using alcohol as a model compound. For example, through alcohol absorption and elimination circulatory and excretory systems are introduced. Similar approach is used to give fundamentals of other organ systems, psychology, genetics and biochemistry. The idea is to teach science through addiction and not merely discuss the problems and treatment. The emphasis is not on memorizing large number of facts about various drugs and addictive compounds but to use compounds that have different modes of action to teach human physiology, psychology, biochemistry and genetics.

The first module on alcohol covers fundamentals that are applicable to all other modules that follow. The knowledge gained in the first module helps understand the variations and builds on what was previously learned in the course. For example, after having learned basics of human physiology in the alcohol module the nicotine module starts with the history of tobacco use and addictive components and then covers absorption, metabolism, and excretion, mechanisms of action, craving patterns (and blood levels), acute effects, withdrawal effects, fetal effects, genetic component, and psychology. Since the students are familiar with all systems such as nervous, circulatory and excretory systems, and have learned fundamentals of psychology, genetics and biochemistry, the module progresses with ease and requires less time. A similar pattern is used for remaining modules.

Fundamentals of human biology and physiology are taught by Ahmed Mustafa, psychology is covered by J. DiClementi and genetics and biochemistry are presented by Shree Dhawale. On the first day of the course and at the end of each module all instructors are in class to help review and integrate the material.

In addition to lectures, students were assigned reading related to associated issues mentioned in the table in showing science topics covered and their link to civic or policy issues (section 1). Discussing relevant issues was a part of majority of lectures and students were given associated readings. Examples of lectures and associated readings can be found in appendices. During collaborative learning exercises, students discuss issues and learn in groups.

During last weeks of classes the students give oral presentation on the topic of their choice (topics are approved by instructors to make sure that they are appropriate for the course and do not merely repeat what was learned in class). This assignment requires students to apply their knowledge and show the ability to integrate biology, psychology and issues. They are required to demonstrate the ability to understand, synthesize and present the material in an organized manner to their peers. All instructors attend student presentation and evaluate each student. Evaluation rubric is attached in the appendix.

Pedagogical Methodologies

Why is this course an emerging SENCER model?

As defined by Ehrlich, T. (2000) in Civic responsibility and higher education Oryx Press, Indiana University, “Civic engagement means working to make a difference in the civic life of our communities and developing the combination of knowledge, skills, values and motivation to make the difference.” The Addictions: Biology, Psychology and Society course integrates all these elements of civic engagement with evidence-based principles, critical thinking and scientific methodology and knowledge.

Addiction to alcohol and other drugs is a serious global problem that has major impact on society. In American society, the socioeconomic impact is huge, and despite the availability of many social services, addiction is increasing at alarming rates. The problem is not limited to any age group or ethnic background and the civic, social, medical, legal, economic and policy issues that are associated with addiction are numerous. The course covers a wide variety of civic issues and maintains the breadth because addiction is a multifaceted complex problem that needs to be understood along with its scientific basis.

For the non-science major, taking science courses is often a daunting, if not downright distasteful requirement of most undergraduate liberal arts and sciences programs. At times, students who have not had much exposure to the basic sciences fail to see the relevance of science in their lives, or recognize the important role of scientific evidence. Making the sciences relevant to ‘real life’ often can help motivate the non-science majors to become an active participant in the learning process in the science classes. By incorporating relevant issues with science the course engages students in active learning. Since addiction is a problem that affects nearly everyone in direct or indirect way we chose this topic as a means of teaching biology and psychology to non-science majors.

Using addiction to four compounds (alcohol, marijuana, nicotine and psycostimulants) that have different modes of action and are among the most commonly abused substances, the course provides an understanding of the biological, psychological, and psychosocial functioning of the human system. The course presents conceptual understanding of the mechanisms of action of selected drugs upon the body and mind and how addiction affects individuals, communities and society. It incorporates current, controversial, legal, medical and policy issues related to alcohol and drug abuse. The purpose of discussing issues is to make students aware that the problem of addiction is pervasive, issues are complex, and there are no simple solutions or answers.

In addition, there is a service learning component to this course and students are expected to disseminate information on campus, in local high school and some clinical facilities. There are many health and treatment-based facilities in America but those facilities do not provide the scientific information that might help the addicted persons and their loved ones in understanding the basis of their addiction. The service learning component of the course places higher emphasis in learning that comes with attempting to educate others. Students are expected to have thorough understanding of the topic that they chose for dissemination. Thus, the course has a potential of helping students learn while having a far reaching impact on the local community.

Service Learning

This course has a service learning component designed to connect your classroom learning to social issues of concern in the community. We will discuss several options for the service learning projects in class the beginning of the semester; the primary focus will be on developing educational programming for the campus community. Due dates and specific requirements will be provided on a separate handout.

Group Exercises

Periodically throughout the semester, there will be in-class small group exercises. Participation in these will earn points toward your final grade. You must be present for the entire exercise to receive credit; do not come in late and expect to get credit.

Evaluating Learning

Student Assessment

In addition to the non-traditional assignments mentioned in the Pegagogical Methodologies section, the following, traditional assessment strategies were used to evaluate student understanding of course material:

Exams:

There will be exams over each module. They will consist of 50 multiple choice questions each and non-cumulative. You are expected to be present for the exams. In the event of a documented emergency and you notify one of us within 24 hours of the exam, you may take a makeup exam within one week of the original date.

Written/oral Assignments:

All students are required to give an oral presentation based on their own literature review. This assignment will be an integration of literature from the three disciplines-biology, psychology, and nutritional chemistry-in keeping with our interdisciplinary approach. Students will have their topics approved by the instructors, and will work in collaborative pairs to produce the assignment. We, your instructors, will serve as your advisory panel as you develop your topic and search the literature for evidence-based publications. Be sure to use us and to come to us when you are struggling with any part of this assignment.

Evaluation and Assessment:

In 2006 we are planning to use widely accepted instruments such as TOSRA (Test of Science Related Attitudes) to assess goal #3 (improving science related attitudes). SALG (Student Assessment of Learning Gains) will be used to assess increase of student involvement in civic engagement, interest in science and scientific literacy. Pre and post testing will be used to determine the increase or improvement. Student presentations and exams will be used to assess if student learning goals have been met. In addition standard IPFW student evaluations will be used to get feedback on the course and instructors.

Course Assessment

The course was fairly well received and we intend to keep much of its format. Given the fact that we have taught the course only once, we intend to keep working on improving it by attempting better integrations of topics and a refinement of the course goals. To improve our service learning component Ahmed Mustafa has become a University Trainer in the program called “Training for Intervention ProcedureS(TIPS). He will be giving a two-hour training to all students enrolled in class. We also intend to produce a textbook type version of our lectures and continue to update discussion topics. An internet version of the course is also under development. Assessment efforts will reveal strengths and weakness that need to be addressed and we will make changes as needed.

Background and Context

Dr. Shree Dhawale
Associate Professor, Biology, Honors Program Director
Telephone: (260) 481-5735
dhawale@ipfw.edu

Dr. Jeannie DiClimenti
Assistant Professor, Psychology
Telephone: (260) 481-6397
diclemej@ipfw.edu

Dr. Ahmed Mustafa
Assistant Professor, Biology
Telephone: (260) 481-6328
mustafaa@ipfw.edu

Indiana University Purdue University Fort Wayne (IPFW)
2101 Coliseum Blvd. East
Fort Wayne, IN 46805

Who created the course?

This course is a product of collaboration between two faculty members from the department of biology (Shree Dhawale and Ahmed Mustafa) and a faculty member from the psychology department (Jeannie Diclementi). S. W. Dhawale and Elliott Blumenthal also participated in the initial summer institute and continue to be involved as guest faculty.

Shree Dhawale is a molecular geneticist who has taught genetics and cell biology for biology majors, graduate level molecular genetics, cancer biology and biotechnology, medical genetics, microbiology for allied health and a course entitled “Biotechnology and Society” for Liberal studies Master’s program. She has also taught honors courses for the university wide Honors Program and is the current director of that program. She has over 16 years of teaching experience and has been awarded a membership in Indiana University Faculty Colloquium on Excellence in Teaching. This award is in recognition of distinguished teaching. In 2004 she was also recognized as the Science Teacher of the Year by the Fort Wayne Chapter of Sigma Xi Scientific Research Society. Her research has been in the area of gene regulation, biodegradation and effect of natural compounds on cancer cells. Her research has been funded by NIH and other internal and external grants. She teaches genetics, metabolism and biochemistry portions of the course.

Jeannie D. DiClementi has 18 years’ experience teaching psychology to undergraduate psychology majors and non-science majors formerly at the University of Colorado at Denver where she also developed and taught new courses for the psychology department, and currently at IPFW. She has held faculty appointments at two teaching hospitals and a school of medicine, she was the Project Coordinator for a NIH/NIMH funded Cooperative Research Center at the National Jewish Medical and Research Center for three years. She was certified as a senior-level addictions educator by the State of Colorado for ten years. All of her research has been as part of multidisciplinary research teams and combined biomedical with psychological research. She is a regional trainer for the American Psychological Association’s HIV Office of Psychology Education and regularly conducts educational seminars on addiction and HIV infection. She is a member of the Purdue University Institutional Review Board Human Subjects Committee. She teaches psychological component and is the major coordinator for service learning activities.

Ahmed Mustafa has 4 years of teaching experience at IPFW, and is the primary instructor of pharmacology for nursing students and physiology for biology students. Beside his Ph.D., he has a Diploma in University Teaching. He has demonstrated high success in stimulating student interest in physiology and pharmacology and developed a WebCT pharmacology course with the support of a Distant Learning Development Grant. His program of research is in the area of stress physiology. He is investigating the physiological, endocrinological, and immunological changes that occur in stressed animals, and identifying the problems of pathogens and environments, which are responsible for causing stress in animals. He teaches physiology/ pharmacology component of the course.

Where is the course taught? What is the role of the course in undergraduate curriculum?

Indiana University Purdue University (IPFW) is the largest public institution in northeast Indiana. Student population is quite diverse and the university has close ties to the local community and industry. The undergraduate degrees are offered in a liberal arts tradition and there are science course requirements for all non-science majors. Since the Addictions: Biology, Psychology and Society course has been approved as a general education course in the area of “Inquiry and Analysis”, students from various disciplines take the course. Biology and psychology majors are encouraged to take this class because the knowledge acquired in this course is relevant in today’s society and is presented with an interdisciplinary perspective.

Internal or external funding

The proposal entitled “Development of an interdisciplinary course on drug addiction that will serve as a SENCER model” was funded by SENCER ( NSF subgrantee through Association of American Colleges and Universities). The total amount including institutional matching funds was $17,850. PI Shree Dhawale, Co-PIs Elliott Blumenthal, Jeannie Diclementi and Ahmed Mustafa. We have also received $11,000 grant to develop an internet version of this course.