substance related disorders. substance use disorders problems associated with using and abusing...

Substance Related Disorders

Substance Use Disorders Problems associated with

using and abusing drugs or substances which alter the way people think, feel, and behave.

Substance dependence Maladaptive pattern of substance use that leads to

clinically significant impairment or distress Substance abuse

Recurrent and significant adverse consequences related to substance use

Abnormal Psychology, 11/e by Sarason & Sarason © 2005

Substance Dependence Tolerance Withdrawal Ingestion of more than intended Persistent desire or unsuccessful effort to use less Spending a lot of time on obtaining, using, or

recovering from the substance Reduced social, occupational, or recreational

activities due to use of substance Continued use despite knowledge of the

psychological and/or physical problems caused Presence of 3 or more of the above in a 12-month

period


Substance Abuse Recurrent substance use leading to failure to

fulfill work, school, home obligations Recurrent substance use in hazardous

situations, like driving Recurrent substance-related legal problems, like

arrests Continued substance use despite persistent

social or interpersonal problems caused by using the substance, such as getting in fights

The presence of three or more of the above within a 12-month period


Substance Intoxication

Disturbances of perception wakefulness attention thinking judgment motor behavior interpersonal behavior


Substance Intoxication Level of intoxication depends on

the substance the dose history of use person’s tolerance (related to body size,

gender, history of use) person’s expectation of use environment or setting in which substance is

ingested


The effects of alcohol Ethyl alcohol (a CNS depressant), or ethanol, is the

alcohol in beer, wine, hard liquor Alcohol blocks messages between nerve cells First affects frontal lobes where reasoning, memory,

judgment, and inhibitions take place Next affects cerebellum, seat of motor and muscle

control, balance, five senses Finally affects the spinal cord and medulla, which

governs breathing, heart rate, and body temperature Blood alcohol content of 0.5% or more can lead to

death


Alcohol use and risks

70% of Americans drink occasionally 21- to 34-year olds drink the most Half of all alcohol is consumed in binge sprees (5 or

more drinks at a time) Alcohol use in US implicated in

40% of traffic fatalities 50% of deaths from falls 52% of fire-related deaths 38% of drowning deaths 20% of health-related expenditures


Models of Alcohol Disorders Biological

Metabolic, genetic, and neural processes Psychodynamic

Effort to change negative emotional states Behavioral

Learned from modeling and social reinforcement Cognitive

Expectations about effects of alcohol Interactional

Stress precipitates use in people with predisposition to use


Treatment of Alcohol Disorders Biological

Drug Management of withdrawal symptoms

Psychodynamic Psychotherapy provides little benefit unless family

contexts of drinking explored Cognitive-behavioral

Aversive conditioning Covert sensitization Controlled drinking Relapse prevention

Community-based treatment Alcoholics Anonymous most widely used


Relapse in Drug Treatment


Alcohol-related Disorders: Risk Factors Poverty Neighborhood disorganization Childhood behavior problems Poor family management practices Family conflict Lack of family cohesion Academic failure Social pressure to use Alienation and rebelliousness Rejection by peers


Barbiturates and Tranquilizers

Depressing effect on central nervous system Dangerous in combination with alcohol Barbiturates often prescribed to relieve

anxiety and prevent convulsions Tranquilizers can lead to tolerance and thus

overuse


Opioids Drugs from the opium class; with morphine-like effect

that bind to brain’s opioid receptors Sometimes called narcotics Heroin and morphine most commonly used Endorphins, enkephalins, and polymorphins are

body’s endogenous opioids Cause change in mood, sleepiness, mental clouding,

constipation, slow respiratory system Withdrawal can be severe Methadone maintenance is most widely used

treatment


Cocaine Produced from leaves of coca plant Stimulates CNS and decreases appetite Can produce mania, paranoia, and impaired

judgment Crack is more potent distilled form and is

highly addictive Treatment focuses on self-help and social

support (AA-type programs)


Amphetamines Psychomotor stimulants

Affect central nervous system and cardiovascular system

Moderate use Wakefulness, alertness, elevated mood

High dosage Nervousness, dizziness, confusion, elevated blood

pressure Tolerance develops rapidly Methamphetamines

Chemically similar but has greater CNS impact


Hallucinogens

Also known as psychedelics CNS action produces alterations in

consciousness Natural hallucinogens (e.g., Mescaline,

Psilocybin) Synthetic hallucinogens (e.g., STP, LSD) Abuse leads to respiratory or cardiovascular

collapse and psychotic behavior Treatment consists of support groups of

enhancing social skillsAbnormal Psychology, 11/e

by Sarason & Sarason © 2005

Phencyclidine (PCP)

Synthetic chemical Causes disorientation and hallucination User may feel dissociated Users may develop severe depression or

psychosis Effects may be irreversible


Inhalents

Volatile substances or organic solvents (gasoline, spray paint)

Produce changes in perception Use may lead to withdrawal from social,

occupational, or recreational activities More commonly used by young people Use can lead to dependence with tolerance

and withdrawal symptoms


Cannabis Sativa (Marijuana/ Hashish) Most often used in marijuana form Hashish is the solidified resin of the cannabis

plant Major active ingredient in cannabis is THC Marijuana use

Impairs motor coordination and perception Affects short-term memory and learning

Treatment Relapse prevention Social support groups Legalized in some countries (e.g Holland)


Nicotine CNS stimulant found in tobacco Stimulates acetylcholine receptors Increases heart rate and blood pressure Can be highly addictive Cessation requires

commitment to change implementation of change relapse prevention

Nicotine gum and patch may be helpful if used with counseling.

Note that the negative effects are not limited to nicotine addiction, but other effects of smoking


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