Download Substance Disorders

Ethnicity and Alcohol Use and abuse
Jewish Americans
Asian Americans
Hispanic American men
White American men
Hispanic American women
White American women
African Americans
Native American Indians
Acculturation
Racial/Ethnic Differences in Substance Dependence
NCS studies:
African Americans compared to White Americans
Hispanic Americans compared to White Americans
African American adolescents compared to White Adolescents
Information is for overall drug use
Pathways to Drug Dependence
Experimentation
Routine use
Addiction or dependence
Lifetime prevalence of drug dependence by type of drug
Outline
Know the descriptions of substance abuse, dependence, withdrawal, & intoxication
Be familiar with each substance in Depressants, stimulants, & hallucinogens
For each substance be able to describe: effect of drug, withdrawal symptoms,
dependency potential, risks, & societal impact
Be familiar with the theories & treatments for substance disorders
Classification of Substance-Related Disorders
Substance Use Disorders: maladaptive use of psychoactive substances
Substance abuse
Substance dependence
Substance-Induced Disorders: disorders that can be induced by using psychoactive
substances
Intoxication
Withdrawal syndromes
Mood disorders
Delirium
Dementia
Amnesia
Psychotic disorders
Anxiety disorders
Sexual dysfunction
Substance Abuse
A maladaptive pattern of substance use leads to impairment or distress, shown by one
or more of the following:
1) results in a failure to fulfill major role obligations
2) Use in which it is physically hazardous
3) recurrent substance-related legal problems
4) continued substance use despite persistent or recurrent social or interpersonal
problems
Substance Dependence
A maladaptive pattern of substance use, leading to clinically significant impairment or
distress, as manifested by 3 or more of the following:
1) tolerance
2) withdrawal
3) the substance is taken in larger amounts or over a longer period than intended
4) unsuccessful attempts to quit
(Con)
5) spend much time obtaining, using, or recovering
6) important social, occupational, or recreational activities are given up or reduced
7) use continues in spite of knowledge that use causes problems
NOTE: compulsive use & physiological dependence  not always together
Substance Intoxication
1) development of a reversible substance-specific syndrome due to recent use of a
substance
2) clinically significant maladaptive behavioral or psychological changes due to
substance on CNS that develop shortly after substance use
3) not due to a medical or other mental disorder
Substance Withdrawal
1) development of a substance-specific syndrome due to the cessation of substance use
that has been heavy & prolonged
2) the substance-specific syndrome causes clinically significant distress or impairment
in social, occupational or other areas of functioning
3) the symptoms are not due to another medical or mental disorder.
Addiction
Impaired control over use of chemical substance
Physiological dependence
Psychological dependence
Substance overview
Depressants
Stimulants
Hallucinogens
Depressants
Substances that slow the activity of the CNS
Alcohol
Barbiturates
Benzodiazepines (Valium, Librium)
Opioids
Morphine, heroin, codeine (derived from juice of poppy
Demerol, Percodan, Darvon (manufactured in lab to have opiate-like effects)
Risk factors for Alcoholism
Gender
Age
Family history
Socio-demographic factors
Affects of Alcohol
Drinking for "fun"
Effects of Alcohol
Ethyl alcohol quickly absorbed
Begins to take effect immediately slows CNS
Enzyme difference: males and females
Different metabolism for Asians

Alcohol:
Binds to GABA receptors
Depresses judgment & inhibition
Can impair memory
Become physically uncoordinated
Effects based on concentration in blood
Effects decline ONLY after metabolized by liver
Your body clock
.
It is impossible to ‘speed up’ elimination of alcohol from your body
The body can break down around 6 - 10 grams of alcohol an hour.
It will take an average person five to eight hours to rid the body of the alcohol in
half a bottle of wine or one and a half pints of beer.
Societal Problems
College binge drinking
Plays a role in 1/3 or: suicides, homicides, assaults, rapes, and accidental deaths
High costs financially for society ($148 billion annually)
High levels of conflicts
Affects of Alcoholism
Long-term drinking
Physical Problems: Withdrawal
"shakes" (hands, tongue)
Weak & nauseous
Increased heart rate & blood pressure
Vomiting
Delerium Tremens (DT)
Personal Risks
Fatal car accidents
Cirrhosis of the liver
Korsakoff's syndrome
confabulation
Fetal alcohol syndrome
Barbiturates & Benzodiazepines
Produce relaxation
Induce sleep
bind to GABA receptors
Taken in pill form
Depress reticular formation
Too high: coma & death
Withdrawal: nausea, anxiety & sleep deficit, convulsions
Benzo: less likely to cause death from ODing
Opioids
Noted for reducing pain (physical & mental)
High dependency potential
Morphine: derived from opium, relieves pain better than opium
Heroin: derived from Morphine (even more addictive)
Narcotics: all natural & synthetic opioids
effects
Smoked, inhaled, snorted, injected
Quick rush (warmth)
Hours of high
Relieve pain
Bind to endorphin receptors
Nausea & constipation
Heroin Withdrawal
Anxiety, restlessness
Rapid breathing
Severe twitches, fever, vomiting
Diarrhea, no appetite
High blood pressure
Weight loss
Disappear in about a week
Often leads to criminal activity
risk
Overdoseshuts down respiration in brain
Can result in death
HIV infection (injection of dirty needles)
Stimulants
Increase activity of CNS
Cocaine
Amphetamines
Caffeine
Cocaine
From coca plant
Powder when processed
Snorted, free-basing, crack
Increases DA (dopamine), NE, & 5-HT
Effect: euphoric rush
Excited, energetic
High blood pressure, fast breathing
Arousal/wakefulness
sometimes: cocaine intoxication or cocaine-induced psychotic disorder
Withdrawal
Depression
Fatigue
Sleep problems
Irritability
Anxiety
May last weeks to months
risks
Overdose: too much stimulation then depression
Respiration arrest
Heart problems
Amphetamines
Manufactured in lab
Ice & crank
Increase energy & reduce appetite
Increase DA, NE, & 5-HT
Methamphetamine abuser
vs. control
Hallucinogens (Psychedelic drugs)
Causes major change in sensory perception
LSD: binds to some 5-HT sites, altering activity
Effects: exaggerated senses (increased colors)
Hallucinations
Synesthesia
Increased emotional intensity
Wears off in 6 hrs
marijuana
Can develop tolerance
Withdrawal: flulike symptoms
Restlessness
Irritability
Risks:
Panic
Cognitive functions
Car accidents
Memory loss
Lung disease
Cancer
Lower sperm count & abnormal ovulation
Cannabis
Cannabis: drugs from hemp plant
Include: hashish (most powerful), and marijuana
THC: compound in cannabis, one most responsible for its effects.
Effects: produces feelings of joy & relaxation, sometimes sharpened perceptions. Time
seems to slow.
Last 3-6 hours
risks
Tolerance development low
No withdrawal
So powerful can cause adverse reactions
flashbacks
Theories
Sociocultural
Psychodynamic
Cognitive
Behavioral
Biological: genetic & biochemical
treatments
Behavioral
Cognitive-behavioral
Biological: detox, drugs,
Sociocultural: self-help, community programs