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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 Overdoseshuts 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