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Chapter 11

Terms in this set (43)

Substance Abuse
excessive or harmful use of drugs and alcohol
Substance-Use Disorder
8.5% of the population met criteria in 2012
Psychoactive Substances
substance-related disorders arise when psychoactive substances are used excessively (PAS alter moods, thought processes, or other psychological states)
Addiction
-compulsive drug-seeking behavior and loss of control over drug use
-withdrawal symptoms occur when discontinued
Substance-Use Disorder Severity
-Mild: 2-3 designated symptoms present
-Moderate: 4-5 symptoms present
-Severe: 6+ symptoms present
Depressants
-causes nervous system to slow down

Alcohol
-moderate drinking: no more than one drink (women) or 2 drinks (men) per day
-Heavy drinking: levels exceeding moderate
-Binge drinking: 4-5+ drinks on a single occasion
Alcohol Poisoning
can result in impaired breathing, coma and death
Alcohol-Use Disorder
-2x likely to develop in men
-alcoholism progresses more quickly in women
Delirium Tremens
life-threatening conditioning produced by alcohol withdrawal symptoms
Opioids
Pain-agents that depress the central nervous system
-Illegal substances (heroin and opium)
-Prescription pain relievers (morphine, codeine, oxycodone - gateway drugs)
-Highly addictive
-produce both euphoria and drowsiness
Sedatives
have calming effects
-used to treat agitation, muscle tension, insomnia, and anxiety

-drowsiness, impaired judgement, diminished motor skills
-excessive use can lead to accidental overdose and death (alcohol + sedatives = danger)
-High potential for tolerance and physiological dependence (withdrawal symptoms)
Hypnotics
induce sleep
-used to treat agitation, muscle tension, insomnia, and anxiety
Anxiolytics
reduces anxiety
-used to treat agitation, muscle tension, insomnia, and anxiety
Barbiturates and Benzodiazepines
-rapid anxiolytic effects in moderate doses
-hypnotic effects in higher doses
Stimulants
-speed up CNS activity
-produce feelings of euphoria and well-being (improve mental and physical performance, reduce appetite and prevent sleep)
-Unwanted effects (anxiety, restlessness, agitation, paranoia)
-Tolerance to stimulant develops rapidly
Caffeine
-stimulant found in coffee, chocolate, tea and soft drinks
-90% adults use daily
-withdrawal symptoms: headache, fatigue, irritability, difficulty concentrating
Amphetamines (uppers)
-Speed up CNS activity
-prescribed for attention and sleep disorders (increasingly used illicitly)
-can cause psychosis and brain damage
-Methamphetamine (can cause permanent damage to heart / high potential for abuse and addiction)
Cocaine
Crack
-potent form of cocaine produced by heating cocaine with other substances
-typically smoked
-produces immediate but short-lived effects

Withdrawal
-lethargy and depression

Users often have a shortened lifespan
Hallucinogens
-produces vivid sensory awareness (hallucinations)
-effects can vary significantly (good vs. bad trips)
-hallucinogen persisting perception disorder
-Hallucinations used by 1.1mil people in 2012
Dissociative Anesthetics
-produces dream-like detachment

Phencyclidine (PCP) and Ketamine (Special K)
-highly dangerous and addictive
-dissociative, stimulant, depressant, amnesic, and hallucinogenic properties
-club drugs

Dextromethorphan (DXM)
-ingredient in OTC cold medicines
Nicotine
-highly addictive substance found in tobacco
-stimulant in low doses (relaxant in high doses)
-26.7% of US pop uses tobacco
-Euphoric effects decrease over the day (tolerance increases)
-Top preventable cause of premature death
Cannabis
-Botanical name for plant with chemical THC
-can produce stimulant, depressant and hallucinogenic effects
-growing conditions affect THC content
-marijuana is derived from leaves and flower
-hashish comes from pressed resin
Marijuana
-most commonly used illicit drug worldwide
-20mill adults and adolescents report current use (males more likely)
-most frequently associated with diagnosis of substance abuse
-dependence produces a pervasive lack of concern over consequences
-withdrawal symptoms
Inhalants
-intoxication from chemical vapors found in common household products (solvents, aerosol sprays, and compressed air products)
-intoxicating effects are brief
-most common among 12-17yo
-Hypoxia (sudden sniffing death)
Designer drugs
-Ecstasy (MDMA)
-synthetic marijuana
-MDPV (bath salts or plant food)
-DOM (aka: STP)
-Bromo-Dragonfly
-MXE
-Opioid substances
Ecstasy
-has both stimulant and hallucinogenic properties

Effects:
-euphoria, mild sensory and cognitive distortion, feelings of intimacy and well-being, followed by intense depression
-hypothermia, involuntary jaw spasms or teeth clenching

-has properties that accelerate dependence
-withdrawal symptoms (depression, irritability, social withdrawal)
-linked to long-lasting damage in brain areas critical for thought and memory
Club Drugs
-used to induce energy, excitement and reduce inhibitions
-cocaine may be used
-GHB (dangerous when combined with alcohol)
Synergistic Effect
interactions between the substances intensify effects
-can create unique side effects
Dangerous Combo's
-Tranquilizers and alcohol
-stimulants and sleeping pills
-multiple drug use involving ecstasy
-alcohol and energy drinks (caffeine)
Typical Progression
Initial use -- Increasing use -- heavy use -- drug lifestyle
Etiology of Substance-Use Disorders: Psychological
Coping with psychological stress and emotional symptoms
-Major motive for substance use
-stress plays a role in development of alcoholism and relapse
-45% of abusers have a concurrent psychiatric disorder

Behavioral undercontrol
-personality characteristic associated with rebelliousness, impulsivity, and risk taking
Etiology of Substance-Use Disorders: Social
Influence varies across lifespan
-Childhood (victimization and stressful events-neglect)
-Adolescents (parental attitudes and behaviors, lack of parental monitoring, peer pressure and wish to fit in, desire to assert independence and rebel, desire to "have fun" or take risks
-College: first year is a vulnerable transitional period, students frequently overestimate the extent of alcohol and marijuana use by peers
Etiology of Substance-Use Disorders: Sociocultural
-use and abuse of alcohol and other substances pervades all social classes

Trends in US:
-drug and alcohol use is normative
-media messages are powerful and increasing
-African Americans have lower rates of substance use than European Americans and Lantinx/Hispanic
Etiology of Substance-Use Disorders: Biological
-Genetic factors account for 56% of alcohol dependence risk (55% nicotine dependence, 75% illicit drug use)
-Genes can influence individual response to specific drugs
-Genes can decrease substance abuse risk
Treatment for Substance-Use Disorders
-22mill had substance-use disorder (4mill seeking treatment)

-Treatment and supportive intervention settings (self help groups, mental health clinics, and inpatient and outpatient treatment centers)

-most effective when incorporating best practices from high-quality addiction research
-integrated care enhances treatment outcome
-two phases: Detoxification, preventing relapse
Relapse
-relapse prevention considers physiological and psychological effects

-neuroplasticity (ability of the brain to change its structure and function in response to experience)

-Motivational enhancement therapy (addresses ambivalence about giving up substance use)
Treatment for Alcohol-Use Disorder
-AA (regards alcoholism as a disease and advocates total abstinence
-controlled drinking
-medications (modest effects)
Treatment: Opioid Use Disorder
-early detoxification and treatment critical
-Synthetic opioids (can reduce cravings without producing euphoria)
-Improved outcomes (behaviorally oriented counseling, contingency management with incentives for abstinence)
Treatment for Stimulant-Use Disorder
-no effective pharmacological interventions
-incentives for stimulant-free toxicology reports
-researchers testing a vaccine to help individuals dependent on cocaine (antibodies prevent cocaine from reaching brain)
Treatment for Cannabis-Use Disorder
-search for medications
-Psychological approaches show promise (CBT, motivational enhancement, short/frequent therapy sessions)
-rewards for verified abstinence
-not easily treated in outpatient settings
Treatment for Tobacco-Use Disorder
-relapse remains high despite cessation (need long term treatment)
-Pharmaceutical treatments (nicotine replacement therapy NRT, Bupropion)
-Varenicline

Psychological strategies (learn to cope with negative emotions)

women have more difficulty with smoking cessation (phase of menstrual cycle, fear of weight gain)
Gambling Disorder/Other Addictions
-Compulsive desire to engage in gambling activities (exhibits 4+ defining characteristics in 12mo) (mild/moderately severe/severe)

Treatment: Group therapy, CBT, improving financial management skills
Internet Gaming Disorder
-condition involving excessive and prolonged engagement in computerized or Internet games
-Criteria are similar to gambling disorder
-most common among adolescent males
-disagreement over whether compulsive behaviors should be considered addictions
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