CHAPTER 14: SUBSTANCE-RELATED DISORDERS

Substance Use Disorder

Chronic difficulties in resisting the desire to use substances.

Substance

Any natural or synthesized product with psychoactive effects.

Substance Intoxication

Behavioral and psychological changes from substance use.

Substance Abuse

Excessive use of a substance resulting in impairment and hazardous behavior.

Substance Dependence

Physiological need for a substance.

Tolerance

Diminished effects of a substance due to regular use.

Withdrawal

Physiological and behavioral symptoms occurring when a person stops using a substance.

DSM-5 Criteria for Substance Use Disorder

2 or more symptoms in a 1 year period.

Prevalence of Substance Use Disorders

10.8% of the population.

CNS Depressants

Substances that slow the central nervous system.

Alcohol's Effects on the Brain

At low doses, activates pleasure areas; at high doses, depresses functioning.

Sign of Alcohol Intoxication

Blood alcohol level of 0.08%.

Alcohol Abuse Statistics

• 40% of deaths suffered in automobile accidents 

• 40-50% of all murders 

• 40% of all assaults 

• 50% of all sexual assaults 

• 43% of violent encounters with police 

• 66% of domestic violence incidents

Alcohol Withdrawal Symptoms (Stage 1)

• Tremulousness, weakness, and profuse perspiration

• Anxiety, headache, nausea, and abdominal cramps  

• EEG pattern may be mildly abnormal

Stage 2: 2nd or 3rd day

Convulsive seizures 

Stage 3

• Delirium tremens: auditory, visual, and tactile hallucinations

• Death from hyperthermia or collapse of the peripheral vascular system (10%)

Long-term Effects of Alcohol Misuse

Hypertension, cirrhosis, malnutrition.

Benzodiazepines and Barbiturates

Treat anxiety and insomnia, can lead to respiratory collapse if overdosed.

Cocaine

A stimulant that creates intense euphoria and leads to impulsiveness.

Withdrawal Symptoms from Cocaine and Amphetamines

Depression, fatigue, insomnia, vivid unpleasant dreams.

Nicotine

Alkaloids found in tobacco that stimulate both central and peripheral nervous systems.

Caffeine Intoxication

Pharmaceutical classifications for excessive caffeine use.

Opioids

Natural substances from opium poppy; causes euphoria and drowsiness.

Withdrawal Symptoms from Opioids

Long list of physiological symptoms experienced upon cessation.

Hallucinogens

Substances that produce perceptual changes, e.g., LSD, PCP.

Cannabis

The most commonly used illegal drug that impairs cognitive functioning.

Inhalants

Substances inhaled for their chemical vapors to depress the CNS.

Factors Influencing Substance Use Disorders

Biological, psychological, and sociocultural factors.

Psychosocial Treatments for Substance Use Disorders

Includes motivational interviewing and cognitive treatments.

Relapse Prevention

Focuses on situations that lead to slips and the importance of abstinence.

Alcoholics Anonymous (AA)

An organization for people with alcohol-related problems.

Older Adults Substance Use Treatment

Therapies focused on social skills and emotional states in elder populations.

Harm Reduction Model

Focuses on reducing immediate risks of excess drinking.

1. Clea has been using cocaine for a while now. She has been without any cocaine for 24 hours and as a result is experiencing strange behaviors and physiological responses. She is most likely showing signs of: 

   1. tolerance.

   2. substance intoxication.

   3. a drive-control disorder.

   4. substance withdrawal.

substance withdrawal

1. Which of the following is the most commonly used illegal drug in the United States? 

   1. Cocaine

   2. Cannabis

   3. LSD

   4. Heroin

Cannabis

1. What is the physiological effect of nicotine? 

   1. It resembles a fight-or-flight response.

   2. It suppresses several biochemicals including dopamine and norepinephrine.

   3. It reduces the craving to smoke more.

   4. It reduces stress and anxiety.

It resembles a fight-or-flight response.

1. Dennis is undergoing treatment to stop alcohol use. As a result of treatment, he cannot even take one alcoholic drink because he starts to feel sick and dizzy and feels like vomiting when he thinks about drinking or tries to drink. Which form of treatment is he using?

   1. harm reduction therapy

   2. prevention therapy

   3. cognitive therapy

   4. antagonist drug therapy

antagonist drug therapy

1. Passing out from a high blood level of alcohol

   1. may be the result of an allergic reaction to alcohol.

   2. may actually be a safety device.

   3. means that a person’s blackouts have worsened and increased over time.

   4. means a person has not yet developed tolerance.

may actually be a safety device.

1. Cocaine prevents the reuptake of _____ into the transmitting neuron, causing it to accumulate in the synapse and maintaining the pleasurable feeling associated with cocaine use. 

   1. epinephrine

   2. serotonin

   3. prolactin

   4. Dopamine

dopamine

1. Some psychologists have argued that a more credible approach to college drinking than abstinence programs is to recognize drinking as normative behavior and focus education on the immediate risks of drinking to excess and the payoffs of moderation. This is an example of a: 

   1. covert sensitization therapy.

   2. disease model.

   3. harm reduction model.

   4. benefit-maximization mode

harm reduction model

1. _____ are volatile substances that produce chemical vapors, which can be inhaled and which depress the central nervous system. 

   1. Inhalants

   2. Amphetamines

   3. Opioids

   4. Barbiturates

Inhalants

1. Jim is over at a friend's house to pregame before going out. He takes a substance that provides an instant rush of euphoria followed by heightened self-esteem, alertness, energy, and feelings of competence. He has most likely taken: 

   1. opiates

   2. benzodiazepines

   3. alcohol

   4. Cocaine

Cocaine

1. Alicia's doctor has prescribed medication to help with her anxiety and insomnia. Which of the following best represents the class of medications he most likely prescribed? 

   1. Opioids

   2. Benzodiazepines

   3. Phencyclidine

   4. Amphetamines

Benzodiazepines