Substance Related and Addictive Disorders

3 primary components of addiction

Preoccupation, compulsion, relapse

Preoccupation

Placing emphasis on acquiring drugs

Compulsion

Continuing to use drugs despite serious negative consequences

Relapse

Discontinuing drug use for a period, then reusing use at an abnormal level

It’s hard to tell when ____ becomes ____ and becomes a ____

Normal drug use, problematic use, disorder

The DSM-V removed the terms ___ and ___, and replaced them with the single diagnosis of substance use disorder

abuse, dependence

Substance use, abuse, and addition are best viewed as a…

Continuum of behavior

How are symptoms viewed in the biopsychosocial model for addictions

acquired habits that emerge from a combination of biological, psychological, and social factors

What is used to determine when use moves from recreational to disordered?

the social and cultural context in which the behavior occurs (deviates from socially accepted standards)

Who benefits from the definition of drug abuse?

Mental health practitioners, medical community, law enforcement/prison system

According to the textbook, mainstream American culture’s problem use often consists of

Public intoxication, drinking early in the morning, drinking while at work, drinking and driving

Moral view: drinking and drug use are…

freely chosen acts for which individuals are responsible

Disease view of substance abuse

it’s a disease which is biologically difficult for individuals to control

A lot of effort at a socially policy level is spent veering between ___ and ___

drug treatment vs. jail

WHO estimates that ___ individuals have an AUD, and ___ have drug use disorders

76.3 million, 5.3 million

Lifetime prevalence of drug use disorders is roughly __% in the US

10

Lifetime cannabis abuse is __% and is…

6.3, the most common substance use disorder

Substance abuse for males 12+ was nearly __ as high as females

2x

Males were ____ likely than females to be current users of _____ _____ drugs including marijuana, cocaine, and hallucinogens

the gap is ___

more, several different, decreasing

Female substance users have higher rates of ______ than men do

comorbid psychiatric disorders

Men are more likely than women to…

introduce their partners to substance use, initiate their females partners into injection drugs, and supply drugs to their partners

Lesbian and bisexual women were ____ more likely to be current heavy drinkers than heterosexual women

2-3x

Drug use disorder estimates were higher for ___ and ___ men, though not significantly different than _______ men

Gay, bisexual, heterosexual

Potential factors impacting sexual orientation and substance use

Pressure to conform

bullying/peer rejection

greater social community in bars/clubs

stress related to identity concealment

experienced/anticipate rejection/discrimination

internalized homophobia

10 classes of drugs (All cool cats have interesting obsessions, seeking stimulants, tobacco, and others

Alcohol

Caffeine

Cannabis

Hallucinogens (PCP, etc.)

Inhalants

Opioids

Sedatives, hypnotics, and anxiolytics

Stimulants (amphetamines cocaine, etc.)

Tobacco

Other/Unknown

Substance Use Disorder

A pathological pattern of behaviors related to use of the substance

Criterion A (problematic pattern of use leading to clinically significant impairment or distress, as manifested by at least 2 symptoms occurring within a 12-month period)

Impaired control

Social impairment

Risky use

Pharmacological criteria

Severity of Substance Use Disorders

Mild: 2-3 symptoms

Moderate: 4-5

Severe: 6+

Reinforcer

event that increases the likelihood of a subsequent response

increases in dopamine induced by drugs are 3-5x higher than those of natural reinforcers (sex, food)

4 Systems involved in drug abuse (can be changed with experience)

1. reward (accumbens and verbal pallidum)

2. Motivation/Drive (orbitofrontal cortex, subcallosal cortex)

3. Memory and learning (amygdala, hippocampus)

4. Control (prefrontal cortex, anterior cingulate gyrus)

Adult twin studies of alcohol dependence show a heritability of…

50-60%

AUDs in parents were associated with

lower levels of parental monitoring → which seemed to significantly increase youth alcohol and marijuana use

stress and negative affect → associated with alcohol use in adolescents

Etiological theories of substance abuse

1. it’s a learned behavior

2. it’s reinforced because it reduces anxiety/tension (previous good experiences paired with substance- conditioned cognitions)

Disulfram (Antabuse)

Alcohol abuse treatment

produces a sensitivity to alcohol which results in a highly unpleasant reaction when the patient ingests even small amounts of alcohol

Effectiveness is mixed since it’s self-administered and they could stop taking it

Naltrexone

Alcohol abuse treatment

helps reduce cravings by blocking pleasure-producing effects of alcohol

Effective in reducing binge drinking

Methadone and L-alpha-acetylmethadol (LAAM)

Opioid abuse treatment

only available through licensed programs that closely monitor the patient’s substance use

Satisfy the craving for heroin or other opioids but are equally addictive

What meds are offered for abuse of drugs like cocaine, cannabis, and inhalants?

none

Support groups like AA and 12-step programs promote…

total abstinence from alcohol and drugs

Motivational interviewing

directive, client-centered therapy style designed to elicit change by assisting clients with exploring and resolving ambivalence

Other psychosocial interventions

CBT, harm-reduction model (?)

____ is the leading cause of preventable death in the US

tobacco

tobacco dependence is the most prevalent drug abuse disorder among _______

adults with psychiatric diagnosis or illness

Those in treatment fro alcohol dependence are more likely to die from _____ than _____

their tobacco use, their alcohol use

Individuals with drug problems who also smoke are ___ times more likely to die prematurely relative to individuals with drug problems that don’t use tobacco

4

Tobacco history previously marketed their product to…

people with mental illness

________ have a higher prevalence of AUDs (__%) than any other age group, and rate among males is ___ that of females

young adults, 16

Factors involved in college drinking rates

campus environment mitigates legal/driving-related consequences

those who experience negative consequences tend to not view their drinking as particularly problematic

students report drinking facilitates socializing and fun

Gen-Zers receive their first cell phone at

10.3 years

roughly X/X children has a smartphone by the age of 8

1/5

___% of students are distracted by phones/gadgets in class

49

__% of parents admit they spend more time on their phones than with their children

17.3

Mindfulness

Disrupting mindlessness

Paying attention to the present on purpose

non-judgmental observation

How are gratitude exercises mindful?

They acknowledge the small details of our day that we might have tuned out

Expectancies

Conditioned cognitions (can be associated with positive experiences or positive subjected respected) to alcohol or other drugs

True or False: In 2025, most mental health training programs provide high levels of training in treating tobacco dependence

False (literally the opposite)