Substance Use and Addictive Disorders

Substance Use Disorder

a problematic pattern of substance use that causes significant distress or impairment (difficulty functioning)

Substance Use Disorder Criteria

A person must experience at least 2 symptoms within 12 months

What are the different subgroups for Substance Use Disorder

Impaired control, social impairment, risky use, and pharmacological criteria

Impaired control

difficulty limiting substance use, experiencing cravings, or using more than intendedSo

Social Impairment

Substances that interfere with responsibilities, relationships, or social activities

Risky Use

Continuing substance use despite physical dangers or negative health consequences

Pharmacological Criteria

experiencing tolerance (needing more of a substance) or withdrawal

Tolerance

Increasing the amount of substance to experience the same effects because the original amount becomes less effective

Withdrawal

Psychological (mental) and physiological (physical) reactions that occur when someone stops using a substance

What is the main neurotransmitter that alcohol acts on?

GABA

GABA

the main neurotransmitter that alcohol acts on, which slows brain activity and promotes relaxation — alcohol increases GABA

Alcohol Withdrawal Symptoms

shaking, nausea, increased heart rate, high blood pressure, anxiety, and depression — symptoms can begin within hours and last several days

Delirium Tremens

a severe form of alcohol withdrawal involving confusion, clouded consciousness (reduced awareness), and visual hallucinations — can occur within 3 days of sobriety and last 2-3 days

Hepatic Cirrhosis

a chronic liver disease in which healthy liver cells are replaced with scar tissue

Korsakoff’s Syndrome

an alcohol-induced major neurocognitive disorder caused by thiamine (vitamin B1) deficiency, resulting in anterograde amnesia (inability to form new memories)

Fetal Alcohol Spectrum Disorder

a condition caused by prenatal alcohol exposure (exposure before birth) — there is no known safe amount of alcohol during pregnancy

Opioids

a type of depressant and pain-relieving substance that attach to receptors normally activated by endorphins (natural chemicals that reduce pain and emotional tension)

Types of Opioids

Opium, morphine, codeine, oxycodone, fentanyl, and heroin

Opium

natural substance used for pain management from the sap of the opium poppy

Morphine

Powerful opioid used to relieve severe pain

Codeine

Weaker opioid used to relieve mild to moderate pain and suppress coughing

Fentanyl

Extremely powerful opioid used for severe pain, about 50 to 100 times stronger than morphine

Heroin

Highly addictive opioid that produces intense euphoria (pleasure), relaxation, and pain relief

Effects of Amphetamines

a manufactured stimulant drug that increases dopamine, norepinephrine, and serotonin activity to improve focus, increase energy, and reduce the need for sleep

Uses of Amphetamines

Some stimulants, such as Adderall and Ritalin, are prescribed to treat ADHD

Misuses of Amphetamines

Students may misuse stimulants to improve academic performance, suppress appetite, or experience a high

Methamphetamine (meth)

can cause meth-induced psychosis — about 15% of individuals who experience meth-induced psychosis do not recover, meaning symptoms may become permanent

THC (tetrahydrocannabinol)

the active substance in cannabis responsible for producing a high

The effects of cannabis

can cause joy and relaxation but may also produce anxiety, irritability, and paranoia — higher doses can cause hallucinations as well as greater tolerance and withdrawal symptoms

Biological View Causes of Substance Disorders

substance use disorders develop through genetics, changes in neurotransmitter production, and the brain’s reward system

Genetics as a cause of substance disorders

the biological view that identical twins have the same amount of chance of alcohol use disorder

Neurotransmitters as a cause of substance disorders

the biological view that a repeated substance reduces the body’s natural neurotransmitter production

Incentive-Sensitization Theory as a cause of substance disorders

the biological view that a repeated substance use makes the brain increasingly sensitive to substances

Reward Deficiency Theory as a cause of substance disorders

the biological view where the brain’s reward circuit is less responsive to normal pleasurable activities, such as hobbies or physical affection

Cause of substance use disorder based on the behavioral view (operant conditioning)

substance use is reinforced (encouraged) because drugs produce pleasurable feelings, such as euphoria (intense happiness), or reduce unpleasant feelings, such as stress and tension — these rewarding effects increase the likelihood of repeated substance use

CBT treatments for substance use disorders

aversion therapy, contingency management, relapse-prevention training, and harm reduction

Aversion therapy

pairs substance use with unpleasant reactions, such as nausea or vomiting, to discourage use — CBT treatment

Contingency Management

rewards behaviors, such as providing prizes for drug-free urine tests — CBT treatment

Relapse-Prevention Training

identifies triggers (situations that encourage substance use) and develops coping strategies to prevent relapse — CBT treatment

Harm Reduction

Focuses on reducing the negative consequences of substance use rather than solely achieving sobriety

Biological Treatments for substance use disorders

detoxification and antagonist drugs (Antabuse & naloxone — Narcan)

Detoxification

a medically supervised withdrawal from a substance, sometimes using medication to manage withdrawal symptoms

Antagonist drugs

medications that block or change the effects of substances — antabuse & narcan

Antabuse

an antagonist drug that causes unpleasant reactions, such as nausea and vomiting, when alcohol is consumed

Naloxone (Narcan)

an antagonist drug that block opioid receptors to reverse the effects of an opioid overdose

Behavioral Addictions in the DSM-5

Gambling Disorder and Internet Gaming Disorder

What behavioral addiction is in the DSM-5

Gambling Disorder

What behavioral addiction is proposed in the DSM-5?

internet gaming disorder