Ch 12 Substance Use and Impulse Control

why is substance abuse rate rising?

increased accessibility of drugs, increased life stresses

Physical Consequences of Substance Abuse

• damage to vital organs

• decreased immune system

• neurological impairment

• overdose (can be fatal, often a miscalculation)

Psychological Consequences of Substance Abuse

• increased anxiety, depression, emotional instability

• impaired judgment and decision-making

• development or worsening of mental health problems

Social Consequences of Substance Abuse

• strained relationships with peers

• social isolation and withdrawal

• difficulties in work

• legal problems

Life Consequences of Substance ABuse

• money issues

• legal issues

• loss of employment or academic opportunities

Substance Use

ingestion of psychoactive substances

Intoxication

physiological reaction to ingestion of a substance

Substance Abuse

loss of control of use of a particular substance

Tolerance

increasingly more of a substance needed to experience the same effect

• or diminished effect with continued use

Withdrawal

negative symptoms from cessation or reduction of use of a drug

Craving

psychological intent to get a drug, drive behavioural responses (drug-seeking behaviour)

Substance Use Disorder- Diagnosis

• loss of control of substance use

• unsuccessful attempts to stop

• significant time spent obtaining & using substance

• craving or strong desires to use

• continued use despite social problems, physical hazards, health problems

• tolerance & withdrawal

Depressants

decrease CNS activity

• sedative, hypnotic, and anxiolytic drugs

What type of drugs are most likely to produce tolerance and withdrawal?

depressants

Alcohol Use Disorder- Diagnosis

• 2 criteria over 12 months

• cravings for alcohol

• impaired control of alcohol use

• preoccupation with using or obtaining alcohol

• tolerance & withdrawal

• neglect of responsibilities due to use

• continued use despite health, social, or interpersonal issues

absorption of alcohol into body

stomach → small intestine → heart → liver

long-term alcohol use- problems

major loss of brain tissue, severe liver damage

Alcohol Withdrawn Delirium

symptoms resulting from alcohol withdrawal: agitation, insomnia, disorientation to time and place, hallucinations

Wernicke-Korsakoff Syndrome

• severe thiamine deficiency → cognitive issues and muscle problems

Wernicke-Korsakoff: Cognitive Issues

• confusion, issues with planning, problem-solving, attention

• confabulation: making stuff up

• speech problems

Fetal Alcohol Syndrome

• excessive alcohol during pregnancy → severe effects on infant

• growth retardation, cognitive/behaviour/learning issues, anatomical abnormalities

sedatives

calming

hypnotic drugs

sleep-inducing

Anxiolytic drugs

anxiety-reducing

barbiturates

• CNS depressants that enhance GABA activity (inhibitory)

• produce sedative and calming effects

• uses: anesthesia, anxiety relief, seizure treatment

• BARBitals

barbiturates risks

dependence, overdose, respiratory depression, withdrawal

Benzodiazepines (benzes)

• enhance GABA activity (GABA-A) → calming, anxiolytic, sedative, muscle-relaxant and anticonvulsant effects

• end in -am

Sedative-, hypnotic-, and anxiolytic-related disorders- Diagnosis

• use despite physical or psychological problems from substance

• repeated unsuccessful attempts to reduce use

• significant impairment or distress from use

• tolerance & withdrawal

• recurrent use in physically hazardous situations

Prescription excess

• overprescription of sedative and hypnotic drugs (benzos, sleeping pills)

• especially to vulnerable populations (elderly, ppl wit substance abuse issues) → may have negative consequences

Stimulants