Substance Use and Addictive Disorders: Abnormal Psychology

Substance misuse cost

$740 billion in U.S. alone (combining costs of crime, lost work productivity, and health care).

Cocaine and heroin use

135 million people in U.S. have used cocaine, heroin, or another illegal substance; 32 million have used illegal substances in the past month.

Teen substance use

One-quarter of all teenagers have used an illegal substance.

Substance use disorder prevalence

In any given year, 7.4 percent of all teens and adults in the United States, more than 20 million people, have a substance use disorder.

Substance use disorder rates by ethnicity

American Indians have the highest rate (10.1 percent), Asian Americans have the lowest (4.8 percent).

Substance use disorder treatment

Only 18.4 percent of all those with substance use disorders receive treatment from a mental health professional.

Drug

Any substance other than food affecting our bodies or minds, including alcohol, tobacco, and caffeine.

Substance intoxication

Cluster of changes in behavior, emotion, or thought caused by substances (DSM-5).

Substance use disorders

Maladaptive behavior patterns and reactions caused by repeated substance use.

Substance Use Disorder Checklist (part 1)

Presence of at least 2 of the following symptoms within a 1-year period: substance often taken in larger amounts, unsuccessful efforts to reduce or control substance use, much time spent trying to obtain, use, or recover from the effects of substance use, failure to fulfill major role obligations.

Substance Use Disorder Checklist (part 2)

Presence of at least 2 of the following symptoms within a 1-year period (continued): continued use despite persistent interpersonal problems, reduction of important activities, continuing use in dangerous situations, continued use despite worsening of physical or psychological problems, craving for substance, tolerance effects, withdrawal reactions.

Tolerance

Need for increasing doses of substances to produce desired effect.

Withdrawal

Unpleasant and sometimes dangerous symptoms occurring with drug stopping or cutting back.

Depressants

Slow the activity of the central nervous system (CNS), reduce tension and inhibitions, may interfere with judgment, motor activity, and concentration.

Most widely used depressants

Alcohol, sedative-hypnotic drugs, opioids.

Alcohol consumption

2 billion people worldwide consume alcohol; more than half of U.S. residents drink alcoholic beverages.

Ethyl alcohol

All alcoholic beverages contain ethyl alcohol, absorbed into the blood through the stomach lining.

Alcohol intoxication level

Intoxication = 0.09 percent; level of impairment is closely tied to the concentration of ethyl alcohol in the blood.

Alcohol metabolism

Effects of alcohol subside only after alcohol is metabolized by the liver.

GABA and alcohol

Alcohol increases the activity of the neurotransmitter GABA at key sites in the brain.

Gender and blood alcohol concentration

Gender affects blood alcohol concentration.

Alcohol use

Middle schoolers: 25 percent report some use; High school seniors: 29 percent drink monthly; 2 percent drink daily; College students: 38 percent engage in monthly binge drinking.

Alcohol use disorder (alcoholism)

U.S. population older than 11 years: 5.4 percent; Teenagers: 2.3 percent; Men versus women: 2:1.

Regular consumption and reliance

Affects cognition, social life, and work behaviors. Individual alcoholism patterns vary. Damage in various structures of the brain and, correspondingly, impairments in memory, speed of thinking, attention skills, and balance found in chronic heavy drinkers.

Tolerance and withdrawal

Tolerance increases consumption levels. Variety of negative withdrawal symptoms.

Delirium tremens (DTs)

A severe form of alcohol withdrawal characterized by confusion, severe agitation, hallucinations, and autonomic instability.

Personal and social impacts of alcoholism

Alcoholism destroys families, social relationships, and careers. Alcohol plays a role in suicides, homicides, assaults, rapes, and fatal automobile accidents.

Long-term excessive drinking

Can seriously damage physical health (cirrhosis of the liver) and result in major nutritional problems (Korsakoff's syndrome, when body has too little vitamin B and too much alcohol).

Fetal alcohol syndrome (FAS)

A range of effects that can occur in an individual whose mother drank alcohol during pregnancy.

Sedative-hypnotic (anxiolytic) drugs

Produce feelings of relaxation and drowsiness to reduce anxiety and help people sleep.

Low doses of sedative-hypnotics

Calming or sedative effect.

High doses of sedative-hypnotics

Sleep inducers or hypnotics.

Barbiturates

Widely prescribed for the first half of the twentieth century; largely replaced.

Benzodiazepines

Safer and less likely to lead to intoxication, tolerance effects, and withdrawal reactions.

Cognitive impairment from benzodiazepines

Long term use by elderly can cause severe cognitive impairment.

GABA activity

Benzodiazepines increase GABA activity.

Elderly population prescribed benzodiazepines

As many as 17 percent of the elderly population are prescribed benzodiazepine medications, including as many as 40 percent of elderly individuals living in nursing homes.

College binge drinking

38 percent of students binge drink once a month; one-third binge 6 times or more monthly.

Impacts of binge drinking

Bingeing has lingering impacts on mood, memory, and brain/heart functioning.

Campus sexual assaults and alcohol

Half of all campus sexual assaults involve alcohol use.

Trauma from student drinkers

700,000 students are physically or emotionally traumatized or assaulted yearly by student drinkers.

College-age deaths tied to binge drinking

2,000 college-age deaths are tied to binge drinking.

Opioids

Known for pain-relieving effects; include natural (opium, heroin, morphine, codeine) and synthetic (methadone) blended drugs.

Opioid use disorder

After just a few weeks, users may become caught in a pattern of abuse (and often dependence). Tolerance for the drug quickly builds and withdrawal occurs when drug ingestion stops.

Early withdrawal symptoms

Include anxiety and restlessness.

Later withdrawal symptoms

Include twitching, aches, fever, vomiting, diarrhea, and weight loss from dehydration.

Increased doses

Required to avoid withdrawal.

Immediate danger of opioid use

Overdose.

Naloxone

Used in emergency situations when an individual is overdosing to override the effects of the opioid.

Ignorance of tolerance

A factor contributing to the dangers of opioid use.

Impure drugs

Can lead to infection from dirty needles and other equipment, and deadly substances mixed with opioids.

Cocaine

Most powerful known natural stimulant that produces a euphoric rush of well-being, followed by letdown.

Dopamine

Increased supply at key neurons throughout the brain due to cocaine use.

Cocaine intoxication

Effects of high doses of cocaine.

Cocaine-induced psychotic disorder

A potential effect of high doses of cocaine.

Overdose risk from cocaine

Greatest risk includes excessive doses that depress the brain's respiratory function and stop breathing.

Death from cocaine overdose

Over 10,000 persons in the United States die from a cocaine overdose each year.

Amphetamines

Laboratory-manufactured stimulant drugs, examples include amphetamine, dextroamphetamine, and methamphetamine.

Stimulant diversion

Almost 1 of 10 undergraduates acquire amphetamines or related stimulants without prescriptions.

Methamphetamine

Used at least once by 5.4 percent of all U.S. residents older than age 11.

Stimulant use disorder

Stimulant dominates the individual's life, leading to poor functioning in social relationships and at work.

Caffeine

Consumed daily by around 90 percent of the world's population and serves as a CNS stimulant.

Caffeine intoxication

Can occur at more than 2 to 3 cups of brewed coffee, 6 cans of cola, or 3 cans of Red Bull.

Seizures from caffeine

Can occur at doses greater than 10 grams of caffeine (about 100 cups of coffee).

Caffeine

Enhances physical stamina and reduces fatigue.

Caffeine effects

Can disrupt mood, fine motor movements, reaction time, and sleep.

Caffeine effects at high doses

Increases gastric acid secretions and breathing rate.

Caffeine reduction

Sudden stop or cutback of usual caffeine intake can cause withdrawal symptoms, including headaches, depression, anxiety, and fatigue.

Caffeine use disorder

Is not listed in DSM-5.

Hallucinogens

Produce powerful changes primarily in sensory perception (trips).

Natural hallucinogens

Include Lysergic acid diethylamide (LSD), Mescaline, Psilocybin, and MDMA (Ecstasy).

LSD (lysergic acid diethylamide)

One of most powerful hallucinogens derived from ergot alkaloids.

Hallucinogen intoxication

Brings on a state of hallucination with increased and altered sensory perception, psychological changes, and physical symptoms.

Effects of LSD

Effects wear off in about 6 hours.

Hallucinogen use prevalence

Hallucinogens use at some point in their lives: 10 percent of U.S. population.

Current LSD users

Around 0.2 percent, or 485,000 people.

Dangers of hallucinogens

Long-term effects include self-injury, bad trips, and flashbacks.

MDMA (3,4-methylenedioxymethamphetamine)

Stimulant that produces hallucinogenic effects; provides an energy boost and strong feelings of connectedness.

Dangers of MDMA

Immediate psychological problems, cognitive impairment, unpleasant and potential dangerous physical symptoms.

Cannabis

Produced from varieties of hemp plants.

Hashish

Solidified resin of the cannabis plant, most powerful form of cannabis.

Marijuana

Mixture of buds, crushed leaves, and flowering tops.

Major active ingredient in cannabis

Tetrahydrocannabinol (THC).

Cannabis intoxication

When smoked, produces a mixture of hallucinogenic, depressant, and stimulant effects.

Duration of cannabis effects

Most of the effects last 2 to 6 hours.

Cannabis use disorder

Influenced by regular use; affects the social and occupational lives of 1.6 percent of people in the United States.

Current marijuana potency

Current varieties of marijuana are 7 times more powerful than those found in 1970s, due to the higher THC content (8 percent).

Dangers of cannabis

Tolerance and withdrawal symptoms, occasional panic reactions, automobile accidents, and decreased memory while high.

Vaping

Electronic cigarettes, or e-cigarettes, can involve tobacco or cannabis (THC).

Teenage nicotine vaping incidence

50 percent yearly increase in teenage nicotine vaping; 26 percent of all high school seniors vape.

Polysubstance use

People often take more than one drug at a time.

Sociocultural views

People who are most likely to develop these disorders: Living in stressful socioeconomic conditions, Have families that value or tolerate drug use, Are confronted regularly by other kinds of stress.

Psychodynamic views

People who are most likely to develop these disorders: Have powerful early years dependency needs, Display substance abuse personality.

Cognitive-behavioral views

People who are most likely to develop these disorders: Operant conditioned by tension-reduction, rewarding effects of drugs (self-medication), Have rewards-produced expectancy that substances will be rewarding, Influenced by classical conditioning when cues or objects are present during drug use—results in cravings.

Biological views

Biological factors play a major role in drug misuse.

Genetic predisposition

Similarity of alcohol preferences among alcohol-preferring animals and their offspring, Alcoholism concordance rate in identical twins, Biological parent-adoptee child alcohol abuse rate.

Abnormal form of dopamine-2 (D-2) receptor gene

Found in people with substance use disorders using molecular biology techniques.

Neurotransmitter-focused explanation

Drug tolerance and withdrawal symptoms are caused by cutbacks in the brain's production of particular neurotransmitters during excessive and chronic drug use.

Lower GABA production

Caused by Alcohol or benzodiazepines.

Lower endorphin production

Caused by Cocaine or amphetamines.