Substance-Related, Addictive, and Impulse-Control Disorders

substance-related and addictive disorders

associated with the abuse of drugs and other substances people take to alter the way they think, feel, and behave

impulse-control disorders

represent a number of related problems that involve the inability to resist acting on a drive or temptation

polysubstance use

using multiple substances

psychoactive substances

alter mood, behavior, or both.

substances

refers to chemical compounds

that are ingested to alter mood or behavior

substance use

is the ingestion of psychoactive substances in

moderate amounts that does not significantly interfere with

social, educational, or occupational functionin

substance intoxication

Our physiological reaction to ingested

substances—drunkenness or getting high—

substance abuse

defined in the dsm5 in terms of how significantly it interferes with the user’s life. If substances disrupt your education, job,

or relationships with others, and put you

in physically dangerous situations (for

example, while driving)

substance dependence (addiction)

the person is physiologically dependent on the drug or drugs, requires increasingly greater

amounts of the drug to experience the same effect,

and will respond physically in a negative way when the substance

is no longer ingested

tolerance

requires increasingly greater

amounts of the drug to experience the same effect

withdrawal

will respond physically in a negative way when the substance

is no longer ingested

cocaine withdrawal

has a pattern that includes anxiety, lack of motivation, and boredom

cannabis withdrawal

includes such symptoms as

nervousness, appetite change, and sleep disturbance

depressants

these substances result in behavioral sedation and can induce relaxation.

depressants

include alcohol (ethyl

alcohol) and the sedative and hypnotic drugs in the families

of barbiturates (for example, Seconal) and benzodiazepines

(for example, Valium, Xanax).

stimulants

These substances cause us to be more active

and alert and can elevate mood.

stimulants

Included in this group are amphetamines, cocaine, nicotine, and caffeine

opiates

: The major effect of these substances is to produce analgesia temporarily (reduce pain) and euphoria

opiates

Heroin, opium, codeine, and morphine are included in this group

hallucinogens

These substances alter sensory perception

and can produce delusions, paranoia, and hallucinations.

hallucinogens

cannabis and LSD

other drugs of abuse

These substances produce a

variety of psychoactive effects that are characteristic of the

substances described in the previous categories

gambling disorder

individuals who display gambling

disorder are unable to resist the urge to gamble which,

in turn, results in negative personal consequences (e.g.,

divorce, loss of employment).

depressants

primarily decrease central nervous system activity. Their principal effect is to reduce our levels of physiological

arousal and help us relax

alcohol use disorder

A problematic pattern of alcohol use leading to clinically significant impairment or distress, as manifested by at least two of

the symptoms occurring within a 12-month period

inhibitory centers

We generally experience a feeling of well-being,

our inhibitions are reduced, and we become more outgoing.

This is because the _____ in the brain are initially

depressed—or slowed.

breathalyzer test

ome of the alcohol

goes to the lungs, where it vaporizes and is exhaled, a phenomenon that is the basis for the ____ that measures levels

of intoxication.

gamma-aminobutyric acid (GABA) system

neuroreceptor system particularly sensitive to alcohol; seems to act on our feelings of anxiety, alcohol’s antianxiety properties may result from its interaction

1. ingestion

2. stomach

3. small intestine

4. heart

5. liver

path traveled by alcohol throughout the body

glutamate system

is excitatory, helping neurons fire.

It is suspected to involve learning and

memory, and it may be the avenue through

which alcohol affects our cognitive abilities

blackouts

the loss of memory for what happens during intoxication

serotonin system

This neurotransmitter

system affects mood, sleep, and eating behavior and is thought to

be responsible for alcohol cravings

chronic alcohol use withdrawal

typically includes hand

tremors and, within several hours, nausea or vomiting, anxiety,

transient hallucinations, agitation, insomnia, and, at its most

extreme, withdrawal delirium

withdrawal delirium / delirium tremens

extreme alcohol withdrawl; a condition that can produce frightening hallucinations and body tremors

dementia and Wenicke-Korsakoff syndrome

two types of organic brain syndromes may result from long-term heavy alcohol use:

Dementia, (or neurocognitive disorder)

involves the general loss of

intellectual abilities and can be a direct result of neurotoxicity or

“poisoning of the brain” by excessive amounts of alcohol

Werknicke-Korsakoff syndrome

results in confusion,

loss of muscle coordination, and unintelligible speech; it is believed to be caused by

a deficiency of thiamine, a vitamin metabolized poorly by heavy

drinkers.

fetal alcohol syndrome (FAS)

recognized as a combination of problems that can

occur in a child whose mother drank while she was pregnant.

These problems include fetal growth retardation, cognitive deficits, behavior problems, and learning difficulties

alcohol dehydrogenase (ADH)

We metabolize alcohol with the help of an enzyme called

sedatives

calming depressants

hypnotics

sleed-inducing depressants

anxiolytic

anxiety reducing depressants

barbiturates

family of sedative drugs prescribed to help people sleep and replaced such drugs as alcohol and opium

benzodiazepines

have been used since the 1960s, primarily to reduce anxiety.

These drugs were originally touted as a miracle cure for the anxieties of living in our highly pressured technological society

Rophynol

otherwise known as “forget-me-pill,” “roofenol,” “roofies,” “ruffies”

Rophynol

same effect as alcohol without the telltale odor. There have been

numerous incidents of men giving the drug to women without their

knowledge, however, making it easier for them to engage in date

rape

barbiturates

relax the muscles and can produce

a mild feeling of well-being. Larger doses can have results

similar to those of heavy drinking: slurred speech and problems

walking, concentrating, and working

Abuse

Giya started a new job 5 weeks ago and is about to be

fired. This is her third job this year. She has been absent

from work at least once a week for the past 5 weeks.

She was reprimanded in the past after being seen at a local pub in a drunken state during regular office hours

although she called in sick. At her previous job, she was

fired after she came to work unable to conduct herself

appropriately and with alcohol on her breath. When

confronted about her problems, Giya went to the nearest

bar and drank some more to try to forget about the

situation. _________________

intoxication

Brennan scored the winning goal for his high school

soccer team and his friends take him out to celebrate.

He doesn’t smoke, but he doesn’t mind drinking alcohol occasionally. Because Brennan had such a good

game, he decides to have a few drinks. Despite his

great performance in the game, he is easily irritated,

laughing one minute and yelling the next. The

more Brennan rambles on about his game-winning

goal, the more difficult it is to understand him.

_________________

dependence

Marti is a 24-year-old college student who started

drinking heavily when he was 15. Marti drinks a

moderate amount every night, unlike his schoolmates

who get drunk at weekend parties. In high school,

he would become drunk after about four beers; now

his tolerance has more than doubled. Marti claims

alcohol relieves the pressures of college life. He once

attempted to quit drinking, but he had chills, fever, diarrhea, nausea and vomiting, and body aches and pains.

_________________

use

Over the past year Henry picked up a habit of having

a cigarette every day after lunch. Instead of sitting in

the lounge with his friends he goes to his favorite spot

in the courtyard and has his cigarette. If for some

reason he is unable to have his cigarette after lunch, he

is not dependent on it and can still function normally.

__________________

impulse-control disorder

Disorder that deprives a person of the ability to resist acting on a drive or temptation.

alcohol use disorder

Disorder in which the effects of the drug impede

the ability to function properly by affecting vision,

motor control, reaction time, memory, and hearing.

dementia

The decline of intellectual abilities through, for example, excess consumption of alcohol.

substance-related and addictive disorder

A class of disorders that affects the way people think, feel, and behave

ma-huang (Ephedra sinica)

Chinese physicians, for example, prescribed an amphetamine

compound called ____ for more than 5,000

years for illnesses such as headaches, asthma, and the common cold

amphetamines

an induce feelings of elation and vigor

and can reduce fatigue. You feel “up.” After a period of elevation,

however, you come back down and “crash,” feeling depressed or tired.

amphetamine use disorders

include significant behavioral symptoms, such as

euphoria or affective blunting (a lack of emotional expression),

changes in sociability, interpersonal sensitivity, anxiety, tension,

anger, stereotyped behaviors, impaired judgment, and impaired

social or occupational functioning

methylene-dioxymethamphetamine (MDMA) / Ecstasy

irst synthesized in 1912 in Germany, was used as an appetite suppressant

stimulant use disorder

A pattern of amphetamine-type substance, cocaine, or other stimulant use leading to clinically significant impairment or

distress, as manifested by at least two of the symptoms, occurring within a 12-month period

cocaine

is derived from

the leaves of the coca plant, a

flowering bush indigenous to

South America

cocaine

increases alertness,

produces euphoria, increases blood pressure and pulse, and causes

insomnia and loss of appetite.

cocaine-induced paranoia

exaggerated fears that he would be caught

or that someone would steal his cocaine; common among persons with

cocaine use disorders, occurring in two thirds or more

nicotine

colorless, oily liquid that gives smoking its pleasurable qualities

nicotine

in small doses stimulates the central nervous

system; it can relieve stress and improve mood. But it can also

cause high blood pressure and increase the risk of heart disease

and cancer

nicotinic acetylcholine receptors (nAChRs)

Nicotine appears to stimulate specific receptors, _______, in

the midbrain reticular formation and the limbic system

tobacco use disorder

A problematic pattern of tobacco use leading to clinically significant impairment or distress

caffeine

is the most common of the psychoactive substances

caffeine intoxication

Recent consumption of caffeine (typically a high dose well in excess of 250 mg)

adenosine

Caffeine’s effect on the brain seems to involve the neuromodulator _____

opiate

refers to the natural chemicals in the opium

poppy that have a narcotic effect

narcotic effect

they relieve pain and induce sleep

opiods

refers to the family of substances that includes natural opiates, synthetic

variations (heroin, methadone, hydrocodone, oxycodone), and the comparable

substances that occur naturally in the

brain

heroin

most commonly abused opiate

opiod use disorder

A problematic pattern of opioid use leading to clinically

significant impairment or distress

marijuana

the name given to the dried parts of

the cannabis or hemp plant

Cannabis sativa

scientific name for marijuana

cannabis use disorder

A problematic pattern of cannabis use leading to clinically significant impairment or distress,

cannabinoids

Marijuana contains more than 80 varieties of the chemicals

called _____, which are believed to alter mood and behavior.

tetrahydro-cannabinols (THC)

most common cannabinoids

anandamide

brain makes its own version

of THC, a neurochemical called

LSD (d-lysergic acid diethylamide)

sometimes referred to as “acid,” is the most common hallucinogenic drug

ergotism

In Europe during the Middle Ages, an outbreak of illnesses

occurred as a result of people’s eating grain that was infected with

the fungus

hallucinogen use disorder

A problematic pattern of hallucinogen (other than phencyclidine) use leading to clinically significant impairment or distress,

psilocybin

hallucinogen found in certain species of mushrooms

lysergic acid amide

hallucinogen found in the seeds of the morning glory plant

dimethyltryptamine (DMT)

hallucinogen found in the bark of the Virola tree, which grows in South and Central America

mescaline

hallucinogen found in the peyote cactus plant

Phencyclidine (or PCP)

is snorted, smoked, or injected intravenously, and it causes impulsivity and aggressiveness.

inhalant

include a variety of substances found in volatile solvents—making them available to breathe into the lungs directly.

sudden sniffing death

If users are startled from inhalants , this can

cause a cardiac event that can lead to death

anabolic-androgenic steroids

are derived from or are a synthesized

form of the hormone testosterone

inhalant use disorder

problematic pattern of use of a hydrocarbon-based

inhalant substance leading to clinically significant

impairment or distress

False

T/F: Use of crack cocaine by a pregnant woman

always adversely affects the developing fetus.

True

T/F: Regular use of stimulants can result in tolerance and dependence on the drugs

True

T/F: Amphetamines have been used as appetite suppressants.

False

T/F: Compared with all other drugs, caffeine can produce the most variable reactions in people.

False

Amphetamines are naturally occurring drugs that induce feelings of elation and vigor and can reduce fatigue.

True

T/F: An ingredient of the beverage Coca-Cola in the 1800s was cocaine.

False

T/F: Stimulants are produced only in a

laboratory