Substance-Related Disorders part 2

Expectancy Theory:

• beliefs that alcohol enhances social success, relaxation, and improved mood

College Binge Drinking & Sociocultural Factors

Approximately 80% of college students drink; half engage in binge drinking.

Alcohol Amnestic Disorder (Korsakoff’s Syndrome)

• Severe memory issues and confabulation

• Due to thiamine (vitamin B1) deficiency

• Can be reversed early with thiamine; may become irreversible if untreated

Drinking Approaches

• Traditional programs emphasize complete abstinence.

• Some interventions (e.g., Brief Motivational Intervention, self-control training) aim at moderated or controlled drinking.

Medications:

• Antabuse (Disulfiram)

• Creates an aversive reaction if alcohol is consumed.

Medications: Naltrexone:

• Blocks alcohol’s pleasure-producing effects.

Medications: Acamprosate:

• Properties still under study; helps reduce heavy drinking.

Psychological & Behavioral Treatments

Individual and Group Therapy:

Group therapy helps confront denial and facilitates learning through shared experiences.

Brief Motivational Intervention (BMI):

• A short session that enhances self-regulation and readiness to change.

another brief intervention

• Computer-based self-control training programs have shown promise in reducing problem drinking.

Abstinence Violation Effect:

• Minor transgressions may lead to feelings of failure, increasing the risk of full relapse.

• Emphasizes the need for continuous self-monitoring and support.

Family Involvement:

• Family counseling (e.g., Al-Anon) addresses relational dynamics and provides mutual support.

Abstinence Approach

Emphasizes total cessation of alcohol use; favored by many self-help groups like AA.

Controlled Drinking Approach:

Suggests some individuals (often with less severe problems) can learn to moderate their intake.

research findings

1. Studies indicate a minority of subjects maintain controlled drinking post-treatment.

2. Ongoing debate among professionals regarding which approach yields better long-term results.

Alcoholics Anonymous (AA) & Self-Help Models

• AA provides social support through group meetings, testimonials, and mutual help.

strength and limitations of AA

• AA helps reduce personal responsibility by framing alcohol use disorder as a chronic condition.

• Outcome studies are mixed due to methodological challenges; however, AA participation is associated with decreased drinking in both short- and long-term follow-up.

Opiate Abuse – An Introduction

Common Opiates:

• Include opium, morphine, codeine, heroin, and methadone.

Historical Context:

• Opium has been used for centuries; morphine was widely used during the Civil War.

• Heroin was developed from morphine and quickly became more potent and addictive.

when do withdrawal symptoms generally peak within?

3–4 days and subside by days 7–8.

Opiate addiction often leads to

criminal behaviors and serious health issues (e.g., hepatitis from unsterile injection practices).

Opiate Receptors:

• Opiates bind to receptors that regulate pleasure, pain, and breathing.

Dopamine Reward Pathway

• Addiction is linked to dysfunction in the dopamine system—from the ventral tegmental area to the nucleus accumbens.

Deficiency Syndrome

Individuals with genetic variations may find natural rewards less satisfying, predisposing them to seek external stimulation via drugs.

According to the DSM-5, how many criteria must be met within a 12-month period to be diagnosed with Alcohol Use Disorder?

At least 2

What is the main cause of alcohol amnestic disorder (Korsakoff’s syndrome)?

Lack of vitamin B1 (thiamine)