Lesson 7: Substance-Related & Addictive Disorders

Substance

ingested chemical compounds that change mood or behavior.

Psychoactive Substances

• Ingested chemical compounds that change mood, behavior, or both.

• The Substance-Relared Disorders are divided into two groups: Substance Use Disorders (SUD), Substance-Induced Disorders (SID)

Substance Use Disorder (SUD)

refers to long-term problematic use of substances, often involving addiction. Its focus is on dependence and loss of control, making it an ongoing and chronic condition. An example is alcohol use disorder

Substance-Induced Disorder (SID)

deals with the short-term effects of substances. The focus is on intoxication, withdrawal, or substance-induced mental disorders. It is temporary and reversible, with examples such as alcohol intoxication or withdrawal.

Substance Use

• Ingestion of psychoactive substances in moderate amounts without major interference in social, educational, or occupational functioning.

• Examples:

  • Drinking coffee to wake up

  • Smoking cigarettes

  • Drinking alcohol socially

  • Occasional use of illegal drugs (e.g., cannabis, cocaine, amphetamines, barbiturates)

Substance Intoxication

• Physiological reaction to ingested substances (e.g., drunkenness or getting high).

• Factors affecting intoxication:

  • Type of drug

  • Amount ingested

  • Individual biological reaction

• Effects:

  • Impaired judgment

  • Mood changes

  • Reduced motor abilities (e.g., difficulty walking or talking)

Substance Abuse

• Not based on the amount ingested, but on the degree of life disruption caused.

• Key Considerations:

  • Questions like “Is two glasses of wine abuse?” are not enough to define abuse.

• DSM-5 Criteria: A person is considered a substance abuser if substances:

  • Disrupt education, work, or relationships

  • Put them in physically dangerous situations (e.g., driving under influence)

Substance (Drug) Dependence

• Often called addiction; refers to a state where a person is under the control of drugs.

• Key Features of Physiological Dependence:

  1. Tolerance: Needing more of the drug to achieve the same effect.

  2. Withdrawal: Experiencing negative physical reactions when the substance is reduced or stopped.

Tolerance

A condition in which the body becomes used to the effect of a medicine, so the body requires increasingly larger doses to produce the

same effect

Withdrawal

Occurs when a person stops using a medicine on which he or the has become physiologically dependent.

Depressants

These substances result in behavioral sedation and can induce relaxation.

They include:

• Alcohol (ethyl alcohol)

• Sedative and hypnotic drugs in the families of: Barbiturates (e.g., Seconal), Benzodiazepines (e.g., Valium, Xanax)

Alcohol-Related disorder

• acts on the central nervous system, blocking nerve message transmission.

• Effects:

  • Impairs ability to achieve goals and fulfill responsibilities

  • Affects relationships and multiple body systems: metabolism, gastrointestinal, nervous, bone marrow, endocrine

• Symptoms: Tolerance, Withdrawal, Disorientation (time, place, person), Hallucinations (visual, auditory, tactile), Delusions (paranoid, grandeur, suspicion), Preoccupation with obtaining alcohol, Disordered perception, Overnight abstinence issue, Irritability, Nausea and vomiting

• More common in males (2× than females)

• Affects all races and socioeconomic classes

• treatments: Detoxification, Rehabilitation, Medications, Stress-relief, diets, accupunture

Sedative, Hypnotic, and Anxiolytic (SHA) Related Disorders

• Drugs that cause sedation and at the same time relieve anxiety (anxiolytics) or can induce sleep

• They are used primarily to treat anxiety and insomnia.

• In general, these drugs will induce sleep when given ill high doses at night and will provide sedation and reduce anxiety then given in low divided doses during the day.

Barbiturates

• Prescription sedatives or tranquilizers, also called “Downers”.

• Central Nervous System (CNS) depressants → cause drowsiness.

• Forms: Multi-colored pills and tablets.

• Uses:

  • Treat seizure disorders

  • Manage neonatal withdrawal

  • Treat insomnia

  • Reduce preoperative anxiety

  • Induce coma for increased intracranial pressure (ICP)

  • Aid in anesthesia

Benzodiazepines

• CNS depressants that produce sedation, hypnosis, relieve anxiety and muscle spasms, and reduce seizures.

• Common Drugs: Valium®, Xanax®, Halcion®, Ativan®, Klonopin®.

• Medical Uses:

  • Anxiety relief

  • Muscle relaxation

  • Sedation for procedures or sleep disorders

  • Seizure control

• Effects of Abuse:

  • Dependence and addiction risk

  • Drowsiness, impaired coordination, and memory problems

  • Risk of overdose, especially when combined with other depressants (e.g., alcohol)

Stimulants

• These substances cause us to be more active and alert and can elevate mood.

• Included in this group are: Amphetamines, Cocaine, Nicotine, Caffeine

Amphetamine

• Highly addictive central nervous system (CNS) stimulants that initially may be used for medicinal purposes but can become addictive with continuous use.

• Dextroamphetamine (Dexedrine), Methamphetamine / Shabu (Desoxyn), Methylphenidate (Ritalin)

• Medical Uses:

  • Attention Deficit Hyperactivity Disorder (ADHD)

  • Obesity (appetite suppression)

  • Depression

• Effects of Abuse:

  • Sleep disturbances (falling asleep at odd times)

  • Behavioral and psychiatric issues

Caffeine Addiction

• A CNS stimulant and analeptic, derived from coffee and tea; chemically classified along with amphetamines and cocaine.

• Sources: Tea, cocoa, coffee

• Addiction Potential:

  • Less likely to produce severe physical or psychological dependence compared to other drugs

  • Symptoms often overlap with anxiety disorders, making diagnosis difficult

Cocaine

• A highly addictive CNS stimulant derived from the leaves of the coca bush, native to the Andes Mountains in South America.

• Indigenous people of Peru and Bolivia chewed coca leaves for endurance and appetite suppression in high-altitude environments.

• snorted, inhaled, injected, or dissolved in water

• Street names: coke, blow, cornflake, snow, toot

• Effects of Use:

  • Euphoria or intense happiness

  • Hyper-vigilance and increased sensitivity

  • Highly addictive

Nicotine

• Psychoactive ingredient in tobacco that is physically and psychologically addictive.

• Properties:

  • Pure _____ is a colorless liquid that turns brown and smells like tobacco when exposed to air.

• Routes of Absorption:

  • Skin

  • Lining of the mouth and nose

  • Moist tissues lining the lungs

• Effects of Abuse:

  • Addiction, dependence

  • Increased risk of cardiovascular and respiratory diseases

  • Withdrawal symptoms (irritability, anxiety, cravings)

Cigarettes

• The most efficient nicotine delivery system, which is inhaled and reaches the brain in less than 15 seconds.

• Nicotine in chewing tobacco and snuff is absorbed through the mucous membranes lining the mouth and nasal passages.

Cannabis Addiction

• commonly called marijuana, which consists of dried leaves and flower tops of the plant.

• refers to several varieties of ____ Sativa or Indian hemp plant that contain the psychoactive drug delta-9-tetrahydrocannabinol (THC).

• generally taken by either eating or smoking parts of the cannabis plant.

• When the smoke is inhaled, it spreads across the surface of the lungs, is quickly absorbed into the bloodstream, and carried to the brain in a few seconds.

• suppresses the production of male hormones, decreases the size and weight of the prostate gland and testes, and inhibits sperm production (though these effects appear reversible).

• It also impairs short-term memory and slows down learning ability.

Inhalant Abuse Disorders

• A group of disorders caused by abuse of volatile substances such as solvents, glues, paint, fuels, and other chemicals.

• Popularity Factors:

  • Peer influence

  • Rapid mood-elevating effects

  • High accessibility among young people

• Route of Administration: Inhalation (breathing into the body)

• Methods of Use:

  • Breathing vapors directly from a container

  • Inhaling fumes from substances placed in a bag

  • Inhaling substances from a cloth soaked with the substance

• Effects of Abuse:

  • Rapid euphoria or mood changes

  • High risk of fatal outcomes due to toxicity

Gambling Disorder

• Inability to resist the urge to gamble, resulting in negative personal consequences (e.g., divorce, job loss).

• Considered an Addictive Disorder due to similarities with substance-related disorders.

• Key Features:

  • Need to gamble increasing amounts over time (tolerance)

  • “Withdrawal symptoms” such as restlessness and irritability when attempting to stop

  • Cravings similar to substance dependence

Gambler’s Anonymous

12-step program (70–90% drop-out; desire to quit is essential)

Internet Gaming Disorder

• Preoccupation with online games that can lead to tolerance and withdrawal patterns, similar to substance addiction.

• Encourages additional research on its nature and treatment.