Chapter 11 - Substance-Related and Other Addictive Disorders

Abstinence

Restraint from the use of alcohol, drugs, or other addictive substances

Addiction

Compulsive drug-seeking behavior and a loss of control over drug use

Alcohol Poisoning

Potentially life-threatening, toxic effects resulting from rapidly consuming alcohol or ingesting a large quantity of alcohol

Alcoholism

A condition in which the individual is dependent on alcohol and has difficulty controlling drinking

Anxiolytics

A class of medications that reduce anxiety

Behavioral Undercontrol

A personality trait associated with rebelliousness, novelty seeking, risk taking, and impulsivity

Binge Drinking

Episodic intake of five or more alcoholic beverages for men or four or more drinks for women

Controlled Drinking

Consuming no more than a predetermined amount of alcohol

Delirium Tremens

Life-threatening withdrawal symptoms that can result from chronic alcohol use involving profound anxiety, confusion, and seizures

Depressants

A substance that causes a slowing of responses and generalized depression of the central nervous system

Detoxification

The phase of alcohol or drug treatment during which the body is purged of intoxicating substances

Dissociative Anesthetics

A substance that produces a dreamlike detachment

Gateway Drug

A substance that leads to the use of additional substances that are even more lethal

Hallucinogens

A substance that induces perceptual distortions and heightens sensory awareness

Heavy Drinking

Chronic alcohol intake of more than two drinks per day for men and more than one drink per day for women

Hyperthermia

Significantly elevated body temperature

Hypnotics

A class of medications that induce sleep

Intoxication

A condition involving problem behaviors or psychological changes that occur with excessive substance use

Moderate Drinking

A lower-risk pattern of alcohol intake (no more than one or two drinks per day)

Motivational Enhancement Therapy (MET)

A therapeutic approach that addresses ambivalence and helps clients consider the advantages and disadvantages of changing their behavior

Neuroplasticity

The process by which the brain changes to compensate for injury or to adapt to environmental changes

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The brain’s ability to change its structure and function in response to experience, such as reconditioning through abstinence.

Opioids

Painkilling agents that depresses the central nervous system, such as heroin, prescription pain relievers and substances like heroin, morphine, and fentanyl

Physiological Dependence

A state of adaptation that occurs after chronic exposure to a substance; can result in craving and withdrawal symptoms

Psychoactive Substances

A substance that alters mood, thought processes, and/or other psychological states

Relapse

A return to drug or alcohol use after a period of abstinence

Sedatives

A class of drugs that have a calming or sedating effect

Stimulants

A substance that energizes the central nervous system

Substance Abuse

A pattern of excessive or harmful use of any substance for mood-altering purposes

Substance-Use Disorder

A condition in which cognitive, behavioral, and physiological symptoms contribute to the continued use of alcohol or drugs despite significant substance-related problems

Synergistic Effect

The result of chemicals (or substances) interacting to multiply one another’s effects, usually intensifying them or creating unique side effects

Tolerance

Decreases in the effects of a substance that occur after chronic use, often requiring more of the substance to achieve the desired effect.

Withdrawal

The adverse physical and psychological symptoms that occur after reducing or ceasing intake of a substance

A condition where at least two designated characteristics occur within a 12-month period, causing significant impairment or distress.

According to the DSM-5, how is a substance-use disorder defined?

psychoactive

Substances that alter moods, thought processes, or other psychological states are known as _____ substances.

Two or three symptoms.

How many DSM-5 symptoms must be present for a substance-use disorder to be considered 'mild’?

Four or five symptoms.

How many DSM-5 symptoms must be present for a substance-use disorder to be considered 'moderate’?

A severe disorder

If six or more symptoms of a substance-use disorder are present, what is it considered to be?

The quantity of the substance used or the amount of time spent using being often greater than intended.

Which DSM-5 criterion for a substance-use disorder relates to the quantity of substance used or time spent using?

Efforts to control use of the substance are unsuccessful due to a persistent desire for the substance.

Which DSM-5 criterion for a substance-use disorder involves unsuccessful efforts to control use?

Substance use interferes with major role obligations at work, school, or home.

Which DSM-5 criterion for a substance-use disorder relates to interference with major role obligations?

Use of the substance continues despite harmful social or interpersonal effects caused or made worse by substance use.

Which DSM-5 criterion for a substance-use disorder involves continued use despite social or interpersonal problems?

Substance use occurs in situations where substance use may be physically hazardous.

Which DSM-5 criterion for a substance-use disorder describes using a substance in physically hazardous situations?

Alcohol

What is the most commonly abused substance in the United States?

Heroin, crack cocaine, and methamphetamine.

According to a comprehensive analysis, which three substances present the greatest danger to the user?

Depressants

What class of substances causes the central nervous system to slow down?

Moderate Drinking for Men

Two drinks per day

Moderate Drinking for Women

No more than one drink a day

Heavy Drinking

Levels exceeding moderate

Binge Drinking for Women

Four or more drinks

Binge Drinking for Men

Four to five drinks or more

Aldehyde dehydrogenase (ALDH)

An enzyme that helps counteract toxins that build up as the body metabolizes alcohol

50 to 100 times more powerful

Fentanyl is estimated to be how many times more powerful than morphine?

Nitazenes

Highly potent class of novel synthetic opioids, nicknamed 'Frankenstein opioids,' which are up to 1000 times more potent than morphine

They have calming effects and are used to treat agitation, muscle tension, insomnia, and anxiety.

What is the function of sedatives, hypnotics, and anxiolytics?

Hypnotics

Medications that induce sleep

Anxiolytics

Medications that reduce anxiety

Stimulants

Class of substances speeds up central nervous system activity, producing feelings of euphoria and well-being

Caffeine

What is the most widely consumed psychoactive substance in the world?

Headache, fatigue, irritability, and difficulty with concentration.

Common withdrawal symptoms from caffeine

Methampehetamine (Meth)

What particularly dangerous amphetamine has serious health consequences including permanent damage to the heart, lungs, and immune system?

Crack

A potent form of cocaine produced by heating cocaine with other substances, which is typically smoked.

Hallucinogens

Class of substances can produce vivid sensory experiences, including hallucinations

A disorder in which a person has distressing recurrences of hallucinations or other sensations weeks or even years after drug intake.

Hallucinogen Persisting Perception Disorder

Dissociative Anesthetics

Class of substances, including PCP and ketamine, that produces a dreamlike detachment

Robotripping

The misuse of over-the-counter cold medicines containing dextromethorphan (DXM) to get high.

Nicotine

Highly addictive substance, commonly found in cigarettes, acts as both a stimulant and a sedative

Delta-9-tetrahydrocannabinol (THC).

Chemical in cannabis that can produce stimulant, depressant, and hallucinogenic effects

Marijuana

What is the most commonly used illicit drug worldwide?

Huffing

The act of becoming intoxicated from inhaling chemical vapors found in common household products.

Designer Drugs

Substances manufactured as recreational drugs using a variety of chemicals to mimic the effects of other drugs while evading legal restrictions.

Ecstasy (MDMA)

A designer drug that has both stimulant and hallucinogenic properties, popular as a party drug.

Brain chemistry becomes altered from chronic use, leading to physiological dependence, withdrawal, and cravings.

What is the typical third stage in the progression toward drug abuse, after the substance begins to serve an important purpose?

Coping with psychological stress and emotional symptoms like depression and anxiety.

What is a major psychological motive for substance use?

Behavioral undercontrol

What personality characteristic is associated with rebelliousness, impulsivity, and risk-taking, increasing the risk of substance use?

Adolescence and early adulthood

During what period of life are individuals particularly vulnerable to social influences on substance use?

Abrupt changes in parental supervision, increased pressure, easy access to alcohol, and exposure to peers who drink heavily.

In the social dimension of the multipath model, what is a key reason college students are vulnerable to substance abuse?

The stress of everyday discrimination

According to the sociocultural dimension, what societal stressor is associated with an increased risk for substance use, particularly among minority groups?

56%

Genetic factors account for what percentage of alcohol dependence risk?

They flood the brain with dopamine, creating a 'high' that reinforces continued drug use.

How do stimulants like cocaine affect the brain's dopamine reward circuit?

Detoxification, where the user ceases or reduces use of the substance.

What is the first phase of most alcohol and drug treatment programs?

Preventing relapse, which is a return to use of the substance.

What is the focus of the second phase of most substance treatment programs, following detoxification?

Contingency Management

What treatment approach involves providing vouchers or cash incentives for verified abstinence or adherence to treatment goals?

Motivational Enhancement Therapy (MET)

Therapeutic approach that addresses a client's ambivalence about giving up substance use by exploring the pros and cons of change

a disease that requires total abstinence.

According to Alcoholics Anonymous (AA), alcoholism is

An approach assuming that people with alcoholism can learn to limit their drinking to appropriate, low-risk levels.

Controlled Drinking

Antabuse (Disulfiram)

What medication produces an aversion to alcohol by creating highly unpleasant symptoms if alcohol is consumed?

Methadone and Buprenorphine

What synthetic opioids are used in treatment to reduce cravings for more dangerous opioids?

Tolerance develops, leading to an addictive need for the drug itself

A major drawback of using methadone for opioid-use disorder treatment

Individuals who are dependent often resist engaging in treatment and have trouble initiating and maintaining abstinence.

Key difficulty in treating cannabis-use disorder

Varenicline

What smoking cessation medication, marketed as Chantix, reduces cravings and decreases smoking satisfaction?

Nicotine Replacement Therapy (NRT)

A smoking cessation treatment that involves delivering increasingly smaller doses of nicotine via a patch, gum, or other methods to prevent withdrawal symptoms.

Gambling Disorder

A compulsive desire to engage in gambling activities despite negative consequences, requiring at least four defining characteristics in 12 months.

Internet Gaming Disorder

Proposed diagnostic category in the DSM-5-TR involves excessive and prolonged engagement in computerized or Internet games

Adolescent Males

Which demographic is most commonly associated with Internet gaming disorder?

18%

The lifetime prevalence of alcohol-use disorder in the U.S. adult population is approximately

Men

Which gender is twice as likely to develop an alcohol-use disorder?

Women

Which gender does alcohol-use disorder progress more quickly in?

general life stress, stress from trauma, childhood stressors, and the stress of everyday discrimination

Four categories of life stressors that influence substance use

75%

Genetic factors account for what percentage of the risk for illicit drug abuse (excluding alcohol and nicotine)?