Substance Use Disorders

5 main categories of substances

• depressants

  • behavioral sedation

• stimulants

• opiates

• hallucinogens

• other

depressants

• most widely used depressant

  • alcohol

  • sedative-hypnotic drugs

  • opioids

• slow the activity of the CNS

  • reduce tension and inhibitions

  • may interfere with judgement, motor activity, and concentration

alcohol

• more than half of US residents drink alcoholic beverages

• binge drinking episodes

  • when people consume five or more drinks on a single occasion

• contain ethyl alcohol

  • absorbed quickly into the blood, carried to the CNS

  • works on multiple neurotransmitters

  • enhances the inhibitory effects of GABA and brings about relaxation

• extent of the effect of ethyl alcohol is determined by its concentration in the blood

  • 0.06%=person feels relaxed and comfortable

  • 0.08%=intoxication

  • 0.55% will lead to death

• effects subside only after alcohol is metabolized by the liver

• the average rate of this metabolism is 25% of 1 oz per hour

• gender affects blood alcohol concentration-dehydrogenase

alcohol use disorder

• individual alcoholism patterns vary

• damage in various structures of the brain

• impairments in memory, speed of thinking, attention skills, and balance are found in chronic heavy drinkers

• tolerance and withdrawal

• various withdrawal symptoms

  • nausea and vomiting

  • delirium tremens

    • confusion, clouded consciousness, and hallucinations

• plays a role in suicides, homicides, assaults, rapes, and fatal automobile accidents

• seriously damages physical heath

• children of alcoholics at higher risk for abuse, fetal alcohol syndrome, and miscarriage

sedative-hypnotic drugs

• low doses=calming or sedative effect

• high doses=sleep inducers or hypnotics

• barbiturates

  • widely prescribed in the first half of the 20th century, largely replaced

• benzodiazepines

  • xanax, valium, Ativan

  • safer and less likely to lead to intoxication, tolerance effects, and withdrawal reactions compared with barbiturates

  • long-term use by elderly can cause severe cognitive impairment

  • increases GABA activity

• combining depressants can have dangerous synergistic effects

opioids

• include natural and synthetic blended drugs

• known as narcotics

  • cause CNS depression, drugs attach to endorphin-related brain receptors

• each of the drugs has a different strength, speed of action, and tolerance level

• medical opioids

opioids use disorder

• tolerance builds quickly and withdrawal occurs when drug ingestion stops

• early withdrawal symptoms-anxiety and restlessness

• later withdrawal symptoms-twitching, aches, fever, vomiting, diarrhea, and weight loss from dehydration

• increased doses are required to avoid withdrawal

stimulants

• most widely consumed drugs in the US due to caffeine and nicotine

• stimulants increase the activity of the CNS

• most common stimulants

  • caffeine

  • nicotine

  • amphetamines

cocaine

• most powerful known natural stimulant

• increases the supply of dopamine at key neurons throughout the brain as well as norepinephrine and serotonin levels

• effects of high doses

  • cocaine intoxication

  • cocaine-induced psychotic disorder

• physical dangers

  • overdose

  • excessive doses leads to depressing the brain’s respiratory functions, heart irregularities, or brain seizures

  • increased likelihood of birth complications

  • >10,000 deaths per year

amphetamines

• laboratory-manufactured stimulant drugs

• misuse is common among college students

• high doses

  • rush, intoxication, and psychosis

methamphetamine

• meth, crank

• a very potent and addictive amphetamine

• around 42% of current users are women

• designated as a club drug and often tied to raves

• uses dangers

  • serious negative effects on physical, mental, and social life

  • linked to increased ER visits

  • may cause neurotoxicity, methamphetamine-induced psychosis

stimulant use disorder

• stimulant dominates the individual’s life

• leads to poor functioning in social relationships and at work

• tolerance and withdrawal reactions tied to increased doses

• withdrawal symptoms can include deep depression, fatigue, sleep issues

hallucinogens

• produce powerful changes primarily in sensory perception

• natural hallucinogens

  • LSD

  • MDMA, ecstasy

• prevalence

  • hallucinogen use at some point: 10% of US population, current users: 0.2%

• LSD tolerance and withdrawal are rare

• danger is in long-term effects

  • self-injury, bad trips, flashbacks

LSD

• one of the most powerful hallucinogens

• brings on a state of hallucinogen intoxication

• increases and alters sensory perception, psychological changes, and physical symptoms

• hallucinogens and/or synesthesia

• effects typically wear off in about 6 hours