12. Substance-Related & Addictive Disorders

Substance-related and addictive disorders

psychological conditions that happen when a person uses alcohol, drugs, or other substances too much to the point that it harms their body, emotions, and everyday life.

Substance Use

This means just using or trying a substance.

Substance Intoxication

This is what happens right after taking the substance.

Substance Use Disorder (Addiction)

This is when the person cannot stop using it even though it’s causing harm.

addiction

In the past, it was thought to be a personality problem because people with addiction often showed impulsive, rule-breaking, or antisocial behaviors, so it was wrongly linked to sociopathic personality disorder (treated as a behavior problem).

1980 DSM-III

In this year, experts recognized addiction is influenced by biology, genetics, brain chemistry, and emotions.

11

How many symptoms are in the diagnostic criteria in addiction?

2-3

Number of symptoms present for addiction to be diagnosed as mild

4-5

Number of symptoms present for addiction to be diagnosed as moderate

6 or more

Number of symptoms present for addiction to be diagnosed as severe

craving

In DSM-5, this was added as a key symptom since strong desire to use is central to addiction

Fetal alcohol syndrome (FAS)

now generally 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 (Douzgou et al., 2012).

alcohol dehydrogenase and aldehyde dehydrogenase

About 40% of Japanese, Chinese, and Koreans have an enzyme variation that causes unpleasant reactions to alcohol, leading them to drink less and reducing their risk of developing alcohol use disorder.

Anxiolytic

Reduces anxiety, panic, and stress.

Sedative

Produces calmness, relaxation, and reduces arousal without necessarily causing sleep.

Hypnotic

Promotes sleep (sleep-inducing).

stimulants

the most commonly consumed of all the psychoactive drugs

stimulant

a type of psychoactive substance that increases activity in the brain and can temporarily elevate alertness, mood, and awareness.

caffeine, nicotine, amphetamines, cocaine

psychoactive drugs under stimulant group

Amphetamines

At low doses, can induce feelings of elation and vigor and can reduce fatigue. Some people take them to lose weight because it can also reduce appetite.

Methamphetamine (commonly referred to as “crystal meth” or “ice”)

is ingested through smoking. This drug causes marked aggressive tendencies and stays in the system longer than cocaine, making it particularly dangerous.

Cocaine

Derived from the leaves of the coca plant, a flowering bush indigenous to South America

Cocaine

In small amounts, increases alertness, produces euphoria, increases blood pressure and pulse, and causes insomnia and loss of appetite.

Cocaine

also makes the heart beat more rapidly and irregularly, and it can have fatal consequences, depending on a person’s physical condition and the amount of the drug ingested

caffeine

called the “gentle stimulant” because it is thought to be the least harmful of all addictive drugs, it can still lead to problems similar to that of other drugs

Opiate

refers to the natural chemicals in the opium poppy that have a narcotic effect

Opiate

natural painkillers from opium poppy relieve pain and induce sleep

Opioids

family of substances that can cause sleepiness, relaxation, or addiction if misused — similar to opiates, but they can be Natural, Semi-Synthetic, and Fully Synthetic

Cannabis sativa

Scientific name for Marijuana

Cannabis

grows wild throughout the tropical and temperate regions of the world, which accounts for one of its nicknames, “weed.”

marijuana

People who smoke this often experience altered perceptions of the world.

cannabinoids

Marijuana contains more than 80 varieties of the chemicals called __, which are believed to alter mood and behavior

LSD (d-lysergic acid diethylamide)

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

LSD

It is produced synthetically in laboratories, although naturally occurring derivatives of this grain fungus (ergot) have been found historically.

hallucinogens

these substances have no withdrawal symptoms reported

psilocybin

found in certain species of mushrooms

lysergic acid amide

found in the seeds of the morning glory plant

dimethyltryptamine (DMT)

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

mescaline

found in the peyote cactus plant

Inhalants

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

Inhalants

long-term use can damage bone marrow, kidneys, liver, lung, nervous system, and the brain

DOPAMINE

Pleasure, appetite suppression

NOREPINEPHRINE

Arousal, appetite suppression

ACETYLCHOLINE

Arousal, cognitive enhancement

GLUTAMATE

Learning, memory enhancement

SEROTONIN

Mood modulation, appetite suppression

BETA-ENDORPHIN

Reduction of anxiety and tension

GABA

Reduction of anxiety and tension

opponent-process theory

the theory claims that the mechanism of negative reinforcement is strengthened with use and weakened by disuse. So a person who has been using a drug for some time will need more of it to achieve the same results (tolerance)

expectancy effect

refers to how a person’s thoughts and beliefs about drug use influence their likelihood of using substance

moral weakness model

society view that leads to punishing those afflicted with the disorder

disease model

society view includes seeking treatment for a medical problem

Machismo

male dominance in Latin cultures

Tiu lien

loss of face” among Asians, that can lead to shame for not living up to cultural expectations

Marianismo

female Latin role of motherly nurturance and identifying with the Virgin

ALDH gene

People of Asian descent are more likely to have this gene, which produces a severe “flushing” effect (reddening and burning of the face) after drinking alcohol

agonist substitution

Involves providing the person with a safe drug that has a chemical makeup similar to the addictive drug

Methadone

an opiate agonist that is often given as a heroin substitution

Antagonist drugs

block or counteract the effects of psychoactive drugs, and a variety of drugs that seem to cancel out the effects of opiates have been used with people dependent on a variety of substances.

naltrexone

the most often prescribed opiate-antagonist drug that has had only limited success with individuals who are not simultaneously participating in a structured treatment program.

aversive treatment

The goal is that a person who associates the drug with feelings of sickness or discomfort will be less likely to continue using it.

disulfiram (Antabuse)

most commonly known aversive treatment for people who have alcohol use disorder

Clonidine

developed to treat hypertension, has been given to people withdrawing from opiates.

Sedative drugs (benzodiazepines)

often prescribed to help minimize discomfort for people withdrawing from other drugs, such as alcohol

Inpatient Facilities

hospitals or treatment centers where people with serious mental or emotional problems stay to get 24-hour care and supervision.

1935

year the first specialized facility for people with substance abuse problem

First Federal Narcotic Farm

built in Lexington, Kentucky designed to help people get through the initial withdrawal period and to provide supportive therapy so that they can go back to their communities (Morgan, 1981)

Alcoholics Anonymous and Its Variations (AA)

the most popular treatment model for substance abuse.

12

AA is based on _ Steps Program

Aversion Therapy

uses conditioning to pair substance use with negative stimuli, like electric shocks or nausea

Covert Sensitization

imagining unpleasant consequences to create negative associations with substance use

Contingency Management

rewards clients for achieving specific behavioral changes

Motivational Enhancement Therapy (MET)

focuses on empathetic counseling and connecting client goals to personal values, improving clients ' belief in their ability to change

CBT

addresses reactions to cues that trigger substance use, thoughts, and behaviors to resist use, and relapse prevention

relapse prevention model by Marlatt and Gordon

component treatment that focuses on cognitive and behavioral coping skills

DARE Program (Drug Abuse Resistance Education)

traditional prevention program that teaches that drugs are harmful. “Just say no”

The Montana Meth Project

Modern Approach started by Timothy Siegel in Montana that uses emotional ads and shocking videos to show meth danger

4-5

Criteria met for Gambling Disorder to be considered mild

6-7

Criteria met for Gambling Disorder to be considered moderate

8-9

Criteria met for Gambling Disorder to be considered severe

intermittent explosive disorder

The impulsive (or anger-based) aggressive outbursts have a rapid onset and, typically, little or no prodromal period. Outbursts typically last for less than 30 minutes and commonly occur in response to a minor provocation by a close intimate or associate

Kleptomania

a mental health disorder that involves repeatedly being unable to resist urges to steal

Pyromania

literally means “an obsession with fire”, not that the person is “burning”.. It describes the compulsive urge to set fires, not being on fire themselves