Substance Use and Addictive Disorders

Substance

Any substance (excluding food) that affects the body or mind. The term 'substance' includes alcohol, tobacco, and caffeine.

Substance Intoxication

A temporary state of poor judgment, mood changes, irritability, slurred speech, and poor coordination.

Substance Use Disorder

A chronic pattern of behavior where a person excessively relies on a drug, characterized by tolerance and withdrawal.

Categories of Substances

1. Depressants: Slow CNS activity (e.g., alcohol, opioids).
2. Stimulants: Increase CNS activity (e.g., cocaine, amphetamines).
3. Hallucinogens: Cause sensory changes (e.g., LSD).
4. Cannabis: Has both depressant and stimulant effects.

Alcohol Dependence

A condition characterized by a compulsion to consume alcohol, developing tolerance and experiencing withdrawal symptoms.

Alcohol Tolerance

The need to consume increasing amounts of alcohol to achieve the same effects.

Alcohol Withdrawal Symptoms

Unpleasant physical and psychological effects that occur upon cessation of alcohol use, which may include anxiety, tremors, sweating, and nausea.

Long-term Effects of Alcohol Dependence

Can include liver damage, increased risk of cancer, nutritional deficiencies, and fetal alcohol syndrome risk.

Opioids

A class of drugs that include both natural and synthetic substances that act on the opioid receptors in the brain to relieve pain.

Types of Opioids

1. Natural Opioids: Opium, Heroin
2. Synthetic Opioids: Methadone

Effects of Opioids

Provides a pain relief by binding to opioid receptors in the brain and can induce feelings of euphoria.

Dangers of Opioids

Can lead to dependence, overdose, and serious dangers like respiratory depression.

Stimulants

Are drugs that increase CNS activity, leading to heightened alertness, energy, and elevated mood.

Types of Stimulants

1. Cocaine
2. Amphetamines
3. Caffeine

Target Systems of Stimulants

Stimulants primarily target the central nervous system (CNS) to increase dopamine levels.

Effects of Cocaine

The drug increases dopamine, producing euphoria but can lead to cardiac issues, overdose, and 'crashing' post-use.

Effects of Amphetamines

This drug increase alertness, but high doses can result in psychosis and cardiovascular problems.

Effects of Caffeine

A widely used stimulant; withdrawal can cause headaches and fatigue.

Risks of Stimulants

Risks include overdose, addiction, heart issues, and potential mental health disorders.

Hallucinogens

Substances that cause powerful sensory and perceptual changes.

LSD

A potent hallucinogen known for inducing altered states of consciousness and perceptual distortions.

Psilocybin

A naturally occurring psychedelic compound found in certain mushrooms.

Causes of Hallucinogens

Primarily affect serotonin receptors in the brain, leading to altered perception and mood.

Risks of Hallucinogens

Can include bad trips, persistent changes in perception (flashbacks), and psychological distress.

Cannabis

A drug comprising marijuana and hashish, where THC is the active component.

Increase in Cannabis Potency

Potency has increased over time due to selective breeding and cultivation techniques, resulting in higher levels of THC.

Polysubstance Use

The concurrent use of multiple substances, which can enhance effects or lead to dangerous interactions.

Synergistic Effects

When the combined effects of different substances are greater than the sum of their individual effects.

Cross-Tolerance

A phenomenon where tolerance to one drug results in tolerance to another, often seen in polysubstance use.

Behavioral Therapies

Therapies that reinforce drug-free living, often through contingency management techniques.

Cognitive-Behavioral Therapies

Therapies focused on self-control and coping strategies to prevent relapse by addressing distorted beliefs.

Biological Treatments

Treatments that include detoxification and medications blocking substance effects to help with withdrawal and cravings.

Sociocultural Therapies

Therapeutic approaches that involve peer support groups and community programs, emphasizing recovery through social support.

Gambling Disorder

A persistent and recurrent problematic gambling behavior leading to significant impairment or distress.

Cognitive Behavioral Therapy (CBT)

A treatment that focuses on identifying and changing distorted beliefs about gambling, enhancing coping skills, and developing strategies to manage triggers and urges.

Self-Help Groups

Supportive communities, like Gamblers Anonymous, where individuals share experiences and strategies for recovery, following a twelve-step approach.

Motivational Interviewing

A counseling approach that enhances motivation to change by exploring ambivalence and encouraging positive behavioral changes.

Family Therapy

Involves the family in the treatment process, addressing family dynamics that may contribute to gambling behavior.

Financial Counseling

Assists individuals in creating a budget and managing finances to mitigate the financial consequences of gambling.

Internet Gaming Disorder

Currently under consideration for DSM inclusion; characterized by excessive and compulsive use of internet games.