Addictive Disorders ch 17

Substance-Related and Addictive Disorders

Involve the excessive use of a substance or engagement in a behavior despite significant substance-related problems.

Substance Use Disorder

A problematic pattern of substance use leading to significant impairment or distress.

Substance-Induced Disorders

Conditions caused by substance use, including intoxication, withdrawal, and other mental disorders.

DSM-5 Criteria for Substance Use Disorder

At least 2 of 11 criteria within a 12-month period, including tolerance, withdrawal, cravings, and failed attempts to cut down.

Substances Included

Alcohol, caffeine, cannabis, hallucinogens, inhalants, opioids, sedatives, stimulants, tobacco, and others.

Tolerance

Need for increased amounts of a substance to achieve intoxication or diminished effect with the same amount.

Withdrawal

Physiological and psychological symptoms that occur when reducing or stopping substance use.

Gambling Disorder

Persistent and recurrent problematic gambling behavior leading to impairment or distress.

DSM-5 Criteria for Gambling Disorder

At least 4 of 9 criteria over a 12-month period, including preoccupation, tolerance, chasing losses, and jeopardizing relationships.

Etiology of Substance Use Disorders

Includes genetic, neurobiological, psychological, and environmental influences.

Neurobiology of Addiction

Involves dopamine reward pathway and changes in brain regions related to impulse control.

Risk Factors

Include family history, trauma, peer influence, and mental health disorders.

Functional Impact

Affects relationships, employment, legal status, and physical/mental health.

Medical Complications

Liver disease, cardiovascular problems, neurological damage, and infectious diseases.

Psychiatric Comorbidities

High rates of depression, anxiety, PTSD, and other mental illnesses.

Treatment Approaches

Includes detoxification, medication-assisted treatment, psychotherapy, and support groups.

Medication-Assisted Treatment (MAT)

Includes methadone, buprenorphine for opioids; disulfiram, naltrexone for alcohol.

Psychotherapy

CBT, motivational interviewing, and contingency management are effective approaches.

12-Step Programs

Peer-support groups such as Alcoholics Anonymous promoting abstinence and recovery.

Prognosis

Varies by individual and substance; relapse is common but can be managed with ongoing care.

Relapse Prevention

Strategies include coping skills, trigger identification, and support systems.

Difference: Use vs. Use Disorder

Use may be occasional or non-problematic; use disorder includes functional impairment.

Addictive Disorders (Non-Substance)

Only gambling disorder is recognized in DSM-5; others like internet gaming are under study.