Chapter 9 - Features of Drug Abuse and Addiction

Addiction

Certain individuals use certain substances in certain ways thought at certain times to be unacceptable by certain other individuals for reasons both certain and uncertain

(It is hard to define)

Physical Dependence Model

Abstinence of drugs led to unpleasant withdrawl symptoms that motivate the person to return to drug use

(Some drugs produce only minor physical dependance)

Behavior Model

The compulsion of drug seeking; addiction is driven by a craving

Craving

A strong urge to take the drug, regardless of whether it is pleasant to take

Remission

Drug free periods

Relapses

Drug usage recurs after a period of remission, despite the negative consquences

Current Scientific View of Addiction

A chronically relapsing disorder, characterized by compulsions to seek and and take the drug, loss of control in limiting intake, and emergence of a negative emotional stage when access to the drug is prevented.

APA and Addiction/Adict

Conflicting definitionsi and strong negative associations led to the APA to stop using addiction/addict as terminology

Substance Related Disorders

10 Classes of Drugs that are considered in the DSM

Alcohol, Caffeine, Cannabis, Hallucinogens, Inhalants, Opioids, Sedative, Hypnotics & Anxiolytic drugs, Stimulants, Tobacco, and other.

What do all 10 substance-related disorders share?

The ability to activate the neural circuitry that mediates “reward”, commonly experienced as a drug-induced high

Substance USE Disorders

A cluster of cognitive, behavioral, and physiological symptoms that indicates the individual continues using the substance, despite significant substance-related problems

Substance-INDUCED Disorders

Development of a reversible substance-specific syndrome due to recent ingestion of a substance

EX: Substance induced psychotic disorder

DSM definition of Drug Addiction

Chronic, relapsing behavioral disorder

Pattern of use must be ‘problematic” and lead to “clinically significant impairment or distress”

No single criterion for determining the presence of a substance use disorder

Severity ranges from Mild, Moderate, Severe

Non-Substance-Related Disorders

Dont involve a substance, but contribute to harm

EX: Gambling, ED, compulsive sexual behavior, compulsive shopping, ect

Which Non-Substance-Related Disorder is in the DSM-5

Gambling, as it meets several of the criteria for substance abuse disorder, and shows similar neurobiological and cognitive dysfunctions

Gateway Theory

The idea that recreational use of drugs, like marijuana or tobacco, can escalate to feeling safe in taking harder drugs like psychedelics or LSD, which can lead to the addiction of drugs

CSA Schedule of Controlled Substances

5 classes, based on degree of potential misuse and medicinal value

Schedule I

No medicinal value, only obtained for research

II-V

Available for medicinal with prescription from medical professional, and can be permitted for research

Which two drugs are not listed on CSA schedules

Tobacco and alcohol