Module 6 - Substance-Related and Addictive Disorders

Addiction

a treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and the individual’s life experiences

Neurobiology

Addictive substances are used for their pleasurable effects, to alter mental status, to improve performance, to relieve boredom, or to self-medicate.

When these substances are taken in excess, there will be direct activation of the brain's reward system.

How drugs activate the brain’s reward system

1. A person takes a drug

2. Dopamine activity increases

3. The brain learns that the drug is rewarding

4. Repeated use reinforces the behaviour

Intoxication

The development of a reversible substance-specific syndrome due to the recent ingestion of (or exposure to) a substance

Substance Withdrawal

The development of a substance-specific maladaptive behavioural change that is due to the cessation, or reduction, of heavy and prolonged substance use

Withdrawal Seizures

Seizures occur as a result of alterations in neurobiology

Withdrawal seizures are not responsive to the anticonvulsant medication phenytoin  (Dilantin).

Withdrawal seizures are a repeated occurrence in approximately 10% of heavy drinkers.

Delirium Tremens (DTs)

An episode of intense alcohol withdrawal characterized by disorientation and global confusion, agitation, severe tremor, fluctuating levels of consciousness, autonomic instability, incontinence, and frightening visual hallucinations.

Classess of Substances

1. Alcohol - beer, wine, spirits

2. Caffeine - coffee, tea, energy drinks

3. Cannabis - marijuana

4. Hallucinogens - substances that alter perception, thoughts, and sensory experiences

5. Opioids - morphine, heroin, fentanyl

6. Sedatives - substances that decrease CNS activity

7. Hypnotics - substances that promote sleep

8. Anxiolytics - substances that reduce anxiety, such as benzodiazepines

9. Stimulants - substances that increase CNS activity, such as cocaine and amphetamines

10. Tobacco - nicotine

Cage Questionaire

Have you ever felt you should Cut down on your drinking?

Have people Annoyed you by criticizing your drinking?

Have you ever felt Guilty about your drinking?

Have you ever had a drink first thing in the morning to steady your nerves or get rid of a hangover? (Eye-opener)