CH-11-Substance-Related, Addictive & Impulse-Control Disorders – Detailed Study Notes

Key terms and definitions drawn from the lecture on substance-related, addictive, and impulse-control disorders.

DSM-5 category covering problems caused by using drugs (depressants, stimulants, opioids, hallucinogens, etc.) and by gambling.

Substance-Related and Addictive Disorders

Any chemical compound that alters mood, behavior, or perception (e.g., alcohol, nicotine, caffeine).

Psychoactive Substance

Ingestion of psychoactive substances in moderate amounts without major interference in functioning.

Substance Use

Reversible, drug-specific physiological and psychological changes occurring shortly after ingestion (e.g., impaired judgment, motor problems).

Substance Intoxication

Maladaptive pattern of substance use leading to distress/impairment, shown by at least two DSM-5 symptoms within 12 months.

Substance Use Disorder

Body adapts to a drug, shown by tolerance and withdrawal when the substance is reduced or stopped.

Physiological Dependence

Need for markedly increased amounts of a substance to achieve the same effect, or diminished effect with continued use of the same amount.

Tolerance

Unpleasant physical and psychological reactions when a drug is no longer taken (e.g., chills, nausea, tremors).

Withdrawal

Drug class that decreases central nervous system activity and produces relaxation (e.g., alcohol, barbiturates, benzodiazepines).

Depressants

Most widely used depressant; initially acts as a stimulant by inhibiting inhibitory brain centers, then produces sedation.

Alcohol (Ethyl Alcohol)

Problematic drinking marked by craving, loss of control, tolerance, withdrawal, and continued use despite harm.

Alcohol Use Disorder

Severe alcohol withdrawal reaction featuring hallucinations, body tremors, and confusion.

Delirium Tremens (DTs)

Irreversible brain disorder (confusion, memory loss, ataxia) caused by thiamine deficiency in chronic heavy drinkers.

Wernicke-Korsakoff Syndrome

Growth, facial, and cognitive abnormalities in children whose mothers drank heavily during pregnancy.

Fetal Alcohol Syndrome (FAS)

Liver enzyme that metabolizes alcohol; genetic variants affect tolerance and FAS risk.

Alcohol Dehydrogenase (ADH)

Old-generation sedatives (e.g., Seconal) that can cause lethal respiratory depression at high doses.

Barbiturates

Anxiolytic depressants (e.g., Valium, Xanax) that enhance GABA; safer than barbiturates but still addictive.

Benzodiazepines

Drug class that increases alertness and energy (e.g., amphetamines, cocaine, nicotine, caffeine).

Stimulants

Synthetic stimulants that release dopamine/norepinephrine; produce elation and reduce fatigue (e.g., Adderall).

Amphetamines

Potent, long-acting form of amphetamine that is smoked; high addiction and neurotoxicity risk.

Methamphetamine (Crystal Meth)

Designer amphetamine producing stimulant and hallucinogenic effects; can cause memory deficits.

MDMA (Ecstasy/Molly)

Stimulant from coca leaves that blocks dopamine reuptake; produces short-lived euphoria and high addiction risk.

Cocaine

Suspicion and fear occurring in a majority of heavy cocaine users during intoxication.

Cocaine-Induced Paranoia

Addictive stimulant in tobacco that stimulates nicotinic acetylcholine receptors and dopamine pathways.

Nicotine

Brain sites activated by nicotine, leading to dopamine release and reward.

Nicotinic Acetylcholine Receptors (nAChRs)

World’s most used stimulant; blocks adenosine reuptake, increasing alertness; high doses cause jitteriness.

Caffeine

Natural or synthetic substances (heroin, morphine, codeine) that relieve pain and produce euphoria by acting on endorphin receptors.

Opioids (Opiates)

Illicit opioid producing intense rush; high overdose and dependence potential.

Heroin

Long-acting opioid agonist used in agonist-substitution therapy for heroin dependence.

Methadone

Partial opioid agonist used to reduce craving and withdrawal with lower abuse risk than methadone.

Buprenorphine

Dried parts of Cannabis sativa containing THC; causes mood swings, sensory changes, and potential dependence.

Cannabis (Marijuana)

Primary psychoactive cannabinoid in marijuana responsible for the “high.”

THC (Δ-9-Tetrahydrocannabinol)

Naturally occurring brain cannabinoid (“bliss” molecule) that binds THC receptors.

Anandamide

Drugs that alter sensory perception and can cause hallucinations (e.g., LSD, psilocybin).

Hallucinogens

Potent synthetic hallucinogen first synthesized from ergot fungus; produces perceptual disturbances.

LSD (Lysergic Acid Diethylamide)

Hallucinogenic compound found in certain mushrooms; activates serotonin receptors.

Psilocybin

Dissociative anesthetic causing impulsivity and psychosis-like states; nicknamed “angel dust.”

PCP (Phencyclidine)

Synthetic substances (e.g., MDMA, MDPV “bath salts,” ketamine) created to mimic illegal drugs and often sold legally at first.

Designer Drugs

Volatile solvents (glue, paint thinner) inhaled for brief intoxication; can cause organ damage and sudden death.

Inhalants

Synthetic testosterone derivatives misused to increase muscle mass; may cause mood disturbances.

Anabolic-Androgenic Steroids

Treatment using safer drug with similar action to replace abused drug (e.g., methadone for heroin).

Agonist Substitution

Medication blocks or counters drug’s effect (e.g., naltrexone for opioids/alcohol).

Antagonist Treatment

Drug makes substance use unpleasant (e.g., disulfiram/Antabuse causes vomiting if alcohol is consumed).

Aversive Treatment

Behavioral therapy rewarding clients for evidence of abstinence (e.g., voucher for clean urine).

Contingency Management

Multifaceted program improving relationships, employment, recreation to support abstinence.

Community Reinforcement Approach

Brief intervention increasing clients’ motivation by linking drug use to personal goals and values.

Motivational Enhancement Therapy (MET)

Cognitive-behavioral strategy teaching coping skills and viewing slips as temporary, controllable events.

Relapse Prevention

Addictive disorder marked by persistent, maladaptive gambling behavior and cravings similar to substance dependence.

Gambling Disorder

Impulse-control disorder involving repeated aggressive outbursts disproportionate to stressors.

Intermittent Explosive Disorder

Impulse-control disorder with recurrent failure to resist stealing unneeded items, accompanied by tension and relief.

Kleptomania

Impulse-control disorder characterized by compulsive fire-setting and fascination with fire.

Pyromania