Substance Use Disorders

Substance-related and Addictive Disorders

Misuse of drugs and other substances people take to alter the way they think, feel, and behave

Substance

chemical compounds that are ingested to alter mood or behavior.

Impulse-control Disorders

• represent a number of related problems that involve the inability to resist acting on a drive or temptation

• Included in this group are those who cannot resist aggressive impulses or the impulse to steal, for example, or to set fires

Psychoactive Substances

• Alter mood, behavior, or both

• Aside from cocaine and heroine, it includes legal drugs such as alcohol, caffeine, and nicotine

Substance use

• ingestion of psychoactive substances in moderate amounts

• does not significantly interfere with social, educational, or occupational functioning.

• Ex: drinking coffee every morning and occasional use of drugs

Intoxication

Our physiological reaction to ingested substances— drunkenness or getting high

Substance use disorder

at least two symptoms in the past year that interfered with their life or bothered them a great deal

Moderate substance use disorder

four to five symptoms

Severe substance use disorder

6 or more symptoms

Psychological Dependence

symptoms that include tolerance and withdrawal

Tolerance

meaning the use of increasingly greater amounts of the drug to experience the same eect

Withdrawal

having a negative physical response when the substance is no longer ingested

general withdrawal symptoms

chills, fever, diarrhea, nausea and vomiting, and aches and pains.

LSD withdrawal symptoms

no withdrawal symptoms

Cocaine withdrawal symptoms

includes anxiety, sleep changes, lack of motivation, and boredom

Cannabis withdrawal symptoms

irritability, nervousness, appetite change, and sleep disturbance

Withdrawal Delirium

a condition that can produce frightening hallucinations and body tremors

Dementia

involves the general loss of intellectual abilities and can be a direct result of neurotoxicity or “poisoning of the brain” by excessive amounts of alcohol

Wernicke-Korsakoff Syndrome

results in confusion, loss of muscle coordination, and unintelligible speech

thiamine

it is believed to be caused by a deficiency of _______, a vitamin metabolized poorly by heavy drinkers

Fetal Alcohol Syndrome

• a combination of problems that can occur in a child whose mother drank while pregnant

• These problems include fetal growth retardation, cognitive deficits, behavior problems, and learning diculties

sedative

calming

hypnotic

sleep-inducing

anxiolytic

anxiety-reducing

Barbiturates (sedative)

• were prescribed to help people sleep and replaced such drugs as alcohol and opium.

• relaxes the muscles to the point were the diaphragm can relax so much and lead to death by suocation

Examples of barbiturates

Amytal, Seconal, Nembutal

Benzodiazepines (anxiety-reducing)

• Used to reduce anxiety

• Calms the individual, induces sleep, and acts similar to alcohol

• considered much safer than barbiturates, with less risk of excessive use and dependence

Examples of Benzodiazepines

Xanax, Valium, Ativan, and Rohypnol

Rohypnol (“forget-me-pill”)

gaIned popularity in teenagers as it has the same eects as alcohol but without the telltale odor. This drug has been involved in many cases of date rape.

narcolepsy

sleep disorder (excessive sleepiness) where patients with this disorder are prescribed with amphetamines

Ritalin and Adderall

amphetamines prescribed for ADHD

Withdrawal symptoms from Amphetamines

apathy, prolonged sleep, irritability, and depression

Overdose symptoms

causes hallucinations, panic, agitation, paranoid delusions

MDMA (ecstasy)

• common name

• prescribed as appetite suppresant

• club drug after cocaine and meth

• makes u feel happy and love everyone and everything

• can cause memory problems long term

molly

• new variant of MDMA

• purified powder in capsules

Metamphetamines (crystal meth)

• purified, crystallized form of methamphetamines

• ingested via SMOKING

• marked aggressive tendencies (stays in the body longer than cocaine)

Cocaine

• stimulants with are short-lived effects, leading to repeated snorting to keep up

• mainly shows effect through DOPAMINE SYSTEM

Dopamine and Norepinephrine

systems primarily affected by amphetamines

nicotinic acetylcholine receptors(NaRCHs) in midbrain and limbic system

effects to the brain of nicotine

Adenosine and dopamine (to a lesser extent)

effects to the brain of caffeine

agonist substitution

• Administering a medical drug with same chemical makeup but without its harmful effects

• Limitation arises when a patient builds up tolerance.

• For Nicotine - Alternative form can be administered but is gradually reduced

• Nicotine patch, nicotine gum, and inhalant

antagonist treatment

• Blocks the effect of the substance - Patient must be free from withdrawal symptoms and must be highly motivated to continue with the treatment

• MOST COMMON: Naltrexone

aversion treatment

• Introducing unpleasant physiological conditions when exposed to the addictive substance to associate the substance with unpleasant sensations

• MOST COMMON: Antabuse & Disulfiram

component treatment

multiple programs to be attended by the patient

covert sensitization

associates the use with an unpleasant scenario

contingency management

• Encourages positive behavior changes by using positive reinforcement method

• Ex: A patient is rewarded when they reach this milestone

community reinforcement approach

• Patients are encouraged to connect themselves with positive social groups in a form of familial reconnection, blocking negative influences.

• Teaches patients how to recognize negative relationship that may have influenced their Substance use

cognitive behavioral therapy

• Teaches the patient how to handle the disorder and future problems

• aims to identify, avoid, and handle situations that may lead to relapse