Substance Use and Gambling Disorders

Substance Use and Gambling Disorders

Chapter Overview

  • Author: Susan Nolen-Hoeksema

  • Copyright: © 2014 McGraw-Hill Education. All rights reserved.

  • Topics Covered:

    • Defining substance use disorders

    • Depressants

    • Stimulants

    • Opioids

    • Hallucinogens and PCP

    • Cannabis

    • Inhalants

    • Other drugs of abuse

    • Theories of substance use disorders

    • Treatments for substance use disorders

    • Gambling disorder

Substance Use Disorders

  • Definition: Chronic difficulties in resisting the desire to drink alcohol or take drugs.

  • Substance: Any natural or synthesized product that has psychoactive effects.

  • Substance Intoxication: Symptoms arise as a result of the physiological effects of a substance on the central nervous system, which depend on the substance and the setting.

  • Substance Withdrawal: Symptoms that occur when individuals who have been using substances heavily for prolonged periods stop or significantly reduce use.

Criteria for Substance Use Disorder

  • Substance Abuse:

    • Involves recurrent use of a substance leading to:

    • Failing to fulfill important obligations

    • Using the substance in physically hazardous situations

    • Legal problems as a result of substance use

    • Continuing to use the substance despite social or legal issues.

  • Substance Dependence:

    • Characterized by:

    • Tolerance: Diminished effects from the same dose of a substance, necessitating increased amounts for the same effect.

    • Categories of substances:

    • Central Nervous System (CNS) Depressants

    • CNS Stimulants

    • Opioids

    • Hallucinogens and Phencyclidine (PCP)

    • Cannabis

Depressants

  • Effects: Slow down the central nervous system.

    • Moderate doses lead to:

    • Relaxation and drowsiness

    • Reduced concentration

    • Impaired judgment and motor skills.

    • Heavy doses can cause:

    • Stupor or even death.

Alcohol Use

  • Effects on the Brain:

    • Low Doses: Feelings of self-confidence, relaxation, euphoria, and decreased inhibition.

    • Increasing Doses: Symptoms of depression, fatigue, decreased motivation, sleep disturbances, depressed mood, and confusion.

    • Effects are influenced by whether consumed on an empty or full stomach and can interact fatally with various substances.

  • Long-Term Effects: Include a range of health and psychological issues.

Benzodiazepines and Barbiturates

  • Usage: Legally manufactured and sold by prescription as sedatives for treating anxiety and insomnia.

  • Risks: Decrease in blood pressure, respiratory rate, and heart rate; overdose can lead to death from respiratory arrest or cardiovascular collapse.

Stimulants

  • Function: Activate the central nervous system.

    • Cause feelings of energy, happiness, reduced need for sleep, and decreased appetite.

  • Cocaine:

    • A highly addictive substance derived from the coca plant.

    • Crack Cocaine: Freebase cocaine processed into small chunks for smoking.

    • Effects: Produces intense euphoria but quickly wears off, leading to complications like anxiety and paranoia.

Cocaine Intoxication

  • Symptoms: Euphoria, grandiosity, impulsivity, compulsive behavior, agitation, and medical complications.

  • Impact on Brain: Activates reward areas which amplify the sense of pleasure.

Amphetamines

  • Usage: Prescribed for attention problems, narcolepsy, and chronic fatigue.

  • Mechanism: Release dopamine and norepinephrine; rapid tolerance and dependence can develop.

Nicotine

  • Definition: An alkaloid found in tobacco, primarily consumed via cigarettes.

  • Effects: Mimics fight-or-flight responses; associated with severe health issues like lung cancer and heart disease.

  • Withdrawal Symptoms: Include depression, insomnia, irritability, anxiety, and increased appetite.

Caffeine

  • Profile: Most commonly used stimulant.

  • Mechanism: Stimulates CNS leading to increased levels of dopamine, norepinephrine, and serotonin, resulting in heightened metabolism and blood pressure.

Opioids

  • Source: Derived from opium poppy sap used for pain relief.

  • Examples: Morphine, heroin, codeine, methadone.

  • Effects: Lead to drowsiness, lethargy, and suppressed respiratory and cardiovascular systems, which can be fatal.

Hallucinogens, PCP, and Cannabis

  • Hallucinogens: Produce perceptual changes at low doses; include substances like LSD and peyote.

  • PCP (Phencyclidine): Can have severe effects including chronic cough and respiratory issues.

  • Cannabis: Forms various psychoactive compounds with complex effects on cognition and physical health.

Inhalants

  • Nature: Volatile substances inhaled for psychoactive effects.

  • Risks: Chronic use can cause permanent central nervous system damage and be life-threatening.

Theories of Substance Use Disorders

Biological Factors

  • Alterations in reward centers leading to cravings, genetic factors affecting neurotransmitter function, and sensitivity of dopamine receptors.

Psychological Factors

  • Influence of parental modeling, coping with stress through substance use, and behavioral undercontrol leading to prior substance use issues.

Sociocultural Factors

  • Environmental influences, including poverty and family dynamics, reinforcing substance use behaviors.

Gender Differences

  • Societal expectations and risk factor prevalence vary between genders, with women generally facing fewer risk factors and suffering from alcohol-related health issues at lower consumption levels.

Treatments for Substance Use Disorders

Biological Treatments

  • Include antianxiety medications, antidepressants, and drug antagonists that block or alter substance effects. Methadone maintenance programs for heroin addiction exemplify one approach.

Psychosocial Treatments

  • Focus on relapse prevention strategies, cognitive-behavioral techniques to change thought patterns regarding substance use, and support organizations like Alcoholics Anonymous (AA).

Substance Use Treatment for Older Adults

  • Employ nonconfrontational approaches with a focus on emotional states related to substance use, rebuilding social networks, and respecting the needs of older patients through closely coordinated community resources.

Prevention Programs

  • Address college drinking and related problems effectively through educational approaches that encourage moderation rather than insistence on total abstinence. They adopt a harm reduction model, emphasizing safety and realistic drinking behaviors.

Gambling Disorder

  • Definition: Persistent and recurrent problematic gambling behaviors causing significant distress or impairment.

    • Associated with issues in substance use, mental health, and family history of substance abuse.

    • More prevalent in men and linked to the same brain regions impacted by substance dependencies.

Treatment for Gambling Disorder

  • Cognitive-Behavioral Therapy: Focus on altering distorted beliefs surrounding control and gambling, replacing harmful behaviors with positive coping strategies, and addressing underlying emotional struggles.