chapter9 p.2Study Notes for Chapter 9: Substance Use, Abuse, and Addiction

Substance Use, Abuse, and Addiction: Chapter 9

Overview

  • Textbook: Health Psychology: Psychology in Everyday Life by David G. Myers and C. Nathan DeWall

  • Edition: 7th Edition

Statistical Overview of Addictions

  • Global Statistics:

    • Approximately 5% of the global population has used an illicit substance.

    • Nearly 240 million individuals worldwide use alcohol problematically.

    • 15 million individuals engage in injection drug use.

  • Canada Statistics:

    • Estimated 21% of Canadians (about 6 million) will meet the criteria for addiction in their lifetime.

    • Alcohol: Most prevalent substance for addiction criteria at 18%.

    • Cannabis use in Canada: Over 40% have used it in their lifetime; around 10% used it within the past year.

    • In Ontario, around 10% of the population uses substances problematically.

    • Cannabis legalization in Canada occurred in October 2018.

Alcohol Use and Abuse

  • General Characteristics:

    • Alcohol is a depressant, slowing the functioning of the central nervous system.

  • Blood Alcohol Level (BAL):

    • Definition: Amount of alcohol in the blood, measured in grams per 100 milliliters.

    • 0.08 grams/100ml considered legal intoxication in most U.S. states.

    • Factors affecting BAL: gender, weight, tolerances.

    • Dangerous levels: Death may occur at BAL of 0.35% or higher.

Prevalence of Alcohol Use

  • In 2015, about 59.4% of college students (ages 18-22) were current drinkers, with 39% reporting binge drinking in the past month.

  • At-risk drinking: Defined as two or more binge-drinking episodes in the past month or an average of two or more drinks per day in the past month.

  • Prevalence of drinking varies by age, gender, education level, ethnicity, and culture.

Physical Effects of Alcohol Consumption

  • Impact on the Body:

    • Disruption of intracellular communication and gene regulation affecting cell function.

    • Prolonged binge drinking can lead to brain shrinkage and inhibition of neurogenesis.

    • Major effects observed on the hippocampus, vital for memory and learning.

    • Interferes with thiamin absorption, leading to complications such as Korsakoff's syndrome.

Alcohol and the Immune and Endocrine Systems

  • Chronic Alcohol Use Effects:

    • Weakened immune system.

    • Cellular DNA damage.

    • Disruption of endocrine system functions:

    • Secretion of growth hormone.

    • Decreased testosterone levels, linked to impotence and lowered fertility in men.

    • Decreased estrogen levels, contributing to menstrual disturbances and increased miscarriage risks in women.

Alcohol Abuse and Brain Impact

  • Positive and negative effects of excessive alcohol consumption:

    • Encourages formation of fat deposits on heart muscles, contributing to cardiovascular disease.

    • Promotes the formation of ulcers and liver diseases such as hepatitis and cirrhosis.

    • Linked to Fetal Alcohol Syndrome (FAS), resulting in birth defects including facial abnormalities, low intelligence, and delayed physical development caused by maternal alcohol consumption during pregnancy.

Psychosocial Consequences of Alcohol Use

  • Behavioral Disinhibition:

    • Defined as a false sense of confidence and freedom from social constraints attributed to alcohol consumption.

  • Alcohol Myopia:

    • Tendency for alcohol to enhance focus on immediate events while diminishing awareness of more distant or future events.

Alcohol Use Disorder (AUD)

  • Definition:

    • A maladaptive drinking pattern where alcohol use interferes with role obligations.

  • Diagnosis Criteria:

    • A person must meet 2 or more of the 11 problem drinking criteria (categorized as mild, moderate, or severe).

  • Factors Explaining Alcohol Abuse:

    • Multiple factors contribute; no single cause completely explains AUD origins.

Genetic Factors in Alcoholism

  • Some individuals inherit greater tolerance toward alcohol's aversive effects or a higher sensitivity to its pleasurable effects.

  • Having a first-degree relative is the strongest predictor of alcoholism.

  • Twin Studies:

    • Concordance rates are higher in identical twins compared to fraternal twins.

Alcohol, Temperament, and Personality

  • Behavioral Undercontrol:

    • Characterized by impulsiveness, aggressiveness, and unconventionality.

  • Negative Emotionality:

    • Related to alcohol abuse characterized by depression and anxiety.

  • Alcohol Expectancy Effects:

    • Individual beliefs about how alcohol affects their behavior can influence usage.

Treatment and Prevention of AUD

  • Drug Treatment:

    • Use of detoxification agents and opiate antagonists to reduce alcohol's reinforcing properties.

  • Aversion Therapy:

    • Behavioral therapy that pairs unpleasant stimuli with undesirable behaviors (e.g., drinking).

  • Relapse Prevention Programs and Self-Help Groups:

    • Techniques include controlled drinking, drink refusal training, and developing coping/social skills.

Destigmatizing Language

  • Importance of using person-first language to reduce stigma surrounding substance use:

    • Replace terms like "addict" with "person with an addiction".

    • Substitute "alcoholic" with "person that uses alcohol".

    • Replace "substance abuser" with "person with lived experience of substance use".

  • Stigmatizing terms to eliminate:

    • Avoid using derogatory terms such as crackhead, pothead, junkie, and stoner.

Public Health Concerns and Prevention Gains

  • Preventive treatments focus on changing drinking attitudes, strengthening coping skills, and restructuring environments to mitigate alcohol-related issues.

  • Effectiveness is maximized when targeted towards children and adolescents.

  • Example program: Alcohol Misuse Prevention Study (AMPS).

Tobacco Use

  • Demographics of Smoking:

    • Most prevalent among men and those with education levels below high school.

    • Approximately 12% of Canadians aged 15 and older currently smoke.

Physical Effects of Smoking

  • Leading cause of preventable death and disability, responsible for 1 in 5 deaths in the U.S.

  • Contributes to reduced life expectancy, increased heart rate, and cardiovascular diseases.

  • Links to respiratory issues, cancers, SIDS, and adverse pregnancy outcomes including fetal hypoxia.

Stages of Smoking Behavior

  • Stages:

    • Initiation, Maintenance, Cessation, and Relapse.

  • Models: Nicotine-titration model and affect management model explain smoking behaviors.

Prevention Programs for Smoking Cessation

  • Strategy Types:

    • Information campaigns, increasing aversive consequences, inoculation programs, etc.

    • Effective approaches are based on Social Learning Model, focusing on social pressure, media influence, and anxiety management.

Effective Cessation Programs

  • Successful programs for adolescents enhance intrinsic/extrinsic motivation to quit, are tailored for developmental needs, and provide social support.

  • Emphasis on raising awareness of resources for remaining nicotine-free.

Challenges in Smoking Cessation

  • Restrictions on valued activities can impact smoking behaviors and craving levels.

  • Behavioral activation as a strategy to manage smoking-related behaviors.

  • High relapse rates attributed to nicotine dependence, withdrawal symptoms, and conditioned association with smoking.

  • The Stages-of-Change approach has been shown to be effective in assisting smokers.

E-Cigarettes and Vaping

  • Teen Usage: Most frequently used tobacco product among U.S. teens, presenting significant health risks.

  • Concerns: E-cigarettes contain toxic and addictive nicotine, alongside other harmful substances, potentially encouraging traditional tobacco use.

Resurgence of Marijuana

  • Popularity: Cannabis is the most popular recreational drug globally as of 2015.

  • Legality: As of 2021, legal in 36 states and D.C., although still illegal federally.

  • Composition: Derived from hemp (Cannabis sativa) and contains THC.

  • Addictiveness: Less addictive than many other drugs.

Effects of THC on Brain and Behavior

  • Cognitive Impact: Alters mood, time perception, and sensations, while impairing thinking, problem-solving abilities, and memory.

  • Receptor Adaptation: Daily users may experience a reduction in CB1 receptors, adversely affecting memory and motivation.

Harm Reduction

  • Discussion prompted by videos on drug decriminalization and considerations on the effectiveness of such policies.

Additional Resources

  • Canadian Alcohol and Drugs Survey (2019)

  • Addictions Guide: CAMH

  • Legalization of Cannabis: Government of Canada

  • Opioid Crisis Resources

  • Harm Reduction Principles: Harm Reduction Coalition