Substance Use Disorders Lecture Notes

Chapter 1: Introduction to Substance Use Disorder

• Impaired Control

  • Urge to use the substance may persist despite the desire to stop.
  • Time spent obtaining substances can interfere with daily life.
  • Recovery from substance use is possible.

• Impaired Social Life

  • Substance use can lead to failure in fulfilling obligations such as work, school, or family duties.
  • Continued use despite interpersonal problems (e.g., relationships with friends or family) is common.
  • Withdrawal from activities that were once enjoyable in favor of substance use.

• Risky Use

  • Use continues despite physical hazards (e.g., driving under the influence).

• Tolerance and Withdrawal

  • Tolerance: Increased dosage required to achieve the same effect.
  • Withdrawal: Symptoms arise when substance use is reduced or stopped, prompting further use to relieve symptoms.

Chapter 2: Defining Substance Use Disorder

• Individual Variability vs. Tolerance

  • Different reactions to substances among individuals vs. changes in tolerance within the same individual over time.
  • Symptoms related to withdrawal vary by substance (e.g., alcohol, cocaine, tobacco).

• Substance Use Disorder (SUD)

  • Not just regular use; dependent on symptoms affecting life quality, control, and interpersonal relationships.

Chapter 3: Understanding Substance Use Disorders

• Categories of Substance-Related Disorders
  • Types: Alcohol Use Disorder, Tobacco Use Disorder, etc.
  • Substance Intoxication: Behavioral/psychological changes from substance intake.
  • Substance Withdrawal: Behavioral or physiological changes after cessation or reduction.

Chapter 4: Substance-Induced Mental Disorders

• Diagnosis of Substance-Induced Disorders
  • Symptoms are temporary and directly linked to substance use.
  • Distinction between substance-induced issues and independent mental disorders.

Chapter 5: Clinical Diagnosis of SUD

• Structured Clinical Interview
  • Questions to evaluate substance impact on life (e.g., drinking more than intended, effects on relationships).

Chapter 6: Risk Factors in SUD Development

• Influences on SUD
  • Genetic predisposition, early onset of use, and adverse childhood experiences can contribute.
• Psychiatric Comorbidities
  • Often, substance use disorders occur alongside other psychiatric disorders.

Chapter 7: Treatment Approaches

• Two Parts of Treatment

  • Addressing physiological dependence (withdrawal symptoms) and psychological dependence (triggers and cravings).

• Medications Targeting Physiological Dependence

  • Example: Nicotine replacement therapies help manage cravings and withdrawal symptoms.

Chapter 8: Behavioral Interventions in Treatment

• Cognitive Behavioral Therapy (CBT)

  • Modifies dysfunctional thoughts to alter substance use behavior.

• Motivational Interviewing (MI)

  • Helps individuals identify personal motivation for change, acknowledging ambivalence about substance use.

Chapter 9: Special Treatments for Specific Substances

• Medications for Opioid Use Disorder
  • Examples: Methadone and Suboxone.
  • Challenges in treatment for cocaine and amphetamine use disorders.

Chapter 10: Conclusion and Public Health Messaging

• Narcan (Naloxone)
  • Life-saving medication for opioid overdose; widely available for free to prevent deaths from unintended overdoses.
• Importance of keeping Narcan accessible in social settings to save lives.