Substance Use and Addictive Disorders

Chapter 11: Substance Use and Addictive Disorders

Topic Overview

  • Substances covered:

    • Depressants

    • Alcohol

    • Sedative-hypnotic drugs

    • Opioids

    • Stimulants (Cocaine, Amphetamines)

    • Stimulant use disorder

    • Caffeine

    • Hallucinogens

    • Cannabis

    • Combinations of substances

What Causes Substance Use Disorders?

  • Theoretical perspectives:

    • Sociocultural views

    • Psychodynamic views

    • Cognitive behavioral views

    • Biological views

    • Developmental psychopathology view

Treatment of Substance Use Disorders

  • Therapies:

    • Psychodynamic therapies

    • Cognitive-behavioral therapies

    • Biological treatments

    • Sociocultural therapies

Other Addictive Disorders

  • Gambling disorder

  • Internet use disorder

  • Internet gaming disorder

Case Study: Duncan

  • Duncan describes his journey as an alcoholic, reflecting on his first drink at 15 years old, which transformed his experience socially:

    • Early experiences with alcohol made him feel empowered.

    • Initially did not recognize his drinking as a problem, believing it was normal behavior among peers.

    • Noticed deterioration and consequences of drinking during college leading to intervention from friends.

    • Managed to cut down drinking significantly after fears about friendships and academic performance.

    • Experienced cycles of sobriety and relapse, escalating problems ultimately leading him to Alcoholics Anonymous where he found support and has remained sober for over 2 years.

Impact of Substance Misuse

  • Economic Costs:

    • Estimated costs related to substance misuse in the USA: $740 billion annually (including crime, lost productivity, and health care).

  • General trends of substance use:

    • Increase from 4 million to 135 million people in the US who have used illegal substances since 1962.

    • 32 million people have used illegal substances in the past month.

    • High prevalence rates for teenagers involving illegal substances.

  • Drug definition:

    • Any substance other than food that alters bodily or mental functions.

    • The term substance replaces drug due to common misperceptions of accepted substances like alcohol, tobacco, and caffeine.

Substance Intoxication and Use Disorders

  • Key definitions:

    • Substance Intoxication: Temporary changes in behavior, emotion, or thought following substance ingestion.

    • Disorders characterized by craving, reliance on substances, and resultant dysfunction in social or occupational areas.

  • Physical dependence often involves developing a tolerance, experiencing withdrawal symptoms after reduced intake.

  • Withdrawal symptoms may include: cramps, anxiety, nausea, among others.

Depressants

  • Characteristics:

    • Slow CNS activity, reduce tension, interfere with judgment.

  • Most common depressants:

    • Alcohol: consumed by over 2 billion people worldwide, major factor in American society.

Alcohol

  • Epidemiological Data:

    • Over half of US residents drink alcohol at least occasionally.

    • Binge drinking defined as 5+ drinks in a single session, reported by 25% of those over age 11 in the US.

    • Heavy drinking (5+ times a month) accounts for 6.5% of this population, predominantly males.

  • Physiological Effects:

    • Alcohol absorbed quickly, affects CNS by binding to GABA receptors, inhibiting neuronal firing and leading to relaxation.

    • Consequences of overconsumption: impaired coordination, judgment, vision.

  • Alcohol Use Disorder: includes symptoms of tolerance (needing more to achieve effects) and withdrawal (horrifying experiences tied to stopping).

  • Causal Definitions:

    • Affects approximately 5.4% of the population over the age of 11. Men are disproportionately affected (2:1 ratio).

  • Social Impact:

    • Alcoholism is associated with increased risk for suicides and other violent incidents.

Stimulants

  • Definition and effects:

    • Increase CNS activity, resulting in enhanced alertness, heart rate, and behavioral speeds.

    • High-risk stimulants include cocaine and amphetamines, nicotine is also problematic.

  • Cocaine Statistics:

    • Once only used by a very few, now about 40 million have tried it with 2 million currently users.

  • Physiological effects of cocaine:

    • User experiences euphoria, increased confidence, but risks include addiction, psychosis, and severe health dangers (over 10,000 overdose deaths annually).

Amphetamines

  • Amphetamines produced in labs, used for various reasons including academic performance enhancement.

  • Can result in euphoric effects, but misused amphetamines lead to severe negative health consequences.

  • Methamphetamine:

    • Highly addictive form, rising in popularity, particularly more potent forms in recent years.

Cannabis

  • Characteristics and use:

    • Derived from Cannabis sativa, can have mixed effects (stimulant, depressant, and hallucinogen).

    • Rising prevalence of cannabis use disorder.

Hallucinogens

  • General Properties:

    • Induce hallucinations, altered sensory perception. Examples include LSD, psilocybin, and MDMA.

Treatment Strategies for Substance Use Disorders

  • Varied approaches are necessary:

    • Medications for opioid addiction, behavioral therapies, social support networks, etc.

  • Comprehensive care approach is vital for successful treatment outcomes.

Conclusion: Effects on Individual and Society

  • Alcoholism and substance misuse causes extreme personal suffering, family breakdowns, and societal costs through healthcare, law enforcement, lost productivity, and tragic events.

Ethical and Social Implications

  • Significant discussions surrounding societal norms, cultural backgrounds, and the pressure of environments leading to substance misuse.