Substance Use Disorders Notes

Substance Use Disorders

Learning Objectives

  • Understand key terms:
    • Psychoactive: Substances affecting brain function, altering mood and mental state.
    • Illicit drug: Illegal to produce or possess.
    • Abuse: Recurrent use despite negative consequences.
    • Addiction: Compulsive use despite harm; chronic brain disease.
    • Dependency: Inability to function normally without a substance; withdrawal symptoms present.
    • Tolerance: Higher doses needed to achieve the same effect.
  • Explain reasons why people use substances.
  • Identify risk and protective factors for substance use disorders.
  • Explain how addictive substances alter brain function.

Substance Use

  • Substances: Chemicals affecting the brain leading to mood alterations.
  • Psychoactive substances: Change mental, emotional, and physical functioning; resolve effects over time if not damaging tissue.
  • Intoxication: Occurs after acute use, leading to temporary changes in mental state.

Substance Abuse

  • Definition: Recurrent substance use that interferes with obligations and has adverse consequences.
  • Criteria for substance abuse include:
    • Impaired control over substance use.
    • Physical dependence with discomfort upon discontinuation.
    • Risky use in dangerous situations.
    • Social problems from substance use.

Key Characteristics of Abuse

  • Would include:
    • Significant time spent obtaining, using, and recovering from substances.
    • Using larger amounts or over extended periods.
    • Experiencing discomfort or cravings without access to substances.
    • Continuing use despite harmful consequences (health, relationships).

Dependence and Addiction

  • Dependence: Difficulty functioning without the substance; withdrawal symptoms occur upon cessation.
  • Addiction: Chronic brain disease characterized by compulsive use despite negative outcomes.
  • Withdrawal: Unpleasant symptoms when substance is removed.

Scope of Substance Use Disorders

  • In 2021, 161.8 million Americans 12+ faced substance dependence/abuse.
  • Tobacco: Major cause, 480,000 deaths annually.
  • Alcohol: Linked to 99,000 deaths in 2020.
  • Adolescence substance use:
    • 23% consumed alcohol; 16% used marijuana.
    • 18% used electronic vape; 12% misused prescribed opioids.

Reasons for Substance Use

  • Reward Pathway: Brain region activated during pleasurable activities; ties to dopamine, a key neurotransmitter.
  • Substance use motivations:
    • Limited healthy ways to feel better.
    • Ineffective usual remedies.
    • Influence of media and peers.

Risk Factors for Substance Use Disorders

  • Genetics: Family patterns indicate genetic predisposition.
  • Environmental: Ease of access, peer influence, and stress.
  • Personal characteristics: Early use, poor performance, and psychological issues can heighten risk.
  • Specific behaviors: Fighting, delinquency, sleep deprivation connected to increased substance use.

Protective Factors against Substance Misuse

  • Strong family support preventing substance use.
  • Awareness of substances' harm and peer disapproval.
  • Engagement in positive activities (academics, sports).
  • Good mental health, self-image, and coping skills.

Consequences of Substance Use and Abuse

  • Direct impacts include:
    • Poor academic performance.
    • Social and relationship difficulties.
    • Increased risk of injury or suicide.
    • Health issues and reduced lifespan.
    • Financial and legal troubles.

How Substances Affect the Body

  • Body Factors:
    • Mass: Weight and fat impact drug effects.
    • Food Ingestion: Slows absorption of substances.
    • Metabolic Processes: Liver and kidney function influence detox rates.
    • Mental State: Placebo effects can influence perceived impact.
  • Drug Factors:
    • Nature and type of substance affect bodily responses.
    • Methods of administration change effects (oral, intranasal, inhalation, injection).

Treatment of Substance Use Disorders

  • Detox may be necessary in hospitals.
  • Medications can ease withdrawal and cravings.
  • Long-term treatment includes psychotherapy to address triggers and underlying issues.
  • Therapists provide life skills for effective coping and reintegration into society.

General Strategies for Breaking Addictive Behaviors

  • Recognize the problem and acknowledge risks.
  • Commitment to change.
  • Use tools like acceptance, therapy, and relapse management strategies.
  • Break habits one step at a time, identifying triggers, and utilizing medication if necessary.

Key Takeaways

  • Substance abuse is influenced by familial, environmental, and early-use factors.
  • Addiction leads to long-term changes in the brain's reward system.
  • Tolerance and withdrawal complicate recovery.
  • Multiple treatment options exist to support recovery efforts.