Substance-related disorders
Range of problems associated with the use and abuse of drugs and other substances people use to alter the way they think, feel, and behave.
Use and abuse of psychoactive substances, Significant impairment, Costs, and Polysubstance use
Polysubstance abuse
Use of multiple mind- and behavior-altering substances.
Psychoactive Substance
Substances that alter mood or behavior.
Substance abuse
Pattern of psychoactive substance use leading to significant distress or impairment in social and occupational roles and in hazardous situations.
Depressants
Psychoactive substances that result in behavioral sedation including alcohol and the sedative, hypnotic, and anxiolytic drugs
Opiates
Addictive psychoactive substances such as heroin, opium, and morphine that cause temporary euphoria and analgesia (pain reduction)
Hallucinogens
Substances that alter sensory perception and can produce delusions, paranoia, and hallucinations. Any psychoactive substances such as LSD or marijuana that can produce delusions, hallucinations, paranoia, and altered sensory perception
Fetal alcohol syndrom (FAS)
Pattern of problems including learning difficulties, behavior deficits, and characteristic physical flaws, resulting from heavy alcohol use while pregnant. Growth retardation, Cognitive deficits, Behavior problems, and Facial abnormalities. Pattern of pro
Alcohol dehydrogenase (ADH)
Enzyme that helps humans metabolize alcohol. Different levels of its subtypes may account for different susceptibilities to disorders such as fetal alcohol syndrome
Barbiturates
Sedative and addictive drugs used as sleep aids (and addictive) drugs including Amytal, Seconal, and Nembutal that are used as sleep aids
Benzodiazepines
Anti-anxiety drugs also used to treat insomnia. Side effects include some cognitive and motor impairment and may result in dependence. Anti-anxiety drugs, including Valium, Xanax, Dalmane, and Halcion, also used to treat insomnia. Effective against anxiet
Amphetamine use disorders
Cognitive, biological, behavioral, and social problems associated with amphetamine use and abuse.
Cocaine use disorders
Cognitive, biological, behavioral, and social problems associated with the use and abuse of cocaine.
Nicotine use disorders
Cognitive, biological, behavioral, and social problems associated with the use and abuse of nicotine.
Caffeine use disorders
Cognitive, biological, behavioral, and social problems associated with the use and abuse of caffeine.
Opioid use disorders
Cognitive, biological, behavioral, and social problems associated with the use of opiates and their synthetic variants.
Hallucinogen use disorder
Cognitive, biological, behavioral, and social problems associated with the use and abuse of hallucinogenic substances.
Agonist substitution
Providing a safe drug that has a chemical makeup similar to the addictive drug. Replacement of a drug on which a person is dependent with one having a similar chemical makeup, an agonist. Used as a treatment for substance dependence
Antagonist drugs
Medications that block or counteract the effects of psychoactive drugs
Controlled drinking
An extremely controversial treatment approach to alcohol dependence, in which severe abusers are taught to drink in moderation.
Intermittent explosive disorder
Episodes in which people act on aggressive impulses that result in serious assaults or destruction of property. people who suffer from this have episodes in which they act on aggressive impulses that result in serious assaults.
Kleptomania
A recurrent failure to resist urges to steal things that are not needed for personal use or their monetary value. High comorbidity (Mood disorders, Substance abuse, & dependence)
Pathological gambling
Persistent and recurrent maladaptive gambling behavior. 1.9% of adult Americans
Trichotillomania
The urge to pull out one's own hair from anywhere on the body, including the scalp, eyebrows, and arms.
personality disorder
An enduring maladaptive pattern for relating to the environment and self, exhibited in a range of contexts that cause significant functional impairment or subjective distress.
paranoid personality disorder
A cluster A (odd or eccentric) personality disorder involving pervasive distrust and suspiciousness of others such that their motives are interpreted as malevolent.
schizotypal personality disorder
A cluster A (odd or eccentric) personality disorder involving a pervasive pattern of interpersonal deficits detachment from social relationships and a restricted range of expression of emotions. featuring acute discomfort with, and reduced capacity for, c
Antisocial personality disorder
A cluster B (dramatic, emotional, or erratic) personality disorder involving a pervasive pattern of disregard for and violation of the rights of others. Similar to the non-DSM-IV-TR label psychopathy but with greater emphasis on overt behavior than on per
psychopathy
A non-DSM-IV-TR category similar to antisocial personality disorder but with less emphasis on overt behavior. Indicators include superficial charm, lack of remorse, and other personality characteristics.
borderline personality disorder
A cluster B (dramatic, emotional, or erratic) personality disorder involving a pervasive pattern of instability of interpersonal relationships, self-image, affect, and control over impulses.
dialectical behavior therapy
A promising treatment for borderline personality disorder that involves exposing the client to stressors in a controlled situation, as well as helping the client regulate emotions and cope with stressors that might trigger suicidal behavior.
histrionic personality disorder
A cluster B (dramatic, emotional, or erratic) personality disorder involving a pervasive pattern of excessive emotionality and attention seeking.
narcissistic personality disorder
A cluster B (dramatic, emotional, or erratic) personality disorder involving a pervasive pattern of grandiosity in fantasy or behavior, need for admiration, and lack of empathy.
avoidant personality disorder
A cluster C (anxious or fearful) personality disorder featuring a pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to criticism.
dependent personality disorder
A cluster C (anxious or fearful) personality disorder characterized by a person's pervasive and excessive need to be taken care of, a condition that leads to submissive and clinging behavior and fears of separation.
obsessive-compulsive personality disorder
A cluster C (anxious or fearful) personality disorder featuring a pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control at the expense of flexibility, openness, and efficiency.
Alcohol use disorders
Cognitive, biological, behavioral, and social problems associated with alcohol use and abuse
delirium tremens (DTs)
Frightening hallucinations and body tremors that result when a heavy drinker withdraws from alcohol. Also called withdrawal delirium
gamma aminobutyric acid (GABA) system
Inhibitory neurotransmitter system that is thought to be associated with excessive anxiety
harm reduction
Approach to substance abuse prevention and treatment that seeks to minimize the harm associated with substance use as its primary goal (e.g. controlled drinking interventions, safe injection sites for injection drug users)
LSD (d-lysergic acid diethylamide)
Most common hallucinogenic drug; a synthetic version of the grain fungus ergot
polysubstance use
Use of multiple mind-altering and behavior-altering substances, such as drugs
Stimulants
Psychoactive substances that elevate mood, activity, and alertness, including amphetamines, caffeine, cocaine, and nicotine
substance dependence
Maladaptive pattern of substance use characterized by the need for increased amounts to achieve the desired effect, negative physical effects when the substance is withdrawn, unsuccessful efforts to control its use, and substantial effort expended to seek
substance intoxication
Physiological reactions, such as impaired judgment and motor ability as well as mood changes, resulting from the ingestion of psychoactive substances
tolerance
Need for increased amounts of a substance to achieve the desired effect, and a diminished effect with continued use of the same amount
withdrawal
Severely negative physiological reaction to removal of a psychoactive substance, which can be alleviated by the same or a similar substance
withdrawal delirium
Frightening hallucinations and body tremors that result when a heavy drinker withdraws from alcohol. Also called delirium tremens (DTs)
impulse control disorder
a number of related problems that involve the inability to resist acting on a drive or temptation. Inability to resist.
other drugs of abuse
other abused substances that do not fir neatly into one of the categories
- inhalents
- anabolic steroids
- other over-the counter prescription medications
trichotillomania
the urge to pull out one's own hair from anywhere on the body, including eyebrows, scalp, arms.
Relapse prevention:
Looks at the learned aspects of dependence and sees relapse as a failure of cognitive and behavioral coping skills. Learned aspects of dependence, Address distorted cognitions, Identify negative consequences, Increase motivation to change, Identify high r
Component treatment :
Comprehensive ,Individual and group therapy, Aversion therapy,Covert sensitization, and Contingency management
community reinforment
Involvement of collateral, Behavioral analysis, Social service assistance, and New recreational activities
Kleptomania treatments
Behavioral interventions and Antidepressants. Does not always work unless they want to change.
pyromania
an impulse-control disorder that involves having an irresistible urge to set fires... Irresistible urge to set fires, 3% of arsonists, Little etiological and treatment research (CBT)
Levels of involvement
Substance use, Substance intoxication, Substance abuse, Substance dependence
effects of chronic alcohol use
Intoxication, Withdrawal, Dementia, and Wernicke-Korsakoff disorder
Jellinek's four stage model
prealcoholic stage (drinking occasionally with few serious consequences), prodromal stage (drinking heavily but with few outward signs of a problem), crucial stage (loss of control, with occasional binges) and chronic stage (the primary daily activities i
Substance Disorders stimulants :
Amphetamines, Cocaine, Nicotine, and Caffeine
Effects of nicotine:
Stimulates nicotinic acetylcholine receptors and Sensations of relaxation, wellness, pleasure
Statistics for cocaine :
Worldwide, almost 5% of adults, ER admissions for cocaine, and 17% also used crack cocaine
Effects of cocaine:
Blocks dopamine reuptake (Euphoria and Feelings of power and confidence), Increased blood pressure/pulse, Insomnia, Decreases appetite, and Paranoia
CNS effects of amphetamines :
Significant agonist & reuptake blocking effects (Norepinephrine and Dopamine) and Link with hallucinations and delusions
Effects of amphetamines :
Up (Elation, vigor, reduced fatigue) and Crash (Extreme fatigue and depression)
positive reinforcement
Repeated pairings with rewards
negative reinforcement
Escape from unpleasantness , Self-medication, Tension reduction, and Coping mechanism for negative affect
opponent-process theory
Increase in positive, Increase in negative, Remedy is to use more of same drug
contextual normative framework
Expectations about use in specific culture, Gene-environment interactions, Values of specific culture
national institute on drug abuse recommends
13 principles of effective treatment for illicit drug abuse
aversive treatment
Make use of drugs extremely unpleasant and abuse for alcoholism
controlled use
Controlled drinking, Moderation, Possible benefits, and Limited research
Tobacco psychological symptoms
Depressed mood, Irritability, Anxiety, difficulty concentrating, restlessness, increased appetite, and weight gain
effects of caffeine
Used by over 90% of Americans (Tea, coffee, cola, and cocoa products), Blocks adenosine reuptake, Small doses Elevate mood, Reduce fatigue. Regular use Tolerance, Dependence.
Caffeine Withdrawal symptoms:
Psychological (Irritability andUnpleasant mood) & Physiological (drowsiness and headaches)
Nature of hallucinogens (marijuana, psilocybin, LSD):
Alter sensory perception, Can produce delusions, paranoia, hallucinations
Nature of anabolic-androgenic steroids:
Derived or synthesized from testosterone, Used medicinally or to increase body mass. No associated high . "Cycling" or "stacking" patterns of use, Long-term mood disturbances, Physical problems
T or F:
Substance-related disorders are responsible for astronomical financial costs and the tragic waste of hundreds of thousands of human lives each year.
True
Kills 500,000 Americans annually, costs US citizens hundreds of billions of dollars each year and is implicated in street crime, homelessness and gang violence.
(Ch 11, p. 389)
_________ _________ represent a number of related problems that involve the inability to resist acting on a drive or temptation.
impulse-control disorders
(Ch 11, p. 389)
T or F:
Controversy surrounds both substance-related and impulse-control disorders because our society sometimes believes that both these problems are simply a lack of "will.
True
(Ch 11, p. 389)
__________ __________ is the use of multiple substances.
polysubstance use
(Ch 11, p. 389)
The term _______ refers to chemical compounds that are ingested to alter mood or behavior.
substance
(This includes illegal drugs as well as legal drugs such as alcohol, nicotine, caffeine. These so-called safe drugs also affect mood/behavior, can be addictive, and account for more health problems/greater mortality rate than all illegal drugs c
Psychoactive substances alter ______, ______ or both.
mood, behavior
(Ch 11, p. 390)
_________ _________ is the ingestion of psychoactive substances in moderate amounts that does not significantly interfere with social, educational, or occupational functioning.
Substance use
(This includes having a cup of coffee, smoking a cigarette, having a drink with a friend to relax as well as occasional ingestion of illegal drugs)
(Ch 11, p. 390)
________ _________ refers to the physiological reaction to ingested substances (drunkenness or getting high) which may be experienced as impaired judgment, mood changes, and lowered motor ability.
Substance intoxication
Point of intoxication depends on three factors: which drug is taken, how much is ingested and the person's individual biological reaction.
(Ch 11, p. 390)
_________ _________ is the pattern of psychoactive substance use leading to significant distress or impairment in social and occupational roles and in hazardous situations.
Substance abuse
(Ch 11, p. 391)
________ ________ is the maladaptive pattern of substance use characterized by the need for increased amounts to achieve the desired effect, negative physical effects when the substance is withdrawn, unsuccessful efforts to control its use, and substantia
Substance dependence
(Ch 11, p. 391)
___________ is the need for increased amounts of a substance to achieve the desired effect, and a diminished effect with continued use of the same amount.
tolerance
(Ch 11, p. 391)
________ is the severely negative physiological reaction to removal of a psychoactive substance, which can be alleviated by the same or a similar substance.
withdrawal
(Ch 11, p. 391)
________ ________ is experienced as frightening hallucinations and body tremors that result when a heavy drinker withdraws from alcohol.
withdrawal delirium
(also known as delirium tremens or DTs)
(Ch 11, p. 392)
T or F:
All substances are physiologically addicting.
False
There are no severe physical withdrawal symptoms when stopping LSD or marijuana.
(Ch 11, p. 392)
T or F:
Substance dependence can be present without substance abuse.
True
Cancer patients who take morphine for pain may become dependent on the drug, build up a tolerance and go through withdrawal if it is stopped, without abusing the drug.
(Ch 11, p. 392)
_________ and _________ are the top two most addictive substances and the hardest addictions to break.
Nicotine (#1) and methamphetamine (#2)
(Ch 11, p. 394)
Name the five general categories of substances.
depressants, stimulants, opiates, hallucinogens and other drugs of abuse.
(Ch 11, p. 394-395)
_________ is the category of substances that result in behavioral sedation and can induce relaxation. They include alcohol, and the sedative, hypnotic and anxiolytic drugs in the families of barbiturates and benzodiazepines.
Depressants
(Ch 11, p. 394)
_________ is the category of substances that cause an individual to be more active, alert and can elevate mood. Included in this group are amphetamines, cocaine, nicotine and caffeine.
Stimulants
(Ch 11, p.395)
_________ is the category of substances whose major effect is to produce analgesia temporarily (reduce pain) and euphoria. Included in this group is heroin, opium, codeine and morphine.
Opiates
(Ch 11, p. 395)
_________ is the category of substances that alter sensory perception and can produce delusions, paranoia, and hallucinations. Included in this group is marijuana and LSD.
Hallucinogens
(Ch 11, p. 395)
Other Drugs of Abuse is the last category of substances, which produce a variety of psychoactive effects that are characteristic of the substances in the other categories, and include _________, ________ ________, __________ _________ and _________ ______
inhalants, anabolic steroids, over-the-counter medications and prescription medications
(Ch 11, p. 395)
_______ primarily decrease central nervous system activity. Their principal effect is to reduce levels of physiological arousal and help an individual relax.
Depressants
(Ch 11, p. 395)
T or F:
Although alcohol is a depressant, its initial effect is an apparent stimulation.
True
This is because what is initially depressed are the inhibitory centers of the brain.
(Ch 11, p. 395)
Alcohol effects many parts of the body. After ingested, it passes through the esophagus (1), and into the stomach (2), where small amounts are absorbed. From there, most of it travels to the small intestine (3), where it is easily absorbed into the bloods
Consequences of long-term excessive drinking include ______ ______, ______, ______ ______, and ______ ______.
liver disease, pancreatitis, cardiovascular disorders and brain damage.
(Ch 11, p. 396)
________ and ________ ________ are two types of organic brain syndromes that may result from long-term heavy alcohol use.
dementia, Wernicke-Korsakoff syndrome
(Ch 11, p. 396)
________ involves the general loss of intellectual abilities and can be a direct result of neurotoxicity or "poisoning of the brain" by excessive amount of alcohol.
Dementia
(Ch 11, p. 396)
________ syndrome results in confusion, loss of muscle coordination and unintelligible speech and is thought to be caused by a deficiency of thiamine (a vitamin that is poorly metabolized in heavy drinkers).
Wernicke-Korsakoff syndrome
(The dementia caused by this disease does not go away once the brain is damaged)
(Ch 11, p. 396)
_______ _______ _______ is a pattern of problems including learning difficulties, behavior deficits, and characteristic physical flaws, resulting from heavy drinking by the victim's mother when she was pregnant with the victim.
fetal alcohol syndrome (FAS)
(Ch 11, p. 397)
T or F:
All women who drink during pregnancy are at equal risk for having children with fetal alcohol syndrome.
False
African Americans, Apache and Ute Indians appear to be at greater risk than Caucasian women.
(Ch 11, p. 397)
T or F:
In addition to the drinking habits of the mother, the likelihood a child will have Fetal Alcohol Syndrome may depend on whether there is a genetic tendency to have certain enzymes.
True
(Ch 11, p. 397)
T or F:
The course of alcohol dependence may be progressive for most people, however the course of alcohol abuse may be more variable, fluctuating between drinking heavily, drinking "socially" without negative effects and periods of abstinence.
True
(Ch 11, p. 398-399)
T or F:
Alcohol causes aggression and violent behavior.
False
Alcohol does not cause aggression, but it may increase a person's likelihood of engaging in impulsive acts and it may impair the ability to consider the consequences of acting impulsively. Given the right circumstances, such impaired rational thinki
Sedative substances are ______, hypnotic substances are ________, and anxiolytic substances are ________.
calming, sleep-inducing and anxiety-reducing
(Ch 11, p. 399)
________ are sedative (and addictive) drugs including Amytal, Seconal, and Nembutal that are used as sleep aids.
barbiturates
(Ch 11, p. 399)
__________ are antianxiety drugs including Valium, Xanax, Dalmane, and Halcion which is also used to treat insomnia. Effective against anxiety (and, at high potency, panic disorder), they show some side effects, such as some cognitive/motor impairment, an
benzodiazepines
(Ch 11, p. 399)
Multiple Choice:
Match the following disorder with its corresponding effects.
1. Disorder in which the effects of the drug impede the ability to function properly by affecting vision, motor control, reaction time, memory and hearing.
(a) substance-related
(d) alcohol use disorder
(Ch 11, p 401 - Concept Check Part B)
Multiple Choice:
Match the following disorder with its corresponding effects.
2. Disorder that deprives a person of the ability to resist acting on a drive or temptation.
(a) substance-related disorder
(b) dementia
(c) impulse-control disorder
(d) alcohol
(c) impulse-control disorder
(Ch 11, p 401 - Concept Check Part B)
Multiple Choice:
Match the following disorder with its corresponding effects.
3. Disorder that affects the way people think, feel and behave.
(a) substance-related disorder
(b) dementia
(c) impulse-control disorder
(d) alcohol use disorder
(e) Wernicke-Ko
(a) substance-related disorder
(Ch 11, p 401 - Concept Check Part B)
Multiple Choice:
Match the following disorder with its corresponding effects.
4. Disorder involving the decline of intellectual abilities through, for example, excess consumption of alcohol.
(a) substance-related disorder
(b) dementia
(c) impulse-control
(b) dementia
(Ch 11, p 401 - Concept Check Part B)
(b) intoxication
(a) use
(d) dependence
(c) abuse
T or F:
Of all the psychoactive drugs used in the United States, the most commonly consumed are stimulants.
True
(Included in this group are caffeine from coffee, chocolate and sodas, nicotine, amphetamines and cocaine.)
(Ch 11, p. 401)
________ _______ disorders are psychological, biological, behavioral, and social problems associated with amphetamine use and abuse.
amphetamine use disorders
(Ch 11, p. 401)