7128 Lecture Notes - Lecture 9: Problem Gambling, Methamphetamine, Crystalised
21 Jun 2018
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ADDICTION AND ADDICTIVE BEHAVIOURS
DSM-5 Substance use disorders
- Essential feature: “a cluster of cognitive, behavioural and psychological symptoms indicating
that the individual continues using the substance that the individual continues using the
substance despite significant substance-related problems”
- Applied to 10 classes of substances (not caffeine)
- Withdrawal symptoms may not be specified (eg hallucinogen or inhalant use disorder)
- Criterion A groupings
oImpaired control (IC)
oSocial impairment (SI)
oRisky use (R)
oPharmacological: physiological dependence (P)
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- Substance dependence is defined as a maladaptive pattern of substance use leading to
clinically significant impairment or distress, as manifested by 3 (mild) or more of the
following, occurring any time in the same 12 month period
- 1) IC, tolerance, as defined by either of the following a)a need for markedly increased
amounts of the substance to achieve intoxication or the desired effect or b) markedly
diminished effect with continued use of the same amount of the substance
- 2) IC, withdrawal, as manifested by either of the following a) the characteristic withdrawal
by syndrome for the substance or b) the same of closely related substance is taken to relieve
or avoid withdrawal symptoms
- 3) IC the substance is often taken in larger amounts or over a longer period than intended
- 4) IC, there is a persistent desire or unsuccessful effort to cut down or control substance use
- 5) SI, a great deal of time is spent in activities necessary to obtain the substance, use the
substance, r recover from its effects
- 6) SI, important social, occupational, or recreational activities are given up or reduced
because of substance use
- 7) the substance use is continued despite knowledge of having a persistent physical or
psychological problem that is likely to have been caused from the substance.
- 8) recurrent substance use in situatoins which it is physically hazardous
- 9) R, continued substance use despite knowledge of having a persistent or recurrent physical
or psychological problem that is likely to have been caused or made worse by the substance
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- 10) P, tolerance occurs, whereby a markedy inc dose is needed for desired affect
- 11) P, withdrawa symptoms exeriences, after which the individual is likely to consume the
substance to relieve symptoms
DSM-5 Gambling
- Persistent and recurrent problematic gambling behaviour leading to clinically significant
impairment or distress as indicated by the individual exhibiting 4 or more of the following in
12 months
- On a continuum
- The need to gamble with increasing amounts of money is akin to tolerance criteria for
substance use disorder
- The restlessness when attempting to cut down gambling is akin to the withdrawal criteria for
substance use disorder
- Gambling is conceptualized as an addiction on the basis that individuals repeatedly engage
in a behaviour to achieve a euphoric state
Substance use in Australia
- Generally
oFewer Australians are smoking daily and are smoking fewer cigarettes
oFewer people are exceeding the lifetime risk and single occasion risk guidelines for
alcohol use
oOverall illicit drug use has remained stable but some drugs have declined ad some
have increased
oAlcohol continues to be the drug of most concern, but inc with meth/amphetamines
o
oMeth/emphetamine
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No sig inc in use in 2013
Change in main form used
Use of powder dec from 51%-29%
Use of ice (crystalised methamphetamine) more than doubles 22% in 2010
to 50% in 2013
Sig inc in proportion of users taking it daily or weekly from 9.3% to 15.5%,
particularly among use users from (12.4% to 25.3%)
Powder wasn’t very pure
Real problems, could be mixed
Effects took longer than ice
Felt it slower
Less addictive
Ice
Highly pure
Very fast onset
Very addictive
- ACT least amount of methamphetime but with higher SES we have more cocaine
- Aus is 2nd of 18 countries for methamphetamine consumption
- More stats
oIn 2013 42% aged more than 14 had ever illicitly used drugs,incl prescription misue
o15% ad done so in last 12 months
oMales are more likely than females to use illicit drug 18.1% : 12.1%, and age 20-29
most likely age group
- Alcohol 2010-2013
oDaily drinking declined sig 7.2% - 6.5%
oSig inc in people who had never consumed full serve of alcohol 12.1-13.8
oFewer age 12-17 are drinking, abstinence from 64-72%
oYounger people are continuing to delay starting drinking from 14.4-15.7
- Tobacco 2010-2013
o15.1% to 12.8% decline in proportion of daily smokers aged 14 or older
o40-49 age group most likely to smoke daily 16.2%
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Document Summary
Essential feature: a cluster of cognitive, behavioural and psychological symptoms indicating that the individual continues using the substance that the individual continues using the substance despite significant substance-related problems . Applied to 10 classes of substances (not caffeine) Withdrawal symptoms may not be specified (eg hallucinogen or inhalant use disorder) Criterion a groupings: impaired control (ic, social impairment (si, risky use (r, pharmacological: physiological dependence (p) Persistent and recurrent problematic gambling behaviour leading to clinically significant impairment or distress as indicated by the individual exhibiting 4 or more of the following in. The need to gamble with increasing amounts of money is akin to tolerance criteria for substance use disorder. The restlessness when attempting to cut down gambling is akin to the withdrawal criteria for substance use disorder. Gambling is conceptualized as an addiction on the basis that individuals repeatedly engage in a behaviour to achieve a euphoric state. No sig inc in use in 2013.
