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Lecture 18

HLSC 1F90 Lecture 18: Addiction

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Health Sciences
Kelli-an Lawrance

Addiction Note:  How drugs affect the body will not be covered in lecture but will be on the exam  Representative psychoactive drugs will not be covered on th exam with the exception: o Students must know caffeine and marijuana and other cannabis products Addiction  Lots of people say “I’m addicted to”  What does “addition” really mean and how does it develop?  Clicker Question: Addiction is defined as: o A chronic disease that disrupts brain systems which regulate motivation, reward, memory o Loss of control over one’s behaviour o …  Addiction is a chronic disease that involves disruption of the brain’s systems related to reward, motivation, and memory  It may start as a habit, but then become uncontrollable  It causes a pathological use of a substance or pursuit of a behaviour in order to relieve/avoid withdrawal  Historically, addiction was only recognized in relationship to drugs  Now, it is recognized that behaviours can be addictive  For both drugs (substances) and behaviours, addiction has certain characteristics Characteristics of Addiction  Reinforcement – the addiction reinforces itself o Positive – behaviours/substance use reliable results in pleasure or reward o Negative – avoiding behaviour/substance results in stress, anxiety, discomfort, or depression  Compulsion or craving – there is a strong compulsion (irresistible need) to engage in behaviour/use substance  Environmental cues trigger craving  Obsessive planning for next opportunity to engage  Loss of control – the individual cannot overcome the impulse to do the behaviour/use the substance  Escalation – more and more of the behaviour or substance is required to produce its desired effects – this is a result of tolerance o Tolerance – a physical state in which the body adapts to a drug such that the initial dose no longer produces the original physical or psychological effects  Clicker Question: What is tolerance o A change in the body and brain o Physical adaption to a behaviour or substance where the original “doses” of it are too small to produce desired effects  Negative consequences – the behaviour or substance use continues despite very serious negative consequences Risk Factors for Addiction  To understand risk factors, consider how an addiction develops… o A person does something to bring pleasure or avoid pain; drinks, goes online, gambles, shops, smokes, injects drugs o If it works, the person repeats it (positive reinforcement) o Tolerance develops (more of the behaviour/substance is needed to get the desired effect) o Negative consequences emerge, but stopping seems unbearable due to withdrawal symptoms  Clicker Question: What is withdrawal? o A set of symptoms including anxiety, pain, irritability, sweating, tremors, vomiting, and insomnia  Risk of (drug) addiction depends on a combination of physical. Psychological, and social factors o Physical:  Born with certain brain chemistry or metabolic processes that increase risk of substance abuse o Psychological:  Difficulty controlling impulses  Strong need for thrills, stimulation, immediate gratification  Feelings of rejection, hostility, aggression, depression, anxiety, emotional pain o Social (developmental):  Living with family members who abuse drugs, living in poverty  Behaviours that can be addictive: o Gambling o Sex and love o Exercise o Shopping o Work o Internet/device use o Substances that can be Addictive  Usually psychoactive drugs (that alter consciousness) o Legal: Alcohol, caffeine, tobacco o Soon-to-be-legal: marijuana o Illicit: cocaine, party drugs, LSD, opioids, heroin, etc. o Drugs: Recognizing Substance Use Disorder  Substances that can be addictive: o Given the widespread use of drugs, it’s important to know what constitutes “abuse” o o % of Canadians Using (Past Year) o Tobacco o 13% o Alcohol o 76% o Cannabis o 12% o Opioids (therapy and abuse) o 13%, 2% abuse o Cocaine/speed/hallucinogen o 2% s/ecstasy/heroine o Substance Use Disorder  According to American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5), there are 11 criteria for diagnosing a substance use disorder o Criteria for substance use disorder diagnosis  Developing tolerance  Experiencing withdrawal  Taking more/over longer period  Craving  Unsuccessful effort to regulate use  “excessive” time
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