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Chapter-11 PSYCH 257

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Uzma Rehman

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Chapter 11: Substance-Related Disorders Perspectives on Substance-Related Disorders: An Overview *The Nature of Substance-Related Disorders *Problems related to the use and abuse of psychoactive substances *Produce wide-ranging physiological, psychological, and behavioural effects *Some Important Terms and Distinctions *Substance abuse vs. substance dependence *Tolerance vs. withdrawal Type of problem *Substance Abuse *Substance Dependence: Substance Abuse Criteria DSM-IV-TR A) A maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by any of the following criteria within a 12 month period: 1) Recurrent substance use resulting in failure to fulfill major role obligations at work, home, or school 2) Recurrent substance use in situations in which it is physically hazardous 3) Recurrent substance-related legal problems 4) cont’d use despite recurrent interpersonal/social consequence B) Never met criteria for substance dependence for this class of substance *Does not apply to nicotine or caffeine Substance Dependence Criteria DSM-IV-TR A) Three or more of the following occurring at any time during a within a 12 month period: *Tolerance *Withdrawal *Taken in larger quantities or over a longer period than intended *Persistent unsuccessful efforts to cut down *Great deal of time spent trying to acquire the substance *Important social, occupational, or recreational activities are given up or reduced because of substance use *Cont’d use despite recurrent interpersonal/social problems Specify with/without physiological dependence Physiological Responses to Extended Use *Tolerance – increasing amount of substance necessary for the same high *Withdrawal – physical problems follow not taking substance Perspectives on Substance-Related Disorders: An Overview *Five Main Categories of Substances *Depressants – result in behavioural sedation (e.g., alcohol, sedative, anxiolytic drugs) *Stimulants – increase alertness and elevate mood (e.g., cocaine, nicotine, caffeine) *Opiates – primarily produce analgesia and euphoria; pain reduction (e.g., heroin, morphine, codeine) *Hallucinogens – alter sensory perception (e.g., marijuana, LSD) *Other drugs of abuse – include inhalants, anabolic steroids, medications Alcohol Use Disorders *Psychological and Physiological Effects of Alcohol *Central Nervous system depressant *Influences several neurotransmitter systems, but mainly GABA (affects anxiety rate) *Effects of Chronic Alcohol Use What Affects Blood Alcohol Level? *Weight – light people are more responsive than heavy *Sex – females are more responsive than males *Physiological predispositions – family tendencies *Frequency of usage – tolerance *Have you eaten recently? Peak intoxication: *.5 – 2 hours with empty stomach *1-6 hours with full stomach Increased Risk of Relapse *Younger age at onset – started drinking earlier *More extensive substance involvement *Antisocial behavior *Comorbid disorders *Less involvement in school or work *Less social support Sedative, Hypnotic, or Anxiolytics *Effects of Such Drugs Are Similar to Large Doses of Alcohol *Combining such drugs with alcohol is synergistic *All exert their influence via the GABA Neurotransmitter System Stimulants: An Overview *Nature of Stimulants *Most widely consumed drug in Canada and the United States *Such drugs increase alertness and increase energy *Examples include amphetamines, cocaine, nicotine, and caffeine Stimulants: Amphetami
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