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substance related disorders chapter 12 lecture notes

Course Code
Konstantine Zakzanis

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Substance Dependence
2 things:
Substance dependence
Substance abuse
DSM V : dump idea bet and dependence bec. Their difference is
not reliable bec. See them as continuum
Formal diagnosis requires 3 of these symptoms
Tolerance Withdraw or addiction present in user
Tolerance define by 2 criteria (Exam)
Increase or merger doses of substance needed to produce for same desired effect
Smoke more and sense of being had to be taken less effects if not more taken
Withdrawal - physiological dependence negative physical and psychological effects
develop if stop taken or reduces amt. of use of substance
Withdrawal if person uses substance to relieve or avoid withdrawal symptoms
e.g. morning drink inc.alcohol level or push away symptoms of withdrawal
Substance use cause impairment
Substance abuse
Less severe for of substance disorder in DSM 1V
1. e.g. failing to go to work
2. e.g. unsafe sex, drinking and driving
3. e.g. drink-drive , spousal abuse
4. e.g. not taking care of others
Substance intoxication Disorder conduct disorder vandalize, fight

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Alcohol Abuse and Dependence
Difference bet. Alcohol dependence and alcohol use
Alcohol dependence presence of withdrawal and tolerance
- out of control, daily binges of drinking. Impaired ADL
-Typically depressed, physically weak lack of calories vitamin deficient
limit, anxious, cognitively slow, restless, poor sleep can experience Delirium
Tremens (DTs)
Delirium Tremens (DTs) he looks like he has worse flu and trembling , he quit
drinking alcohol level drop suddenly in blood devastating symptoms person is
disoriented, tactile hallucinations crawlinh, visual hallucinations, disorented
feverish look like suffering from horrible flu
Polydrug abuse more than just 1 alcohol or 1 drug coccaine, heroine, tobacco
most comorbid substance of alcoholics 85% the 2 have synergistic effect one
makes another pleasurable.
Synergistic effect in drug and alcohol abuse alcohol eventually become barbituates
often lead to death
Prevalence men 20% and 8% of women alcohol problem
Comorbidity when there is another disorder present likelihood of relapse greater
Course of disorder no single course or pattern accdg. To text but incidence rate of
alcohol abuse drops dramatically by age of 30 (independece) bec. Of responsibilities
families jobs come to realization to stop abuse to live our lives social aspect not
physiological reinforcement
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