Lecture of Substance Abuse and Personality Disorders

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26 Feb 2011
School
Department
Course
SUBSTANCE DEPENDENCE
Difference between Substance Dependence and Abuse
DSMV will probably drop the differences between the two—will see it on a
continuum (from social drinking—to alcohol abuse and dependence)
Call it Addiction and Related Disorders
Symptoms of substance dependence
Formal diagnosis includes a minimum of 3 of these symptoms
If symptoms include Tolerance and Withdrawal—also use the term ADDICTION
Tolerance
Defined by 2 criteria
Increase or larger dose of the substance is needed to produce a
desired affect. INCREASE DOSE
Effect of drug decreases if the usual amount is taken. INCREASE
AMOUNT
Withdrawal
There is a physiological dependence, negative physical and
psychological affects which are substance specific, develop when
the person stops taking the substance or decreases the amount (or
dosage)
Some people will use the substance to decrease withdrawal affects
Person uses more of substance or uses it for a longer time than intended
Person recognizes excessive use of substance
Much of the person’s time is spent trying to obtain substance or recover
from it’s effects
Substance use continues despite problems
Person gives up or cuts back participating in many activities because of
substance
Symptoms of Substance ABUSE
DSM requires the presence of one of these symptoms
Failure to fulfill major obligations
Ex. Failing to go to work and supporting your family
Exposure to physical dangers
Ex. Unsafe sex because you are intoxicated
Ex. Drinking and driving
Legal Problems
Ex. Spousal Abuse
Persistent social or interpersonal problems
Not taking care of your kids or pets
SUBSTANCE INTOXICATION DISORDER—Transient Impairment (short term
problem)
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Cognitive and Behavioural problems are evident
oVandalize things
oGet into fights—and end up in jail for a night
ALCOHOL ABUSE AND DEPENDENCE
Alcoholism
Alcohol Dependence
oNeed presence of tolerance and withdrawal
oTypically person’s that are out of control
oDaily binging
oFail to meet up to all sorts of activities of daily living, e.g., job, family
oHighly anxious
oTypically depressed
oPhysically weak—due to low caloric intakes
Alcohol has a lot of calories—so the alcoholic will limit the other
food that they take in, so they aren’t getting enough vitamins and
minerals
oMentally slow—cognitive problems
oRestless—due to poor sleep
oWhen they experience withdrawal
Delirium tremens (DTs)—when alcohol levels drop suddenly
Person is disorientated, tactile hallucinations, will report
visual hallucination, feverish, look like they
Poly drug abuse—the Alcohol is using more than one drug
oAlcoholics usually will use Tobacco as well—they are synergistic
oAlcohol + Barbiturates can cause death
Prevalence—more common in males
o20% in men
o8% in women
Co-morbidity, if another drugs is being used—higher chance of relapse
According to the text: There is no single course/pattern of alcohol abuse
oIncidence rate of alcohol abuse—drops dramatically at the age of 30
After age of 30, there are more responsibilities (have families,
children, jobs)—THIS IS A SOCIAL AFFECT
Short-term effects
oFeelings of sociability grow
oWhen alcohol level increases more—speech becomes slurred
oWhen you keep drinking—you black out
oAlcohol has a bi-phasic affect
Usually alcohol is stimulating at first—but as it increases, it has
negative affect
oShort term affects are due to 5 factors
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The alcohol level concentration in the bloodstream will dictate
what you feel
(Which depends on)…Amount of alcohol ingested in a certain time
The presence or absence of food in the stomach, to retain the
alcohol and reduce it’s absorption rate
Size of a person’s body
Efficiency of the liver
Long-term effects of Alcohol
oBiological—Cirrhosis of the liver
Cognitive—Atrophy of the brain due to Wernicke-Korsakoff syndrome
Marijuana
oEffects of marijuana
oPsychological
oDepends on potency—how much THC is in it & the size of the dose.
oElevated sense of humour
oLoss of memory
oMight
oSmall dosages—might feel more relaxed
oLarge doses
Time goes very slowly,
Rapid changes of emotions
Dull attention
Fragmented thoughts
Impaired memory
Panic, some have hallucination
oSomatic Effects
oHunger
oRed eyes—changes in physiology, blood circulation
oDry mouth—“The pasties
oTherapeutic Effect
oUsed to increase hunger in people
Sedatives
oOpiates
odowners slow down physiological activities of the body, reduce
responsiveness of the body and mind
oDerived from opiate plant
Morphine, Heroin, Codeine
Used to reduce pain
Will induce sleep
Highly Addictive—probably most addictive substances
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Document Summary

Substance dependence: difference between substance dependence and abuse, dsmv will probably drop the differences between the two will see it on a continuum (from social drinking to alcohol abuse and dependence, call it addiction and related disorders. Symptoms of substance dependence: formal diagnosis includes a minimum of 3 of these symptoms. If symptoms include tolerance and withdrawal also use the term addiction. Increase or larger dose of the substance is needed to produce a desired affect. effect of drug decreases if the usual amount is taken. there is a physiological dependence, negative physical and psychological affects which are substance specific, develop when the person stops taking the substance or decreases the amount (or dosage) some people will use the substance to decrease withdrawal affects. person uses more of substance or uses it for a longer time than intended. much of the person"s time is spent trying to obtain substance or recover from it"s effects.

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