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PSYB32H3 (614)

Chapter 12 Substance related disorders

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Konstantine Zakzanis

November 28  Substance dependence/ symptoms (different than abuse, more serious)  DSM – o Tolerance  larger doses are needed to produce the desired effect  effects of the drugs becomes less if the usual amounts are taken o Withdrawals  Negative physiological or psychological symptoms that develop when person suddenly stops taking/reduces amount of substance  Use substance to avoid withdrawal o Person uses more of substance of uses it for a longer time than intended o Person recognizing excessive use of substance o Much of the person’s time is spent trying to obtain substance or recover from its effects o Substance use continues despite problems o Person gives up or cuts back participating in many activities because of substance  To Qualify for addiction – tolerance and withdrawals have to be present.  Substance abuse o Less severe o Symptoms  Failure to fulfill major obligations  Exposure to physical dangers  Legal problems  persistent social or interpersonal problem  No withdrawal and tolerance  Substance intoxication o Acute effects; o Hallucinations etc  Alcohol abuse and dependence o Alcoholism  4 leading cause of disability world wide; not culture specific  Burden on health care  Dependant – more disability in daily living, evidence of withdrawal and tolerance o Deliriums tremens DTs  Tremble and complain of things were crawling on him  Blood alcohol level drops = psychotic symptoms  Memory problems, terrified  Transient - not permanent o Polydrug abuse  80-85% of alcoholic also smoke because they are synergistic  To accelerate alcohol buzz o Prevalence of alcohol abuse  Prevalence of dependence is lower 12.5% life time  Spend all their time drinking  Abuse; weekend warriors  Try to get things done ie. Keep job and relations o Co morbidity o Course of the disorder  No single pattern of abuse o Short term effects of alcohol  More social, less anxious, more vocal, confidence –  Biphasic; stimulant at first, and then becomes a depressant  Dependant on 5 factors  Level of concentration in blood stream  Amount of food ingested in a particular period of time  Food in stomach = reduce absorption rate of alcohol  Efficacy of the Liver o Long term effects of prolonged alcohol abuse  Wernicke’s korsakoff syndrome – aka alcohol induced dementia – unable to learn or make new memories – tend to confabulate ( make up stories ) to fill in blanks in their life/ or lost time  Cirrhosis the liver  Jaundice- get yellow  Malnutrition’s – very skinny  Hypertension  High blood pressure  Capillaries haemorrhages  Eg.Big red nose  Lower life expectancy by 10 years  Homicides, suicides, car accidents, health risks  Dependence is physical and psychological – to cope with life  AA – self help program  Marijuana o Effects  Psychological effects  THC  Time goes really slow  More relaxed  Giddy  Big doses o Paranoid o Fatigue o Rapid shift of emotion o Unable to focus/ dull attention o Fragment of thoughts o Difficultly process information  Somatic effects  Munchies – get hungry  Vasoconstrictor – dry mouth, red eyes  Decreased lung function  Therapeutic effects (medicinal)  Help nausea with chemo therpahy – increases appetite  Pain  Patients with epilepsy or MS or AIDS/HIV  Sedatives o Opiates  Morphine, heroin, codeine  Euphoria, drowsiness and coordination problems and hallucinations o Heroin (4-6h)  Sense of warmth  Euphoria, drowsiness and coordination problems and hallucinations  Ecstasy  Shedding of worry and negative feeling  Great self confidence  Highly addictive; withdrawal symptoms can happen after the person first uses and can last a few says.  Describes as the worst flew.  Withdrawal symptoms in under 8 hours  Symptoms like the Worst flu  Nausea  Fatigue  Pain  Chills  Insomnia  Twitchiest cramps o Synthetic sedatives o Barbiturates, benzodiazepines (valium)  Stimulants  Increase alertness  Increase Motor activity  Reduce appetite  Make person outgoing  Lots of energy  Self confidence o Amphetamines  Benzedrine, Dexedrine, methedrine o Caffeine o Cocaine  Increases sexual desire and produces feelings of self confidence, well being and indefatigability  Highs dont last long = high substance dependence  Spend all their time trying to get the substance.  Over dose  Withdrawal – nausea, hallucinations and delusions (severe paranoid state  schizophrenia like state)  Can be life threating  Chronic users will Experience change in personality  Disexecutive problems; Hard time planning, judgement, social impairment, irritable  Fatigue and cognitive impairment (memory problems)  Past uses  For tooth ache, tablets for teachers and preachers to smooth voice  LSD and other hallucinogens o Increase dopamine activity in the brain (vivid hallucinations)  Similar to schizophrenia o D-lysergic acid diethylamide o Produces hallucinations  Ecstasy MDMA o Appetite suppressant during WWI o 2 most used recreations o Legal substance used in couples therapy in 50-70s (due to the feeling) o Became a popular choice for recreational use in late 70s- 80s in England in the underground dance scene o Became illegal in 80s with increased use o Currently, the second most use
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