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Chapter 12 notes.docx

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Konstantine Zakzanis

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Chapter 12: Substance-Related Disorders The pathological use of substances falls into 2 categories: Substance dependence  Person develops tolerance, indicated by either larger doses of the substance being needed to produce the desired effect OR the effects of the drug becoming markedly less if the usual amount is taken  Withdrawal symptoms (negative physical and psychological effects- develop when the person stops taking the substance or reduces the amount). An example of substance withdrawal is alcohol withdrawal commonly known as the delirium tremens  Person uses more of the substance or uses it for a longer time than intended  Person recognizes use of the substance; he/she may have tried to reduce usage but has been unable to do so  Much of the person’s time is spent in efforts to obtain the substance or recover from its effects  Substance or use continues despite psychological or physical problems caused by the drug (smoking- knowing that it increases the risk for cancer  Person gives up or cuts back participation in many activities Substance abuse (less serious)  Failure to fulfill major obligations (absence from work or neglecting children)  Exposure to physical dangers (operating machinery or driving while intoxicated)  Legal problems (arrests for disorderly conduct or traffic violations)  Persistent social or interpersonal problems (arguments with a spouse) ALCOHOL ABUSE AND DEPENDENCE Those who begin drinking in early life develop their first withdrawal symptoms in their 30’s or 40’s In rare cases, a person who has been drinking heavily may experience delirium tremens when the level of alcohol in the blood drops suddenly person will have hallucinations (snakes, cockroaches, spiders may appear to be crawling up the wall or over the person’s body, person may claw at his/her own skin to get rid of it Polydrug or polysubstance abuse: using/abusing more than 1 drug at a time (estimated that 80-85% of alcohol abusers are smokers too) can create serious health problems (mixing alcohol and barbiturates is a common means of suicide) The prototypical drinking driver in Canada is a male between the ages of 25 and 34 who drinks large amounts of alcohol on a regular basis or is a social drinker who occasionally drinks heavily Short-term effects of alcohol:  Alcohol is metabolized by enzymes after being swallowed and reaching the stomach  Most of it goes into the small intestines where it is absorbed into the blood  Then it is broken down, mostly in the liver which can metabolize about 30 millilitres of 50% whisky per hour (quantities in excess of this amount stay in the blood stream)  Absorption of alcohol can be rapid, but removal is always slow  Initial effect of alcohol is stimulating- drinker experiences an expansive feeling of sociability and well-being as the blood-alcohol level rises, but after the blood-alcohol level peaks and begins to decline, alcohol acts as a depressant that may lead to negative emotions Long-term effects of prolonged alcohol abuse:  A pint of 80-proof spirits supplies about half a day’s caloric requirements (these calories don’t supply the nutrients essential for health), heavy drinkers often reduce their intake of food  Prolonged alcohol use with reduction in the intake of proteins contributes to the development of cirrhosis of the liver, a potentially fatal disease in which some liver cells become engorged with fat and protein, obstructing their function  Common physiological changes include damage to the endocrine glands and pancreas, heart failure, hypertension, stroke, and capillary hemorrhages, which are responsible for the swelling and redness in the face (especially the nose)  Women’s risk of breast cancer increases steadily with the amount they drink  Heavy alcohol consumption during pregnancy is the leading cause of mental retardation (Fetal alcohol syndrome: growth of fetus is slowed, & cranial, facial, & limb anomalies are produced)  Positives: light drinking (fewer than 3 drinks a day) especially wine has been related to decreased risk for coronary heart diseases and stroke INHALENT USE DISORDERS The peak age of inhalant use is 14-15 years, with initial onsets in children as young as 6 Nicotine: addicting agent of tobacco, it stimulates receptors, called nicotine receptors, in the brain. Study found that the addictive effects of nicotine start very shortly after one’s first puff Estimated that smoking causes more than 47,000 deaths annually in Canada Approximately 17% of Canadians are smokers Second-hand smoke: or environmental tobacco smoke (ETS), contains higher concentration of ammonia, carbon monoxide, nicotine, and tar than does the smoke actually inhaled by the smoker blamed for more than 500,000 deaths a year in the US two thirds of smoke from a cigarette is not inhaled by the smoker but enters the air around them has at least twice the nicotine and tar as the smoke inhaled by smoker regular exposure increases chances of contracting lung disease by 25% and heart disease by 10% can cause eye, nose, and throat irritations, headaches, dizziness, nausea, coughing and wheezing in otherwise healthy people Marijuana: consists of the dried & crushed leaves & flowering tops of the hemp plant (Cannabis sativa) Hashish: much stronger than marijuana Effects of Marijuana: Psychological  Large doses have been reported to bring rapid shifts in emotion, to dull attention, to fragment thoughts, and impair memory  Time seems to move more slowly  Sometimes hallucinations  Current marijuana use resulted in an average decrease of 4.1 IQ points, but only among heavy users who smoked at least 5 joints per week  Impairs driving  Heavy use of marijuana during teenage years may contribute to psychological problems in adulthood Somatic  Short term effects: blood-shot and itchy eyes, dry mouth and throat, increased appetite, reduced pressure within the eye, and somewhat raised blood pressure  No evidence yet that it has an effect on a normal heart  It may be addictive Therapeutic  Marijuana and related drugs can reduce the nausea and loss of appetite that accompany chemotherapy for some cancer patients  treatment for the discomfort of AIDS, as well as glaucoma, epilepsy, & multiple sclerosis SEDATIVES AND STIMULANTS Sedatives: (often called downers), slow the activities of the body and reduce its responsiveness. This group of drugs include: Opiates- addictive sedative that relieve pain & induce sleep when taken in moderate doses Opium- originally the principal drug of illegal international trafficking and known to the people of the Sumerian civilization as long ago as 7000 B.C Morphine- (alkaloid) named after Morpheus (Greek god of dreams) Bitter tasting powder, powerful sedative and pain reliever, addictive Heroin- used initially as a cure for morphine addiction, heroin was substituted for morphine; it was then proved to be even more addictive. User feels a warm and suffusing ecstasy immediately after injection, but then experiences letdown Codeine Barbiturates- began as aids for sleeping and relaxation (addictive). The brain can become damaged and personality deteriorates with prolonged excessive use Stimulants: (or uppers) act on the brain and the sympathetic nervous system to increase alertness and motor activity: Amphetamines o Discovered after seeking a treatment for asthma o First amphetamine, Benzedrine was synthesized in 1927 o Heart rate quickens, and blood vessels in the skin and mucous membranes constrict o Individual seems to be possessed with boundless energy and self-confidence o Larger doses can make people nervous and confused Cocaine o Was extracted from the leaves of the coca plant in the mid-1800’s and has been used since then as an anaesthetic o Acts rapidly on the
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