PSY333H1 Lecture Notes - Lecture 5: Menopause, Bupropion, Bipolar Disorder

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Published on 31 May 2012
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LECTURE 5 Health-Compromising
Behaviors
Health Compromising Behaviors: Behaviors practiced by
people that undermine or harm their current or future
health
-Abusing Alcohol**
-Smoking**
-Illicit dug use
-Unsafe sex
-Risk-taking behavior
Substance Dependence
Dependent on a substance if repeatedly self-administer
it, resulting in tolerance, withdrawal, compulsive
behavior
Physical dependence: state that occurs when body
adjusts to substance and incorporates the use of it
into normal function of body’s tissues
-Often involves tolerance: body increasingly adapts to
use of substance, requiring increased doses to achieve
same effect
-Craving: strong desire to engage in a behavior or
consume a substance
Addiction: occurs when a person becomes physically or
psychologically dependent on a substance following use
over time
Psychological dependence: cognitive dependence on
substance. Example: thinking you need a glass of wine or
you cant sleep, thinking you need a smoke to do work
Withdrawal: unpleasant symptoms experienced when stop
talking substance on which one has become dependent
-Anxiety, irritability, intense cravings, nausea,
headaches, shaking, hallucinations
Costs to Canadians (2002)
-$39.8 billion health care resources, law enforcement,
loss of productivity at work/home
-Smoking accounted for most of this cost (43%)
-Alcohol accounted for 37%
-Substance abuse = 20%
Harm reduction: intervention strategy
-Public health response to substance abuse problem
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-“Approach that focuses on the risks and consequences
of substance use rather than on the use itself”
-Ex) methadone clinics, needle exchange programs
Limit # of cigarettes, nicotine patches, condom use
(STDs), supervise injection facilities
Substance Abuse vs. Dependence
A maladaptive pattern of substance use leading to
clinically significant impairment or distress, as
manifested by one (or more) of the following,
occurring within a 12-month period:
1. Recurrent substance use resulting in a failure to
fulfill major role obligations at work, school, home
-E.g., repeated absences or poor work performance
related to substance use
-Substance-related absences, suspensions, or
expulsions from school
-Neglect of children or household
Not meeting needs
Social conflict between drug abuser and spouse makes
social life impaired
2. Recurrent substance use in situations in which it is
physically hazardous
-E.g., driving an automobile or operating a machine
when impaired by substance use
3. Recurrent substance-related legal problems
-E.g., arrests for substance-related disorderly
conduct
4. Continued substance use despite having persistent or
recurrent social or interpersonal problems caused or
exacerbated by the effects of the substance
E.g., arguments with spouse about consequences of
intoxication
Physical fights
1) Tolerance, as defined by either of the following:
-A need for markedly increased amounts of the
substance to achieve intoxication or desired effect
-Markedly diminished effect with continued use of the
same amount of substance
2) Withdrawal, as manifested by either of the following:
The characteristics withdrawal syndromes for the
substance
-The same (or a closely related) substance is taken to
relive or avoid withdrawal symptoms
3) Substance if often taken in larger amounts or over a
longer period than was intended
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4) There is persistent desire or unsuccessful efforts to
cut down or control substance use
5) A greatly deal of time is spent in activities to
obtain the substance, use the substance, or recover
from its effects
6) Important social, occupational or recreational
activities are given up or reduced because of
substance use
7) Substance use is continued despite knowledge of having
a persistent or recurrent physical or psychological
problem that is likely to have been caused or
exacerbated by the substance (e.g., continued drinking
despite recognition that an ulcer was made worse by
alcohol consumption)
Alcoholism & Problem Drinking
How Does Alcohol Abuse Compromise Health?
Alcohol-related deaths = 8000/year
Linked to a number of disorders:
-High blood pressure
-Stroke cirrhosis of the liver
-Some forms of cancer
-Fetal alcohol spectrum disorder
-Major sleep disorders
-Cognitive impairments (irreversible often)
Economically, costs Canadians $14.6 billion in loss
productivity, treatments, accidents, fire, and crime
-$463/Canadian/year
Nearly 20% of Canadians drinks at levels that exceed
government recommendations
Low-Risk Drinking Guidelines
Maximize Life, Minimize Risk
-0: zero drinks = lowest risk of an alcohol-related
problem
-2: no more than 2 standard drinks on any one day
-9: women: up to 9 standard drinks a week
-14: men: up to 14 standard drinks a week
One Standard Drink = 13.6 g of alcohol
-5 oz./142 mL of wine (12% alcohol)
-1.5 oz./43 mL of spirits (40% alcohol)
-12 oz./341 mL of regular strength beer (5% alcohol)
Origins
-Genetic factors (twin studies), M>F
-Socio-demographic factors (low SES)
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