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Ch. 17 - Substance abuse disorders.

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Lecture 9: Substance Abuse Disorders (Ch. 17) Nov. 24, 09 DSM-IV Disorders There are four substance use disorders recognized by the DSM IV - Substance intoxication - Substance abuse - Substance dependence - Substance withdrawal The vast majority of people will try one type of ~substance~ at least once Substance intoxication - Development of reversible symptoms and maladaptive behavioural or psychological changes due to the direct physiological effects of a substance on the CNS EX: sedatives have a direct impact on wakefulness; acid has an impact on neurophysiologic processes; marijuana has an effect on attentionthinking processes; cocaine has an impact on move-ability; amphetamines have a direct impact on psychomotor agitation; alcohol on judgement and control - Only diagnosed if the behavioural and psychological changes cause significant disruption in the persons life or place the person at risk of adverse effects (like accidents or physical fights) Factors affecting intoxication - Type of substance - Alcohol vs. opiates vs. amphetamines; different impact - Crackcocaine taken up quickly and efficiently (intense but short lived) hence people will try to follow it quickly very addictive Different methods; snort, smoke, inject, oral ingestion Can affect system faster or slower; snortingsmoking have more direct impact on CNS and person will appear more intoxicated - History of use - Differences in how they get intoxicated - Dosage - Tolerance related to body size (smaller=more intensely intoxicated), gender (female=more intoxicated), history of use (long history, tolerance builds up so more drug is required to build high), drug metabolism (individual variation in how different people metabolize drugs) - Expectations of use - Environment or setting in which substance is ingested - If a person is used to alcohol or using heroine in the same setting at the same dose, if they change environment then there might be an overdose; perhaps because some cues triggered an opposite process while the new environment doesnt Substance Abuse
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