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Lecture 12

Psychology 46-228 Lecture 12: Notes on Substance, Drugs, and Addictions

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Lecture 12 on Substance, Drugs, and Addictions Substance Related Disorders  Problems associated with using and abusing drugs that alter patterns of thinking, feeling and behaving  Addictive behaviour Intoxication  Temporary condition  Impaired judgment, disturbed perception, pronounced mood changes, altered thinking, or impaired motor behaviour  Each substance has a unique intoxication profile Abuse  Level of use that is hazardous to a person's health  Significant impairment in work or family life  Produces personal distress  Or leads to legal problems Substance dependence  Maladaptive pattern of substance use, leading to clinically significant impairment or distress  3 or more of the following symptoms, occurring any time in same 12 months: o Tolerance o Withdrawal o Use in amounts larger than and or for longer than planned o Persistent desire/unsuccessful effort cut down o Considerable time devoted to obtaining, using, or recovering from use o Important social, occupational, or recreational activities stopped or reduced due to use o Continued use despite knowing that psychological or physical condition is likely caused/exacerbated Psychological Dependence  Intense desire for the drug and a preoccupation with obtaining it  Devoting a large portion of day to procuring and using drugs  Failure to discontinue drug even when it is causing or aggravating physical problems Physiological Dependence  When substance consumption leads either to tolerance or to a withdrawal syndrome  Tolerance o Increasingly larger doses are required to achieve the same physical effect or subjective state o If the drug is taken repeatedly at the same dose, its effects are significantly reduced  Withdrawal syndrome o Pattern of physical symptoms that results from discontinuing the drug o Creates vicious cycle  person can avoid aversive withdrawal symptoms only by continuing to take the drug Alcohol in the Body  Ethanol first absorbed through the stomach wall, then through the intestine  Carried in the blood to organs, including brain  In the liver, undergoes oxidation, is converted to acetaldehyde by the enzyme alcohol dehydrogenase  Acetaldehyde is further metabolized into other products  The liver can metabolize about a half an ounce to an ounce of alcohol in an hour  Ethyl alcohol ("grain alcohol")  Methyl alcohol ("wood alcohol") o Highly toxic (4oz. Usually fatal) o CNS system depression, build-up of formic acid o Blindness results  When consumption > liver's capacity to oxidize, ethanol and acetaldehyde accumulate in body cells, disrupting cell structure and functions  Unmetabolized ethanol absorbed into the blood from the small intestine and stomach can be measured as blood alcohol concentration (BAC)  A drink is defined as one ounce of 100-proof alcohol o 50% ETOH content (alcohol content) o 1 to 2 drinks yields a BAC of 0.02 to 0.05% o 3 to 5 drinks produce a BAC of 0.06 to 0.10% o 10 to 13 drinks create BACs of 0.2 to 0.25% Effects of Alcohol on Behaviour  1 or 2 drinks  lowered inhibition  As BAC rises, impaired judgment, low self-awareness o 0.05 to 0.08%  slurred speech and mild motor coordination problems o 0.10%  motor coordination problems, drowsiness, impaired perception; mood changes, poor attention and memory, and a lack of inhibition that impairs normal social functioning o BAC over 0.25%  may lose consciousness and suffer respiratory problems that can lead to death Effects of Alcohol in the Brain  Glutamate  major excitatory neurotransmitter in the brain  GABA  the brain's major inhibitory neurotransmitter  Alcohol reduces excitatory action of glutamate and increases inhibitory action of GABA  Results in suppression of cell activity  Alcohol enhances GABA's inhibitory effects in medial septal nucleus o Connected to the limbic system o May account for alcohol's sedating and anxiety-reducing action  Alcohol enhance GABA's inhibitory effects in the cerebellum o Critical to normal sensory and motor functions o Explains impaired gait and other aspects of motor coordination  Dopamine o Alcohol increases levels of dopamine in the nucleus accumbens/other reward centers o Mediates the experience of pleasure  Endogenous opiates o Increases the release of endorphins o These naturally occurring substances are chemically similar to opioid drugs o Produce a state of euphoria and reduce the experience of pain Long Term Effects  Liver toxicity  Depression  Korsakoff's syndrome o Chronic alcoholism and Vitamin B1 (thiamine) deficiency o Loss of recent and past memory; unable to form new memories o Perceptual deficits o Confabulation Causes of Alcohol Use Disorders Neurobiological Influences  Stimulating properties o The degree to which a substance accelerates heart rate may reflect a sensi
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