Chapter 10- Substance Use and Addictive Disorders
- Drug: defined as any substance other than food that affects our body or
- “Substance”: frequently used in place of “drug”, in part because many people
fail to see that such substances as alcohol, tobacco, and caffeine are drugs too.
- Substance intoxication: substances may cause temporary changes in
behavior, emotion, or thought; this cluster of change
o Alcohol intoxication: excessive amount of alcohol that may lead to a
temporary state of poor judgement, mood changes, irritability, slurred
speech, and poor coordination.
o Hallucinogen intoxication: largely of perceptual distortions and
- Substance use disorders: pattern of long-term maladaptive behaviors and
reactions brought about by repeated use of a substance.
o Dx checklist:
▪ 1. Individuals display a maladaptive pattern of substance use
leading to significant impairment or distress.
▪ 2. Presence of at least 2 of the following symptoms within a 1-
• Substance is often taken in large amounts or over a
longer period than intended.
• Unsuccessful efforts or persistent desire to reduce or
control substance error.
• Much time spent trying to obtain, use, or recover from
the effects of substance
• Failure to fulfill major role obligations at work, school
or home as a result of repeated substance
• Continued use of substance despite persistent social or
interpersonal problems caused by it.
• Cessation or reduction of important social,
occupational, or recreational activities because of
• Continuing to use substance despite awareness that it is
causing or worsening a physical or psychological
• Craving for substsances
• Tolerance effects
• Withdrawal reactions
- Tolerance: the brain and body’s need for ever large doses of a drug to
produce earlier effects.
- Withdrawl: unpleasant, sometimes dangerous reactions that may occur when
people who use a drug regularly stop taking or reduce their dosage of the
drug. - 8.9% of all teens and adults in the United States, over 23 million people, have
a substance use disorder.
o Only 11% receive treatment from a mental health professional
- The substances people misuse fall into several categories: depressants,
stimulants, hallucinogens, and cannabis
- depressants: reduce tension and inhibitors and may interfere with a person’s
judgment, motor activity, and concentration.
o Three most widely used groups of depressants are alcohol, sedative,
hypnotic drugs, and opoids.
- alcohol: any beverage containing ethyl alcohol, including beer, wine, and
o Binge- drinking: consuming five or more drinks on a single occasion.
- The ethyl alcohol immediately begins to take effect as it carried in the
bloodstream to the central nervous system.
o At first ethyl alcohol depresses the areas of the brain that control
judgment and inhibition; people become looser, more talkative, and
often more friendly.
o Motor difficultuties increase as a person continues drinking, and
reaction times slow.
o Levels of impairment are closely related to the concentration of ethyl
alcohol in the blood.
Alcohol Use Disorder
- Alcohol is actually one of the most dangerous of recreational drugs, and it
reach extends across the life span.
- People with alcohol use disorder drink large amounts regularly and rely on it
to enable them to do things that would otherwise make them anxious.
Tolerance and Withdrawl
- tolerance- need to drink ever large amounts to feel its effect.
- Withdrawl: can cause [hands, tongue, and eyelids] shaking, feel weak and
nauseated; sweat and vomit; heat beats rapidly; blood pressure rises, can
cause anxious, depression, sleep deprevation, or irritability.
- Delirium tremens (“the DTs): a dramatic withdrawl reaction that some
people who are dependent on alcohol have. It consists of confusion, clouded
consciousness, and terrifying visual hallucinations.
What is the Personal and Social Impact of Alcoholism?
- Medical treatment, lost productivity, and losses due to deaths from
alcoholism cost society many billions of dollar annually.
- Alcoholism has serious effects on the 30 million children of people with this
- Long-term excessive drinking can also seriously damage a person’s physical
o Overworks the liver that can develop cirrhosis. o Damage the heart and lower the immune system’s ability to fight off
cancer, bacterial infections, and AIDS.
- Korsakoff’s syndrome: an alcohol-related disorder marked by extreme
confusion, memory impairment, and other neurological symptoms.