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PSYB32 Textbook Notes III
Chapter 12: Substance-Related Disorders
Substance Dependence (accompanied by addiction ± physiological dependence)
DSM requires at least 3 of the following:
- Tolerance
o Larger doses of the substance being needed to produce the desired effect
o The effects of the drug becoming markedly less if the usual amount is taken
- Withdrawal ± symptoms of negative physical and psychological effects develop when the person
stops taking the substance or reduce amount
o The person may also use the substance to relieve or avoid withdrawal symptoms
o Delirium Tremens (DTs) ± withdrawal delirium, visual/tactile hallucinations
- The person uses more of the substance or uses it for a longer time than intended
- The person recognizes excessive use of the substance; he may have tried to reduce usage but has
been unable to do so
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- Substance use continues despite psychological or physical problems caused by the drug
- The person gives up or cuts back participation in many activities because of use of the substance
Substance Abuse
- Failure to fulfill major obligations
- Exposures to physical dangers
- Legal problems
- Persistent social or interpersonal problems
Substance Intoxication
- When ingestion of a substance affects the central nervous system and produces maladaptive
cognitive and behavioural effects
Alcohol Abuse and Dependence
Poly-drug (poly-substance) abuse ± using or abusing more than one drug at a time
- Synergistic ± effects of each combine to produce an especially strong reaction (alcohol and
barbiturates is a common means of suicide)
Prevalence: more in men than women, alcohol dependence declines with age
Comorbidity: mood and anxiety disorders, other drug use, schizophrenia
Short Term Effects of Alcohol:
- Vary with the level of concentration of drug in bloodstream
- Depends on the amount ingested in a particular period of time
- Presence or absence of food in the stomach to retain the alcohol and reduce its absorption rate
- 6L]HRISHUVRVERG\
- Efficiency of liver
- Biphasic effect ± in small amounts drinker experiences sociability, larger amounts can act as a
depressant that may lead to negative emotions, interfere with complex thought processes
Long Term Effects of Alcohol:
- Biological damage and psychological deterioration:
o Malnutrition ± drinkers reduce food intake, reduce vitamin intake (B-complex vitamins)
o Cirrhosis of the liver ± blood flow obstructed
o Damage to endocrine glands and pancreas, heart failure, hypertension, stroke, capillary
haemorrhages, swelling and redness of nose, reduce immune system function,
o Fetal alcohol syndrome ± growth of fetus is slowed, cranial, facial and limb abnormalities
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Inhalant Use Disorders
- Ex: glue, correction fluid, spray paint, cosmetics, gasoline, aerosol sprays
- Sniffing (nasal inhalation), huffing (small rag stuffed in mouth), bagging (plastic bag)
- Inhalants acts as depressants, similar to alcohol and sedatives, feelings of euphoria and psychic
numbing but can cause damage to central nervous system, headaches and nausea
Nicotine and Cigarette Smoking
- Nicotine ± addicting agent in tobacco, stimulates nicotinic receptors in brain, dopamine in
mesolimbic area
- Even the first puff can be addictive
- Female smokers have greater changes in cognitive activity after nicotine exposure
Prevalence: more men than women, Aboriginal, less educated
Consequences: destruction of lung tissue irreversible
Second-hand smoke (aka environmental tobacco smoke (ETS): contains higher concentrations of
ammonia, carbon monoxide, nicotine, and tar
Marijuana
- Marijuana ± consists of dead and crushed leaves and flowering tops of the hemp plant Cannabis
- Hashish ± much stronger than marijuana, is produced by removing and drying the resin exudates
of the tops of high-quality cannabis plant
- Major active chemical is THC, cannabinoid receptors in brain
Effects of Marijuana
- Psychological Effects ± relaxed, sociable,
o larger doses reported to bring rapid shifts in emotion, to dull attention, fragmented
thoughts, impaired memory, time seems to move slowly,
o extremely large doses may induce hallucinations, effects similar to LSD, extreme panic
- Somatic Effects
o Short term: bloodshot and itchy eyes, dry mouth and throat, increased appetite, reduced
blood pressure within the eye and somewhat raised blood pressure, elevates heart rate
o Respiratory disorders, impaired immune system functioning,
o Reverse tolerance ± T+&FDQEHUHWDLQHGLQERG\VIDWW\WLVVXH
- Therapeutic Effects
o THC can reduce nausea and loss of appetite that accompanies chemotherapy for cancer
Sedatives (aka downers) ± slow activities of the body and reduce its responsiveness
- Opiates ± addictive sedatives that relieve pain and induce sleep when taken in moderate doses
- Opium ± the plant of joy, poppy
- Morphine ± raw opium, powerful sedative and pain reliever
- Heroin ± more addictive and more potent than morphine, acting more quickly and with greater
intensity
Effects of Opium and its Derivatives
- Psychological and physical effects
o Produce euphoria, drowsiness, daydream and lack of coordination
o Heroin has additional initial effect: rush, feeling of warmth, ecstasy immediately
following an intravenous injection
o Shed of worries and fears, has greater self-confidence but then experiences a crash
- Synthetic Sedatives
o Barbiturates ± aids for sleeping and relaxing (Ex: Valium, Methaqualone)
o Sedatives relax muscles, reduce anxiety and in small doses produce a mild euphoric state,
with excessive doses speech becomes slurred, gait unsteady, judgement impaired,
o Delirium and convulsions similar to alcohol withdrawal
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Stimulants (aka Uppers) ± brain & sympathetic nervous system, increase alertness and motor activity
- Amphetamines ± (ex: Benzedrine) ± inhalant to relieve stuffy noses
o Block reuptake of norepinephrine and dopamine
o Wakefulness is heightened and appetite is reduced, heart rate quickens
o Individual becomes alert, euphoric, outgoing, boundless energy and self-confidence
o Larger doses: make people nervous, confused, palpitations, headaches, dizziness and
sleeplessness, can induce similar state to paranoid schizophrenia including delusions
o Methedrine ± speed freaks
- Cocaine ±
o Sigmund Freud used to combat depression,
Blocks reuptake of dopamine in mesolimbic area
o Reduces pain, increases sexual desire, self-confidence, indefatigability
o Overdose: chills, nausea, insomnia, paranoia breakdown, terrifying hallucinations
o Chronic use: heightened irritability, impaired social skills, paranoid thinking,
disturbances in eating and sleeping
o Increased risk of stroke and myocardinal infarction, cognitive impairment, impaired
memory + attention
LSD and Other Hallucinogens (Causes hallucinations)
- LSD ± psychotomimetic, produce effects similar to symptoms of psychosis
- Mescaline ± active ingredient of peyote, from peyote cactus
- Psilocybin - mushroom
- Ecstasy (aka MDA and MDMA ) ± enhances intimacy and insight, improves interpersonal
relationships, elevates mood, and promotes aesthetic awareness
- Muscle tension, rapid eye movements, increased heart rate, blood pressure, nausea, faintness,
chills or sweating, anxiety, depression, and confusion and memory complaints
- PCP (aka angel dust) ± developed as a tranquilizer for horses and large animals causes serious
negative reactions, severe paranoia and violence
Effects of Hlucinogens
- Shifting moods, slow time, flashbacks,
- Bad trip ± full blown panic attack, specific fear of going crazy
Etiology of Substance Abuse and Dependence
- Positive Attitude ± Experimentation ± Regular Use ± Heavy Use ± Physical dependence or abuse
Social Variables ± cultural attitudes, readily availability of drug, family values, media
Psychological Variables
- Mood alteration, situations and role of cognition
o Motivational model of alcohol use ± reinforcement and locus, young people drink
primarily for social motives
o Cognitive Factors in Drinking ± reducing tension,
explicit ± controlled thought processes that can be deliberated upon
implicit ± automatic appraisal of cues that is more uncontrolled and perhaps not
subject to conscious awareness
o Drug Stroop Task ± say the color of the word and ignore its content, addicted people
respond slower to addiction related words ± attentional bias
- Beliefs about prevalence and risks ± the extent to which the person believes the drug is harmful
and the perceive prevalence use by others
- Personality and drug use - sensation/novelty-seeker, high neuroticism and psychoticism,
rebelliousness, aggression, depression
o anti-social personality disorder for men, borderline personality disorder for women
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