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Chapter 12

PSYB30H3 Chapter Notes - Chapter 12: Fetal Alcohol Spectrum Disorder, Passive Smoking, Binge Drinking

Course Code
Lisa Fiksenbaum

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Chapter 12 - Substance-Related Disorders
Substance-related and addictive disorders
- Key terms: DSM-IV-TR
Substance Dependence
Tolerance: larger doses are needed to get same desired effect
Withdrawal: negative physical and/or psychological effects when person stops
taking the drug
- Substance Abuse
considered to be less serious
must have experienced one of the following as a result of recurrent use:
Failure to fulfill major obligations
Exposure to physical dangers
Legal problems
Persistent social or interpersonal problems
Substance Related and Addictive Disorders (DSM-5)
- Eliminated DSM-IV-TR classifications of dependence and abuse since the distinction was
considered to be one of severity not distinct categories
- DSM-5 has single broad category of substance-related and addictive disorders
- Additios o ilude galig disorders
Alcohol Dependence
- Alcohol dependence may include tolerance or withdrawal reactions
People who are physically dependent on alcohol tend to have more severe symptoms of
the disorder anxious, depressed, weak, restless, and unable to sleep
Tremors in the muscles and elevated temperature
A person who has been drinking heavily for years may also experience delirium tremens
DT when the level of alcohol in blood drops suddenly = delirious, tremulous, and
hallucinations primarily visual, may be tactile
Feverish, disoriented and terrified creatures crawling on walls
- Alcohol dependence is often part of polydrug (or polysubstance) use
Using more than one drug at a time
Effects of drugs can be synergistic (combine to produce very strong reaction)
Potentially fatal overdoses (i.e., alcohol can reduce amount of narcotics needed to make
a lethal dose)
Alcohol Dependence
Prevalence and Comorbidity
- Alcohol dependence
Lifetime prevalence rate: 12.5%
12-month prevalence: 3.8%
Higher among men, younger cohorts and whites
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- Comorbid with mood and anxiety disorders, other drug use and schizophrenia
- Comorbidity (psychiatric disorders and substance dependence) is important because:
predicts high relapse rates
less initial treatment improvement
High Risk Drinking
- Defined as more than two drinks per day
- Higher rates in men (25.1%) compared to women (8.9%)
- Prototypic heavy drinker in Canada:
Not married
Relatively well-off financially
Nature of the Disorder
- Disease model is the view that problems like excessive drinking are due to vulnerabilities that
reside within a person (genetic predisposition, brain chemistry) if followed = no cure possible
- Moral Model is the view that excessive drinking reflects personal failings and personal choices
of the afflicted individual
Binge Drinking at University
- 1 in every 4 university students is a frequent binge drinkers (usually once per week) (US stats)
- 32% of undergraduates report hazardous or harmful patterns of drinking (compare to 17% in the
general population)
- More Canadian students drink some alcohol;
American students who use alcohol are heavier drinkers
- First experience of drunkenness prior to age 16 is more likely to lead to heavy drinking later
- 1 in 4 Ontarians in grades 7 to 12 admit binge drinking within last month no gender differences
was found
Cause of the Disorder
- Male alcohol abuser as passing through 4 stages, beginning with social drinking and progressing
to a stage at which he lives only to drink
- Progression from alcohol abuse to alcohol dependence
- Difficulties begin at later age in women than in men because of inordinately stressful
experience like family crisis
Short-Term Effects of Alcohol
- Metabolized by enzymes after swallowed and enters stomach
- Most goes into small intestines where absorbed into blood
- Broken down in liver
can metabolize about 30 millilitres of 100-proof (50% alcohol) whisky/hour
quantities in excess of this amount stay in the bloodstream
- Biphasic effect
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Initial effect of alcohol: acts as a stimulant
Later effect of alcohol: acts as a depressant
Short-Term Effects of Alcohol
Biological Mechanism
- Produces effects through interactions with several neural systems in the brain
Stimulates GABA receptors
Reducing tension
Increases levels of serotonin and dopamine
Pleasurable effects
Inhibits glutamate receptors
Cognitive effects of alcohol intoxication, such as slurred speech and memory
Long-Term Effects
- Chronic drinking causes severe biological damage and psychological deterioration
- Almost every tissue and organ is adversely affected:
Deficiency of B-ople itais → aesti syndrome
Cirrhosis of the liver
Damage to the endocrine glands and pancreas
Heart failure, hypertension, stroke, and capillary hemorrhages, which in turn can
Brain damage
Fetal Alcohol Syndrome
- Leading cause of mental retardation heavy alcohol
consumption during pregnancy
- growth of the fetus is slowed
- cranial, facial, and limb anomalies are produced
- known as fetal alcohol syndrome
- see also partial fetal alcohol syndrome and alcohol-
related neurodevelopmental disorder (ARND)
Inhalant Use Disorders
- Although use not confined to children and adolescents,
alarming # of young people begin their substance abuse by inhaling substances
Glue, correction fluid, spray paint, cosmetics, gasoline, household aerosol sprays,
nitrous oxide found in spray cans of whipped cream
Inhalant use among young people = 17.3%
Nicotine Use and Cigarette Smoking
- Single most preventable cause of premature death (1 in every 5 deaths)
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