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PSYB32H3 (1,174)
Chapter 12

chap 12

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Konstantine Zakzanis

ABNORMAL PSYCHOLOGY CHPATER 12 SUBSTANCE RELATED DISORDERS The pathological use of substances fall into 2 categories: substance abuse and substance dependence By DSM-IV-TR, substance dependence is characterized by 3 of the following: The development of tolerance, indicated by either: larger doses of the substance to produce the same effect or the effect of the drug becomes less if the usual amount is taken Development of withdrawal symptoms adverse physiological or physical effects produced when a person stops taking a substance or reduces the amount ingested The person uses more of the substance or uses it for longer than expected The person recognizes excessive use of substance; they may try to reduce usage but is unable to do so Much of the persons time is spent trying to get the substance or recover from its effect Substance use continues despite psychological or physical problems caused or www.notesolution.com exacerbated by the drug Person cuts back or completely cuts participation in many events (work, socializing etc.) because of drug use According to the DSM-IV-TR, substance abuse is characterized and diagnosed if one of the following is a result from recurrent use of drugs: Failure to fulfill major obligations (e.g. absence from work, or neglect of children) exposure to physical dangers (e.g. operating machinery or driving under the influence) legal problems (e.g. arrests for disorderly conduct or traffic violations) persistent social or interpersonal problems (e.g. argument with a spouse) DT (Delirium Tremens): Withdrawal symptoms from alcohol Alcohol Abuse & Dependence www.notesolution.com The DSM-IV-TR distinguishes between alcohol dependence and alcohol abuse Alcohol dependence may include tolerance and withdrawal reactions. People with alcohol dependence typically have more severe symptoms The body becomes adapted to the alcohol and the abrupt withdrawal of the drug may cause DTs: symptoms include anxiousness, depression, weakness, restlessness, insomnia; tremors in muscles (face, eyelids, and tongue) elevated pulse, BP, and temperature. In rare cases, more serious symptoms such as hallucinations and delusions may appear. The blood alcohol levels of extreme abusers are unexpectedly low after what is considered heavy drinking showing the body adapts to the drug and processes it more efficiently Tolerance results from changes in the number and sensitivity of GABA or glutamate receptors. Overtime, neural pathways adapt to the alcohol use and compensate for its inhibitory effects. When the drinking stops, the inhibitory effects of alcohol are lost, resulting in overexcitation Those who are alcohol dependent have cravings that are out of control. They may be drunk fro many days at a time and drink as much as a litre of alcohol in one sitting. The urge for alcohol may lead them to get it from a non beverage e.g. hair tonic or nail polish remover Alcohol abusers experience negative social and occupational effects for it but do not show tolerance, withdrawal, or the compulsive drinking pattern seen in alcoholic dependent people. Alcohol abuse and dependence are both a part of polydrug abuse (using/abusing more than one drug at once). This is shown by the fact that 80-85% of all drinkers are smokers (may be because alcohol and nicotine are synergetic/cross-tolerant) www.notesolution.com Lifetime prevalence for alcohol dependence is about 20% for men and 8% for women. Prevalence decline with age Alcohol is a big problem in native communities; the drug contributes to 40% of all deaths and virtually all crimes The typical heavy drinker in Canada is a young adult male who is not married and is fairly well off Although alcohol abuse usually leads to alcohol dependence, the exact coarse people take to reach dependence is highly variable. There is no single pattern for alcohol dependence Alcohol problems typically begin later in life in women than in men Short Term Effects of Alcohol Alcohol is metabolized by enzymes after alcohol reaches the stomach, where most of it goes to the small intestine where it is absorbed into the blood. It then goes to the liver, which can metabolize about 30mL of whisky (50% alcohol) per hour. Anything more than that stays in the blood stream. The removal of alcohol is always slow and is very highly variable. It depends on the level of concentration of the drug in the blood stream, how much is ingested at a particular period, presence/absence of food, size of the person, efficiency of the liver etc. www.notesolution.com
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