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Chapter 12

Chapter 12: Substance-Related Disorders.docx

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University of Toronto Scarborough
Konstantine Zakzanis

Chapter 12 Substance-Related Disorders Cost of Alcohol Abuse - 4 leading cause of worldwide disability - More deaths than illegal drugs & tobacco - Often constitute large portion of new admissions to mental & general hospitals - Drinkers uses health services 4 times more often & medical expenses twice as high - Drunken drivers - Drunk pedestrians - May contribute to other injuries o Rape o Family violence o Homicide Long-Term Effects of Prolonged Alcohol Abuse - FAS (Fetal Alcohol Syndrome) o Growth of fetus slowed, & cranial, facial, & limb anomalies produced o Drinking while pregnant is leading cause of mental retardation Inhalant Use Disorders - May be stepping stone towards heavy drug disorders - Glue, aerosol sprays, nitrous oxide in spray cans of whip cream - Inexpensive, easily available - Involve behaviors such as sniffing, huffing, bagging - May act as depressant o Result in feelings of euphoria & psychic numbing - Nicotine & Cigarette Smoking Nicotine Addicting agent of tobacco Chapter 12 Stimulates nicotinic receptors in brain – facilitate NTS release  stimulation, pleasure, & mood modulation - Consequences of Second-Hand Smoke o Contains higher concentrations of ammonia, carbon monoxide, nicotine, & tar than smoke actually inhaled by smoker Marijuana - Consists of dried & crushed leaves & flowering tops of the hemp plant, cannabis sativa o Smoked o Chewed o Prepped as tea o Baked into goods Hashish Stronger than marijuana Produced by removing & drying resin exudate of tops of high-quality cannabis plants - Psychological Effects o Dependent on potency & size of dose o Large Doses  Dull attention, rapid shifts in emotion, impair memory  Time slows o Extreme large doses  Hallucinations  Extreme panic o Chronic Use  Mild impairments – demonstrated on complex tasks that rely on a memory component or strategic planning  Psychological, health, financial, & vocational problems  More likely to use multiple substances Chapter 12  May impair complex psychomotor skills necessary for driving - Somatic Effects o Short Term  Bloodshot, itchy eyes, dry mouth & throat  Increased appetite, reduced blood pressure w/in eye, somewhat raised blood pressure - Therapeutic Effects o May reduce nausea & loss of appetite that accompanies chemotherapy o Treatment of discomfort for AIDS, glaucoma, epilepsy, & multiple sclerosis Sedatives & Stimulants Sedatives Slow activities of body & reduce its aka Downers responsiveness  Opiates Relieve pain, induce sleep when taken in moderate doses Addictive - Opium - Morphine - Heroin (converted from morphine) - Barbiturates - Psychological & Physical Effects o Produces euphoria, drowsiness, reverie, & lack of coordination o Heroin has own additional initial effect – rush, feeling of warm, suffusing ecstasy – shed worries & fears, & great-self confidence  ending in letdown (bordering stupor) o Stimulating neural receptors opioid system – fits into receptors & stimulates them Chapter 12 o Reactions of not having a dose: (usually 8 hours)  Muscle pains, sneezes, sweats, becomes tearful, yawns o Reactions of not having a dose: (within 36 hours)  Cramps, chills and excessive flushing & sweating, muscle twitching, rise in heart rate & blood pressure  Addicts would be: unable to sleep, vomit, & has diarrhea  Persist 72 hours – diminish 5-10 day period o Barbiturates: Synthesize as aids for seeping & relaxation  Relax muscles, reduce anxiety, produce mildly euphoric state (in small doses)  Excessive Doses: Slurred speech, unsteady gait. Judgment, concentration & ability to work become severely impaired. Loses emotional control, falls into deep sleep  Large doses may kill – relaxes diaphragm muscles too much – suffocate  If chronically taken – sudden withdrawal may cause sudden death Stimulants Act on brain & SNS aka Uppers Increase alertness & motor activity - Amphetamines (first  Benzedrine) o Controlled mild depression & appetite o Soldiers supplied to ward off fatigue o Produce effects by causing release of norepinephrine & dopamine & blocking reuptake of the NTS o Wakefulness heightened, intestinal functions inhibited, heart quickens, blood vessels in skin & mucous membranes constrict o Euphoric, outgoing & possessed w/seemingly boundless energy & self-confidence o Larger Doses: Nervous, confused, palpitations, headaches, dizziness, & sleeplessness o Heavy Users: Suspicious & hostile  may be dangerous Chapter 12  State like paranoid schizophrenia o Tolerance develops rapidly; may then stop taking pills & start injecting  Run: maintaining intense & euphoric activity for few days w/o eating or sleeping – after becomes exhausted & depressed  crash for several days  Behavior then becomes erratic & hostile - Cocaine o Reducing pain o Act rapidly on brain – blocking reuptake of dopamine  pleasurable states o Increases sexual desire o Produces feelings of self-confidence, well-being, & indefatigability o Overdose: Chills, nausea, & insomnia, paranoid breakdown & terrifying hallucinations of insects crawling beneath the skin o Chronic Use: Changes in personality  heightened irritability, impaired social skills, paranoid thinking, disturbances in eating & sleeping o Ceasing usage: Severe withdrawal syndrome - Crack (Poor People’s version of Cocaine) LSD & Other Hallucinogens - Hallucinations - Ecstasy o MDMA & MDA o Designer drug produced via chemical synthesis - Effects o Dependent on dose & person’s set (attitudes, expectations, & motivations w/taking the drug) Chapter 12 o Flashbacks: of hallucinatory experiences after physiological effect worn off Etiology of Substance Abuse & Dependence - Person ensnared by biological processes of tolerance
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