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Chapter 12

Chapter 12 Textbook Notes

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Matthias Niemeier

Chapter 12 – Substance-Related Disorders ➢ 2 categories  Substance Dependence  3 of the 7 criteria must be present • 1) Tolerance • 2) Withdrawal • 3) Person continues to use substance despite adverse health effects • 4) Person acknowledges excessive use; has tried to quit in the past but has failed • 5) Person uses substance for a longer time than was originally intended • 6) Misses many activities due to substance use • 7) Spends most of his/her time trying to obtain the substance  Substance Abuse  Less serious & only requires 1 of the 4 criterias • 1) Exposure to physical dangers (drinking & driving) • 2) Legal problems (traffic violation) • 3) Social & Interpersonal problems (conflict with spouse) • 4) Failure to fulfill major obligations (attending work) ➢ Aperson can receive a diagnosis of substance dependence and withdrawal when he/she exhibits withdrawal symptoms when refused the substance. ➢ Withdrawal example: Delerium Tremens AlcoholAbuse and Dependence ➢ AlcoholAbuse is different from alcohol dependence ➢ Alcohol dependence  May include tolerance or withdrawal  Withdrawal  Usually happens w/ heavy drinkers whose bodies have become accustomed to the drug  Can cause many adverse symptoms: anxious, restless, depressed, muscle tremors, Dts, Hallucinations (visual)  Increased Tolerance  Occurs in heavy drinkers when levels of alcohol in the blood become unexpectedly low after what is usually viewed as excessive drinking  Body adapts to the drug; becomes able to process it more efficiently  So more of the drug is needed to produce the same effects  Tolerance players • liver enzymes • GABAreceptors • However, tolerance is due to psychological & physiological factors ➢ Polydrug abuse  Using more than 1 drug at a time  Pple smoke & drink at the same time because 1 drug is supposed to enhance the effects of the other  However, this can be dangerous. Prevalence of Alcohol Abuse & Comorbidity w/ Disorders ➢ More common in men than women however rates for women becoming similar to men's. ➢ Major problems for NativeAmericans/Aboriginal Communities ➢ Prototypical heavy drinker  Ayoung adult male who is not married and who is relatively well of financially ➢ Comorbid with personality disorder, mood disorders, anxiety, & schizophrenia. Course of the Disorder ➢ Jellinek described a trend in all drinkers where they go from social drinkers to heavy drinkers (4 stages) ➢ Although some of this is true, the pattern of drinking varies amongst drinkers. ➢ There is no single pattern of alcohol abuse. ➢ This also doesn't apply to women; they tend to get hooked on alcohol faster than men? ➢ Alcohol abuse is the 4rth leading cause of worlwide disability; it accounts for more years lost to death or disability as opposed to tobacco or other illegal drugs. ➢ Results in car accidents; injuring drivers and others, suicide, medical expenses, rape, assault, homocide. ➢ Believed that over ½ of all murders are committed under the influence of alcohol. ➢ Adirect link between alcohol intoxication & violence. Short-term Effects ➢ Has a biphasic effect  At 1 it produces pleasurable effects that leads to sociability and feelings of well-being (by reducing tension via stimulating GABAreceptors & increasing seratonin & dopamine) and as the alcohol in the blood level peaks, it then declines and leads to negative affect.  Alcohol inhibits glutumate receptors which may cause the cognitive effects ➢ However short-term effects vary depending a variety of factors  Person's weight  The amount of food in stomach; level of concentration of the drug  How much was ingested within a certain amount of time ➢ Your expectations of the effects have an influence  You believing that you'll experience something, will cause you to feel it Long-term Effects ➢ Biological damage & psychological deterioration ➢ Almost every tissue and organ in body is affected by prolonged consumption of alcohol. ➢ Contributes to malnutrition by impairing digestion of food and absorption of vitamins. ➢ Could lead to cirrhosis of the liver (fatal disease) due to reduction in the intake of proteins ➢ Damage to Endocrine glands and pancreas, heart failure, stroke, hypertension, & capillary hemmorhages ➢ Destroys brain cells (loss of grey matter from temporal lobes) ➢ May produce some cognitive impairment ➢ Reduces the effectiveness of the immune system and increases chances of getting diseases (breast cancer) ➢ Fetal Alcohol Syndrome if taken during pregnancy ➢ Positive effects of alcohol (red wine) may lower cholesterol levels for light drinkers ➢ Inhalant Use Disorders ➢ Growing concern; many young children & adolescents are doing this ➢ Sniffing glue, white-out, gasoline, aerosol spray, paint, etc  Sniffing, Huffing (breathing fumes from a rag stuffed in mouth), & Bagging (Breathing fumes from a plastic bag held up to mouth ➢ 2 out of 5 8 graders know that solvent use is dangerous; can cause damage to central nervous system ➢ They`re also dangerous because they are cheap and readily available ➢ Peak age of inhalant use is 14 & 15 ➢ Inhalant use`s frequent among Natives; providing similar effects of alcohol, mainly euphoria & psychic numbing. Nicotine and Cigarette Smoking ➢ When not smoked, tobacco can be chewed or ground into small pieces and then inhaled ➢ Nicotine is the addicting agent of tobacco ➢ We have nicotinic recpetors in our brain and these become stimulated by nicotine and thus the dopamine neurons are also stimulated (the dopamine receptors are responsible for producing reinforcing effects) ➢ Evidence shows that nicotine may be much more addictive than originally thought st st ➢ Some can get addicted with their 1 puff or 1 cigarette ➢ However, mental addiction may occur earlier than physical addiction ➢ Nicotine may operate differently on the brains of females vs. Males  Females and males have different levels of activity in the brain (biological difference)  Females had much greater brain activity, however these differences disappeared when nictorine was administered  Could be responsible for different smoking patterns in females vs. males (Females have greater change in cognitive activity after nicotine exposure) Prevalence & Health Consequences of Smoking ➢ Smoking results in premature death and it is the only one that is preventable ➢ Health risks are less for cigar & pipe smokers since they don`t inhale but cancers of the mouth is still a risk. ➢ Medical Problems  Cardiovascular disease, lung cancer, emphysema, cancer of the larynx  Harmful components of tobacco  Nicotine, Carbon monoxide and tar (consists of carcinogens)  The risks for such problems could be reduced after quitting however, your lung won`t ever get back to the way it used to be ➢ Studies indicate:  Annual comparisons show that fewer Canadians are smoking, & smokers are smoking fewer cigarettes on a daily basis  High prevalance rate amongstAboriginal People in Canada  Increasing in teenagers  Decreasing in grades 5 to 9 ➢ Smoking may lead to errectile problems in men. ➢ Consequences of Second-Hand Smoke nd ➢ 2 hand smoke contains higher concentrations of ammonia, carbon monoxide, nicotine, & tar than does the smoke actually inhaled by the smoker ➢ Dangerous as asbestos & radon ➢ Chances of getting lung disease (25%) and heart disease (10%) with frequent exposure ➢ Infants & children can suffer from middle year infenction, respiratory illnesses, sudden infant death syndrome, etc. Marijuana ➢ Consists of the dried and crushed leaves and flowering tops of the hemp plant Cannabis sativa. ➢ Most often smoked, but it may be chewed, prepared as tea, or eaten in baked goods ➢ It was first used for its fibres in making cloth and rope ➢ It was then used as medication for treating cholera and such, and even though people smoked it for pleasurable effects, it wasn`t that popular ➢ It became popular when alcohol was banned ➢ It was banned due to its link with crimes ➢ It`s now banned in Canada Effects of Marijuana ➢ Effects depend on dosage size ➢ Smok
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