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Ch17 Textbook Notes

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CHAPTER 17 SUBSTANCERELATED DISORDERSSubstance is any natural or synthesized product that has psychoactive effectsChanges perceptions thoughts emotions and behavioursDrug addicts people who have problems as result of taking these drugs A person does not need to be physically dependent on substance in order to have problems resulting from taking the substancesMen are much more likely than women to have used an illicit substance in their livesBut both are equally likely to become dependent women may suffer greater physiological damageSociety and Substance Use Societies differ in attitudes about substances attitudes are reflected in different laws and approaches to treatmentIn Britain substance addiction is considered a medical disease people who abuse or are dependent are treated by physiciansThe Dutch make a distinction in law enforcement between soft drugs and hard drugsMany substances come from plants and have been used for medicinal purposes for centuries1500 BC natives in the Andes Highlands chewed coca leaves to increase endurance Cocaine from coca leaves was used legally throughout Europe and North America into ththe 20 century to relieve fatigue Was an ingredient in the original CocaCola drink and more than 50 other elixirsOpium has been used for 100s of years to relieve pain particularly in Asia and EuropeThe leaves of a plant called Khat had been chewed in parts of E Africa the Middle East and S America for 100s of years to produce a sense of wellbeing and relief from fatigueSubstances have also been used for religious ceremonies to produce psychological changesSubstancerelated disorder use of substance that leads to significant problems in the abilities to function in daily lifeDefinitions Of SubstanceRelated Disorder Four substancerelated conditions recognized by the DSMIVTRsubstance intoxication substance withdrawal substance abuse substance dependenceSubstances are group into 5 categories1 CNS Depressants eg alcohol barbiturates benzodiazepines and inhalants2 CNS Stimulants eg cocaine amphetamines nicotine caffeine3 Opioids eg heroin and morphine4 Hallucinogens and phencyclidine PCP5 CannabisMixed group of drugs club drugs eg ecstasy GHB ketamine rohypnolSubstancerelated disorder experience significant problems in cognitions and mood anxiety hallucinations delusions and seizures when exposed to substances such as muscle relaxants lead pesticides nerve gas antifreeze etcIntoxicationSubstance intoxication a set of behavioural and psychological changes that occur as a direct result of the physiological effects of a substance on the CNS Perceptions change attention diminished or are easily distracted good judgment gone cant control their bodies as they normally do often want to sleep a lot or not at allIntoxication declines as the amount of substance in peoples blood tissue declines symptoms of intoxication may last for hours or days after the substance is no longer detectable in the bodySymptoms depend on what substance is taken how much is taken how long the substance has been ingested users toleranceShortterm acute intoxication can produce different symptoms than chronic intoxicationEnvironment and peoples expectations can also influence types of symptoms people developWithdrawalSubstance withdrawal involves a set of physiological and behavioural symptoms that result when people who have been using substances heavily for prolonged periods of time stop or greatly reduce their useDiagnosis is not made unless the withdrawal symptoms cause significant distressor impairment in a persons everyday functioningIntense symptoms usually end within a few days to a few weeks but subtle physiological signs of withdrawal such as problems in attentions perceptions or motor skills may be present for many weeks or months AbuseDiagnosis of substance abuse is given when a persons recurrent use of a substance results in significant harmful consequencesDSMIVTR Criteria one or more of the following occurs during a 12month period leading to significant impairment or distress1 Failure to fulfill important obligations at work home school2 Repeated use in situations in which it is physically hazardous to do so3 Repeated legal problems as a result of substance use4 Continued use of the substance despite repeated social or legal problemsDependenceSubstance dependence closest to what people often refer to as drug addictionPhysiological dependence on a substance occurs when tolerance or withdrawal is shown from the substanceDSMIVTR criteria maladaptive pattern of substance abuse leading to 3 or more of the following1 Tolerance a need for markedly increased amounts of the substance to achieve intoxication or desired effects OR b markedly diminished effect with continued use of the same amount of the substance
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