Ch. 11 Substance Use Disorders Overview Cirrhosis of liver due to chronic alcoholism is the leading cause of death in the US Substance dependence: a pattern of repeated self-administration that often results in tolerance, the need for increased amounts of the drug to achieve intoxication o Withdrawal after use is stopped o Compulsive drug-taking behavior o (1) tolerance o (2) withdrawal o (3) substance is taken in larger amount or over a longer period than was intended o (4) persistent desirer or unsuccessful efforts to cut down or control substance use o (5) great deal of time spent w/activities necessary to obtain/use/recover from its effects o (6) social/occupational/recreational activities are given up or reduced o (7) use is continued despite knowledge of physical/psychological problems Substance abuse: less severe pattern of drug use that is defined in terms of interference with obligations at home or work o Recurrent use of drug in dangerous situations o (1) a maladaptive pattern of substance use leading to clinically significant impairment of distress within a 12 month period Failure to fulfil major obligations at work/home/school Substance use that is physically hazardous Continued use despite recurrent social or interpersonal problems caused by drug use o (2) symptoms have never met the criteria of substance dependence of this class of substance Addiction: loss of control or craving substance in one form or another o Ex: pathological gambling, excessive use of internet Drug of abuse/psychoactive substance: chemical substance that alters a person’s mood, level of perception, or brain functioning o Increases psychological comfort level; feeling “high” Polysubstance abuse: people with a substance use disorder abuse several types of drugs Symptoms 2 general areas: o Patterns of pathological consumption, psychological and physiological dependence o Consequences of prolonged pattern abuse Concept of substance dependence: o Psychological dependence: feeling compelled to take the drug as a way to prepare for certain activities, or to control how they are feeling, or to relieve negative mood states o Symptoms of tolerance and withdrawal are evidence of physiological dependence o Tolerance: the process which the nervous system becomes less sensitive to the effects of alcohol or any other drug abuse
Metabolic tolerance: develops when repeated exposure to a drug causes the person’s liver to produce more enzymes to break down the drugmetabolized quickly Pharmacodynamic tolerance: receptors in the brain adapt to the presence of the drug Behavioral conditioning mechanisms: cues that are associated w/drug have a conditioned response that is opposite of the natural effect of the drug o Withdrawal: symptoms experienced when a person stops using a drug
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- Spring '14
- cocaine, alcohol dependence, substance dependence, long-term consequences