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
