substance_lec

substance_lec - SUBSTANCE USE DISORDERS DUAL DIAGNOSIS * *...

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SUBSTANCE USE DISORDERS DUAL DIAGNOSIS * Definition: Having both a mental illness and a substance abuse disorder * Note that the relationship of mental illness and drug use is not an easy one to determine: ( a) Drugs may be an attempt to “self medicate” for a mental disorder Examples: - Alcohol abuse in a social phobic to face social situations. - Cigarette smoking to calm down schizophrenic voices. - Caffeine to help focus with ADHD. - Smoking marijuana to reduce OCD symptoms. (b) Psychiatric problems may be caused by drugs in the first place. Examples: - Mania caused by cocaine intoxication in a person who is not bipolar. - Intense anxiety during withdrawal from benzodiazepine dependence. - Depression in a chronic alcoholic (which subsides after quitting drinking). - Permanent psychosis caused by brain damage from meth or PCP abuse. (c) There may be an INTERACTION of mental disorder and drug. Examples: - Stimulants & marijuana make a paranoid individual more paranoid. - Drinking alcohol makes a depressed person even more depressed. - Caffeine abuse can drive hypomania into mania. - Hallucinogens can trigger the onset of schizophrenia in a predisposed individual.
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INTOXICATION * DSM-IV specifies intoxication symptoms for each type of drug. WITHDRAWAL * DSM-IV specifies withdrawal symptoms for each type of drug. TOLERANCE * The user requires larger and larger doses before experiencing the drug’s effect. PHYSICAL DEPENDENCE * There is a physiological need for the drug. * If the drug is discontinued, unpleasant withdrawal symptoms develop. * Physical dependence typically goes along with tolerance. * Quickly acting drugs are more addictive. * Drugs with shorter half-life are more addictive. * Addiction speed depends on way of consumption (e.g., injecting vs. orally). PSYCHOLOGICAL DEPENDENCE * The psychological need to use a drug, e.g.: - not being able to relax without using the drug - not daring to be sociable without the drug * Psychological dependence may or may not go along with physical dependence.
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DSM-IV distinguishes between Substance Abuse and Substance Dependence. The difference is one of degree; substance dependence is more severe than substance abuse and typically is the result of abusing a drug for a while. SUBSTANCE ABUSE * Recurrent use of a drug * Drug has caused important problems in some important areas of life (e.g., work, relationships, health, legal, or the safety of self or others) SUBSTANCE DEPENDENCE * More extensive problems than with abuse, i.e., more areas of life are affected. * User has made unsuccessful efforts to control drug use. * User continues to use the drug despite knowledge of its harmful effects. * Typically includes physical dependence with tolerance and withdrawal. CLASSES OF DRUGS:
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This note was uploaded on 07/16/2009 for the course PSC 168 taught by Professor Zane during the Fall '07 term at UC Davis.

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substance_lec - SUBSTANCE USE DISORDERS DUAL DIAGNOSIS * *...

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