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CHAPTER ELEVEN SUBSTANCE-RELATED AND IMPULSE-CONTROL DISORDERS I. Perspectives on Substance-Related Disorders A. In the U.S. use and abuse of drugs and alcohol costs hundreds of billions of dollars each year, kills 500,000 Americans annually, and is implicated in street crime, homelessness, and gang violence. Polysubstance use – use of multiple mind and behavior-altering substances B. Substance-related disorders - problems associated with using and abusing drugs that alter patterns of thinking, feeling, and behaving. S ubstance - chemical compounds ingested to alter mood or behavior -Includes alcohol, nicotine and caffeine 1. Psychoactive substances - broad class of agents that alter mood and/or behavior which are ingested to become intoxicated or high, with abuse of such substances related to dependence and addiction. 2. Substance use - Ingestion of psychoactive substances on occasion S ubstance intoxication - physiological reaction to ingested substances (e.g. drunkenness, getting high) 3. Substance abuse is difficult to define on the basis of amount of substance ingested. According to the DSM-IV-TR, substance abuse is defined on the basis of interference with the user’s life. 4. Substance dependence – AKA addiction; considerable disagreement about how to define addiction a. One definition considers addiction as physiological dependence on the drug or drugs Tolerance – requiring greater and greater amounts of drug to experience same effect Withdrawal - negative physical reaction when substance is no longer ingested E.G. chills, fever, diarrhea, nausea and vomiting and aches and pains b. Another view focuses on drug-seeking behaviors as a measure of dependence. Examples include repeated use, desperate need to ingest more, stealing money to buy drugs, standing outside in freezing cold to smoke, likelihood that use will resume after a period of abstinence.
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c. The DSM-IV-TR definition of substance dependence combines the physiological aspects of tolerance and withdrawal with the behavioral and psychological aspects. II. Diagnostic Issues A. Five main categories of substances include the following: 1. Depressants result in behavioral sedation and include alcohol, barbiturates and benzodiazepines. 2. Stimulants increase alertness and can elevate mood and include amphetamines, cocaine, nicotine and caffeine. 3. Opiates primarily produce analgesia (i.e., reduce pain) and euphoria and include heroin, opium, codeine and morphine 4. Hallucinogens alter sensory perception and can produce delusions, paranoia, and hallucinations, and include marijuana and LSD 5. Other drugs of abuse include inhalants, anabolic steroids, and over-the- counter prescription medications. III.
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This note was uploaded on 04/12/2010 for the course PSYC 3082 taught by Professor Knapp during the Spring '09 term at LSU.

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