Novaco+P102+2010+Fall+lecture+5

Novaco+P102+2010+Fall+lecture+5 - Adverse Consequences of...

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11/1/2010 1 Substance Use Disorders, Eating Disorders, and Sleep Disorders Raymond W. Novaco University of California, Irvine P102 Fall 2010 Adverse Consequences of Substance Abuse cognitive impairment loss of motoric control can heighten risk of violence interferes with job functioning harms personal and social relationships impairs sexual performance impairs personal health and that of family/offspring depression, anxiety, psychotic symptoms, suicide Substance Use Disorders Drugs of Abuse Depressants ( slow CNS; neurotransmitters; reduce tension/anxiety ) alcohol sedatives (barbiturates) and tranquilizers (benzodiazepines) opioids (morphine, heroin, oxycodone) Stimulants ( boost CNS; neurotransmitters; euphoria, self-confidence ) amphetamines; ecstacy cocaine nicotine Hallucinogens (“ psychedelics”: sensory distortions; relax, euphoria ) cannabis, hashish LSD, psilocybin, mescaline, phencyclidine (PCP, angel dust) Alcohol Use and Causes of Death Ethnic and Gender Differences in Rates of Cigarette Smoking Among U.S. Adults (Center for Disease Control, 2003; National Health Survey) Cigarette Smokers in Relation to Poverty and Level of Education (Center for Disease Control, 2003; National Health Survey)
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11/1/2010 2 Lifetime prevalence of drug dependence disorder Substance Disorders -- Lifetime Prevalence Kessler et al (2005) Archives of General Psychiatry : US national household survey ( N = 9282) lifetime prevalence Alcohol Abuse 13.2% Alcohol Dependence 5.4% Drug Abuse 7.9% circle3 Drug Dependence 3.0% Any Substance Use Disorder 14.6% check highest prevalence occurs in age range 30-44 Harmful Effects of Drugs - Nutt, King, & Phillips (Lancet, 2010) “Drug Harms in the UK: A Multicriteria Decision Analysis” UK Advisory Council on Misuse of Drugs: 16 harm criteria: mortality, phys hlth damage, impairment of mental functioning, dependence, loss of tangibles, loss of relationships, injury, crime, envirnmtl damage, family adversities, internatnl damage, economic cost, community decline checkbld expert panel scored (0-100) 20 drugs at an interactive workshop “harm to users” and “harm to others” were separately scored Overall Harm Scores alcohol 72 heroin 55 crack cocaine 54 methamph 33 tobacco 26 cannabis 20 benzodiazelines 15 ecstacy 9 LSD 7 Substance Abuse Criteria are lower than for Substance Dependence Maladaptive use, with clinically significant impairment/distress, manifested by 1 or more criteria below, same 12-month period: recurrent use results in failure to fulfill major role obligations recurrent use in situations where physically hazardous recurrent substance-related legal problems continue substance use despite having persistent/recurrent social/personal problems due to the substance use check symptoms have never met criteria for Dependence Substance Dependence Maladaptive of use, with clinically significant impairment/distress, manifested by 3 or more criteria below, same 12-month period: tolerance, defined by either - need for markedly increased amounts
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