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Chapter 11_Substance_Use %28compass%29 - Chapter 11 Chapter...

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Chapter 11 Chapter 11 SUBSTANCE SUBSTANCE USE USE DISORDERS DISORDERS
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Substance Use Disorders Definition of psychoactive substance Substance abuse and substance dependence definitions Course Epidemiology Etiology Treatment
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Drugs of Abuse (Psychoactive Substance) A psychoactive substance is a substance that alters mental ability, mood, or behavior Commonly referred to as “drugs” These substances can range from legal (Nicotine) to prescription (Valium) to illegal (LSD) drugs
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Substance Use Disorders In the DSM-IV, substance use disorders are characterized by abuse of or dependence on psychoactive substances Two substance use disorders: Substance abuse Substance dependence
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Substance Abuse Substance abuse is a pattern of maladaptive use of a psychoactive substance that leads to harm or other adverse effects Focuses on the indirect effects of repeated use (e.g., legal problems,, unmet obligations, reckless behavior) and NOT the direct, physiological effects (e.g., tolerance, withdrawal)
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Substance Abuse It is not unusual for people with substance abuse to use more than one drug (polysubstance abuse)
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DSM-IV Definition of Substance Abuse During a 12 month period, 1 or more of the following 4 criteria caused clinically significant impairment or distress: Recurrent substance use: That results in a failure to fulfill role obligations Ex: repeated absences from work, neglect of children, school suspension In situations in which it is hazardous Ex: driving a car under the influence That results in substance-related legal problems Ex: DUIs, disorderly conduct That persists despite continued social or occupational problems caused by the drug Ex: family arguments about your drinking problems
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Substance Dependence In contrast to substance abuse, substance dependence refers to repeated (persistent and compulsive) use of a drug that often results in tolerance, withdrawal, or compulsive drug taking behavior Formerly called addiction
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DSM-IV Substance Dependence Criteria During a 12 month period, 3 or more of the following have caused clinically significant impairment or distress: Tolerance Withdrawal Substance taken in larger amounts or for longer periods of time than intended Persistent desire or failed efforts to cut down on drug use Great deal of time spent trying to obtain, use, or recover from effects of the drug Important social or occupational activities are given up or reduced because of drug use Continuous substance use despite knowledge of physical or psychological problems caused or made worse by drug use (e.g., stomach ulcers, cocaine-induced depression)
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Physiological Dependence Tolerance and withdrawal are seen as indicators of a physiological dependence on a psychoactive substance
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Tolerance With repeated use of a substance, the nervous system becomes less sensitive to the physiological effects of that substance over time
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