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TC335F-13_Ch10SubstanceUse_St - Chapter 10 SUBSTANCE USE...

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12/9/13 1 Chapter 10 SUBSTANCE USE DISORDERS CLINICAL DESCRIPTIONS Prevalence : 22 mil. in US meet criteria for substance use disorder • 15 mil: alcohol use disorder • 4 mil: drug use disorder • 3 mil: drug and alcohol use disorder Stigma : Moral Lapse, Not Psychological Dx Voluntary use of substance + Individual, social, neurobiological, environmental, cultural, factors à Substance use Dx • Risk may be MUCH greater for some • NOT helpless à Bx Changes (like diabetes) DSM-5: SUBSTANCE USE DISORDERS “With physiological dependence” specifier • More severe disorder: more Sx, more severe, tolerance and withdrawal Homeostasis is disrupted Tolerance 1) Larger doses necessary for desired effect 2) Effects of usual amount decreases Withdrawal : negative psychological, physical effects • Substance relieves symptoms DSM-5 Substance Use Disorder Problematic pattern of use impairs functioning. 2 or more Sx within 1 year • Failure to meet obligations • Repeated use in situations where physically dangerous • Repeated relationship problems • Tolerance • Withdrawal • Use for more time or greater amounts than intended • Desire or efforts to reduce or control use fail • Much time spent trying to obtain substance • Social, hobbies, or work activities, given up, reduced • Continued use despite known problems • Strong cravings for substance
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