Chapter 11: Substance Use Disorders

cannabis

botanical name for a plant that contains a chemical (THC) that can produce stimulant, depressant, and hallucinogenic effects.

Addiction

compulsive drug-seeking behavior and loss of control over drug use

binge drinking

episodic intake of five or more alcoholic beverages for men or four or more drinks for women

DRD2

gene that affects dopamine and increases risk for alcoholism

Long term effects of cannabis use

Associated with impaired judgement, memory, and concentration.

Brain changes from substance abuse

"pathological changes in brain function produced by repeated pharmacological insult to the brain circuits that regulate how a person interprets and behaviorally responds to motivationally relevant stimuli. thus, addictive drugs strongly interact with and change the brain circuits that permit us to learn about and behaviorally adapt to umportant environmental stimuli, whether it be how to best approach rewards such as food or sex, or to avoid dangerous situations. " Alters normal dopamine reward and stress pathways, thus flooding brain with more dopamine than secreted normally. Drug tolerance is increased and more and more of substance is needed to obtain same pleasyre due to chrnoic flooding of dopamine.

Family attitudes/behaviors and Substance Use

Affect adolescents' likelihood of experimenting with substances. Those exposed to peer and adult drinkers often develop positive expectancies regarding the use of alcohol such as believing that drinking alcohol makes it easier to be part

Differences in consumption based on ethnic groups

African American adolescents show lower rates of substance use than whites and Hispanics; in the 8th grade, Hispanics have the highest prevalence of use in all drug categories except stimulants and have the highest levels of crack and methamphetamine use in the 12th grade. Most likely to engage: hispanic Least likely: asian

AA

Alcoholics Anonymous-- common intervention for alcoholics. Led to feelings of self-efficacy, active coping, and motivation to stop drinking

Amphetamines

Also known as "uppers", significantly speed up central nervous system activity. Can induce euphoria and confidence but also agitation and assaultive or suicidal behavior. Meth stems from these and has serious health consequences-- permanent damage to heart, lungs, and immune system. High potential for abuse and addiction

Medications for alcohol dependence

Antabuse: produces an aversion to alcohol; few studies support it acamprosate: reduce relapse rates, does not actually decrease craving for alcohol and not strong support Naltrexone: reduce craving and is very successful but not as for sustaining abstinence

Differences in consumption based on age

Becoming more "normative" in adolescent culture. Adolescents whose peer group lacks school commitment abd connected are particularly prone to substance use.

Personality characteristics that increase substance use

Behavioral undercontrol: associated with rebelliousness, novelty-seeking, risk-taking, and impulsivity; find effects rewarding/exciting

Exposure to Violence and Substance Use

Between ages of 8 and 16 was strongly associated with substance use in mid-adolescence

Motivational interviewing and enhancement

Comprehensive analysis of interventions to decrease college drinking revealed that face-to-face interventions using motivational interviewing and providing information correcting misperceptions of social norms regarding drinking yielded the greatest reduction in alcohol-related problems. Paired with challenging positive expectancies successfully reduced binge drinking

Differences in consumption based on religious affiliation

Heavier drinking is found among Catholics compared to Protestants or Jews

Nicotine

Highly addictive substance found in tobacco; mostly associated with cigarette smoking. Causes both release of adrenaline and release of dopamine (energy and pleasure), as tolerance develops craving occur and he nicotine is needed to experience the same energy, pleasure and relation. Withdrawal can cause difficulty concentrating, restlessness, anxiety, depressed mood, and irritability. Smoking is considered the single most preventable cause of premature death.

ALDH and genetic influences of substance abuse

In individuals with impaired production of ALDH, unpleasant physical reactions result as toxins from metabolized alcohol accumulate; this naturally occurring effect makes alcohol consumption aversive and thus reduces risk of alcoholism.

Drug most frequently associated with diagnosis of substance abuse

Marijuana

Which ethnicities are most likely to use/abuse alcohol?

Native Americans of both genders demonstrate the earliest onset of drinking and highest weekly alcohol consumption, whereas Hispanic men have the highest rates of daily alcohol consumption.

Physiological consequences of heavy alcohol use

Neurological effects include impaired motor skills, reduced reasoning and judgement, memory deficits, distractibility, and reduced motivation. Also affects the entire cardiovascular system and can cause cirrhosis of the liver and alcoholic hepatitis, as well as cancers of the mouth and throat.

What is regulated vs. compulsive relapse?

Regulated: process of weighing choices and making a conscious decision to use a substance Compulsive: automatic resumption of drug-seeking behavior in response to stressors or substance-related cues

substance-induced changes in area of brain known as the Frontal Cortex

Result in impaired judgement and decision making. When cravings occur, compulsive drug-seeking ensues without consideration of negative consequences. Can lead to permanent damage for reason and impulse control for adolescents who abuse

Short and long term effects of ecstasy

Short term: euphoria, mild sensory and cognitive distortion, and feelings of intimacy and well-being, often followed by intense depression. Hypothermia or need to suck on lollipops/pacifiers tou counteract jaw spasms. Long term: Drug dependence, withdrawal symptoms (depression, irritability, unsociable), long lasting damage in brain areas critical for thought and memory, reduced ability to complete challenging cognitive tasks (even with multiple practice opportunities)

Comorbidity of substance use with other diagnoses

Smokers-- anxiety; Meth-- concurrent mental illness, most commonly mood, anxiety, or antisocial personality disorders; adolescent girls with eating disorders high risk for substance abuse; college students coping with anxiety and depression

Gender differences in progression to alcohol dependence

There's a hormonal influence on women's susceptibility to the reinforcing effects of addictive substances. Additionally, physiological differences may influence the more rapid progression to alcoholism seen in females-- women tend to weigh less, have less fat tissue and less muscle mass; produce fewer enzymes to metabolize alcohol; possess less total body fluid to dilute alcohol in blood and are more likely to limit food intake which can further increase alcohol toxicity. Also reactions to stress

What mental disorder are adolescents that use cannabis are at a higher risk of developing later in life?

They have increased risk of developing schizophrenia as well as an earlier age of onset of symptoms.

Has ecstasy been linked as the cause of death for people?

Yes-- ecstasy was sole cause of death in 23 percent of the cases in a 82 case study

Can people who abuse cannabis develop withdrawal symptoms?

Yes-- withdrawal symptoms include irritability, anxiety, insomnia, restlessness, and depression as well as distressing physical symptoms such as stomach pain, tremors, sweating, fever, and headache

what is neuroplasticity?

ability of the brain to change its structure and function in response to experience; the brain can be reconditioned through therapy to undo changes caused by addiction

withdrawal

adverse physical and psychological symptoms that occur after reducing or ceasing intake of a substance

detoxification

alcohol or drug treatment phase during which the body is purged of intoxicating substances

Ecstasy

also known as MDMA; has both stimulant and hallucinogen properties.

heavy drinking

chronic alcohol intake of more than two drinks per day for men and more than one drink per day for women

tolerance

decreases in the effects of a substance that occur after chronic use

Danger of combining ecstasy with other drugs?

extreme depression and anxiety (as well as acute physical symptoms due to dehydration or changes in blood pressure and heart rhythm) can occur, particularly when drugs are combined or taken with alcohol

delirium tremens

life-threatening withdrawal symptom that can result from chronic alcohol use

moderate drinking of alcohol

lower-risk pattern of alcohol intake (no more than one or two drinks per day)

relapse

return to drug or alcohol use after a period of abstention

physiological dependence

state of adaption that occurs after chronic exposure to a substance; can result in craving and withdrawl symptoms

Caffeine

stimulant found in coffee, chocolate, tea, and soft drinks that increases attentiveness; too much and frequent use can produce tolerance and side effects such as headache and heart palpitations

ALDH

the clean-up enzyme for alcohol for our bodies that counteract toxins that build up as alcohol is metabolized

Synergistic effect

the result of chemicals (or substances) interacting to multiply one another's effects

alcohol poisoning

toxic effects resulting from rapidly consuming alcohol or ingesting a large quantity of alcohol; can result in impaired breathing, coma, and death