Chapter 12: Substance Use and Addictive Disorders

Ethyl alcohol

A chemical that is quickly absorbed into the blood through the lining of the stomach and the intestine.

Fetal alcohol syndrome

A cluster of problems in a child, including low birth weight, irregularities in the head and face, and intellectual deficits, caused by excessive alcohol intake by the mother during pregnancy.

Substance intoxication

A cluster of temporary undesirable behavioral or psychological changes that develop during or shortly after the ingestion of a substance.

Gambling disorder

A disorder marked by persistent and recurrent gambling behavior, leading to a range of life problems. Dx Checklist: 1. Individual displays a maladaptive pattern of gambling, featuring at least 4 of the following symptoms over the course of a full year. (a) Can achieve desired excitement only by gambling more and more money. (b) Feels restless or irritable when tries to reduce gambling. (c) Repeatedly tries and fails at efforts to control, reduce, or cease gambling. (d) Consumed with gambling thoughts or plans. (e) Gambling is often triggered by upset feelings. (f) Frequently returns to gambling to try to recoup previous losses. (g) Covers up amount of gambling by lying. (h) Gambling has put important relationships, job, or educational/career opportunities at risk. (i) Seeks money from others to address gambling-induced financial problems. 2. Individual experiences significant distress or impairment. Information from: APA, 2013.

Internet gaming disorder

A disorder marked by persistent, recurrent, and excessive Internet activity, particularly gaming. Recommended for further study by the DSM study group.

Reward center

A dopamine-rich pathway in the brain that produces feelings of pleasure when activated.

Delirium tremens ("the DTs")

A dramatic withdrawal reaction experienced by some people with alcoholism. It consists of confusion, clouded consciousness, and terrifying visual hallucinations.

LSD (lysergic acid diethylamide)

A hallucinogenic drug derived from ergot alkaloids.

Morphine

A highly addictive substance derived from opium that is particularly effective in relieving pain.

Opium

A highly addictive substance made from the sap of the opium poppy.

Inhibitory message

A message to stop firing.

Residential treatment center (therapeutic community)

A place where people formerly addicted to drugs live, work, and socialize in a drug-free environment. e.g., Daytop Village and Phoenix House.

Methamphetamine ("crank"; "ice"; "crystal meth")

A powerful amphetamine drug that has experienced a surge in popularity in recent years, posing major health and law enforcement problems. Almost 6% of all persons over the age of 11 in the United States have used this stimulant as least once (NSDUH, 2013).

Crack

A powerful, ready-to-smoke freebase cocaine.

Alcohol Anonymous (AA)

A self-help organization that provides support and guidance for people with alcoholism.

Rush

A spasm of warmth and ecstasy that is sometimes compared with orgasm.

Hallucinogens (psychedelic drugs)

A substance that causes powerful changes primarily in sensory perception, including strengthening perceptions and producing illusions and hallucinations.

Freebase

A technique for ingesting cocaine in which the pure cocaine basic alkaloid is chemically separated from processed cocaine, vaporized by heat from a flame, and inhaled with a pipe.

Aversion therapy

A treatment in which clients are repeatedly presented with unpleasant stimuli while performing undesirable behaviors such as taking a drug.

Substance use disorder.

According to the DSM-5, the gambling disorder of the man in this video is most similar to which of the following disorders?

1. Amphetamine. 2. MDMA (Ecstasy) 3. Cocaine.

According to the textbook, each of the following is a stimulant drug....

Dopamine.

According to the textbook, the neurotransmitter most closely tied to cocaine use disorder is...

1. LSD. 2. MDMA (ecstasy) 3. Mescaline.

According to the textbook; what drugs are hallucinogens?

Interfering with the communication among nerve cells (neurons) and causing the formation of new networks of neurons.

According to the video ("Hallucinogens and the Brain"), ketamine and other hallucinogens may produce illusions and hallucinations by...

Abnormal functioning of the brain's pleasure pathway.

According to the video, the cause of his pathological gambling is....

Marijuana (Johnston et al., 2014).

After alcohol and cigarettes, teenagers who were polled reported that _____ is the easiest substance/ drug to get.

Fetal alcohol spectrum disorder

Alcohol-related birth defects. Higher rate per 1000 heavy drinking women (80-200 births).

Narcotics

All opioid drugs—natural and synthetic—are known collectively as narcotics.

Cocaine

An addictive stimulant obtained from the coca plant. It is the most powerful natural stimulant known. Potential Intoxication: High. Addiction Potential: High. Risk of Organ Damage or Death: Moderate. Risk of Severe Social or Economic Consequences: Low to moderate. Risk of Severe or Long Lasting Mental and Behavioral Change: Low. Information from: Hart & Ksir, 2014; APA, 2013; Hart et al., 2010.

Korsakoff's syndrome

An alchohol-related disorder marked by extreme confusion, memory impairment, and other neurological symptoms.

Methadone maintenance program

An approach to treating heroin-centered substance use disorder in which clients are given legally and medically supervised doses of a substitute drug, methadone.

Alcohol dehydrogenase

An stomach enzyme that breaks down alcohol in the stomach before it enters the blood.

Alcohol

Any beverage containing ethyl alcohol, including beer, wine, and liquor. Potential Intoxication: High. Addiction Potential: Moderate. Risk of Organ Damage or Death: High. Risk of Severe Social or Economic Consequences: High. Risk of Severe or Long Lasting Mental and Behavioral Change: High. Information from: Hart & Ksir, 2014; APA, 2013; Hart et al., 2010.

Drug

Any substance other than food that affects our bodies or minds.

Absolute alcohol (oz.) (1/2)

Beverage Intake*: 1 oz. spirits+ 1 glass wine. 1 can beer. Female (100 lb.): 0.045. Male (100 lb.): 0.037. Female (150 lb.): 0.030. Male (150 lb.): 0.025. Female (200 lb.): 0.022. Male (200 lb.): 0.019. *In 1 hour. +100-proof spirits. From Hart & Ksir, 2013. (Relationships Between Sex, Weight, Oral Alcohol Consumption, and Blood Alcohol Level)

Absolute alcohol (oz.) (5)

Beverage Intake*: 10 oz. spirits+ 10 glasses wine. 10 cans beer. Female (100 lb.): 0.450. Male (100 lb.): 0.370. Female (150 lb.): 0.300. Male (150 lb.): 0.250. Female (200 lb.): 0.220. Male 200 lb.): 0.180. *In 1 hour. +100-proof spirits. From Hart & Ksir, 2013. (Relationships Between Sex, Weight, Oral Alcohol Consumption, and Blood Alcohol Level)

Absolute alcohol (oz.) (1)

Beverage Intake*: 2 oz. spirits+. 2 glasses wine. 2 cans beer. Female (100 lb.): 0.090. Male (100 lb.): 0.075. Female (150 lb.): 0.060. Male (150 lb.): 0.050. Female (200 lb.): 0.045. Male (200 lb.): 0.037. *In 1 hour. +100-proof spirits. From Hart & Ksir, 2013. (Relationships Between Sex, Weight, Oral Alcohol Consumption, and Blood Alcohol Level)

Absolute alcohol (oz.) (2)

Beverage Intake*: 4 oz. spirits+. 4 glasses wine. 4 cans beer. Female (100 lb.): 0.180. Male (100 lb.): 0.150. Female (150 lb.): 0.120. Male (150 lb.): 0.100. Female (200 lb.): 0.090. Male (200 lb.): 0.070. *In 1 hour. +100-proof spirits. From Hart & Ksir, 2013. (Relationships Between Sex, Weight, Oral Alcohol Consumption, and Blood Alcohol Level)

Absolute alcohol (oz.) (3)

Beverage Intake*: 6 oz. sprits+. 6 glasses wine. 6 cans beer. Female (100 lb.): 0.270. Male (100 lb.): 0.220. Female (150 lb.): 0.180. Male (150 lb.): 0.150. Female (200 lb.): 0.130. Male (200 lb.): 0.150. *In 1 hour. +100-proof spirits. From Hart & Ksir, 2013. (Relationships Between Sex, Weight, Oral Alcohol Consumption, and Blood Alcohol Level)

Absolute alcohol (oz.) (4)

Beverage Intake*: 8 oz. spirits+. 8 glasses wine. 8 cans beer. Female (100 lb.): 0.360. Male (100 lb.): 0.300. Female (150 lb.): 0.240. Male (150 lb.): 0.200. Female (200 lb.): 0.180. Male (200 lb.): 0.150. *In 1 hour. +100-proof spirits. From Hart & Ksir, 2013. (Relationships Between Sex, Weight, Oral Alcohol Consumption, and Blood Alcohol Level)

Receptor (Cosgrove, 2010; Blum et al., 1996, 1990).

Biological research into the cause of substance-related disorders has found an abnormal form of the so-called dopamine-2 (D2) _____ gene in a majority of research participants who suffered from addictions.

Metabolized

Broken down.

Hallucinogen intoxication (hallucinosis)

Consists largely of perceptual distortions and hallucinations.

Neurotoxicity

Damage to the nerve endings.

Injection

Drug in liquid form directly enters the body through a needle. This may be intravenous or intramuscular (subcutaneous) Time to reach brain: 20 seconds (intravenous). 4 minutes (intramuscular). (Methods of taking substances. Information from: Hart & Ksir, 2014; Landry, 1994.)

Snorting

Drug in powdered form is snorted into the nose. Some of the drug lands on nasal mucous membranes, is absorbed by blood vessels, and enters the bloodstream. Time to reach brain: 4 minutes. (Methods of taking substances. Information from: Hart & Ksir, 2014; Landry, 1994.)

Oral ingestion

Drug in solid or liquid form passes though esophagus and stomach and finally to the small intestines. It is absorbed by blood vessels in the intestines. Time to reach brain: 30 minutes. (Methods of taking substances. Information from: Hart & Ksir, 2014; Landry, 1994.)

Inhaling

Drug in vapor form is inhaled through mouth and lungs into circulatory system. Time to reach brain: 7 seconds. (Methods of taking substances. Information from: Hart & Ksir, 2014; Landry, 1994.)

Behavioral perspective on substance use disorders

Drug use is seen as being reinforced initially because it reduces tensions and raises spirits.

Other routes

Drugs can be absorbed through areas that contain mucous membranes. Drugs can be placed under the tongue, inserted anally and vaginally, and administered as eyedrops. Time to reach brain: Variable. (Methods of taking substances. Information from: Hart & Ksir, 2014; Landry, 1994.)

Antagonist drugs

Drugs that block or change the effects of an addictive drug.

Depressants

Drugs that slow the activity of the central nervous system.

Flashback.

Even long after their use of hallucinogens, some users experience a recurrence of the sensory and memory changes brought about by the drug. This effect is called a _____.

Cocaine-induced psychosis

Hallucinations, delusions, or both.

Can be prosecuted if caught.

In 2005, the US Supreme Court ruled that in states where medical marijuana has been legalized, those who use it and those who supply it...

Synergistic effect

In pharmacology, an increase of effects that occur when more than one substance is acting on the body at the same time.

54% (Kaji, 1960).

In studies investigating the presence of a genetic predisposition to substance dependence, it was found that, if one identical twin abuses alcohol, the other twin will also abuse alcohol in _____ of cases.

Science has not found any medical benefits to cannabis.

In the video ("The Medical Use of Marijuana"), U.S. drug czar John Walters justifies the continued criminalization of cannabis, despite potential medical benefits, by saying that...

Partially paralyzed.

In the video, Angel claims that before she took cannabis she was _______, a condition that cannabis has reversed.

Synesthesia

In this video. The hallucinogen causes the man's senses to cross (for example, he may "hear" colors). This effect is known as...

3-10% (Nowak & Aloe, 2013; Black et al., 2012; Splevins et al., 2010).

It is estimated that ____ to ____ of teenagers and college students suffer from gambling disorder

Synthetic

Laboratory-blended.

Partial antagonists

Narcotic antagonists that produce less severe withdrawal symptoms.

Endorphins

Neurotransmitters that help relieve pain and reduce emotional tension. They are sometimes referred to as the body's own opioids.

Barbiturates

One group of sedative-hypnotic drugs that reduce anxiety and help produce sleep. Potential Intoxication: Moderate. Addiction Potential: Moderate to high. Risk of Organ Damage or Death: Moderate to high. Risk of Severe Social or Economic Consequences: Moderate to high. Risk of Severe or Long Lasting Mental and Behavioral Change: Low. Information from: Hart & Ksir, 2014; APA, 2013; Hart et al., 2010.

Marijuana

One of the cannabis drugs, derived from the buds, leaves, and flowering tips of the hemp plant Cannabis sativa.

Heroin

One of the most addictive substances derived from opium.

Few weeks.

Opioid use disorder can be developed after taking an opioid such as heroin for just a...

Opioids

Opium or any of the drugs derived from opium, including morphine, heroin, and codeine. Potential Intoxication: High. Addiction Potential: High. Risk of Organ Damage or Death: Moderate. Risk of Severe Social or Economic Consequences: High. Risk of Severe or Long Lasting Mental and Behavioral Change: Low to moderate. Information from: Hart & Ksir, 2014; APA, 2013; Hart et al., 2010.

Substance use disorder

Pattern of maladaptive behaviors and reactions brought about by repeated use of a substance, sometimes also including tolerance for the substance and withdrawal reactions. Dx Checklist: 1. Individual displays a maladaptive pattern of substance use leading to significant impairment or distress. 2. Presence of at least two of the following symptoms within a one year period: (a) Substance is often taken in larger amounts are over a larger period then intended. (b) Unsuccessful efforts or persistent desire to reduce or control substance use. (c) Much time spent trying to obtain, use, or recover from the effects of a substance. (d) Failure to fulfill major role obligations at work, school, or home as a result of repeated substance use. (e) Continued use of substance despite persistent social or interpersonal problems caused by it. (f) Cessation or reduction of important social, occupational, or recreational activities because of substance use. (g) Continuing to use substance in situations where use poses physical risks. (h) Continuing to use substance despite awareness that it is causing or worsening a physical or psychological problem. (i) Craving for substance. (j) Tolerance effects. (k) Withdrawal reactions. Information from: APA, 2013)

Psychodynamic perspective on substance use disorders

People who develop substance use disorder have excessive DEPENDENCY needs traceable to early stages of life. Some psychodynamic theorists also believe that certain people have a SUBSTANCE ABUSE PERSONALITY that makes them prone to drug use.

Hydrochloride powder

Processed cocaine. An odorless, white, fluffy powder.

Concentration

Proportion.

Confabulating

Reciting made-up events to fill in the gaps.

Flashbacks

Recurrence of the sensory and emotional changes after the LSD has left the body.

Sedative-hypnotic use disorder

Repeated use of barbiturates can quickly result in this. Users may spend much of the day intoxicated, irritable, and unable to do their work.

1. Glaucoma. 2. Chronic pain. 3. Asthma. 4. Reduce nausea and vomiting of cancer patients in chemotherapy. 5. Improve the appetites of people with AIDS and so then combat weight loss. (Mack & Joy, 2001)

Researchers have claimed that marijuana can be of used in combating what?

1. Barbiturates. 2. Benzodiazepines.

Sedative-hypnotic drugs include what 2 categories?

High (nod)

Several hours of a pleasant feeling after taking a narcotic.

Amphetamines

Stimulant drugs that are manufactured in the laboratory. Potential Intoxication: High. Addiction Potential: High. Risk of Organ Damage or Death: Moderate. Risk of Severe Social or Economic Consequences: Low to moderate. Risk of Severe or Long Lasting Mental and Behavioral Change: Moderate to high. Information from: Hart & Ksir, 2014; APA, 2013; Hart et al., 2010.

Cannabis

Substance produced from the varieties of the hemp plant, Cannabis sativa. It causes a mixture of hallucinogenic, depressant, and stimulant effects. Potential Intoxication: High. Addiction Potential: Low to moderate. Risk of Organ Damage or Death: Low. Risk of Severe Social or Economic Consequences: Low to moderate. Risk of Severe or Long Lasting Mental and Behavioral Change: Low. Information from: Hart & Ksir, 2014; APA, 2013; Hart et al., 2010.

Cognitive perspective on substance use disorders

Such reductions (in tension) may also lead to an expectancy that drugs will be comforting and helpful.

Detoxification

Systematic and medically supervised withdrawal from a drug.

Mixed drugs (polysubstance use)

Taking more than one drug at a time. Potential Intoxication: High. Addiction Potential: High. Risk of Organ Damage or Death: High. Risk of Severe Social or Economic Consequences: High. Risk of Severe or Long Lasting Mental and Behavioral Change: High. Information from: Hart & Ksir, 2014; APA, 2013; Hart et al., 2010.

Behaviors and activities.

The DSM-5 listing of gambling disorder suggests that people may become addicted to _____ beyond substance use.

Tolerance

The adjustment that the brain and the body make to the regular use of certain drugs so that ever larger doses are needed to achieve the earlier effects.

1. Different substance use disorders pose different problems. 2. Many people with such disorders drop out of treatment very early (Radcliffe & Stevens, 2010). 3. Some people recover without any intervention at all (Wilson, 2010), while many overs recover and then relapse (Belendiuk & Riggs, 2014). 4. Different criteria are used by different clinical researchers.

The effectiveness of treatment for substance use disorders can be difficult to determine for what four reasons?

Cirrhosis

The liver becomes scarred and dysfunctional.

Tetrahydrocannabinol (THC)

The main active ingredient of cannabis.

1. Craving cocaine when he could not have it for a period of time. 2. Poor functioning in his job. 3. Poor functioning in his family life and responsibilities.

The man in this video case ("Craving for Cocaine: A Substance Use Disorder") experiences the following symptoms of cocaine use disorder...

Drug and substance dependence.

The medications taken by the man in this video are also used to help treat...

Benzodiazepines

The most common group of antianxiety drugs, which includes Valium and Xanax. Potential Intoxication: Moderate. Addiction Potential: Moderate. Risk of Organ Damage or Death: Low. Risk of Severe Social or Economic Consequences: Low. Risk of Severe or Long Lasting Mental and Behavioral Change: Low. Information from: Hart & Ksir, 2014; APA, 2013; Hart et al., 2010.

Cannabis intoxication

The overall "high" from taking cannabis. Physical changes include reddening of the eyes, fast heartbeat, increases in blood pressure and appetite, dryness in the mouth, and dizziness.

Sociocultural perspective on substance use disorderz

The people most likely to develop these disorders are those living in the socioeconomic conditions that generate stress or whose families value or tolerate drug use.

Stimulant; hallucinogenic. (Litjens et al., 2014; McDowell, 2011, 2005).

The popular club drug Ecstacy is technically a _____ but categorized as a ______ because of the majority of effects that it causes.

Reward-deficiency syndrome

The reward center is not readily activated by usual events in one's life, so a person turns to drugs to stimulate this pleasure pathway, particularly in times of stress (de Haan et al., 2014; Garfield et al., 2014; Blum et al., 200).

Stimulant use disorder

The stimulant comes to dominate an individual's life, and the person remains under drug's effects much of each day and function poorly in social relationships and at work.

1. Depressants. 2. Stimulants. 3. Hallucinogens. 4. Cannabis.

The substances people misuse fall into what 4 major categories?

1. Alcohol. 2. Sedative-hypnotic drugs. 3. Opioids.

The three most widely used groups of depressants are (what 3 substances?)

Opioid use disorder

The use of heroin interferes significantly with one's social and occupational functioning, and their lives center around the drug.

Obsession.

The video ("Gambling Disorder: A Behavioral Addiction") describes the gambling disorder of Theodore as an...

Caffeine

The world's most widely used stimulant, most often consumed in coffee.

Cross-tolerance

Tolerance that a person develops for a substance as a result of regularly using another substance similar to it.

Withdrawl

Unpleasant, sometimes dangerous reactions that may occur when people who use a drug regularly stop taking or reduce their dosage of the drug.

1. Detoxification. 2. Antagonist drugs. 3. Drug maintenance therapy.

What are the 3 biological treatments for substance use disorders?

1. Self-help programs. 2. Cultural-and gender-sensitive programs. 3. Community prevention programs.

What are the 3 sociocultural approaches that have been used to help people overcome substance use disorders.

1. Inherit a genetic predisposition to develop the disorder (Vitaro et al., 2014; Jabr, 2013). 2. Experience heightened dopamine activity and operation of the brain's reward center when they gamble (Jabr, 2013). 3. Have impulsive, novelty-seeking, and other personality styles that leave them prone to gambling disorder (Leeman et al., 2014). 4. Make repeated and cognitive mistakes such as inaccurate expectations and misinterpretations of their emotions and bodily stated (Fortune & Goodie, 2012; Williams et al., 2012).

What are the 4 common explanations proposed for gambling disorder (e.g., people with gambling disorder may...)

1. Cocaine. 2. Amphetamines. 3. Caffeine. 4. Nicotine.

What are the 4 types of stimulants?

1. Therapists have clients keep track of their drinking. 2. Therapists teach clients coping strategies to use when such situations arise. 3. Therapists teach clients to plan ahead of time.

What are the strategies included in relapse-prevention training for alcohol use disorder?

1. Cross-tolerance. 2. Synergistic effects.

What are two important discoveries that have emerged from the study of polysubstance use?

Disulfiram (Antabuse)

What drug might you use to detox from alcohol?

80%.

What percent of the world's population consumed the stimulant caffeine daily?

Cognitive and behavioral therapy.

What treatment helped this man to overcome his cocaine use disorder?

Binge drinking

When people consume five or more drinks on a single occasion.

incentive-sensitization theory

When substances repeatedly stimulate the reward center, the center develops a hypersensitivity to the substances.

Relapse-prevention training

a cognitive-behavioral approach to treating alcohol use disorder (and applied to certain other disorders) in which clients are taught to keep track of their drinking behavior, apply coping strategies in situations that typically trigger excessive drinking, and plan ahead for risky situations and reactions.

Sedative-hypnotic drug (anxiolytic drug)

a drug used in low doses to reduce anxiety and in higher doses to help people sleep; "anxiolytic" means "anxiety reducing". Includes Barbiturates and Benzodiazepines. Potential Intoxication: Addiction Potential: Risk of Organ Damage or Death: Risk of Severe Social or Economic Consequences: Risk of Severe or Long Lasting Mental and Behavioral Change: Information from: Hart & Ksir, 2014; APA, 2013; Hart et al., 2010.

Alcohol intoxication

a temporary state of poor judgement, mood changes, irritability, slurred speech, and poor coordination.

Crashing

depression-like letdown. A pattern that may also include headaches, dizziness, and fainting (Acosta et al.. 2011, 2005).

Contingency management

makes incentives contingent on the submission of drug-free urine specimens (Godley et al., 2014; Dallery et al., 2012).

Cocaine intoxication

poor muscle coordination, grandiosity, bad judgment, anger, aggression, compulsive behavior, anxiety, and confusion.

Stimulants

substances that increase the activity of the central nervous system, resulting in increased blood pressure and heart rate, more alertness, and sped-up behavior thinking.