Addictive Behaviors Unit 2 Exam

Differentiating sex addiction from healthy sex life

- Are there aspects of sexual behavior that are hidden or kept secret, leading to a "double life?" - Is the behavior used in an exploitive manner? - Is the behavior palliative to painful emotions? - Is the person having difficulty with truly intimate relationships?

common features of eating disorders and substance use disorders

- Both are important diseases where loss of control and compulsive use are preeminent. - Both are diseases with diverse groups with unknown etiology. - Both are characterized by chronic relapse. - Both involve the acquired pathological attachment to the agent of their ultimate compromise and possible destruction. - Both may involve a host of risk factors which predispose a person to extreme reward after consumption or use thereby making repetition more likely to occur. - Both involve denial and reluctance to accept that they are in fact ill and in need of treatment. - Both can be relapse triggers for each other. - Drugs are used to decrease eating and eating is used to decrease drug taking. - Both can result in early death. - Both generally involve early experimentation; one with drugs, the other with dieting

Symptoms of binge eating disorder

- Eating unusually large amounts of food in a specific amount of time - Eating even when you're full or not hungry - Eating fast during binge episodes - Eating until you're uncomfortably full - Eating alone or in secret to avoid embarrassment - Feeling distressed, ashamed, or guilty about your eating - Frequently dieting, possibly without weight loss

negative effects of porn

- Often, the wakeup comes in the form of a spouse or girlfriend who senses the physical and emotional withdrawal and lack of intimacy that a porn addiction creates. - Currently, the idea of tolerance and increasing dosage (amount and variety of porn) is controversial. Whetherporn addiction progresses into more graphic or disgusting images to achieve the same level of arousal is disputed. - Simple boredom with the standard set of sex acts or curiosity may explain why some users venture into areas they once thought were "over the top."

Eating disorder NOS (binge eating)

- People with binge-eating disorder lose control over their eating. Unlike bulimia nervosa, periods of binge-eating are not followed by purging, excessive exercise, or fasting. As a result, people with binge-eating disorder often are overweight or obese. Binge-eating disorder is the most common eating disorder in the US - binge eating disorder is defined as a recurring episodes of eating significantly more food in a short period of time than most people would eat under similar circumstances, with episodes marked by feelings lack of control. someone with BED may eat too quickly even when they're not that hungry

1960 - early uses of methamphetamines

- amphetamine + heroin injected together = speedball - most street amphetamines came from prescriptions - "speed scene" = a time and place in which people used and became dependent on intravenous amphetamine

a gambler's cognitive distortions

- attribution - magical thinking - superstitions - selective recall - systems - personification of a gambling device - "near miss" beliefs - chasing losses

pharmacology effects of caffeine

- caffeine partially onsets the effects of fatigue on both mental and physical tasks, but it may not improve performance in well-rested individuals - high caffeine consumption among college students is associated with lower academic performance - headache treatment: helps relieve both migraine and non-migraine headaches - hyperactivity treatment: high doses may decrease hyperactivity - caffeine does not lower blood alcohol concentration and will not help a person sober up

adverse health effects of caffeine

- caffeinism: excessive use of caffeine - unpleasant symptoms: nervousness, irritability, tremors, insomnia, flushed appearance, elevated temp, palpitations, heart arrhythmias, gastrointestinal disturbances

Similarities of sex addiction with substance use disorders

- characteristic course: sexual "addiction" as a disorder typically begins in adolescence or early adulthood and follows a chronic course with remissions and exacerbations - continuing the behavior despite harmful consequences - engaging in more of the behaviors and eliminating other healthier behaviors from experience - craving, excitement, preoccupation during preparatory activity - mood altering effects of the behavior - sense of loss of control - progressive development of the behavior - tolerance as behavior increases and is repeated, its ability to produce reinforcing effects in diminished - withdrawal psychological and physical discomfort when behavior is discontinued - tendency to relapse after the behavior has been discontinued or control of behavior has been achieved - neglect of other areas of life; relationships, hobbies, work...

Causes for concern: acute and chronic toxicity - cocaine

- cocaine used during pregnancy: increased risk of miscarriage and torn placenta and long-term effects of prenatal cocaine exposure still under study

US alcohol consumption - drinking among college students

- college students drink more than their nonstudent peers - many campuses have banned sale and advertising alcohol, and many frats have banned keg parties - today's college students are less likely to drink and drive compared to students in the early 1980s

signs of prescription drug abuse and dependence

- complaining of vague symptoms to get more medication - lack of interest in other treatment options other than medication - mood swings - seeing several doctors and/or pharmacies to get more pills - past history of drug addiction - on and off relief from anxiety - using more than the recommended dose or dosage frequency of the medication - using prescription pills prescribed for others

pros of legalization

- drug use continues, not everyone automatically becomes an addict - the budgetary impact of ending the war on drugs - the ability of addicts to seek treatment without risking jail time - the end of the corruption of some on the police force produced by the war on drugs - a reduction in the scope and source of income for organized-crime organizations - a transformation of the outlook of cities - reduction in incarceration - the end of an illegal market whose violence spills far beyond our borders - an expansion of personal freedom

Cocaine estimated number of users vs. addicts

- estimated that between 22 and 25 million people have used cocaine once - two million people are cocaine addicts

Social and public health costs of gambling

- estimates of the amount of money spent on gambling in the US rose from $17.4 billion in 1974 to $860 billion in 2001 - the costs attributed to problem gambling and pathological gambling have been estimated in the 1990s to be 5 billion annually

subjective effects of marijuana

- euphoria, "high," mellowness, hunger, and stimulation - peaks effects occur within five to ten minutes and last for about two hours - oral THC has similar effects but a different time course - magnitude of effects is greater with increasing THC concentrations - regular marijuana smokers can recognize the effects and distinguish between real and placebo marijuana cigarettes - infrequent smokers experience similar but more intense effects - also may experience paranoia and hallucinations

smoking and health in other countries

- four to five million deaths worldwide each year - perhaps as high as 8 million by 2030 - Third World demand for American cigarettes has increased markedly - Asian countries also experiencing increased demand for American cigarettes

problem and pathological gambling

- gambling beyond their means - incur substantial debt - experience bankruptcies - experience "bailouts" - are willing to risk close relationships - resort to illegal behaviors

opioids

- hydrocodone (Vicodin) - oxycodone (OxyContin) - propoxyphene (Darvon) - hydromorphone (Dilaudid) - meperidine (Demerol) - diphenoxylate (Lomotil)

adverse health effects of smoking (tobacco)

- lung cancer - cardiovascular disease - chronic obstructive lung diseases (including emphysema) - risk increases for those who start young, smoke many cigarettes, and continue to smoke for a long time - smoking is the single greatest avoidable cause of death

Early uses of methamphetamines - what happened when amphetamines became more tightly controlled?

- many look-alikes appeared - some users switched back to cocaine - illicit manufacture of methamphetamine grew

medical uses of marijuana

- may be effective as an anticonvulsant in some cases when preferred medication is ineffective - may relieve tension and migraine headaches - reduces fluid pressure in the eyes - may be useful in glaucoma patients - limited program in which NIDA supplied medical-grade marijuana cigarettes to certain patients on a "compassionate use" protocol - reduces severe nausea caused by certain drugs to treat cancer

Causes of prescription drug dependence

- medication changes the brain's chemistry - brain is less effective at producing chemicals like dopamine or endorphins - since the brain has stopped producing these chemicals itself, they must be introduced through another source - the addict has become physically dependant on the medication

demographics of gambling - populations most impacted by gambling

- men are 2x more likely to develop problem gambling than women - women suffer from more physical and mental health complications at the same level of severity of disordered gambling - among teens boys to girls, the ratio of problem gambling is estimated between 3:1 and 5:1 - boys gamble more frequently and wager larger amounts, begin at an earlier age, and more often prefer skill-based games - African Americans are disproportionately represented in populations of disordered gamblers

withdrawal symptoms associated with cannabis

- most common: anxiety, irritability, anger or aggression, disturbed sleep/dreaming, depressed mood, loss of appetite - less common: chills, headaches, physical tension, sweating, stomach pain

demographics of eating disorders

- most commonly developed in adolescence and young adulthood - can occur at any point in life - peak age of onset for AN is 13-17 - Peak age of onset for BN is late adolescence through young adulthood - The development of BED develops in young to middle adulthood

obesity statistics - who is obese?

- obesity is a disease that affects an estimated 35 percent of adults age 20 and over in the US - this amounts to more than 72 million people - about 32.2 percent of American men - about 35.5 percent of American women

Pediatric Guidelines for Television time (screen time in general) and the average amount of time children and teenagers spend with screens

- one to two hours per day with no TV in bedroom

commonly abused classes of prescription medication and some of their common drug names

- opioids (for pain) - central nervous system depressants (for anxiety and sleep disorders) - stimulants (for ADHD and narcolepsy)

opioids vs opiates

- opioids: synthetic pain medications - opiates: a natural pain remedy

Pros of decriminalization

- reducing number of people arrested - reducing the number of people incarcerated - increasing uptake into drug treatment - reducing criminal justice costs and redirecting resources from criminal justice to health systems - redirecting law enforcement resources to prevent serious and violent crime - diminishing unjust racial disparities in drug law enforcement and sentencing, incarceration and related health characteristics and outcomes - minimizing the social exclusion of people who use drugs, and creating a climate in which they are less fearful of seeking and accessing treatment, utilizing harm reduction services and receiving HIV/AIDS services - improving relations between law enforcement and the community - protecting people from the wide-ranging and debilitating consequences of a criminal convictions

Characteristics that substances share with other addictive behaviors (Jon Grant)

- repetitive and compulsive engagement in a behavior despite adverse consequences - diminished control over problematic behavior - appetitive urge or craving state prior to engagement in problematic behavior - hedonic quality during the performance of the problematic behavior

classification of cannabis

- schedule 1 drug along with heroin and LSD - primary psychoactive agent in cannabis is delta-9-tetrahydrocannabinol - THC concentration is the resin, most of which is in the flowering tops - psychoactive potency of cannabis preparations depends on the amount of resin present

US Alcohol Consumption - Regional differences in the US

- stress index: drinking rates higher in states where people experience a great deal of social stress and tension - drinking norms: drinking rates higher in states where people tend to approve of the use of alcohol to relieve stress

why patients typically present for treatment

- strong tendency to compartmentalize the behavior or dissociate themselves from the behavior - present for treatment because of threat of divorce, job loss due to spending time online at sex sites or sexual harassment, confrontations with the legal system

causes for concern with caffeine

- there is no clear evidence that moderate caffeine consumption is dangerous - cancer: caffeine is not a risk factor in human cancer - high consumption of caffeine reduces a woman's chances of becoming pregnant and slows the growth of the fetus - research is mixed on whether caffeine increases the risk of miscarriage - heart disease: high intake of caffeine may increase the risk of heart attack, particularly in people with other risk factors

Trends in US alcohol consumption

- use peaked in 1981, followed by a decline, mirroring patterns of illicit drug use - decline particularly significant for distilled spirits - about 1/3 of Americans abstain - Average consumption among drinkers = about 3 drinks per day, but most drink far less - half of all alcohol consumed in the US is consumed by about 10 percent of the drinkers

cybersex cons

- users engage in cyber sex to the exclusion of personal relationships - This can negatively impact intimate relationships - Cybersex often requires the"double life" associated with many addictions. - Cybersex can become financially, socially, emotionally, spiritually exhausting.

smokeless tobacco

- vaping is less harmful than smoking, but still not safe - research suggests that vaping is harmful for your heart and lungs - vaping is just as addictive as smoking - e-cigs are not the best smoking cessation strategy

Common characteristics shared by all addictive behaviors (DiClemente)

1) They represent habitual patterns of intentional, appetitive behaviors 2) They can become excessive and produce serious consequences 3) There is stability of these problematic behavior patterns over time 4) There are interrelated psychological and physiological components to the behavior 5) In every case, individuals who become addicted to these behaviors have difficulty stopping or modifying them

prevalence of use worldwide (2019) from WHO

147 million

tobacco - cost of addiction (lives lost)

8.7 million (World, 2019)

diagnosis of sexual addiction - Aviel Goodman

A condition in which some form of sexual behavior that can function both to produce pleasure and reduce painful affects is part of a pattern that has two key features; - 1. recurrent failure to control the sexual behavior. - 2. continuation of the behavior despite significant harmful consequences No specific form of sexualbehavior in itself defines sexualaddiction. Addiction is determinednot on the basis of a specificbehavior or its frequency, butrather on the basis of how thebehavior relates to and affects aperson's life with regard to his/herhealth, relationships, work, etc.

similarities between eating disorders and substance use disorders

Addictions and eating disorders share many common clinical features: - Cravings - Cognitive Dysfunction - Use to relieve negative affect: anxiety or depression. - Secretiveness about the problematic behavior - Social isolation - Maintenance of the problem behavior despite adverse consequences. - Denial of the presence or severity of the disorder. - Depression - Experience of a transition where the behavior (food or substance) no longer relieves negative affect but now creates the feelings they were originally used to allay. - Presence of identical or similar changes and function of brain neurotransmitter reward/pleasure system pathways.

Mate's definition of addiction

Any repeated behavior, substance-related or not, in which a person feels compelled to persist, regardless of its negative impact on his life and the lives of others. Addiction involves: compulsive engagement with the behavior, a preoccupation with it, impaired control over the behavior; persistence or relapse despite evidence of harm; and dissatisfaction, irritability or intense craving when the object- be it a drug, activity, or other goal- is not immediately available, Addiction is a continuum from the workaholic to the street haunted drug addict.

View of alcohol during time of the Revolutionary War

Before - People drank more alcohol than water - drunkenness was viewed as misuse of positive product After - Alcohol itself viewed as the cause of serious problems, an active agent of evil - alcohol was first psychoactive substance to become demonized in American culture

Country that decriminalized all drug use?

Portugal

Brief Biosocial Gambling Screen (BBGS)

This 3-item assessment is based on the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders criteria for pathological gambling. This scale is extremely practical for clinical application because it uses only 3 items and they are easy to ask, answer, and include in all modes of interviewing, including self-administered surveys.

legalization of drugs

a status where responsible adults may legally acquire, possess, and use a particular drug, although there may be restrictions on time, place and manner

cybersex pros

affordable, accessible, anonymous, and safe

Types of eating disorders/disordered eating

anorexia nervose, bulimia nervosa, binge eating disorder, obesity

CNS depressants

barbiturates (pentobarbital sodium - nembutal), benzodiazepines (diazepam - valium, and alprazolam - xanax), nonbenzodiazepines (ambien and lunesta)

Why don't people take prescription drug abuse as seriously as illicit drug abuse?

because the drugs were originally prescribed by a doctor

similarities between pathological gambling and substance use disorder

both experience the thoughts and behaviors associated with the disorder as ego-syntonic; experience pleasure, minimize/deny the problems

physiological effects - what happens when a person ingests cannabis?

cardiovascular effects - increased heart rate - blood pressure (research is mixed) - CV risks haven't been shown in young, healthy users

Stimulants

dextroamphetamine (dexedrine), methylphenidate (ritalin and concerta), amphetamines (adderall)

what does the acronym LEAP stand for?

first was Law Enforcement Against Prohibition and now is Law Enforcement Action Partnership

health problems associated with gambling

hypertension, insomnia, gastrointestinal complaints, cardiac arrest, sustained stress

marijuana abuse and dependence potential

increases an individual's risk of using and/or developing addiction to other licit and illicit substances that may be perceived as more harmful, such as opioids, cocaine, and meth

latrogenic

induced inadvertently by a physician or surgeon or by medical treatment or diagnostic procedures

US Alcohol consumption gender differences

males more likely to drink than females, and more likely to drink more

DSM V Criteria for Gambling Addiction

persistent and recurrent problematic gambling behavior: - needing to gamble with more money to get the same excitement from gambling as before - feels restless or irritable when trying to reduce or stop gambling - keeps trying to reduce or stop gambling without success - gambling is frequently on the person's mind--both reliving past gambling experiences, and planning future gambling events - gambles when feeling depressed, guilty, or anxious - tries to win back gambling losses - lies to cover up how much they are gambling - loses not only money, but also relationships, their job, or a significant career opportunity as a result of gambling - becomes dependent on other people to give them money to deal with financial problems that have been caused by gambling - the gambling behavior is not better accounted for by a manic episode

definition of gambling

placing something of value at risk in the hopes of gaining something of greater value

effects on the family

problem and pathological gambling may include damaging behaviors to loved ones: - domestic violence - child abuse - child neglect - high rate of divorce - poor mental and physical health of family members

three kinds of gambling

recreational, problem, pathological

pornography symptoms

secretive actions, money problems, changes in sleep patterns, guilt, neglecting family, risk motivated

Marijuana is classified separately because its effects are varied and complex

sedation, pain relief, hallucinations (in large doses)

populations that seem most vulnerable to prescription drug abuse and addiction

seniors are especially at risk simply because they are prescribed drugs more often than other groups

What do stimulants do? Why do people use stimulants?

stimulants are substances that keep a person going mentally and physically

prescription drug abuse definition

taking a prescription medication that is not prescribed for you, or taking it for reasons in dosages other than as prescribed

Decriminalization

the removal of criminal penalties for drug law violations (usually possession for personal use)

goal of decriminalization

to shift resources and invest in treatment and harm reduction services thereby reducing the harms of drug misuse while improving public safety and health

SASH

tracking data from 2010 by Nielsen Online showed that more than 25% of those with Internet access at work viewed pornography during working hours. This is an increase from 2007 figures.

Early uses of methamphetamines

used by soldiers in WW2 to fight fatigue