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Substance-Abuse Disorders - Coggle Diagram
Substance-Abuse Disorders
ALCOHOL-RELATED DISORDERS
harmful use of alcohol: detrimental health and social consequences
heavy episodic drinking: 6+ alcoholic drinks on at least one occasion at least once per month
prevalence
15% point, 30% lifetime
increased risk for death by accident, suicide, homicide, heart disease, cancer, stroke, 12 year shorter life span, cirrhosis of the liver, malnutrition, gastrointestinal symptoms
chronic fatigue, oversensitivity, depression, innapropriate behavior
clinical picture
decreases behavioral inhibition
impairs learning and memory
negatively impacts judgement, decision making, and motor coordination
fetal alcohol syndrome
alcohol-induced psychotic disorders: marked by temporary loss of contact w/ reality
alcohol withdrawal delirium (3-6 days, followed by deep sleep)
alcohol amnestic disorder (memory deficit with regard to recent events and falsification of events)
treatments
detoxification, physical rehabilitation, control over alcohol abuse behavior, new coping strategies in the face of problems, living a rewarding life without alcohol
medications
disulfiram (Antabuse) = violent vomiting following the ingestion of alcohol (preventing an immediate return to drinking)
naltrexone = reducing the craving for alcohol (effective)
acamprosate = still being studied (effective)
benzodiazepines (Diazepam) & Valium = treatment of withdrawal symptoms
tranquillizers = bad bc they are misused too, lead to return of the use of alcohol
psychological approaches
group therapy (effective)
environmental intervention
behavioral and CB therapy (effective/modest)
MI (motivational interviewing) 35 min, positive effects
causal factors
alcohol stimulates MCLP -- production of euphoria -- great pleasure, strong reinforcing properties
great heritability (to the sensitivity of the addictive power of alcohol); not very well proven
'alcohol flush reaction' in Asians and Native Americans
failures in parental guidance
psychological vulnerability
expectations of social success
stress and tension reduction
marital and other intimate relationships
pervasive in social life
SUBSTANCE USE DISORDER
opium and its derivatives
morphine
eliminates pain without a loss of consciousness (analgesic)
addictive
heroin
morphine + acetic anhydride
powerful analgesic: used for pain relief
dangerous, acting more rapidly and intensely, more addictive
codeine
cough syrups
biological effects
intense feeling of euphoria 60 sec -- high state (lethargic, diminished bodily needs; pleasant and relaxed) 4-6 hrs -- negative phase (desire for more of the drug)
physiological craving (after continual use over 30 days)
withdrawal symptoms 8 hrs after the last dose
physiological balance can be restored w/ morphine
after a week it gets better, but the former tolerance is reduced (a risk of overdose if taking the former large dose)!
gradually built up tolerance
social effects
life becomes centered on obtaining and using drugs (theft, lying, prostitution...)
disruption of immune system -- effects on well-being
unsterile equipment -- hepatitis, AIDS virus
premature babies addicted to heroin :(
causal factors
pleasurable high, escaping life stress...
heroin plugs into opiate receptors (instead of endorphins) and works much more quickly, producing extreme euphoria
dopamine theory of addiction
result of a dysfunction of the dopamine reward pathway
connected to the amygdala and prefrontal cortex
reward deficiency syndrome
addiction is much more likely in individuals who have genetic deviations in components of the reward pathway, which leads them to be less satisfied by natural rewards
connection to psychopathology
70% have psychological diagnoses, 36% history of trauma
more likely to use the full range of medical services
depression and anxiety may lead people to use opiates as a way to escape from their negative thoughts and feelings (or the other way around, or both)
treatments
restoring physical and psych health
methadone + counseling (equally physiologically addictive, used in a clinical context)
buprenorphine (fewer side effects, effective as methadone, no physiological dependence) + behavior therapy
stimulants
cocaine
crack = cocaine without cocaine hydrochloride
blocking dopamine 'absorbers', thus increasing the amount of dopamine in the synapse
when abused, acute toxic psychotic symptoms may occur (hallucinations seen in those w/ shizo)
effects: tolerance, cognitive impairment, life problems
treatments: methadone + naltrexone (reducing withdrawal), psychological interventions (CBT, CM - slightly more effective, but not if using low-cost stuff)
amphetamines
benzedrine, dexedrine, methedrine ('speed') -- more dangerous
helps people stay awake and function at a level beyond normal, counteracting barbiturates, weight loss, narcolepsy, hyperactive children (paradoxal effect), depression
hazardous fatigue, psych and phyisiologically addictive, built up tolerance
raising blood pressure to cause immediate death, brain damage, psychosis, suicide...
treatments: abrupt withdrawal w/ severe symptoms, feelings of depression, brain damage (impaired ability to concentrate, learn, remember...)
methamphetamine (meth)
highly addictive, long-lasting high (metabolizes more slowly)
changes structure of the brain, psychiatric symptoms, cognitive dysfunction, severe mental health problems (paranoia, hallucinations), depression
highly resistant to treatment, more quickly addicted, relapse is common
caffeine and nicotine
easy to abuse, available, addictive, difficult to quit, withdrawals, health problems, side effects...
caffeine-related disorder: restlessness, nervousness, excitement, insomnia, muscle twitching, gastrointestinal complaints
nicotine-dependence disorder: daily use for several weeks, cravings (irritability, frustration, restlessness, weight gain, insomnia, tremors, coughing, headaches...)
buproprion (Zyban) -- relapse rates low only when drug is administered, highest quit rates in the hospitalized, behavioral or CBT
sedatives
(barbiturates)
producing sleep almost immediately, impaired decision making and problem solving, sluggishness, slow speech, mood shifts
brain damage, personality deterioration, tolerance does not increase the amount needed to cause death (accidental overdose)
most are not dependent, but middle-aged or older people who rely on them as sleeping pills and do not use other drugs
alcohol + barbiturates = death
withdrawal symptoms are most dangerous (than opiate): anxiety, weakness, rapid heart rate, acute delirious psychosis (usually fine within the week - administering smaller doses of barbiturates or other similar drugs)
hallucinogens
inducing hallucinations: do not create sensory images, but distort them so they are perceived in unusual ways
LSD
changes in sensory perceptions, mood swings, feelings of depersonalizations and detachment; not always pleasant
flashbacks: involuntary recurrence of perceptual distortions weeks or even months after
mescaline & psilocybin
cactus & mushrooms
enabling an individual to see, hear, and experience events in unaccustomed ways -- transporting them into a realm of nonordinary reality
mainly alter or distort experience
marijuana
withdrawal symptoms: nervousness, tension, sleep problems, apetite change...
psychological treatment: effective, but no treatment is more effective than others
no pharmacotherapy, maybe buspirone
synthetic cannabinoids: much more likely to have adverse side effects (anxiety, tachycardia, hypertension, seizures, psychosis...)
synthetic cathinones: mimic amphetamines & cocaine (bath salts; produce motor activity, agitation, violence, heart problems, psychosis..)
ecstasy
blocking serotonin reuptake: feelings of euphoria, energy, and well-being; serotonin depletion after use: feelings of depression, irritability, anxiety
intense experience of color, sound, and mild hallucinations; high levels of energy and excitement
not as addictive as cocaine
neurocognitive problems, memory deficiencies, psychiatric problems