T8: Substance-Related and Addictive Disorders

• The term substance refers to chemical compounds that are ingested to alter mood or behavior.
• Psychoactive substance is a substance that alters mood, behavior, or both.
• Substance use is the ingestion of psychoactive substances in moderate amounts that does not significantly interfere with social, educational, or occupational functioning.
• Substance intoxication is our physiological reaction to ingested substances—drunkenness or getting high.
• Substance Abuse by how much of a substance is ingested is problematic and how significantly it interferes with the user’s life.
• Withdrawal from alcohol can cause alcohol withdrawal delirium, in which a person can experience frightening hallucinations and body tremors
• Six General Categories of Substances:

  1. Depressants
  2. Stimulants
  3. Opiates
  4. Hallucinogens
  5. Other Drugs of Abuse
  6. Gambling Disorder
• Depressants are substances that results in behavioral sedation and can induce relaxation. (ex. alcohol, benzodiazepines)
• Stimulants are substances that causes us to be more active and alert and can elevate mood. (ex. cocaine, caffeine)
• Opiates are substances that produces analgesia temporarily (reduce pain) and euphoria. (ex. heroin, opium, morphine)
• Hallucinogens are substances that alters sensory perception and can produce delusions, paranoia, and hallucinations. (ex. cannabis, LSD)
• Other Drugs of Abuse - other substances that are abused that produces a variety of psychoactive effects. (ex. inhalants, prescribe medicine)
• Individuals who display gambling disorder are unable to resist the urge to gamble which, in turn, results in negative personal consequences (e.g., divorce, loss of employment).
• Alcohol Use Disorder is a problematic pattern of alcohol use leading to clinically significant impairment or distress. It can be manifested by at least two of the criteria, occurring within 12-month period.
• Two types of organic brain syndromes may result from long-term heavy alcohol use: Dementia and Wernicke-Korsakoff Syndrome
• Dementia, (or neurocognitive disorder), involves the general loss of intellectual abilities and can be a direct result of neurotoxicity or “poisoning of the brain” by excessive amounts of alcohol.
• Wernicke-Korsakoff syndrome results in confusion, loss of muscle coordination, and unintelligible speech; it is believed to be caused by a deficiency of thiamine; a vitamin metabolized poorly by heavy drinkers.
• Fetal alcohol syndrome (FAS) is a combination of problems that can occur in a child whose mother drank while she was pregnant. These problems include fetal growth retardation, cognitive deficits, behavior problems, and learning difficulties. Among children with FAS, beta-3 ADH may be prevalent according to new research.
• We metabolize alcohol with the help of an enzyme called alcohol dehydrogenase (ADH). Three different forms of this enzyme have been identified (beta-1, beta-2, and beta-3 ADH).
• The general group of depressants also includes sedative (calming), hypnotic (sleep-inducing), and anxiolytic (anxiety-reducing) drugs.
• Barbiturates (which include Amytal, Seconal, and Nembutal) are a family of sedative drugs first synthesized in Germany in 1882. They were prescribed to help people sleep and replaced such drugs as alcohol and opium.
• Benzodiazepines (which today include Valium, Xanax, and Ativan) have been used since the 1960s, primarily to reduce anxiety. It is also used to calm an individual and induce sleep.
• Rohypnol (otherwise known as “forget-me-pill,” “roofenol,” “roofies,” “ruffies”) is a type of benzodiazepines that gained a following among teenagers in the 1990s because it has the same effect as alcohol without the telltale odor.
• Amphetamines is a kind of stimulant drug that can induce feelings of elation and vigor and can reduce fatigue. You feel “up”. After a period of elevation, however, you come back down and “crash,” feeling depressed or tired. It is prescribed for people with narcolepsy, a sleep disorder characterized by excessive sleepiness.
• An amphetamine called methylene-dioxymethamphetamine (MDMA), first synthesized in 1912 in Germany, was used as an appetite suppressant. Recreational use of this drug, now commonly called Ecstasy that makes you “feel happy” and “love everyone and everything”; “music feels better” and “it’s more fun to dance”; “You can say what is on your mind without worrying what others will think”
• A purified, crystallized form of amphetamine, called methamphetamine (commonly referred to as “crystal meth” or “ice”), is ingested through smoking. This drug causes marked aggressive tendencies and stays in the system longer than cocaine, making it particularly dangerous.
• Cocaine is a kind of stimulant drugs which is derived from the leaves of the coca plant, a flowering bush indigenous to South America. The effects of it are short lived and the short amount of it increases alertness, produces euphoria, increases blood pressure and pulse, and causes insomnia and loss of appetite.
• An effect of cocaine is referred as cocaine-induced paranoia in which a person became paranoid experiencing exaggerated fears that he would be caught or that someone would steal his cocaine.
• Caffeine is the most common of the psychoactive substances, used regularly by almost 90% of all Americans. Called the “gentle stimulant” because it is thought to be the least harmful of all addictive drugs, it can still lead to problems such as similar to that of other drugs (e.g., interfering with social and work obligations)
• Opiate refers to the natural chemicals in the opium poppy that have a narcotic effect (relieve pain and induce sleep). It induces euphoria, drowsiness, and slowed breathing. High doses can lead to death if respiration is completely depressed. It is also analgesics, substances that help relieve pain.
• Marijuana is the name given to the dried parts of the cannabis or hemp plant (its full scientific name is Cannabis sativa).
• Cannabis also known as "weed". Its effect usually includes mood swings. It also heightened sensory experiences, seeing vivid colors, or appreciating the subtleties of music.
• LSD (d-lysergic acid diethylamide), sometimes referred to as “acid”, is the most common hallucinogenic drug. The intoxication includes perceptual changes such as the subjective intensification of perceptions, depersonalization, and hallucinations. Physical symptoms include pupillary dilation, rapid heartbeat, sweating, and blurred vision.
• Causes of Substance-Related Disorders:

  1. Biological Dimensions
  2. Neurobiological Dimensions
  3. Psychological Dimensions
  4. Cognitive Dimensions
  5. Social Dimensions
  6. Cultural Dimensions
• Agonist substitution is a biological treatment for substance-related disorders that provides the person with a safe drug that has a chemical makeup similar to the addictive drug (therefore the name agonist).
• Methadone is an opiate agonist that is often given as a heroin substitute. Although it does not give the quick high of heroin, methadone initially provides the same analgesic (pain reducing) and sedative effects.
• Antagonist drugs are biological treatment for substance-related disorders that blocks or counteract the effects of psychoactive drugs, and a variety of drugs that seem to cancel out the effects of opiates.
• The most often prescribed opiate-antagonist drug, naltrexone, it produces immediate withdrawal symptoms, an extremely unpleasant effect. A person must be free from these withdrawal symptoms completely before starting taking it, and because it removes the euphoric effects of opiates, the user must be highly motivated to continue treatment.
• Aversive treatment is a biological treatment for substance-related disorders in which prescribed drugs makes the ingesting substances extremely unpleasant.
• The most commonly known aversive treatment uses disulfiram (Antabuse), it prevents the breakdown of acetaldehyde, a by-product of alcohol, and the resulting buildup of acetaldehyde causes feelings of illness. People who drink alcohol after taking it experiences nausea, vomiting, and elevated heart rate and respiration.