lecture 10 substance

• Substance use disorder


  Misuse, abuse, dependence

  
• Drug dependence


  Need to maintain certain level of drug in the bloodstream to avoid withdrawal symptoms
• Drug tolerance


  Consuming increasing amounts of a drug to experience desired effect
• Drug dependence


  • Can be physical and/or psychological
  • Physical: need to maintain certain level of drug in the bloodstream to avoid withdrawal symptoms
  • Psychological: craving for the feeling a drug produces
• Drug tolerance


  • Metabolic (Pharmacokinetic): repeated exposure accelerates the rate at which the drug is decomposed by the liver
  • Pharmacodynamic: repeated exposure leads to cellular adaptation
• Causes of substance use disorders


  • Biological factors
  • Psychological
  • Interpersonal
  • Environmental

  
• Substance misuse


  Use that results in adverse consequences that are not recurrent
• Substance abuse


  Maladaptive pattern of use that manifests recurrently and has significant consequences
• Substance dependence


  Cluster of cognitive, behavioural and physiological symptoms that indicate that a person compulsively continues to use a substance
• Substance use behaviour occurs on a continuum

  
• Substance dependence can be understood as addiction
• Different degrees of severity require different types of interventions
• Biological factors


  • Inherited vulnerability
  • Neurological processes that contribute to substance dependence: Reinforcement, Neuro-adaptation

  
• Psychological factors


  • Personality traits: High levels of novelty seeking and sensation seeking, High levels of disinhibition, Deficits in psychosocial skills, depression and anxiety disorders
• Interpersonal factors


  • Family risk factors: Family dysfunction, Inadequate and inconsistent family management practices, Normalisation of substance use
  • Peer risk factors: Drug-using peers, Peer pressure
• Environmental factors


  • Dropping out of school, low levels of educational achievement
  • Exposure to substance use/abuse
  • Degree of acceptance or approval in community
  • Availability of drugs in community
  • Occupational factors, such as the dop system in farming/viticulture