Substance Use Disorders

• Drug


  Any substance (other than food) that affects the body or mind, including alcohol, tobacco, and caffeine
• Substance Intoxication


  Changes in behavior, emotion, or thought caused by substances
• Substance Use Disorders


  Maladaptive patterns of substance use leading to significant impairment or distress
• DSM-5 Checklist for Substance Use Disorders

  • Maladaptive Pattern: Significant impairment or distress from substance use
  • At Least Two Symptoms in One Year: Use in larger amounts or over longer periods than intended
  • Unsuccessful efforts to reduce or control use
  • Excessive time spent obtaining, using, or recovering
  • Failure to fulfill major role obligations
  • Continued use despite social or interpersonal problems
  • Reduction of important activities due to use
  • Use in physically risky situations
  • Continued use despite awareness of physical or psychological problems
  • Craving for the substance
  • Tolerance effects
  • Withdrawal reactions
• Tolerance


  Need for increasing doses to achieve desired effects
• Withdrawal


  Unpleasant and dangerous symptoms that occur when drug use is stopped or reduced
• Depressants


  Slow down the CNS, reduce tension and inhibitions
• Types of Depressants


  • Alcohol
  • Sedative-hypnotic drugs
  • Opioids
• 2 billion worldwide consumers of alcohol, more than half of US residents drink alcohol
• Alcohol Intoxication


  Blood alcohol concentration (BAC) of 0.09% or higher (3-4 drinks)
• Alcohol Intoxication Effects


  Impaired judgment, motor activity, concentration
• Women have higher BACs than men with equal consumption
• Alcohol Use Disorder (Alcoholism)


  Regular consumption and reliance, cognitive, social, and work impairment
• Tolerance increases


  Consumption increases
• Withdrawal symptoms


  Delirium tremens (DTs)
• Alcohol impacts: Family destruction, social relationships, careers, health (cirrhosis, Korsakoff's syndrome), fetal alcohol syndrome (FAS)
• Sedative-Hypnotic Drugs


  Barbiturates (older), benzodiazepines (safer), produce relaxation and drowsiness
• Sedative-Hypnotic Drugs Mechanism


  Increase GABA activity
• Types of Opioids


  • Natural (opium, heroin, morphine, codeine)
  • Synthetic (methadone)
• Opioids Mechanism


  Attach to endorphin-related brain receptors, cause CNS depression
• Heroin Addiction


  Rapid tolerance, withdrawal symptoms (anxiety, restlessness, twitching, aches, fever, vomiting, diarrhea, weight loss)
• 2 million people in the US annually have Opioid Use Disorder, 75% addicted to pain relievers, 25% addicted to heroin
• Opioid Use Disorder dangers: Overdose, impure drugs, infection
• Stimulants


  Increase CNS activity, elevate blood pressure, heart rate, alertness, cause rapid behavior and thinking
• Types of Stimulants


  • Nicotine
  • Caffeine
  • Cocaine
  • Amphetamines
• 40 million in the US have tried cocaine, currently used by 2 million
• Cocaine Mechanism


  Increases dopamine, norepinephrine, and serotonin levels in the brain
• Cocaine Effects


  Euphoric rush, intoxication, psychotic disorder, depression-like "crash"
• Cocaine dangers: Overdose, heart failure, brain seizures
• Types of Amphetamines


  • Amphetamine
  • Dextroamphetamine
  • Methamphetamine
• Amphetamine Effects


  Increase energy, alertness, reduce appetite, produce a rush, psychosis
• Methamphetamine (Ice/Crystal Meth) is widely used, linked to raves
• Amphetamine dangers: Serious negative effects on physical, mental, and social life, neurotoxicity
• Stimulant Use Disorder


  Stimulant dominates the individual's life, impaired social and work functioning, tolerance, withdrawal reactions
• 0.4% of US population have Cocaine Use Disorder, 0.6% have Amphetamine Use Disorder
• Hallucinogens (Psychedelic Drugs)


  Cause powerful changes in sensory perception (trips)
• Types of Hallucinogens


  • LSD
  • Mescaline
  • Psilocybin
  • MDMA (Ecstasy, Molly)
• LSD


  Derived from ergot alkaloids, causes hallucinogen intoxication (hallucinosis), hallucinations, synesthesia
• MDMA (Ecstasy, Molly)


  Stimulant and hallucinogen, energy boost, feelings of connectedness
• Hallucinogens dangers: Psychological problems, cognitive impairment, physical symptoms</b>