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Overview. Brief history and definitions of Substance-Related DisordersSummary of the DSM-IV criteria for Substance-Related DisordersReported trends and facts related to substance useDescription of specific substances, and current pharmacological treatmentsAlcoholCocaineHallucinogens. Substan
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1. Pharmacological Treatment for Substance Related Disorders Claudia Flato
Texas A&M University
2. Overview Brief history and definitions of Substance-Related Disorders
Summary of the DSM-IV criteria for Substance-Related Disorders
Reported trends and facts related to substance use
Description of specific substances, and current pharmacological treatments
Alcohol
Cocaine
Hallucinogens
3. Substance Abuse and Dependence DSM IV Definition of Substance Abuse
Brief history
the transition of Substance Abuse Diagnosis across the DSMs
Substance abuse vs. substance dependence
The validity of Substance Dependence
The validity of Substance Abuse
DSM IV Substance-related Disorders
Substance Use Disorders
Substance abuse:
misuse of a substance followed by social or occupational consequences but without physiological processes (withdrawal, tolerance and compulsive use)
Substance dependence:
compulsive use of the substance with or without physiological consequences
Substance Induced Disorders
4. Substance Abuse and Dependence Substance Abuse
A maladaptive pattern of substance use
failure to fulfill major obligations
continued use under hazardous conditions
multiple legal problems
recurring social and interpersonal problems.
Sans tolerance, withdrawal or a pattern of compulsive use of the substance
Symptoms have never met criteria for dependence
Substance abuse does not apply to nicotine and caffeine.
5. Substance Abuse and Dependence Substance Dependence
Addiction to a substance except caffeine
Cognitive, behavioral and physiological symptoms
Three of the 7 criteria specified must have occurred within the same 12 months
Criteria for this disorder include tolerance, withdrawal, reduced involvement in pleasurable activities, and compulsive use of the substance
Does not apply to caffeine
Specify: With or Without Physiological Dependence
6. Substance-Induced Disorders(Differential Diagnosis) The Substance Induced Disorders
Intoxication
Reversible, maladaptive, and not due to a GMC (NA for nicotine)
Withdrawal
Problems after cessation or reduction of a substance
NA for caffeine, cannabis, hallucinogens, inhalants, and PCP
Substance Induce Disorders that share phenomenology with other mental disorders
Substance-Induced
Delirium
Persisting Dementia
Persisting Amnestic Disorder
Psychotic Disorder
Mood Disorder
Anxiety Disorder
Sexual Dysfunction
Sleep Disorder
7. Substance Abuse Factsand Treatment Trends
8. Substance Abuse Factsand Treatment Trends
9. Alcohol (Ethanol) Background
10. Alcohol (Ethanol)
11. Drug mechanisms Alcohol
Metabolism
12. Drug mechanisms
13. Alcohol and Treatment
16. Drug mechanism Cocaine
Mechanism:
Cocaine attaches to
dopamine transporter
causing dopamine to
build-up in the synapse.
18. Cocaine and Treatment
20. Hallucinogens Background
Hallucinogens produce transient psychotic states
LSD, PCP, Ketamine, Dextromethorphan
Known to affect the serotonin system
Mescaline, psilocybin, and ibogaine
Often used in religious and cultural rituals
In natural form (peyote) availability is limited
LSD synthetic compound
No unique criteria for Hallucinogen Dependence and Abuse in DSM-IV
No withdrawal syndrome
22. Hallucinogens and Treatment
23. Websites http://www.nida.nih.gov/NIDAHome.html
http://www.samhsa.gov/
http://www.niaaa.nih.gov/
http://nhsn.med.miami.edu/
http://www.bnl.gov
24. References American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders (4th Ed). Washington, DC: Author
Johnson, B., & Ait-Daoud, N. (1999). Medications to treat alcoholism. Alcohol Research & Health, (23), 99 -106. www.niaaa.nih.gov
Moras, K. (1997). Outcome measurement considerations: Pharmachological treatments for substance abuse. Nida Research Monograph, (175), 118 -136
Preston, J.D., ONeal, J.H., & Talaga, M.C. (2004). Handbook of clinical psychopharmachology for therapists (4th ed.). Oakland, CA: New Harbinger Publications
Swift, R., & Davidson, D. (1998). Alcohol hangover: Mechanisms and mediators. Alcohol Research & Health, (22), 54 - 60. www.niaaa.nih.gov
Tapert, S.F., Tate, S. R., & Brown, S.A. (2001). Substance abuse: An overview. In P. B. Sutker, & H. E. Adams (Eds.), Comprehensive handbook of psychopathology (3rd ed.). New York, NY: Kluwer Academic/Plenum.
Carlson, N. R. (2004). Physiology of behavior (8th ed.). Boston, MA: Allyn and Bacon.