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substance use disorders

Substance Abuse. One or more of the following in a 12-month period:Recurrent use resulting in not meeting major obligationsRecurrent use in physically dangerous situationsRecurrent substance-related legal problemsContinued use despite knowing it causes or exacerbates persistent or recurrent social or interpersonal problems.

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substance use disorders

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    1: Substance Use Disorders 7.5.2007

    3: Substance Dependence A. Maladaptive pattern of substance use, leading to clinically significant impairment or distress, as manifested by three (or more) of the following, occurring at any time in the same 12-month period: 1. Tolerance, as defined by either of the following: a. Need more to get the same effect b. Diminished effect when the same amount is used 2. Withdrawal as manifested by either of the following: a. Characteristic withdrawal syndrome for the substance b. The same substance is taken to relieve or avoid withdrawal symptoms

    4: Substance Dependence 3. Substance is often taken in larger amounts or over a longer period of time intended 4. There is a persistent desire or unsuccessful efforts to cut down or control substance use 5. Great deal of time is spent obtaining, using, or recovering from the substance 6. Important social, occupational, or recreational activities are given up or reduced because of substance use 7. Substance use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance

    5: Abuse vs. Dependence Abuse (v.) – to put to wrong or improper use Dependence (n.) – the quality or state of being influenced or determined by another, also relying on another (physically or psychologically addicted/dependent)

    6: Administration Method of administration influences Most rapid and efficient absorption

    7: Alcohol Effects Low levels: High levels: Blood Alcohol Level of .08: Intoxication Blood Alcohol Level of .5: Neural balance completely upset, person passes out Blood Alcohol Level of .55: Lethal

    8: Alcohol Effects of chronic use Physical changes Psychological changes Behavior changes

    9: Alcohol Withdrawal Autonomic hyperactivity (increased heart rate, sweating, etc.) Tremors Insomnia Nausea/vomiting Agitation Anxiety Grand mal seizures Headaches Transient visual, auditory, or tactile hallucinations/illusions Taking substance to stave off withdrawal symptoms

    10: Alcohol Dependence Prevalence: Gender: Age of Onset:

    11: Alcohol Dependence Course: w/o treatment: w/ treatment: Culture:

    12: ALDH2 Allele Metabolism of Alcohol Alcohol is transformed into toxin called acetaldehyde Acetaldehyde is then transformed into water and acetate 50% of Asians have a genetic variation that does not produce the enzyme required to transform acetaldehyde into water and acetate Drinking alcohol is a very unpleasant experience Flushing of the face Nausea Dizziness Feeling ill at ease (dysphoria) People with this genetic variation essentially never experience alcohol dependence

    13: Alcohol Dependence Risk Factors Alcohol and drug dependence are the only completely preventable mental disorders

    14: Alcohol Dependence - Treatment Medication Antabuse – Naltrexone – Environmental Interventions Therapy Group therapy – Family therapy – Individual therapy –

    15: Alcohol Dependence - Treatment Alcoholics Anonymous Started in 1935, “fundamental spiritual change” Beliefs Results

    16: Alcohol Dependence - Treatment Controlled Drinking vs. Abstinence Relapse Prevention Outcomes

    17: Classes of Drugs Caffeine and Nicotine Sedatives (Alcohol and Barbituates) Stimulants (Cocaine and Amphetamines) Narcotics (Opium and its derivatives) Psychedelics/Hallucinogens Marijuana (Mild Hallucinogen)

    18: Caffeine and Nicotine Effects of Caffeine Intoxication Restlessness Nervousness Excitement Insomnia Muscle Twitching Gastrointestinal complatints Can mimic anxiety symtpoms Caffeine Withdrawal Headaches (usually mild)

    19: Caffeine and Nicotine Nicotine Withdrawal Disorder Craving for nicotine Irritability Frustration Anger Anxiety Difficulty concentrating Restlessness Decreased heart rate Increased appetite/weight gain Headaches Insomnia

    20: Sedatives (Barbituates) Depressants – Alcohol and Barbituates Most are legal Were widely used as sleeping pills – slow down central nervous system and induce sleep Barbituates and Alcohol often used in combination, this combination is very deadly When using alcohol, lethal dose of barbituates is about half the normal lethal dose Adolescents/young adults – often experiment and abuse Middle-aged and elderly - most likely to become dependent

    21: Sedatives (Barbituates) Administration Effects Addiction/Dependency

    22: Sedatives (Barbituates) Withdrawal Symptoms more severe, long-lasting, and dangerous than opiate withdrawal Anxious, apprehensive Tremors in hands and face Insomnia Abdominal cramps, nausea, vomiting Increases in heart rate, blood pressure Weight loss Delirium, psychosis Brain damage

    23: Stimulants (Cocaine and Amphetamines) Cocaine Amphetamines (Dexedrine, “Meth”, Benzedrine)

    24: Stimulants (Cocaine and Amphetamines) Administration Effects

    25: Stimulants (Cocaine and Amphetamines) Addiction/Dependency Withdrawal

    26: Narcotics (Opium and its derivatives) Morphine (after Morpheus, Greek god of sleep) Heroin Codeine

    27: Narcotics (Opium and its derivatives) Administration Effects Addiction

    28: Narcotics (Opium and its derivatives) Withdrawal Symptoms of withdrawal occur after about 8 hours and last up to a week Perspiration Restlessness Chills/Flushes Vomiting/diarrhea Refusal of food/water Weight loss and dehydration Cramps, back pain, headaches Tremors Insomnia Occasionally – delirium, hallucinations, and manic activity

    29: Psychodelics and Hallucinogens LSD – 1961: Harvard’s Dr. Timothy Leary Mescaline/Psilocybin – Ecstasy –

    30: Psychodelics and Hallucinogens Administration Effects Fiction: Fact:

    31: Psychodelics and Hallucinogens Addiction/Dependency Withdrawal

    32: Marijuana (Mild Hallucinogen) Marijuana – Hashish – Administration

    33: Marijuana Effects Mild doses – mild euphoria, increased feelings of well-being, perceptual acuity, enhanced pleasure, memory loss, distortions in sense of time, overtalkativeness, and pleasant relaxation High doses – extreme euphoria, hilarity, overtalkativeness, anxiety, depression, hallucinations, etc. Physiological effects – increased heart rate, slowed reaction time, enlarged pupils, dry mouth, increased appetite

    34: Marijuana Dependence/Addiction Withdrawal

    35: Illicit Drug Abuse and Dependence Prevalence: Typical Course: **People who don’t use drugs as adolescents rarely develop any substance abuse problem

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