Substance Abuse & Substance Dependence (Addiction)

1. Substance Abuse &Substance Dependence (Addiction)

2. Substance Abuse A pattern of drug (including alcohol) use that diminishes the ability to fulfill responsibilities at home, work, or school that results in repeated use of a drug in dangerous situations or that leads to legal difficulties related to drug abuse. What are some examples of drug abuse?

3. Binge Drinking “Five or more drinks in a row for men; Four or more drinks in a row for women.” What does “in a row” mean? It means “at one seating”, or “over the course of a couple of hours or so.” The blood alcohol level depends on the person’s size and weight. Women on birth control pills will have higher blood alcohol levels.

4. Binge Drinking (continued) People engage in more high risk behaviors when binge drinking. There are higher rates of violence, use of poor judgment, and date rape associated with binge drinking. Do people who binge drink have an alcohol problem?” Does binge drinking lead to alcoholism?

5. Signs of Substance Dependence (Addiction) Increased tolerance. Withdrawal symptoms Using the substance for a longer period or in greater quantities than intended Having a desire or making repeated attempts to cut back usage Devoting a lot of time to obtaining or using the substance Giving up or reducing social, occupational, or recreational activities as a result of abuse Continued use in face of ongoing physical, psychological or social problems caused by substance abuse.

6. What is the difference between physical addiction and psychological dependence? Physical addiction causes increased tolerance and withdrawal symptoms. But even withdrawal has a psychological component, as the body and the mind are two sides of the same coin.

7. Prevalence of substance abuse and dependence Approximately 10.3 % of U.S. adults appear to have drug abuse problems during their lives, including 2.6% who become drug dependent. (Archives of General Psychiatry, May 2007) One third of adults report have an alcohol problem at some time during their lifetime. 20.2% of Americans smoke cigarettes. Kentucky has the highest rate of smokers, at 28.6% (2006 data; CDC)

8. “Prevalence” & “Incidence” Prevalence – How much of a disease exists in a population at a particular point in time, stated as percentage. Incidence – the rate of occurrence, or number of new cases in a time period (usually a year). The rate may be expressed in how many new cases in a year per 100,000 people. Which number is greater for a disease, prevalence or incidence?

9. The following words are from a book, Person to Person, by Sharon L. Hanna (Prentiss Hall, 2003):Smoking Cigarettes. If you smoke, you inhale several potentially dangerous substances, including the most potent cancer-causing substances known as carcinogens. A number of substances in tobacco smoke cause cancer in human beings (Centers for Disease Control, 2001a). The high risks have been apparent for years, and the future for a smoker is bleak. Nearly 5 million children living today will die prematurely because of a decision they will eventually make-to smoke cigarettes (CDC, 2001a). Tobacco use worldwide, which causes nearly 4 million people to die in a year, is the leading preventable cause of death (Satcher, 2001). The death rate in the United States alone is equivalent to two jumbo jets colliding in midair every day over a year's time with all passengers being killed (Rathus, 1999). Consider these research-based facts about smoking: * Kills more people each year than AIDS, alcohol, drug abuse, car crashes, murders, suicides, and fires combined (CDC, 2001a). * Results in more than 5 million years of potential life lost each year (CDC, 2001a). * Causes heart disease, lung and esophageal cancer, and chronic lung disease, and leads to a high likelihood of dying of these diseases as well as emphysema, other respiratory diseases, and various types of cancer (CDC,2001a). * Is related to erectile dysfunction and general sexual fitness (Wuh & Fox, 2001). * Puts babies at risk for sudden infant death syndrome (SIDS), poor lung development, asthma, and respiratory infections and increases the risk of stillbirths, premature births, low weight babies, and a higher rate of infant mortality (CDC, 2001a). Cigarette Smoking

10. Cigarette Smoking (continued) Think of 24 hours ago. During that time, there have been over 10,000 tobacco-related deaths (Pediatrics, 2001). A smoker loses 11 minutes of life per cigarette (Health, 2000). If health isn't that important, other reasons may be. As employers become more aware of the relationship between health and cigarette smoking, smokers may find it difficult to get jobs. Typically, smokers average more sick days. Another reason is skin aging. A student said, "I've heard it all, and nothing has jolted me to quit smoking until I heard about wrinkling. That did it!" She was referring to research which found that those who smoke have much more prominent wrinkling (Lauerman, 2(01).Or perhaps a smoker will consider money. Jon figured how many dollars he would save in a year and was motivated to quit. And cigarettes aren't the total cost. Smokers spend more on cold remedies, health care, and life insurance. Tobacco addiction is a major economic handicap. Smokers are significantly less knowledgeable about smoke-related diseases than ex-smokers or nonsmokers (Najem, Batuman, Smith, & Feuerman, 1997).Knowing all this the obvious question is "Why do people take up smoking?" Again, look at research-based facts. * Approximately 80 percent of adult smokers started smoking before age 18 (CDC, 2001a). Individuals at young ages are more suggestible and tend to conform. * Many start because their peers and family members smoke (Williams & Covington, 1997)(End of quote from Sharon Hanna)The CDC also reports that 90% of all lung cancers are caused by cigarette smoking.What is your direct knowledge of health problems associated with smoking?

13. Kentucky has one of the highest rates of smoking, largely due to the fact that tobacco has been a major part of the Kentucky economy, which in turn led to tobacco being a political issue, leading to low taxes on cigarettes, which promotes smoking. In Kentucky, until recently it was the law that state office buildings may not ban smoking entirely, whereas in many states it is the law that smoking is not allowed in state office buildings. Research has found that the states with the highest rates of smoking have the lowest rates of perceived health risk from heavy cigarette use (U.S. Department of Health and Human Services, Office of Applied Studies (http://oas.samhsa.gov/nhsda/2k1State/vol1/ch4.htm). This adds up to fewer people in Kentucky quitting smoking than in most other states, and there being fewer programs and less knowledge of smoking cessation techniques in Kentucky than in most other states. Have you tried (successfully or unsuccessfully) to quit smoking? What methods have you tried, and what methods do you think are the most useful? Have you plans to quit smoking? Do you smoke and plan to continue smoking indefinitely? If you do smoke, do you worry about possible health effects, or do you discount statements, like those in Hanna's book quoted earlier, that smoking is strongly associated with serious health problems and early deaths?

14. Alcohol Abuse & Alcoholism Most people who drink alcohol drink in moderation. Fourteen million Americans have problems with alcohol and that more than 8 million Americans are alcoholics. Almost everyone at some time deals with someone who has a problem with alcohol. In some families almost everyone is a heavy drinker.  What are your experiences/observations about alcohol abuse? Have you known someone who overcame a problem with alcohol, and if so, how did they do it? Do you think that alcoholism is a disease? Why or why not?

15. Drug Abuse Your instructor is so old that when he was in high school, the largest high school in a big city, he never saw or even heard of anyone in the school using illegal drugs. You probably cannot imagine that. Illicit drug use and drug abuse is common today, and almost every school child is confronted with it to some degree. There are many types of drugs, some more dangerous than others. Marijuana has generally increased in potency over the years to the point that it is almost a different drug today than it was 40 years ago (the years of the fabled pot smoking hippies of the sixties). What are your observations/experiences/opinions regarding illegal drugs and drug abuse?

16. Substance Abuse Treatment What goes on in Detox? What goes on in Rehab? What happens after Rehab? What is an “Intervention?” How successful is substance abuse treatment?

17. Hypnosis Is hypnosis real? What is hypnosis? What are the uses of hypnosis?

18. Legitimate Uses of Hypnosis Smoking cessation Weight loss Anxiety Child Birth Dentistry Major surgery ??? Pain management Therapists who use hypnosis to treat everything should be avoided

19. Does Hypnosis Enhance Memory In some cases memory is improved with hypnosis In some cases memory is distorted by hypnosis Confabulation may occur Do police and the courts use hypnosis?

20. What is hypnosis? Relaxation, focused attention. Subject is awake, not asleep. Hypnosis cannot make people do what they are unwilling to do. Posthypnotic suggestions work, but are weak, and wear off Most people can be hypnotized; some easily, some with difficulty