PSYC 316 Book Notes Chapter 10
PSYC 316 Book Notes Chapter 10 PSYC 316
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Date Created: 10/28/15
Chapter 10 Substance Use and Addictive Disorders Substance Use Disorders Maladaptive behavior and reaction patterns brought about by the repeated use of a substance This sometimes includes tolerance for the substance and Withdrawal reactions Tolerance adjustments that the brain and body make to the regular use of certain drugs so that larger doses are needed to achieve the earlier results Withdrawal Unpleasant and sometimes dangerous reactions that may occur When those Who regularly use a drug stop taking or reduce their dosage of the drug I Depressant Substances A Alcohol any beverage that contains ethyl alcohol includes beer Wine and liquor Ethyl Alcohol chemical that is quickly absorbed into the blood through the lining of the stomach and intestine It binds to neurotransmitters that normally receive GABA l which carries inhibitory messages a b C d 0 Ethyl Alcohol depresses brain areas that control judgment and inhibitions Motor dif culties increase and reaction times slow Extent of effect is determined by its concentration in the blood Alcohol Dehvdroeenz enzyme that breaks down alcohol in the stomach before it enters the blood 1 Women have less alcohol dehydrogenase than men Blood Alcohol Concentration l 006 relaxed and comfortable 2 009 intoxication 3 055 death Most of the consumed alcohol is metabolized by the liver into carbon dioxide and water 1 Average rate of metabolization 25 of an ounce per hour Over 1000 US individuals die each year from high blood alcohol levels Alcohol Use Disorder a Statistics 1 Around 14 of elementary school students admit to using alcohol 2 41 of high school seniors drink alcohol each month a 3 report drinking every day 3 In any given year alcoholism is present in 7 9 of white Americans African Americans and Hispanic Americans a White American and Hispanic American Men alcoholism rates are highest at over 18 during young adulthood b African American men rates are highest at around 18 during late middle age i 8 for white Americans and Hispanic americans during late middle age c American indians have the highest rates of alcohol use disorder 15 have the disorder d Asian Americans have lower rates of alcoholism at 3 b Surveys 1 74 of all US adults display alcohol use disorder alcoholism 2 Over 13 will display signs of alcoholism at some point in their lives 3 Menwomen 21 c Clinical Picture 1 Individuals with alcohol use disorder drink large amounts of alcohol to allow them to do things that would otherwise be unpleasant 2 Drinking eventually interferes with their social lives and their ability to think and work a arguments with familyfriends missing work losing jobs 3 Damage to brain regions and impairments in shortterm memory thinking speed attention skills and balance d Tolerance and WithdraLal 1 An individual builds a tolerance after drinking alcohol regularly a Need to drink more alcohol to eXperience the effects 2 Withdrawal symptoms after an individual stops drinking a Hands tongue and eyelids shake b Feeling weak and nauseated c Sweating and vomiting d Increased heart great and rising blood pressure e Anxiety depression insomnia or irritability 3 Delimium Tremens visual hallucinations that set in within three days after stopping or reducing their consumption of alcohol DTs usually subside in 23 days 4 Severe WithdraLal seizures loss of consciousness stroke or death 3 What is the Personal and Social Impact of Alcoholism a Alcoholism plays a role in over 13 of all suicides homicides assaults rapes and accidental deaths 30 of all fatal car accidents in the US 1 Intoxicated drivers are responsible for 12000 deaths per year 2 Over 30 million adults have driven while intoxicated at least once in the past year b Children 1 Children living in homes where alcoholism is present in parents are exposed to con ict and maybe sexual or other forms of abuse a These children have higher rates of psychological problems low self esteem poor communication skills poor sociability and marital problems c Physical Health 1 Cirrhosis of the Liver irreversible condition in which the liver becomes scarred and dysfunctional a Accounts for over 29000 deaths each year 2 Damage to the heart and lower the ability of the immune system to ght off cancer and bacterial infections and AIDS after infection 3 LongTerm Effects a Maj or Nutritional Problems chronic drinkers become malnourished weak and prone to disease b Vitamin and Mineral Deficiencies leads to Korsakoff s Syndrome i Korsakoff s Syndrome alcohol related disorder marked by extreme confusion memory impairment and other neurological symptoms 1 Confabulating filling in memory gaps with madeup events ii Fetal Alcohol Syndromelow birth weight irregularities in the head and face and intellectual de cits caused by the mother s excessive alcohol intake during her pregnancy 1 About 1 of every 1000 infants are born with FAS 2 Rate may increase to 29 of every 1000 infants of women with alcohol problems 3 Fetal Alcohol Effect counted alcoholrelated birth defects rate becomes 80200 FAS infants born for every 1000 heavydrinking women 4 10 of pregnant American women drank alcohol during the past month 5 44 of pregnant woman have had bingedrinking episodes B SedativeHypnotic Drugs also called anxiolytic drugs produce feelings of relaxation and drowsiness 3 b Low Doses calmingsedative Higher Doses sleep inducershypnotics 2 Barbiturates addictive sedativehypnotic drugs that reduce anxiety and help induce sleep a b C d 6 Several thousand deaths are caused by accidental or suicidal overdoses each year Low Doses reduce excitement by attaching to receptors that receive GABA the neurotransmitter that sends inhibitory messages Larger Doses intoxication Too High Levels stop breathing lower blood pressure may lead to comadeath Sedativeannotic Use Disorder due to repeated use 1 The individual spends most of the day intoxicated irritable and unable to work life is focused on the drug and find it impossible to calm down or sleep without them 2 Lethal dose remains the same regardless of the individual s tolerance to the drugs 3 Withdrawal convulsions 3 Benzodiazepines most common group of anxiety drugs includes Valium and Xanax 3 b C d Calming effect binding to receptors that receive GABA by increasing its activity in neurons Less likely to slow breathing therefore less likely to cause death from overdose Thought to be safer and more effective but high doses were found to cause intoxication and addiction Up to 1 of North American adults display SedativeHypnotic Use Disorders that center on benzodiazepines C Opioids reduced physical and emotional pain Opium highly addictive substance made from opium poppy sap Morphine highly addictive painrelieving substance derived from opium Soldier s Disease morphine misuse for wounded soldiers in the US during the civil war Heroin one of the most addictive substances derived from opium m spasm of warmth and ecstasy that follows injection HighNod several hours of a pleasant feeling that follows the rush Narcotics Synthetic Opioids Methadone Endorphins neurotransmitters that help relieve pain and reduce emotional tension sometimes called the body s own opioids l Opioid Use Disorder disorder may develop after an individual takes the drug repeatedly for only a few weeks a Interfering with social functioning their jobs lives center around using the drug b Tolerance for heroin and experience withdrawal when they stop taking it 1 m anxiety restlessness sweating rapid breathing 2 m twitching aches fever vomiting diarrhea loss of appetite high blood pressure and weight loss c Surveys 1 Around 1 of US adults display Opioid Use Disorder at some time in their lives 2 Rates dropped during 1980s 3 Rose in early 1990s 4 Fell in the late 1990s 5 Lately rates seem high again 6 Currently around 400000 people are estimated to be addicted to opioids 2 What Are the Dangers of Opioid Use a Overdose closes respiratory center in the brain almost paralyzing breathing and causing death 1 Particularly likely during sleep individual is unable to fight it off because they are not consciously working to breathe 2 Tolerance after an individual takes heroin after not having taken it for a while will sometimes take the same dose to which they had built up their tolerance before they quit Since their bodies have been without the drug they can no longer tolerate such a high dose This leads to death b Other Risks 1 Mixing Drugs heroin is often mixed with cheaper drugs or deadly substances cyanide or battery acid 2 Unsanitary using dirty needles other unsterilized equipment may lead to AIDS hepatitis C and skin abcesses a HIV infection rates among US heroin users 60 II Stimulant Substances l Stimulants increase the Central Nervous system activity a increased blood pressure and heart rate b higher alertness c faster behavior and thinking B Cocaine most powerful natural stimulant addictive drug derived from the coca plant 1 Statistics a Early 1960s 10000 estimated US individuals tried cocaine b Today 28 million people have tried it 1 16 million mainly teenagers or young adults are currently using it c 3 of all high school seniors have used cocaine within the past month 1 Almost 7 have used it within the past year 2 m Euphoria rush of wellbeing con dence High enough doses may produce an orgasmic effect First cocaine stimulates higher centers of the CNS producing excitement energy talkativeness and euphoria After more doses other centers of the CNS are stimulated faster pulse elevated blood pressure faster and deeper breathing further arousal and wakefulness a Cocaine increases the supply of dopamine at key neurons in the brain The excessive dopamine overstimulates the neurons and increases norepinephrine and serotonin activity in some brain areas 3 Cocaine Intoxication poor muscle coordination grandiosity bad judgement anger aggression compulsive behavior anxiety and confusion a Some experience hallucinations delusions or both 4 Crashing depressionlike letdown when the cocaine effects fade away a Headaches dizziness loss of consciousness 5 Ingesting Cocaine snorting less powerful effects than smoking or injection a FreeBasing pure cocaine basic alkaloid is chemically separated freed from the processed cocaine It is then vaporized by heat and inhaled through a pipe b m powerful form of freebase cocaine that has been boiled down into crystalline balls and smoked with a special pipe that makes a crackling sound 1 Lower cost c Statistics 1 Around 14 of high school seniors have used crack within the past ear a Same rate as 1993 b Lower rate in 1999 when the rate was 27 What Are the Dangers of Cocaine a Cocainerelated emergency room incidents in the US have multiplied over 100 times since 1982 1 4000 cases rose to 423000 b Cocaine has been linked to about 20 of all suicides by men under 61 years of age c Overdose respiratory center of the brain is rst stimulated then depressed to the point where breathing may cease all together Other Health Concerns 1 Maj orfatal heart irregularities 2 Brain seizures that suddenly stop breathing or heart functions 3 Pregnant women using cocaine risk miscarriage or giving birth to a child with d abnormalities in immune functioning attention and learning thyroid size and dopamine and serotonin activity C Amphetamines labmanufactured drugs amphetamine Benzedrine dextroamphetamine Dexedrine methamphetamine Methedrine 1 959 First used to treat asthma then became popular as a weight loss method source of extra energy or a way to stay awake to study Increase energy and alertness reduce appetite Small Doses rush intoxication High Doses psychosis emotional letdown as the effects subside Amphetamines stimulate the CNS by increasing the release of dopamine norepinephrine and serotonin in the brain 6 Methamphetamine crank powerful amphetamine that has increased in popularity in recent years This poses big problems for health law enforcement 3 b Stoveton Laboratiries in operation for a few days in remote areas frequently moving to new locations 1 Increased eightfold in number production and con scations by authorities since the 1960s Media Exposure 1 Dangers of methamphetamine were reported around 1989 and usage rates rose dramatically as well as emergency room visits related to methamphetamine Prevalence l 40 of current users are women 2 Popular among biker gangs rural Americans urban gay community Club Drug m 1 increases activity of dopamine serotonin and norepinephrine a increased arousal attention etc 2 Negative Effects a Physical mental and social life b Damage to nerve endings 3 Positive Effects perceptions by users a Hypersexuality b Lower inhibitions c Societal Issues i 13 of all HIVPositive men in Los Angeles in 2004 reported using methamphetamine ii Police agencies 58 reported that methamphetamine is the leading drug they battle today D Stimulant Use Disorder the result of regularly using cocaine or amphetamines l 2 The stimulant eventually dominates the user s life User may be affected by the drug for most of the day and have dysfunctional social relationships and related problems at work Regular Stimulant Use shortterm memory or attention Tolerance and Withdrawal Reactions a Higher doses needed to gain previous effects Quitting results in severe depression fatigue sleep problems irritability and anxiety Withdrawal lasts between weeks and months after the use has ended 05 of all individuals over 11 years in any given year display stimulant use disorder centered on cocaine 02 display stimulant use disorder centered on amphetamines III Hallucinogens Cannabis and Combinations of Substances A Hallucinogens also called psychedelic drugs substance that causes powerful changes in sensory perception including strengthening perceptions and producing illusions and hallucinations Hallucinogenic Drugs include LSD mescaline psilocybin and MDMA Ecstasy 1 Lysergic Acid Diethylamide LSD most famous and most powerful hallucinogen derived by Albert Hoffman in 1938 from naturally occurring ergot alkaloids 3 b d LSD causes a state of Hallucinogen Intoxication or Hallucinosis strengthening perceptions specifically visual along with psychological and physical changes and symptoms Hallucinosis hearing sounds more clearly tingling or numb sensation in limbs confusing sensations of hot and cold 1 Synesthesia crossing different senses a hearing or feeling colors m 1 Strong emotions joy anxiety depression 2 Slowed perception of time 3 Resurfacing longforgotten thoughts and feelings 4 Physical Symptoms a Sweating b Palpitations c Blurred vision d Tremors e Poor Coordination 5 Effects wear off after around 6 hours Mechanisms l LSD produces symptoms by binding to neurons that typically receive serotonin a Changes activity at these sites on neurons that help the brain convey visual information and control emotions 2 Statistics a Over 14 of all US individuals have used LSD or another hallucinogen at some point throughout their lives b Around 05 are currently using LSD 3 Dangers a LSD is powerful enough that any dose can produce signi cant perceptual emotional and behavioral reactions all of which can be extremely unpleasant bad trip b Lingering Effects i Some users can develop psychosis or a mood or anXiety disorder ii Some can have ashbacks of their eXperiences even after the effects of LSD have subsided B Cannabis Cannabis Sativa hemp plant Cannabis drugs produced from varieties of hemp Hashish most powerful form of cannabis Marijuana weaker but most wellknown form of cannabis Derived from buds crushed leaves and owering tops of hemp plants Tetrahydrocannabinol THC main active ingredient of cannabis 1 Effects 3 b Smoked hallucinogenic depressant and stimulant effects Low Doses 1 Joy 2 Relaxation 3 Becoming either quiet or talkative 4 Some become anXious suspicious or irritated Cannabis Intoxication the high 1 Sharpened perceptions and fascination with the intensified sounds and sights 2 Slowed perception of time 3 Disrupted perception or distance and size 4 Physical Changes a Red eyes b Increased heartbeat blood pressure and appetite c Dry mouth d Dizziness e Sometimes drowsiness 5 High Doses a Odd visual experiences b Changes in body image c Hallucinations d Confusion e Impulsive f Paranoia 6 Most effects last between 26 hours but the mood changes may last longer 2 Cannabis Use Disorder many people have been getting high regularly which affects their social occupational and academic lives a Tolerance and WithdraLal 1 Many regular users develop marijuana tolerance 2 Flulike symptoms restlessness and irritability after stopping for a while b Prevalence 1 Around 17 of all US individuals have displayed cannabis use disorder in the past year c Changes 1 Marijuana in the US is at least 4 times more powerful than what was available int the early 197 Os 2 THC content is now around 8 2 in the late 1960s 3 Is Mariiuana Dangerous a Dangers 1 Panic reactions similar to the effects of hallucinogens 2 Feeling that they are losing their minds feelings subside after 36 hours 3 Automobile Accidents marijuana interferes with compleX sensorimotor tasks and cognitive functioning 4 Shortterm memory loss general memory problems while high 5 Concentration problems trouble at school or work b Study 1 Blood ow in brain arteries of chronic marijuana users and nonusers 2 After 1 month without smoking marijuana the blood ow of light users and of moderate users had improved but not totally For heavy users blood ow did not improve c LongTerm Health Problems 1 May contribute to lung disease 2 Marijuana vs Tobacco a Studies show that smoking marijuana reduces the ability to expel air from the lungs more than smoking tobacco b Marijuana smoke contains more tar and benzopyrene than tobacco smoke c Both substances have links to cancer 3 Reproduction Issues a Lower sperm counts in men who regularly smoke marijuana b Abnormal ovulation in women who regularly smoke marijuana d Current Rates 1 Percentage of high school seniors who were daily marijuana smokers decreased from 11 1978 to 2 1992 2 Today 5 of high school seniors smoke marijuana daily 3 Around 50 of seniors do not believe that regular use can lead to dangerous outcomes C Cannabis and Society A Rocky Relationship 1 Cannabis was recommended as a surgical anesthetic and as a treatment for cholera malaria coughs insomnia and rheumatism Marijuana became a recreational drug its distribution became illegal and law enforcements have had a problem with it M a Researchers developed measuring and extraction methods and techniques for THC b Developed laboratory forms of THC c Cannabis as a treatment for glaucoma 1 Helpful in reducing nausea and vomiting in cancer patients in chemotherapy 2 Improve appetites of SIDS patients to combat weight loss 3 Medical Legalization of Marijuana w a US Supreme Court ruled 6 to 3 that medically ill people who smoke marijuana and those who help them grow or obtain marijuana can be prosecuted even if 1 they have a prescription 2 they live in states where marijuana use is legal 5 2009 a US Attorney General orders prosecutors not to pursue cases against individuals using medicinal marijuana or their caregivers who comply with state laws 6 20112012 a Several state governors and city majors petitioned the federal government to reclassify marijuana for medicinal purposes b Fought for the decriminalization for possession or use of marijuana c In 2012 Colorado and Washington voted to legalize any use of marijuana 7 Canada a Health Canada legally perm ids medicinal marijuana for individuals suffering from severe and debilitating illnesses b Allows sale of medical marijuana in some pharmacies c Canada is the second country in the world to do this After the Netherlands D Combinations of Substances 1 PolvSubstance Use using more than one drug at a time 2 Svnergistic Effect when multiple drugs are in the body at the same time they can multiply or intensify each other s effects effects are greater than the sum of each drug taken alone a When combined alcohol benzodiazepines barbiturates and opioids can severely depress the central nervous system This can lead to extreme intoxication coma or death 3 Opposite or Antagonistic Actions a Stimulants interfere with the liver s ability to dispose of barbiturates and alcohol 1 Individual may build up a toxic or lethal level of depressants in their systems 2 Students using amphetamines to study and then take barbiturates to fall asleep are taking a serious risk 4 Statistics a Up to 90 of individuals using one illegal drug are also using another IV What Causes Substance Use Disorders A Sociocultural Views 1 Theorists Beliefs 3 b Individuals are most likely to develop substance use disorders when they live under stressful socioeconomic conditions 1 Compared to wealthier people poorer people display higher rates of substance use disorders 2 In areas with high levels of unemployment there are higher rates of alcoholism 3 17 of unemployed adults are currently using illegal drugs a Compared to the 8 of individuals working fulltime and 115 of part time workers Substance use disorders are more likely to appear in families and social environments where substance use is valued or accepted 1 Research a Drinking problems are more common among teenagers whose parents and peers drink and among teenagers in stressfulunsupportive family environments b Jews and Protestants show lower rates of alcoholism i Religious standards values c Irish and Eastern Europeans show higher rates of alcoholism B Psychodynamic Views Theorists Beliefs 1 a b d People with substance use disorders have strong dependency needs that can be traced far back in their history When parents fail to nurture their child the child is likely to grow up with excessive dependence on others for help and comfort 1 Compensate for the lack of nurturance in their early years Certain individuals respond to their early deprivations by developing a substance abuse personality 1 Prone to drug abuse Individuals who develop substance use disorders tend to be more dependent antisocial impulsive noveltyseeking and depressive than others 1 Correlation does not mean causation 2 Wide range of personality traits have been tied to substance use disorders however researchers are unable to determine that any single personality trait or group of traits is to blame for developing these disorders C CoenitiveBehavioral Views Theorists Beliefs l a b Operant Conditioning when a drug produces rewarding effects temporary reduction of tension or raised spirits it increases the likelihood that the individual will use the drug again 1 These rewarding effects may lead to higher dosages or more powerful methods of ingestion 2 Rewards Cause Expectancy substances should bring rewards thus motivating individuals to use drugs in times of tension SelfMedication many people take drugs in times of stress 1 Higher rates are expected in those who suffer from anxiety and depression a Over 22 of adults suffering from psychological disorders have displayed substance use disorders in the past year Classical Conditioning objects present at the time drugs are taken may become classically conditioned stimuli and eventually produce similar pleasure that the drugs produce classical conditioning has not received widespread research support as a key factor in such disorders 1 Seeing a needle a friend with whom the person takes drugs or a supplier may produce calming feelings to addicts 2 Objects present during withdrawal produce withdrawallike symptoms 2 Studies 3 Individuals participated in an alcohol taste task b Participants who had been harassed drank more alcohol than the control participants who had not been criticized D Bioloqical Views 1 Genetic Predisnosition a Studies 1 Breeding experiments tested whether or not certain animals are genetically predisposed to drug addiction a Offspring of animals that prefer alcohol have a high preference for alcohol 2 Twin Studies a Monozygotic Twins if one identical twin was alcoholic the other twin was alcoholic in 54 of cases b Dizygotic Twins if one twin was alcoholic the other twin was alcoholic in only 28 of cases 3 Adoption a Individuals with biological parents who abused alcohol show higher rates of alcoholism than those with nonalcoholic biological parents 4 Genetic Linkage strategies and Molecular Biology techniques a Abnormal form of dopamine2 receptor gene is found in research participants with substance use disorder i less present gt20 in those without the disorder 2 Biochemical Factors a When a particular drug is ingested activity of certain neurotransmitters calmness pain relief elevated mood increased alertness is increased 1 When the drug intake increases the body decreases neurotransmitter production 2 Tolerance is built 3 Increased reliance 4 Withdrawal when they stop taking the drug b Reward Center pleasure pathway is eventually activated by drugs 1 Dopamine is a key neurotransmitter pleasure 2 Direct or indirect stimulation a After drugs repeatedly stimulate this reward center it develops a hypersensitivity to the drugs neurons fire more contributing to the drive to use the drug c RewardDe ciency Syndrome the brain s reward center is not readily activated by normal life so the individual uses drugs to stimulate the pleasure pathway usually in times of stress V How Are Substance Use Disorders Treated A Psychodynamic Therapies 1 Clients are guided to recognize and work through their underlying needs and con icts that may have led to the development of their substance use disorder a Not found to be particularly effective because the disorders develop into other problems that should be the main point in the treatment if the individual stops using drugs This approach is more helpful when combined with other treatment approaches B Behavioral Therapies 1 Aversion Theranv techniques based on classical conditioning a Pairing an unpleasant stimulus with taking a drug b After repetitive pairings client will hopefully react negatively to the drug and therefore be less driven to use it c Applied to alcoholism drinking paired with druginduced nausea and vomiting individual is required to imagine extremely upsetting ideas while drinking Contingency Management incentives presented for drugfree clean urine specimens a 68 of cocaine abusers achieved at least 8 clean weeks after completing a six month contingency program b Found to be effective in shortterm treatment Behavioral approaches as the only treatment has shown only limited success a Treatment is only effective when the individual is motivated to improve Behavioral approaches are more effective when combined with biological or cognitive approaches C CoenitiveBehavioral Therapies 1 Clients are guided to recognize and change their behaviors and thought processes that contribute to their substance abuse RelapsePrevention Training clients work towards gaining control over their substancerelated behaviors by a Identifying highrisk situations b Appreciating the decisions they confront in the highrisk situations c Changing their dysfunctional lifestyles d Learning from mistakes and lapses Strategies for Alcohol Use Disorder a Clients are instructed to keep track of their drinking behavior by documenting the times locations emotions bodily changes etc b Clients learn coping strategies when they confront the highrisk situations c Clients learn to plan ahead determining the appropriate amount of drinking what to drink and when it is appropriate d These strategies have showed to lower frequency of intoxication and binge drinking in some individuals D Biological Treatment 1 Detoxification systematic and medically supervised Withdrawal from a drug a One Approach clients Withdraw gradually by taking smaller and smaller doses until they do not take any amount b Second Annrom medically preferred clients are given other drugs that reduce the Withdrawal symptoms c Relapses tend to be high for those Who do not receive followup treatments after successful detoxi cation Antagonist Drugs drugs that block or change the effects of addictive drugs a Disul ram drug that induces intense nausea vomiting blushing increased heart rate dizziness and sometimes fainting When the individual drinks alcohol 1 Helpful only in those Who are motivated to take it as prescribed b OpioidCentered Substance Use Disorders 1 Narcotic Antagonists a Naloxone antagonists attach to receptor sites throughout the brain making it impossible for the opioids to produce their usual effects This makes taking the drug pointless b Dangerous antagonists can throw individuals into severe Withdrawal Drug Maintenance Therapy a Methadone Maintenance Program treating heroincentered substance use disorder clients are given legally and medically supervised doses of methadone 1 Addiction to methadone is maintained under medical supervision b Approaches seem effective but became less popular in the 1980s c Many clinicians believe that that substituting one addiction for another is not an acceptable solution d Many addicted individuals complained that methadone addiction created another drug problem e Methadone is harder to Withdraw from than heroin 1 Methadone Withdrawal symptoms last longer 0 Methadone maintenance programs are most effective When combined With education psychotherapy family therapy and employment counseling E Sociocultural Therapies 1 SelfHelp and Residential Treatment Pr02rams a Alcoholics Anonymous AA selfhelp organization that provides support and guidance With individuals With alcoholism abstinence rather than controlled drinking 1 Over 2 million members in 116000 AA groups across the US and 180 in other countries a AlAnon and Alateen offer support for individuals living With and caring for those With alcoholism 2 Narcotics Anonymous and Cocaine Anonymous developed for other substance use disorders b Residential Treatment Centers Therapeutic Communities formerly addicted people live work and socialize in a drugfree environment c Controlled drinking and abstinence can be useful depending on the nature of the drinking problem 1 Daytop Village 2 Phoenix House Culture and GenderSensitive Proqrams a Many individuals With substance use disorders live in poor and sometimes violent environments 1 Approaches are tailored to the speci c sociocultural issues of drug abusers Who are poor homeless members of minority groups etc b Women require different treatment methods than men 1 Different physical and psychological reactions to drugs Communitv Prevention Proqrams possibly the most effective approach a Around 77 of adolescents report seeing or hearing substance use prevention messages Within the past year 1 60 have discussed the dangers of alcohol and other drugs With their parents b Program Focuses 1 Individual educating the individual about the dangers of drugs 2 Family teaching parenting skills 3 Peer Group teaching resistance to peer pressure 4 School enforcement of drug policies 5 Community c TheTruthcom 1 Antismoking campaign aimed at young people d 6 Above the In uence l Conducted by the Office of National Drug Control Policy in the United States Surveys 1 8 of eighth graders who are familiar with the campaign eventually started using marijuana 2 12 of the students who never saw the ads eventually started using marijuana VI Other Addictive Disorders A Gambling Disorder persistent and recurrent gambling behavior leading to a variety of life problems B Internet Gaming Disorder Awaiting Official Status Internet Addiction persistent recurrent and excessive Internet activity particularly gaming 1 Symptoms are similar to tolerance and withdrawal from substance abuse disorders 3 b Preoccupation with gambling cannot walk away from a bet Repeated loss of money leads to more gambling to win the money back Gambling continues in the face of nancial social occupational educational and health problems More gambling in times of stress Lying to cover up extent of the gambling problem Need to gamble with more money to get the previous excitement Feeling restless or irritable upon attempting to resist and stop gambling Explanations for Gambling Disorders similar to those for substance use disorders 3 b C d inherit a genetic predisposition to the development of the disorder heightened dopamine activity and operation of the brain s reward center personality styles including impulsiveness and noveltyseeking make individuals more prone to gambling disorders repeated and cognitive mistakes such as inaccurate expectations and misinterpretations of emotions and bodily states Gamblers Anonvmous modeled after Alcoholics Anonymous Internet Gaming Disorder also called intemet use disorder intemet addiction and problematic intemet use a b At least 1 of people spend all or most of their time texting tweeting networking gaming browsing emailing blogging Visiting in Virtual words online shopping or Viewing online pornography Treatments 1 Psychotropic Drugs 2 CognitiveBehavioral Therapies 3 Support Groups admitting to the problem and exchanging ideas for how to reduce their use of the internet Recommended that Internet Gaming Disorder should receive further studies so that it may be included in further editions of the DSM
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