Chapter 12 Book Notes
Chapter 12 Book Notes psy 240
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This 11 page Class Notes was uploaded by Alicia Rinaldi on Tuesday September 8, 2015. The Class Notes belongs to psy 240 at University of Miami taught by Dr. Parlade in Fall 2014. Since its upload, it has received 41 views. For similar materials see abnormal psychology in Psychlogy at University of Miami.
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Chapter 12 Substance Use and Addictive Disorders Preface A B C F Misuse of drugs costs society 600 billion and numbers of people who use them are on the rise Drug is any substance other than food that affects our bodies or minds Substance use disorder pattern of maladaptive behaviors and reactions brought about by repeated use of a substance sometimes also including tolerance for the substance and withdrawal reaction Tolerance the adjustment that the brain and body make to the regular use of certain drugs so that ever larger doses are needed to achieve the earlier effects Withdrawal unpleasant sometimes dangerous reactions that may occur when people who use a drug regularly stop taking or reduce their dosage of the drug 89 of teens amp adults have substance use disorders highest in American Indians lowest in Asian Americans Depressants A Alcohol 1 Preface a Alcohol any beverage containing ethyl alcohol including beer wine and liquor b 2 billion people worldwide consume alcohol c bingedrinking 5 drinks on a single occasion d males outnumber females 21 on heavy drinking e ethyl alcohol is absorbed into bloodstream slows down functioning by binding to neurons including GABA f if you re really in college at UMiami you should know the effects of alcohol g extent of alcohol in blood is determined by concentration in blood i 06 relaxed and comfortable ii 09 intoxication iii 55 death iv alcohol later is metabolized or broken down in blood h women have less of stomach enzyme alcohol dehydrogenase that breaks down alcohol get drunk more easily 2 Alcohol Use Disorder a Preface i 74 of adults in USA display alcohol use disorder men outnumber women 21 ii American Indians have highest rate of alcohol use disorder b Clinical Picture i People rely on alcohol to enable them to do things that would make them anxious ii Drinking interferes with social behavior and ability to think and work iii People show different patterns of drinking problems c Tolerance and Withdrawal i Needing to drink more to feel the same effects and experiencing side effects when you stop drinking ii Delirium tremens DTs a dramatic withdrawal reaction experienced by some people who are alcoholdependent It consists of confusion clouded consciousness and terrifying visual hallucinations 3 What is the Personal and Social Impact of Alcoholism a Destroys families relationships amp careers involved in more than 13 of all suicides homicides assaults rapes and accidental deaths b Children with alcoholic parents have higher rates of psychological problems c MedicalNutritional problems i Cirrhosis the liver becomes scarred and dysfunctional ii Damaged heart weakened immune system iii Malnourishment amp weakness iv Korsakoff s syndrome an alcoholrelated disorder marked by extreme confusion memory impairment and other neurological symptoms d Fetal alcohol syndrome a cluster of problems in a child including low birth weight irregularities in the head and face and intellectual de cits caused by excessive alcohol intake by the mother during pregnancy B SedativeHypnotic Drugs 1 Sedativehypnotic anxiolytic drug a drug used in low doses to reduce anxiety and in higher doses to help people sleep 2 Barbiturates a b c d e f Barbiturates addictive sedativehypnotic drugs that reduce anxiety and help produce sleep Several thousand deathsyear overdoses Attach to GABA receptors and help GABA operate neurons Broken down in liver People build a tolerance which makes it easier to overdose Withdrawal symptoms do exist including convulsions 3 Benzodiazepines a C Opioids Benzodiazepines the most common group of antianxiety drubs which includes valium and Xanax Calm people by binding onto neurons that receive GABA and increasing GABA s activity Don t make people drowsy or slow breathing as much Doctors didn t immediately realize that these drugs can be addictive and cause intoxication 1 Preface a Opioids opium or any of the drugs derived from opium including morphine heroin and codeine Opium a highly addictive substance made from the sap of the opium poppy i Used to be used to treat medical disorders Morphine a highly addictive substance derived from opium that is particularly effective in relieving pain i Worked better than opium amp was used on soldiers Heroin one of the most addictive substances derived from opium Methadone is an example of a synthetic opioid All opioid drugs natural and synthetic are called narcotics Most common method is injection feel a rush then high Depress the nervous system i Attach to brain receptor sites that usually receive endorphins neurotransmitters that help relieve pain and reduce emotional tension quotnatural opioidsquot 2 Opioid Use Disorder a b C Developed after just a few weeks Withdrawal symptoms anxiety restlessness sweating twitching fever vomiting loss of appetite weight loss Some users must keep taking more heroin to avoid going into withdrawal 3 What Are the Dangers of Opioid Use a b c Overdose usually causes death i Resuming with same dose after stopping for a while is lethal Sometimes mixed with cyanide or battery acid Risks associated with sharing needles Stimulants increase activity of the nervous system increased blood pressure amp heart rate greater alertness spedup behavior and thinking A Cocaine 1 Preface a g Cocaine an addictive stimulant obtained from the coca plant It is the most powerful natural stimulant known Most often snorted but can also be injected or smoked Numbers using it are on the rise mostly teensyoung adults Euphoric rush of wellbeing and con dence Stimulates central nervous system faster pulse higher blood pressure faster breathing Increased supply of dopamine and increased norepinephrine and serotonin activity Users experience crashing when coming down 2 Ingesting cocaine a b Freebase a technique for ingesting cocaine in which the pure cocaine basic akaoid is chemically separated from processed cocaine vaporized by heat from a ame and inhaled with a pipe Crack a powerful readytosmoke freebase cocaine sold at a lower cost than cocaine 3 What are the Dangers of Cocaine a Overdose linked to suicides b Can create majorfatal heart irregularities or brains seizures c Pregnant users may have miscarriage or children with abnormalities B Amphetamine 1 Amphetamine stimulant drug that is manufactured in the laboratory 2 Became popular in the 39305 before doctors knew they were so dangerous 3 Like cocaine a lncrease energy amp alertness in small doses b Produces rush amp intoxication in high doses c Stimulates central nervous system dopamine norepinephrine serotonin 4 Methamphetamine meth a powerful amphetamine drug that has experienced a surge in popularity in recent years posing major health and law enforcement problems a Meth labs operate for a few days before moving somewhere else 5 As likely to be used by women and men a Neurotoxicity damages nerve endings C Stimulant Use Disorder 1 Causes problems in shortterm memory or attention 2 Tolerance amp withdrawal is also an issue D Caffeine 1 Caffeine the world s most widely used stimulant most often consumed in coffee 2 Promotes release of serotonin dopamine and norepinephrine 3 Caffeine intoxication includes restlessness nervousness anxiety stomach disturbances twitching increased heart rate 4 High doses of caffeine correlate with heart rhythm irregularities high cholesterol heart attacks miscarriages IV Hallucinogens Cannabis and Combinations of Substances A Hallucinogens 1 De nition a substance that causes powerful changes primarily in sensory perception including strengthening perceptions and producing illusions and hallucinations aka psychedelic drug a Include LSD mescaline psilocybin MDMA ecstasy 2 LSD lysergic acid diethylamide a hallucinogenic drug derived from ergot alkaloids a Within 2 hours brings on state of hallucinogen intoxication marked by general strengthening of perceptions along with psychological changes and physical symptoms 3 Hallucinating is seeing people objects or forms that are not actually present 4 Many people mix up sensations confusing the difference btw hot amp cold and crossing senses quothearing colorsquot 5 Can induce strong emotions and physical symptoms such as sweating palpitations blurred vision tremors poor coordination Binds to neurons that normally receive serotonin People don t usually develop tolerance or have withdrawal 8 Some problems a Extremely unpleasant reaction quotbad tripquot b Some users develop mood or anxiety disorder c Flashbacks recurrence of the sensory and emotional changes after the LSD has left the body lm B Cannabis 1 Preface a Cannabis drugs drugs produced from the varieties of the hemp plane cannabis sativa They cause a mixture of hallucinogenic depressant and stimulant effects b Marijuana mary jane in the brain one of the cannabis drugs derived from buds leaves and owering tops of the hemp plant cannabis sativa c Tetrahydrocannabinol THC the main active ingredient of cannabis substances d Smoker typically has feelings of joy and relaxation but some become anxious or irritated e Cannabis intoxication the overall high felt from weed 2 Cannabis Use Disorder a becoming more prevalent esp in younger people because TCH content is becoming higher b Strongest when grown in a hot dry climate c 45 of people will have this 17 have this 3 Is Marijuana Dangerous No a Can cause panic reactions similar to hallucinogens and fear of quotlosing mindquot b Causes car accidents c Affects short term memory so can affect someone at school or work d Higher blood ow to the brain could be reason for memory impairment e Reduces ability to expel air from lungs f Contains tar amp benzopyrene which have been linked to cancer g Effects on reproduction h Education has worked somewhat but 5 of hs seniors use it daily and 50 don t believe there s a risk 4 Cannabis and Society A Rocky Relationship a Was originally used as an anesthetic or medicine then gradually became more popular as recreational drug b Many groups campaigned for medical legalization of marijuana because it works faster than legal THC capsules c Supreme court ruled against it but some states are for it complicated blurred lines C Combination of Substances 1 Polysubstance use is taking more than one drug at a time 2 Crosstolerance tolerance for a substance one has not taken before as a result of using another substance similar to it a Alcohol and antianxiety drugs 3 Synergistic effect in pharmacology an increase of effects that occurs when more than one substance is acting on the body at the same time a Combining two depressant drugs 4 Some combinations of drugs have oppositeantagonistic actions a Coke and alcohol coke blocks liver from absorbing alcohol b Causes many deaths each year c Drugs could be mixed purposely or the person might not realize what they re doing ex drinking then taking sleeping pills to go to sleep V What Causes Substance Use Disorders A Sociocultural Views 1 People are most likely to develop substance use disorders when they live under stressful socioeconomic conditions 2 Problems more common among teenagers whose parents and peers drink or with unsupportive environments B Psychodynamic Views 1 People with substance use disorders have dependency needs that can be traced to their early years parents failed to satisfy need for nurturance Some develop a substance abuse personality People who abuse drugs tend to be more dependent antisocial impulsive depressive and noveltyseeking but not one trait sticks out C CognitiveBehavioral Views 1 Operant conditioning plays a role in substance use disorder because doing the drug has a rewarding effect a May lead people to try higher dosages or more powerful ingestion methods b Expectancies motivate individuals to increase drug use they seek it in times of stress 2 Classical conditioning plays a role because cues or objects in the environment when the drug is taken may bring the same pleasure as the drug D Biological Views 1 Genetic Predisposition a Animal tests adoption studies amp twin studies con rm genetic predisposition b Genetic linkage strategies amp molecular biology techniques provide more direct evidence i Dopamine2 receptor gene linked to disorder 2 Biochemical Factors a When someone takes too much of a drug that increases neurotransmitter activity the brain will reduce its natural levels so the person will need the drug to have normal levels again i Withdrawal is the low levels being restored to higher levels b Alcohol or banzodiazepines lower GABA opioids lower endorphins coke or amphetamines lower dopamine thc lowers anandamide c Drugs activate a reward center a dopamine rich pathway in the brain that produces JUN feelings of pleasure when activated dopamine but so do other positive things d Rewardde ciency syndrome a condition suspected to be present in some individuals in which the brain s reward center is not readily activated by the usual events in their life i People with this return to drugs Vl How Are Substance Use Disorders Treated A Psychodynamic Therapies 1 Working through the underlying con icts that cause the disorder 2 Not very effective because the disorder itself is often the prob B Behavioral Therapies 1 Aversion therapy a treatment in which clients are repeatedly presented with unpleasant stimuli while performing undesirable behaviors such as taking a drug 2 Contingency management rewards people for remaining drug free C CognitiveBehavioral Therapies 1 Identifying and changing the behaviors and cognitions that contribute to their disorder 2 Relapseprevention training a cognitivebehavioral approach to treating alcohol use disorder in which clients are taught to keep track of their drinking behavior apply coping strategies in situations that typically trigger excessive drinking and plan ahead for risky situations and reactions 3 Strategies in relapseprevention training a Therapists have clients keep track of their drinking behavior b Therapists teach clients coping strategies to use when such situations arise c Therapists teach clients to pan ahead of time D Biological Treatments best when combined with other approaches 1 Detoxi cation a De nition systematic and medically supervised withdrawal from a drug b One approach take smaller and smaller amounts of the drug until you re off it completely c 2nCI approach give clients other drugs that reduce withdrawal symptoms 2 Antagonist Drugs a De nition drugs that block or change the effects of an addictive drug b Ex people who drink alcohol take medicine so that only one drink will make them sick c Narcotic antagonists block effects of opioids d Partial antagonists produce less severe withdrawal 3 Drug Maintenance Therapy a Methadone maintenance program an approach to treating heroincentered substance use disorder in which clients are given legally and medically supervised doses of a substitute drug methadone b Effective until people realized the dangers of methadone itself E Sociocultural Therapies 1 SelfHelp and Residential Treatment Programs a Many people form groups to help each other without professional help b Alcoholics anonymous AA a selfhelp organization that provides support and guidance for persons with alcohol use disorder c AA is shown to help but researchers argue whether total abstinence or controlled drinking is better d Residential treatment centertherapeutic community a place where people formerly addicted to drugs live work and socialize in a drugfree environment 2 Culture and GenderSensitive Programs a Treatment programs are sensitive to special sociocultural pressures and problems b Men and women often require different treatment methods 3 Community Prevention Program a Prevention efforts are in schools workplaces activity centers and other community settings b May focus on the individual family peer group school or community c Truth and above the in uence are two programs Vll Other Addictive Disorders A Gambling Disorder 1 De nition a disorder marked by persistent and recurrent gambling behavior leading to a range of life problems JUN 23 of adults and 38 of teenscollege students de ned more by the addictive nature of the behavior than actual money lost or gained repeated losses of money lead to more gambling to win it back people with gambling disorders may a inherit genetic predisposition to develop the disorder b experience heightened dopamine activity and operation of the brain s reward center c have impulsive noveltyseeking and other personality styles d make repeated and cognitive mistakes treatments a relapse prevention training b narcotic antagonists c Gamblers Anonymous B Internet Use Gaming Disorder Awaiting Of cial Status 1 JUN Internet use gaming disorder A disorder marked by persistent recurrent and excessive internet activity particularly gaming Recommended for further study by DSM5 a Aka internet addiction internet use disorder problematic internet use b Narrowed to emphasize excessive gaming 1 of all people involves spending all or most of their waking hours somehow connected to the internet through gaming browsing texting shopping etc