Substance Use Disorders (ps2008- week 8)

Substance Use Disorders

• Addiction is a complex interplay of physical, social, biological, and psychological factors.
• Substance use disorders are characterized by a chronic relapsing condition, involving unsuccessful attempts to control substance use, preoccupation with the substance, and unintentional overuse.
• This often leads to neglecting life activities.
• Psychoactive substances impact brain chemistry and perception. Individual responses vary significantly.

Psychoactive Substances

• Substances like alcohol, cannabis, hallucinogens, opioids, sedatives, and stimulants affect the brain.
• Different categories of psychoactive substances affect the brain in varied ways.
• Varying responses to substances exist due to individual sensitivities.

Neurotransmitter Systems

• The dopaminergic system (a subgroup of monoamines) is crucial in modulating and stimulating/inhibiting other neurotransmitters.
• Dopamine receptors and pathways are critical to various brain regions.
• The mesolimbic pathway is primarily implicated in addiction.
• Other monoamines like serotonin affect brain regions and functions differently according to receptor types and brain location.

Dopaminergic System and Addiction

• Dopamine imbalances in the brain, particularly in areas like the nucleus accumbens and ventral tegmentum, are central to addiction.
• Treating Parkinson's disease can incidentally cause symptoms of schizophrenia, suggesting overlapping neurotransmitter pathways.
• Treatment strategies may have unintended consequences in other neurotransmitter systems.
• Treatment of one condition/pathway can impact others.

Serotonin and Addiction

• Serotonin system activation in certain brain regions can result in hallucinations.
• LSD and similar substances affect serotonin pathways.

DSM Criteria for Substance Use Disorders

• DSM criteria define significant impairment or distress in multiple areas including substance use patterns, amount, frequency, and consequences, for at least two criteria in the past 12 months, to meet a diagnosis.

Epidemiology of Drug Use

• Drug use varies by age, sex, and ethnicity.
• The prevalence of illicit drug use shows a variation across age groups, with certain age groups having lower usage frequencies compared to others.

Family and Socio-Cultural Factors

• Chaotic family environments, insufficient parental support, and lack of clear boundaries contribute to risk factors.
• Strong family bonds & clear rules positively influence the likelihood of substance abuse.
• Increased addiction is linked to adverse childhood experiences.
• Environmental and socio-cultural exposures influence adolescent substance use behaviors.
• Drug use impacts various socio-economic levels.

Treatment Approaches

• Holistic treatment like the "Power Threat Meaning" framework acknowledges personal narratives.
• Combining CBT with Contingency Management (CM) may be more effective in treating single-substance addictions compared to other methods.
• Compassion-Focused Therapy, combined with the Power Threat Meaning Framework, helps understand substance use by focusing on the DRIVE, THREAT, and SOOTHING response centers.