Substance-Use Disorders (PS2008 Week 8) PDF

[Substance-use Disorders] **Addiction** is a complex mix of **physical, social, biological and psychological dependency** factors. Substance-use disorders are often associated with **chronic relapsing condition**. This is the **unsuccessful control** of taking/withdrawing from the drug, **preoccup...

[Substance-use Disorders] **Addiction** is a complex mix of **physical, social, biological and psychological dependency** factors. Substance-use disorders are often associated with **chronic relapsing condition**. This is the **unsuccessful control** of taking/withdrawing from the drug, **preoccupation** with the substance, **unintentional overuse**. When the addiction become **overwhelming**, people often **neglect life activities** in favor of the substance. [Psychoactive substances:] These substances have an **impact** on your **brain chemistry and perceptual mechanisms**. Different people have different experiences to certain drugs. People also have different sensitivities to these substances (caffeine). altered perceptions = hallucinogenic this distorts perceptions there is an overlap between medicinal and recreational use of drugs like morphine anxiolytics reduces anxiety affecting GABA system a lot of research on many of these for microdosing. [Neurotransmitter systems:]  A yellow and black text Description automatically generated The **dopaminergic system** is **catecholamine** (subsection of monoamines), these NTs work in tandem, modulating and **stimulating/inhibiting** each other. Within dopamine there is a range of **receptors** that give rise to certain effects and **pathways** that connect to different regions of the brain. The **mesolimbic** pathway is the most implicated in terms of addiction. **Treatment for one pathway, increases the dopamine in both** of them. This suggests that treating Parkinson's disease may lead to **induced symptoms** of SZ (vice-versa). Areas like the **Nucleus accumbens and ventral tegmentum** are the most impacted by the addiction. Another monoamine is **serotonin**. The effect of serotonin depends on the type of receptor, its location, and in which area of the brain. If there is a**ctivation in the medial temporal lobe of serotonergic receptors or the default mode network or posterior cingulate cortex**, **hallucinations** are induced. This effect also occurs after **taking LSD & MDMA**, along with an **altered sense of perception and** **connection** due to the impact on the **limbic system**. Due to the connection between serotonin and the limbic system, regular drug users find their **mood becomes dysregulated** (experience **depression or anxiety through NT dysregulation**). It may impact libido, decision making, executive function or even the **dopaminergic pathways, giving rise to the addiction**.  A graph of blue and red bars Description automatically generated The **DSM** criteria suggests the individual must report s**ignificant impairment or distress in 2 or more** of the following, for the **last 12 months**: **larger amounts/longer use than intended** (impaired decision making), **unsuccessful effort to cut down/**control, great deal of **time spent obtaining/using/recovering**, experience of **craving**, **recurrent use leading to failure to fulfill roles** in life, r**ecurrent use despite persistent interpersonal issues,** important activities **neglected**, **risky** use, **using** **despite awareness** it increases problems, **tolerance** (**less sensitive**), **failed withdrawal** (number of **attempts**).  can be explained as a **coping** technique or form of **self-medication**. [Epidemiology of drugs:] In the age group between **16-59**, **1 in 12** used an **elicit drug** in the **last year**. **6-7**% used **cannabis**, **2-3**% using **cocaine** and **1-2**% **ecstasy**. The incidence in **males**, for all of these drugs, **outweighs** the incidence for females. Male teenagers are **more likely to have dependency** (4.3%) compared to females (1.9%). Since **1996**, drug use in younger age groups has **declined**. Also, drug use is **less frequent** for younger age groups. [Epidemiology of alcohol:] A close-up of some words Description automatically generated **Males** were more likely to use alcohol, in every age and ethnicity group. The highest percentage was from **white males, aged 16-40**. There is a particular **decline** of alcohol use **after the age of 45**.  One **wholistic** method of treatment is the **Power Threat Meaning framework**. This is designed by **Johnson & Boyle** (2018) to highlight the patients **personal narrative**. these factors affect the likelihood someone experiences trauma or adverse effects and on to develop an addition OR stands for odds ratio (probability) Regarding **family factors**: a **chaotic** environment with **ineffective parenting** and a **lack of attachments** are the **risk** factors to developing addiction. Whereas **protective factors** include **strong bonds**, clear **rules of acceptable conduct** and **involvement** in their child's life.  **Adolescence** is a **vulnerable age** that sees an **increase** in smoking, drugs and alcohol consumption. As the brain is **still developing**, it is **more susceptible** to substance use or changes in behaviour. elements that drive substance abuse in teenagers [Socio-cultural factors:]  drug use is prevalent in both socio-economic extremes. A green brain with black text Description automatically generated with medium confidence [Behavioural theories:] **Positive reinforcement** come from **socialization** through others **enjoyment** and **negative reinforcement** come from **withdrawal symptoms** when attempting to stop. **Classical conditioning** states **internal and external cues can elicit cravings**.  [Gateway hypothesis:] Suggests the **1^st^ drug of use is a pathway to more serious drugs** (cannabis leads to heroin). However, this is **a non-linear development** as many heroin users use cannabis but not all cannabis users use heroin. how dopamine and serotonin is broken down in the body  A page of a paper Description automatically generated Combination therapy of CBT and Contingency management is more effecttive for those with an addiction to 1 substance.  **Compassion Focused Therapy combined with the Power Threat Meaning Framework can be helpful** to understand substance abuse. It suggests that **we have 3 centers driven by NTs: DRIVE system (motivation and reward seeking), THREAT (threat detection), SOOTHING (affiliating).** DRIVE system is triggered by threat to self/identity or ability to function. To achieve long term success, SOOTHING center must be stimulated to activate social support. A close-up of a text Description automatically generated