Substance-Related, Addictive, and Impulse-Control Disorders PDF

10/21/2024 Substance-Related, Addictive, and Impulse-Control Disorders Keisha Charisse O. Digon //kcodigon2024 Chapter Outline Perspectives on Substan...

10/21/2024 Substance-Related, Addictive, and Impulse-Control Disorders Keisha Charisse O. Digon //kcodigon2024 Chapter Outline Perspectives on Substance - Related and Addictive Disorders Depressants Stimulants Opioids Cannabis-Related Disorders Hallucinogen-Related Disorders Other Drugs of Abuse Gambling Disorder Impulse-Control Disorders //kcodigon2024 1  10/21/2024 The Case of Danny At the age of 43, Danny was in jail, awaiting trial on vehicular manslaughter charges stemming from a DWI accident that left one woman dead. Danny’s story illustrates the lifelong pattern that characterizes the behavior of many people who are affected by substance-related disorders. Danny grew up in the suburban United States, the youngest of three children. He was well liked in school and an average student. Like many of his friends, he smoked cigarettes in his early teens and drank beer with his friends at night behind his high school. Unlike most of his friends, however, Danny almost always drank until he was obviously drunk; he also experimented with many other drugs, including cocaine, heroin, “speed” (amphetamines), and “downers” (barbiturates). After high school, Danny attended a local community college for one semester, but he dropped out after failing most of his courses. His dismal performance in school seemed to be related to his missing most classes rather than to an inability to learn and understand the material. He had difficulty getting up for classes after partying most of the night, which he did with increasing frequency. His moods were highly variable, and he was often unpleasant. Danny’sfamily knew he occasionally drank too much, but they didn’t know (or didn’t want to know) about his other drug use. He had for years forbidden anyone to go into his room after his mother found little packets of white powder (probably cocaine) in his sock drawer. //kcodigon2024 He said he was keeping them for a friend and that he would return them immediately. He was furious that his family might suspect him of using drugs. Money was sometimes missing from the house, and once some stereo equipment “disappeared,” but if his family members suspected Danny they never admitted it. Danny held a series of low-paying jobs, and when he was working his family reassured themselves that he was back on track and things would be fi ne. Unfortunately, he rarely held a job for more than a few months. The money he earned had a magical way of turning into drugs, and he was usually fi red for poor job attendance and performance. Because he continued to live at home, Danny could survive despite frequent periods of unemployment. When he was in his late 20s, Danny seemed to have a personal revelation. He announced that he needed help and planned to check into an alcohol rehabilitation center; he still would not admit to using other drugs. His family’s joy and relief were overwhelming, and no one questioned his request for several thousand dollars to help pay for the private program he said he wanted to attend. Danny disappeared for several weeks, presumably because he was in the rehabilitation program. However, a call from the local police station put an end to this fantasy: Danny had been found quite high, living in an abandoned building. As with many of these incidents, we never learned all the details, but it appears that Danny spent his family’s money on drugs and had a 3-week binge with some friends. //kcodigon2024 2  10/21/2024 Danny’s deceptiveness and fi nancial irresponsibility greatly strained his relationship with his family. He was allowed to continue living at home, but his parents and siblings excluded him from their emotional lives. Danny seemed to straighten out, and he held a job at a gas station for almost 2 years. He became friendly with the station owner and his son, and he often went hunting with them during the season. However, without any obvious warning, Danny resumed drinking and using drugs and was arrested for robbing the very place that had kept him employed for many months. Although he received probation for that offense upon promising to attend drug treatment, his pattern continued. Years later while driving under the influence of multiple substances, he hit another car and the 28-year-old driver of that car was killed. Why did Danny become dependent on drugs when many of his friends and siblings did not? Why did he steal from his family and friends? What ultimately became of him? We return to Danny’s frustrating story later when we look at the causes and treatment of substance-related disorders. //kcodigon2024 Can you use drugs and not abuse them? Can you abuse drugs and not become addicted to them? //kcodigon2024 3  10/21/2024 //kcodigon2024 Substance Refers to chemical compounds that are ingested to alter mood or behavior. //kcodigon2024 4  10/21/2024 Psychoactive Substances Alter mood, behavior, or both You might first think of drugs such as cocaine and heroin but this definition also includes more commonplace legal drugs like alcohol, nicotine found in tobacco, the caffeine in coffee, softdrinks, and chocolate The so - called “safe drugs” also affect m o o d a n d b e h a v i o r, t h e y c a n b e addictive, and they account for more health problems and a greater mortality rate than all illegal drugs combined //kcodigon2024 Substance Use Ingestion of psychoactive substances in moderate amounts that does not significantly interfere with social, education, or occupational functioning Example: Drinking a cup of coffee in the morning to wake up or smoking a cigarette and having a drink with a friend to relax //kcodigon2024 5  10/21/2024 Substance Intoxication Our physiological reaction to ingested substances (drunkenness or getting high) May manifest: impaired judgment, mood changes, and lowered motor ability (problems with walking or talking) //kcodigon2024 How do we define SUBSTANCE ABUSE? How much of a substance should be ingested for it to be considered as problematic? Is drinking two glasses of wine in an hour abuse? Three glasses? Six? Is taking one injection of heroin considered abuse? //kcodigon2024 6  10/21/2024 Substance Abuse DSM 5 defines substance abuse in terms of how significantly it interferes with the user’s life If substances disrupt your education, job or relationships with others, and put you in physica lly dangerous si tuati ons (example while driving), you would be considered a “drug abuser” //kcodigon2024 Who are coffee lovers here? How many of you have experience headaches when you didn’t get your morning coffee? You were probably going through CAFFEINE WITHDRAWAL //kcodigon2024 7  10/21/2024 Substance Dependence Usually described as “addiction” In o ne d ef i ni ti on , t h e pe rs o n i s physiologically dependent on the drug or drugs, requires increasingly greater amounts of the drug to experience the same effect (tolerance), and will respond physically in a negative way when the substance is no longer ingested (withdrawal) //kcodigon2024 Six General Categories Depressants behavioral sedation; relaxation Stimulants active; alert; elavate mood Opiates reduce pain; euphoria Hallucinogens alter sensory perception (produce delusions, paranoia, hallucinations) Other Drugs of Abuse inhalants, steroids, otc and prescription drugs Gambling Disorder unable to resist the urge to gamble (results in negative consequences) //kcodigon2024 8  10/21/2024 Depressants Depressants primarily decrease central nervous system (CNS) activity, reducing physiological arousal and promoting relaxation. Common depressants include alcohol and various sedative, hypnotic, and anxiolytic drugs. These substances often lead to physical dependence, tolerance, and withdrawal symptoms. //kcodigon2024 //kcodigon2024 9  10/21/2024 //kcodigon2024 Stimulants Makes you more alert and energetic Of all the psychoactive drugs used in the US, the most commonly consumed are stimulants. Included in this group are caffeine (in coffee, chocolate, and many softdrinks), nicotine (in tobacco products such as cigarettes), amphetamines, and cocaine //kcodigon2024 10  10/21/2024 //kcodigon2024 //kcodigon2024 11  10/21/2024 //kcodigon2024 Opioids The word opiate refers to the natural chemicals in the opium poopy that have a narcotic effect (they relieve pain and induce sleep) The broader term opioids refer to the family of substances that include natural opiates, synthetic variations (heroin, methadone, hydrocodone, oxycodone), and the comparable substances that occur naturally in the brain (enkephalins, beta-endorphins, and dynorphins) //kcodigon2024 12  10/21/2024 //kcodigon2024 Cannabis (Marijuana) Marijuana is the name given to the dried parts of the cannabis or hemp plant Cannabis grows wild throughout the tropical and temperate regions of the world, which accounts for one of its nicknames, “weed” //kcodigon2024 13  10/21/2024 //kcodigon2024 Hallucinogen - Related LSD (d-lyservic acid diethylamide), sometimes referred to as “acid” is the most common hallucinogenic drug produced synthetically in laboratories, although naturally occuring derivatives of this grain fungus (ergot) have been found historically //kcodigon2024 14  10/21/2024 //kcodigon2024 Other Drugs of Abuse Inhalants, steroids, and a group of drugs commonly referred to as “designer drugs” Inhalants are volatile substances commonly abused by adolescents, producing short-term euphoria but posing severe risks like sudden death and long-term neurological damage. Anabolic-androgenic steroids are synthetic variants of te sto steron e us ed to e n h a n ce m u sc l e m a ss a nd performance, but their misuse can lead to severe physical and psychological consequences, including aggression and organ damage. Designer drugs, such as synthetic cannabinoids and MDMA, are chemically engineered to mimic illegal substances and often cause dangerous effects like hallucinations, paranoia, and severe physical health risks. //kcodigon2024 15  10/21/2024 //kcodigon2024 //kcodigon2024 16  10/21/2024 //kcodigon2024 17