Substance Related

1
Substance Related

• Addictive Behavior
• Alcohol
• Opiates
• Cocaine and Amphetamines
• Barbiturates
• LSD and Related Drugs
• Marijuana
• Pathological Gambling
• Methadone?

2
Addictive Behavior

• Behavior based on the pathological need for
  substance or activity.
• May involve the abuse of substances such as-
• Nicotine
• Alcohol
• Cocaine

3
Addictive Behavior

• Substance abuse generally involves a pathological
  use of a substance resulting in
• Potentially hazardous behavior
• Continued use despite a persistent-
• Social
• Psychological
• Occupational
• Health problem

4
Alcohol

• Alcoholic
• Person with a serious drinking problem whose
  drinking impairs
• Health
• Personal relationships
• Occupational functioning
• Alcoholism
• Dependence on alcohol that seriously interferes
  with life adjustment.

5
Alcohol

• One in seven people meet the criteria for alcohol
  abuse.
• More than 37 of alcohol abusers suffer from at
  least one coexisting mental disorder.
• Alcohol abuse cuts across all
• Age
• Educational
• Occupational
• Socioeconomic boundaries

6
Alcohol

• Alcohol has complex and often contradictory
  effects on the brain
• At lower levels-
• Alcohol stimulates certain brain cells and
  activates the brains pleasure areas.
• At higher levels-
• Alcohol depresses brain functioning.

7
Alcohol

• Excessive drinking can be viewed as progressing
  from early- to middle- to late-stage alcohol
  abuse disorder
• For individuals who drink to excess, the clinical
  picture is highly unfavorable and may include
• Cirrhosis of the liver
• Malnutrition
• Stomach pains

8
Alcohol

• Psychosocial effects of alcohol abuse and
  dependence include
• Chronic fatigue
• Oversensitivity
• Depression
• Impaired reasoning
• Personality deterioration
• Several acute psychotic reactions fit the
  diagnostic classification of substance-induced
  disorders.

9
Alcohol

• Genetics probably play an important role in
  developing sensitivity to the addictive power of
  drugs like alcohol.
• Learning factors appear to play an important role
  in the development of substance abuse.

10
Alcohol

• Potential alcohol abusers tend to-
• Be emotionally immature.
• Expect a great deal of the world.
• Require an inordinate amount of praise and
  appreciation.
• React to failure with marked feelings of hurt and
  inferiority.
• Have low frustration tolerance.
• Feel inadequate and unsure of their abilities to
  fulfill expected male or female roles.

11
Alcohol

• Alcohol abusers also tend to be unable or
  unwilling to tolerate tension and stress.
• Many people expect that alcohol use will lower
  tension and anxiety and increase sexual desire
  and pleasure in life.
• Adults with less intimate and supportive
  relationships tend to show greater drinking
  following sadness or hostility.

12
Alcohol

• The incidence of alcoholism is minimal among
  Muslims and Mormons, whose religious views
  prohibit the use of alcohol.
• The incidence of alcoholism is high among
  Europeans (15 in France).

13
Alcohol

• Biological approaches include
• Medications to block the desire to drink
• Antabuse
• Naltrexone
• Medications to lower the side effects of acute
  withdrawal
• Valium
• Psychological treatment approaches include
• Group therapy
• Environmental intervention
• Behavior therapy

14
Alcohol

• Alcoholics Anonymous
• Success of alcoholism treatments range from low
  rates for hard-core substance abusers to rates of
  7090 where modern treatment procedures are used
• Project MATCH found equal success rates among the
  following treatments
• A 12-step program
• A CBT program
• Motivational enhancement therapy
• Relapse prevention programs attempt to maintain
  abstinence once the behavioral excesses have been
  checked

15
Opiates

• Narcotics include
• Opium
• Morphine
• Heroin
• These drugs were originally praised for their
  medical uses, but they are dangerously addictive

16
Opiates

• The immediate effects of narcotics include
• Alleviation of physical pain
• Relaxation and pleasant reverie
• Alleviation of anxiety and tension
• Euphoric spasm
• Long-term effects include
• Physiological craving for the drug
• Withdrawal symptoms
• Gradual deterioration of well-being

17
Opiates

• Some investigators have suspected that endorphins
  play a role
• A high incidence of antisocial personality has
  been found among heroin addicts
• In our country, addiction is associated with a
  narcotics subculture

18
Opiates

• Treatment
• Treatment for narcotics addiction is initially
  similar to that for alcohol addiction
• Methadone and buprenorphine are often used in
  conjunction with a rehabilitation program

19
Cocaine and Amphetamines

• Cocaine and amphetamines-
• Increase feelings of alertness and confidence
• Decrease feelings of fatigue
• Over the long-term, however, amphetamines-
• Are psychologically and physically addictive
• May result in brain damage and psychopathology

20
Barbiturates

• Barbiturates were once widely used to induce
  sleep
• They are dangerous drugs commonly associated with
• Physiological and psychological dependence
• Lethal overdoses
• Those who become dependent on barbiturates tend
  to be middle-aged people who rely on them as
  sleeping aids
• Withdrawal is a key issue in treatment

21
LSD and Related Drugs

• Hallucinogens cause an individual to see or hear
  things in different and unusual ways
• This category includes
• LSD
• Mescaline
• Psilocybin
• PCP
• Ecstasy

22
Marijuana

• Marijuana may be classified as a mild
  hallucinogen
• The effects of marijuana vary but may include
• Euphoria
• Hilarity
• Hyper-talkativeness
• Anxiety
• Depression
• Hallucination

23
Marijuana

• Marijuana is not strongly physiologically
  addictive, but it may be psychologically
  addictive for some people
• Psychological treatment methods have been shown
  to be effective in reducing use in dependent
  adults

24
Pathological Gambling

• Although pathological gambling does not involve a
  chemically addictive substance it is similar in
  the following ways
• The personality factors that tend to characterize
  addictive gamblers
• The difficulties attributable to compulsive
  gambling
• The treatment problems involved

25
Methadone

• Is the use of methadone effective, or does it
  simply exchange one addiction for another?