10 10 2013 Just How Severe is the Problem Substance use low to moderate use of a substance that does not impair functioning Substance intoxication acute effects of substance use Substance abuse disorder 2 separate diagnosis o Alcohol abuse do you use alcohol obsessively and have a lot of experiences Drunk driving putting your self into danger o Alcohol dependence need for the substance withdrawal high tolerance avoid recovering from the substance o DSM just linked them together to make SAD Caffeine is the most widely used and socially accepted drug Fact Death by cigarettes cigars pipes and smokeless tobacco fact Caffeine is a stimulant Anxiety can be a side affect Benefits at very low levels Can t meet for an abuse disorder with caffeine but can have intoxication and withdrawal Can cause death in extreme cases Caffeine intoxication o You can only meet for this disorder if it causes distress or impairment o Certain amount of caffeine will help you focus but to much will put you over the top and impair your functioning Caffeine withdrawal o Him stopping getting headaches and took Excedrin then realized he was just replacing the caffeine with another type of caffeine so stopped taking it and started getting flu like symptoms Nicotine Enters your blood stream really quickly especially smoking Immediate Cultural aspects Stimulant and a sedative initial high you get Works on the adrenal glands initial affect Longer more nicotine in the blood stream and produces a calming affect Affect mood Increases serotonin Increases blood pressure heart rate some people use it as an appetite suppressant used to lose weight 20 of people smoke right now o little more in men and women no difference in SES race ethnicity More restrictive now Don t know why it s so much harder to quit Ask smokers about 70 want to quit about 50 has tried only 2 3 succeed When you quit nicotine have to do it on your own other things causes burning bridges in your life it doesn t cause huge impact on your life in very negative way First cigarette in the morning is the hardest to get ride of because you have the withdrawal over night Complications with pregnancy low birth rate pre mature Same criteria for all use disorders tobacco alcohol caffeine marijuana etc except Tobacco Can not have tobacco intoxication o It s not as severe in changing your behavior in a significant way But can have withdrawal Alcohol Actually considered a depressant central nervous symptom depressant GABA stops other neurotransmitters from working shuts down serotonin decreases brain activity o Why you have slower reaction times o Things become out of focus o Balance is off slurred speech dizzy all brain related poor judgment cognitively your brain is not as efficient Second most common psychoactive substance next to caffeine Depends on your tolerance size ingest in food Scary part people who become dependent on alcohol tend to report that they don t feel the affects of alcohol as much so drink more o Take greater risk Men drink more but women are more susceptible for negative health risk o Women may have more enzymes that don t break down as easily Asians almost like a poison to them and they get sick easily Alcohol cirrhosis of the liver detoxifies your blood can t filter it as well over time scare tissue develops o Some people need liver transplants Wernike Korsakoff syndrome thiamine o Confusion amnesia confabulation filling in the details of a story you don t remember with made up material o Never recover if they stop drinking o 80 have to do into living system because they get confused and can t function Fetal o o o alcohol syndrome FAS Can have major effects on them Lower birth rate Older have a lot of learning disorders impulse control disorders o Poor eye hand coordination Alcohol intoxication o These start to happen around blood alcohol of about 1 bigger ones happen at about 2 02 06 is the good feeling of it with very little impairment at that level Same for all use disorders except Alcohol use disorder o Take in larger amounts have to have 0 or you go all the way Can t have one cause then ill have 20 o Tried to cut down and can t cut down o Lots of time o Craving urges o Don t go to work spend time with family o One will continue use despite health problems or psychological problems Even though my liver functioning is getting bad I continue to do it o Continued use despite interpersonal problems o Continued use despite physical health or psychological problems o Use in situations where it will be dangerous o Any 2 of these in a 12 month period Alcohol withdrawal o Deliria high blood pressure fever DT s Illicit Drugs Marijuana Leaves can be used but normally flower of the plant some people use stem of the plant Increased appetite Humor things are funnier More relaxed Slows perception of time Increased visual and auditory senses fishbowl affect some experience dull Cannabinoid receptors respond in the pleasure parts of the brain responds to THC Most highly and often used illicit substance More common in men then in women More chemically engineered most potent more THC some are stronger than others different high feel in them Able to enhance them stronger doses Help manage weight Marijuana Intoxication o Slow tongue social withdrawal some very social blood shot eyes munchies increased heart rate o Rare but can have hallucinations o Euphoria tranquility calming affect Marijuana Withdrawal o Restless abdominal health issues depressed anxiety o Withdrawal might increase risk aggression between relationships Research Hot Topic Medical Uses of Marijuana o California caught with it in your pocket 100 fine o 18 states exempt laws for patients o has its benefits but also has its downfalls side affects Illicit Drugs CNS Stimulants Dopamine being the big one Produce euphoria energy sexual pleasure power positive reinforces Amphetamines Ecstasy Crystal methamphetamine Risk blood pressure risk of heart attack Use for asthma ADHA in kids opposite affect in kids brings them into focus Functional Impairment and Epidemiology o Paranoid become aggressive o Tolerance develops rapidly which can increase addiction Withdrawal o Depression irritability what is the opposite of the drug Illicit Drugs Cocaine Derived from leaves of coca plant produced numbing feeling Powder liquid mixed with water rock form immediate high and super strong tends to last longer Use to be in coke Used more by males Acts on dopamine Painkiller numbing High dosage especially if smoked