PSYCH 333 1nd Edition Lecture 18 Outline of Last Lecture I Cognitive Behavioral Therapy II Sociocultural Factors III Preventative Intervention IV Other Factors Outline of Current Lecture II Substance Use Disorder III Alcohol IV Cannabis V Opioids Current Lecture Substance Use Disorder o Use despite causing harm dysfunction Inability to meet obligation Physical danger Relationship problems Give up hobbies social activities o Changes in use Tolerance needing more to feel a buzz Withdrawal I need this to function Failed attempts to cut back or quit Substance taken in larger quantities than intended Time spent obtaining using or recovering from substance Cravings strong urge to use o Types Alcohol Cannabis Opioids Amphetamines methamphetamines Cocaine Nicotine tobacco Alcohol These notes represent a detailed interpretation of the professor s lecture GradeBuddy is best used as a supplement to your own notes not as a substitute o BAC of 02 Relaxed mellow feeling slight body warmth o BAC 05 Noticeable relaxation less self focused minor coordination impairment o BAC 08 Impairment in coordination judgment o BAC 10 Noisy possibly embarrassing behaviors mood swings drastic reduction in reaction time o BAC 15 Impaired balance and movement clearly drunk o BAC 30 Many people lose consciousness o BAC 40 Most people lose consciousness some die o BAC 50 Severely inhibited breathing many people die o Intoxication symptoms Slurred speech Loss of coordination unsteady gait Nystagmus eyes cannot follow smoothly Impairment in attention concentration judgment Stupor coma o Withdrawal symptoms Agitation ANS arousal Insomnia Nausea vomiting Tremors shakiness Hallucinations Delirium Seizures Clonic tonic o How it works Stimulation of GABA receptors CNS depressants calming effects Inhibition of glutamate receptors Cognitive effects of alcohol CNS depressant Increased levels of 5HT and dopamine Impact on sleep mood pleasantness of drinking o Physiological consequences of alcohol abuse B complex deficiency Korsakoff s syndrome thiamine deficiency Liver damage Cirrhosis scar tissue developing in liver Pancreatitis Alcohol identified as sugar increase insulin output Cardiovascular Heart arrhythmias heart failure capillary hemorrhages erectile dysfunction o Alcohol use in pregnancy Fetal alcohol syndrome Intellectual disability Physical deformations of face and limbs Highest risk is during first trimester Neural tube development disrupted o Other risks Binge drinking More than four drinks women or five drinks men within one sitting Alcohol related accidents Sexual assault Date rape drug Exacerbation of other psychological disorders Cannabis o Psychological Relaxation social disinhibition Emotional lability paranoia panic in large doses Hallucinations perceptual disturbances rare o Physiological Bloodshot eyes Dry mouth and throat Increased appetite munchies Hypertension Reduce ocular tension o Psychomotor coordination impairment o Effects Intoxication Conjunctional injection Increase appetite Dry mouth Tachycardia Transient hallucinations Withdrawal Irritability anger Nervousness anxiety restlessness Sleep difficulties insomnia vivid dreams Decrease appetite Depressed mood Physical symptoms abdominal pain tremor shakiness sweating fever chills headaches o How cannabis works Cannabinoid receptors Anandamide endocannabinoid Regulate release of dopamine THC increases dopamine CB1 receptors on hippocampus may explain STM deficits Increased activation of limbic system amygdala and ACC Decreased activation of temporal lobe attention especially auditory attention o Long term effects Cognitive decline Short term memory deficits Reduction in IQ over time with continued use More evidence research needed Lung damage Contains many of the same carcinogens as cigarettes Addiction Cannabis is addictive Psychosis Opioids o Opiate derived from the opium poppy morphine codeine and heroin o Opioid all drugs that bind to the opioid receptors includes all opiates and synthetic pain killers such as hydrocodone and oxycodone o Effects Analgesia pain relief Euphoria Drowsiness Stupor coma A rush of ecstatic high can happen when a large amount is taken such as injecting heroin Relaxation of smooth muscle tissue Constipation Intoxication Pupillary constriction Drowsiness coma stupor Slurred speech Impairment in attention and memory Withdrawal Dysphoric mood Nausea vomiting diarrhea Muscle aches Lacrimation rhinorrhea Pupillary dilation Piloerection Fever Insomnia o How opioids works Dopamine Opioids block inhibitory neurotransmitters which thus increases the amount of dopamine Opioid receptors are found throughout the limbic system ACC neural reward network Some evidence for effects in the nucleus accumbens independent from dopamine effects o Additional problem with opioid abuse Excessive amount of time spent obtaining using and recovering from the drug Criminal activity Drug seeking behaviors in healthcare settings Heroin Commonly used IV Risks of shared dirty needles Significant gastrointestinal problems