PSYCH 333 1nd Edition Lecture 18 Outline of Last Lecture I. Cognitive-Behavioral TherapyII. Sociocultural FactorsIII. Preventative InterventionIV. Other Factors Outline of Current Lecture II. Substance Use DisorderIII. AlcoholIV. CannabisV. 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 inreaction 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 thedrug.- Criminal activity.- Drug-seeking behaviors in healthcare settings. Heroin.- Commonly used IV.- Risks of shared/dirty needles. Significant gastrointestinal