PSYC 281 1st EditionExam 3 Study GuideChapter 9: Substance Use Disorders- Differentiate between substance use, intoxication, substance use disorder, and substance-induced disorders.o Substance Use Low/moderate use experiences Do not lead to problems with social, educational, occupational functioningo Substance Intoxication Reversible & substance-specific Maladaptive behavioral/psychological changes associated with CNS- Emerge during/shortly after drug useo Substance Use Disorder 2 or more of the following:- Using more than intended amount- Desire/unsuccessful efforts to cut down- Extra time spent trying to get substance- Giving up activities due to use- Continued use despite detrimental effects- Tolerance and withdrawal Severity: 2-3 (mild), 4-5 (moderate), 6+ (severe)- Define tolerance and withdrawalo Tolerance Diminished response to drug after repeated exposureo Withdrawal Physical symptoms associated with removal of drugo Examples: Ernest Hemingway- By the end of the 1930s, he was drinking 17 scotch and sodas per day, gin in his morning tea, a quart of whiskey per day, and a bottle of champagne before bed. He was missing deadlines for his columns and books.- Does this meet criteria for a substance use disorder?o Answer: Yes, it’s impairing his working ability & life, and also is drinking an excessive amount (abusing it)  Are keg stands and beer bong examples of abuse?- Answer: Depends if it impairs their daily lives and they have a dependence or a need to do them. _____ refers to the physical symptoms that occur when unable to abuse the substance anymore- Answer: Withdrawal- Name the commonly used “licit” and “illicit” drugs? Most common of each? Know the main effects, side effects, withdrawal symptoms, and long-term risks of the following drugs. Also know how quickly tolerance develops in each: (caffeine, nicotine, alcohol, marijuana, amphetamines, cocaine, barbiturates, benzodiazepines, opioids, hallucinogens, and inhalants)o Licit Caffeine (Most common)- CNS stimulant- Boosts energy, mood, awareness, concentration, alertness- The down side? Side effects:o Agitationo Headacheso Mood lability o Rebound fatigueo Insomnia- Most commonly used legal drug- High doses lead to anxiety, acute intoxication- Heavy, chronic use may lead to physical problems- Most widely used drug worldwideo Over 80% consume daily- No DSM disorder! Nicotine- Component of tobaccoo Cigarettes (most common of nicotine methods)o Chewing tobacco/snuffo Nicotine patch/gum- Highly addictiveo Effects felt in around 8 secondso The “rush” o The immediate satisfaction is what reinforces the behavior- Considered CNS stimulant and sedativeo Releases adrenaline and dopamine- Smoking cessation very difficult- Tobacco use: largest preventable cause of death in the worldo Increased risk for cancero Pregnancy complications- Although decline in smokers, 44.5 million adults and 3 million adolescents still smokeo The Ugly Truth- New in DSM-V: Tobacco use disorder Alcohol- Second most commonly used substance, after caffeine- CNS sedative/depressant- Affects GABAo Brain’s primary inhibitory neurotransmittero Alcohol increases the affects of GABA- Serious withdrawal symptomso Hallucinationso Delirium tremens (DTs) Disorientation Agitation Fevero Formication Small insects crawling on body- Serious physical effectso Cirrhosis Liver damageo Wernicke-Korsakoff syndrome Confusion Amnesia- Confabulationo Fetal Alcohol Syndrome (FAS) Neurodevelopmental problems Neurological problems- What is considered a binge for:o Girls? 4 or moreo Guys? 5 or moreHow Alcohol Attacks the Brain… o Illicit- Marijuana (Most Common Illicit)o Comes from Cannabis sativa Active ingredient: THC Produces mild intoxication Effects last for 1-3 hourso Stimulates dopamine release Pleasant state of relaxation Intensified senses- Sight and hearing Slowed perception of timeo Side effects- Heavy use:o Cognitive difficultieso Respiratory problemso Increased risk of cancer (head, neck, lung)- Also has useful medicinal purposes- Is Marijuana Addictive?o Is not self administered in animal studieso Some studies report tolerance, others don’to “Cravings” do occuro Withdrawal symptoms occuro Short answer: For most people, no; for some (~10%), yes(CNS Stimulants that are illicit drugs) - Amphetamines o Legal amphetamineso Ecstasy (MDMA)o Crystal meth Pick at their skin and feels like bugs are crawling under it Gives off increased age looko CNS stimulant Increased wakefulness/energy Euphoria Sense of “power” or courage Increased sexual arousal Suppresses appetite- Some young women are starting to take these drugs as means to lose, or control weighto Increase in dopamineo Increased heart rate/blood pressure Possible stroke, heart attack Respiratory arrest Seizureso Increased violence/aggression Chronic paranoia, confusion, insomnia Depression, irritability o Emaciation/malnutrition- Cocaineo Was advocated by Freud who regularly used it and gave it to patients Published articles describing its benefits o Was used as a legal pain killero Was a legal additive to cigars and cigaretteso CNS stimulanto Comes from leaves of coca plant Indigenous to South Americao Highly addictive (psychological AND physical) Increased dopamine availabilityo Tolerance leads to larger does – more risk for death Convulsing effectsStimulants vs Sedative DrugsSedative Drugs (CNS Depressants)o Barbiturates (Seconal, Amatol) Act on GABA system (like alcohol) Often used to counteract effect of “uppers” Relaxation, disinhibition- Slurring, fatigue, disorientation…o Benzodiazepines (Valium, Xanax) Can be used to treat anxiety “Mother’s little helper” Rohipnol (AKA “roofies”)o Benzodiazepines vs Barbiturates Safer Lower potential of abuse- When used as prescribedo But, people still abuseo Tolerance/withdrawal can occur in both Need to wean yourself off (by giving yourself smaller and smaller doses) even if you think you’re fine and don’t need it anymore, because you’ve built up a tolerance to it and the withdrawal symptoms will negatively effect you by stopping cold turkeyo Overdoseo Opioids- Heroin, morphine, codeineo Derived from the opium poppyo Methadone: synthetic form- CNS sedative/depressanto Mimic body’s natural opioids (endorphins)o Produce pain relief, euphoria, sedation, reduced