Chapter 9 Presentation outlineSubstance Use Disorders-TrullSubstance Use vs. Substance Abuse- Many of us engage in substance use that somehow affects our behavior. Such use is normal and may not lead to significant problems if we use the drug carefully. o Substance abuse  se too much it effects your lifeo Substance intoxication  a disorder when you get so messed up you do something crazy/ irrational o Substance Use Disorder  a problematic pattern of substance use leading to clinically significant impairment or distress, as manifested by at least 2 of 11 symptoms with in a 12 month period  Exists on a spectrum of severity o Symptoms  Substance Withdrawl feel the opposite of what the drug is the supposed to do  Tolerance use more and more of a drug to get the same effect Substance-related disorders - Substance-related disorders include substance intoxication, abuse, and dependence and withdrawal. - Substance intoxication is a reversible condition brought on by excessive use of alcohol oranother drug. - Substance abuse refers to repeated use of substances that lead to recurring problems - Substance-related disorders, like other disorders, occur on a continuum of normal to severe disorder. - Substance dependence refers to a maladaptive pattern of substance use potentially defied by tolerance and withdrawal.- Substance withdrawal refers to maladaptive behavioral changes when a person stops using a drug.- Tolerance refers to need to ingest greater amounts of a drug to achieve the same effect. Types of Substances: Depressants - Examples: alcohol, anesthetics, antiseizure meds, barbiturate drugs, hypnotic drugs - Depressants inhibit the central nervous system, whereas stimulants activate the central nervous system.o Things that normally inhibit you are getting depressed Example: you drink to get rid of nerves (nerves being inhibited)- Video: Mark, a profile of substance use disorder. - Fetal Alcohol Syndrome: Characteristic facial features of individuals with fetal alcohol syndrome o Rare, seen as a result of women who drink really heavily during pregnancy o Facial abnormalitieso Neglected/ mistreated after birth Types of Substances: Stimulants - Stimulants include caffeine, nicotine, cocaine, and amphetamines, crack, metho Stimulants: activate or stimulate the central nervous system o Speed up hearto Adderal identical to cocaine just a slower release o Meth - The pleasurable effects of meth…o the drug helps stimulate pleasure centers in the brain to release large amounts ofdopamine  extremely intense and include strong euphoria  enhanced sexual drive and stamina  lowered sexual inhibition- Downsides of meth….o brain and liver damageo malnutrition, o skin infectionso immune system problemso convulsionso strokeo death Types of Substances: Opiates - A commonly abused opiate, heroin is a strong opiate that leads to an increased risk of cancer and infertility. o Feel a rush of euphoria o Injected, dangerous especially if dirty- Morphine or Codeine (common)o Relieve pain or cough Types of Substances: Hallucinogens- Hallucinogens cause symptoms of psychosis such as hallucinations, disorganized thinking, odd perceptions, and delirium. o Cognitive drug Disorganized thinking, delirium- powerful changes in perception See, hear thingso Not addictive, don’t act on receptors o Last long time  exhausted o Ecstacy- both a stimulant and hallucinogenTypes of Substances: Cannabis - Heavy users of marijuana may become physically and psychologically dependent, and is also used as treatment for glaucoma and other medical symptoms. o Legalize: will sell it in store fronts o Decriminalize: you cant go out and buy it but id you’re caught with it you will just get a ticket, not put in jailo Addictive o 80% of the weed smoked is used by 20% of the populationAge and Drug Use- Percentage of individuals by age using illegal drugs. - 18-20 year olds highest amounto 22% use illicit drugs in the past month Biological Risk Factors- The mesolimbic pathway links to other brain areas central to addiction o Genetics Alcohol dependence: 40-60% Sensitivity of alcohol (protective factor) Metabolism of alcohol Craving o Substances increase dopamine  Stimulate D2 receptors/block reuptake of DA  Pleasure, reward, desire o Brain Mesolimbic pathways- Amygdala- Prefrontal cortex - Hippocampus- Anterior cingulateEnvironmental risk factors - Environmental risk factors include- Stress- cognitive factorso cognitive expectances o what you think you will get out of drinking- learningo cues and conditioning o negative reinforcemento modeling o example: certain environments make you want to use - personality factorso impulsivity o may turn to sky diving, extreme sports to get - family factorso raised by alcoholics - cultural factors- evolutionary influencesCauses of Substance Use Disorders- Distal factors are background factors that indirectly affect a person and can generally contribute to a mental disorder. - Biological distal factors with respect to substance-related disorders include genetic predisposition and perhaps temperaments such as an impulsive personality. - Environmental distal factors include association with deviant peers, problematic family relationships, parental drug use, culture, and early learning and drug experiences.- Proximal factors are more immediate factors that directly affect a person and more specifically contribute to a mental disorder. - Biological proximal factors include activation of the mesolimbic dopamine pathway upondrug use. o Really stress RIGHT NOWo Just got activated by somethingo Just finished test after studying for hours and all I want to do is drink - Environmental proximal factors include stress, depression, peer pressure, positive expectancies about substance use, and availability of substances. - Proximal factors may also include consequences of drug use, both positive and negative. Prevention- Prevention of substance-related disorder can occur at the adult level, as with relapse prevention, or at the youth level to prevent abuse and dependence before they begin.o Accurate infoo Promoting responsible decision makingo Correct misperceptionso Policy changeo Harm reductiono Relapse preventionAssessment- Assessing people with substance-related disorders often includes screening and motivational interviews as well as psychological testing and observations from others.- Therapists also use psychological tests (MMPI-2) to