Substances and effects
Caffeine
Stimulant; effects central nervous system
Functional impairment: health problems, anxiety, and Acute Caffeine Intoxication
Substance-Use criteria (how long) and categories
2+ symptoms from any category within 12 months. Categories: impaired control, social/occupational problems, hazardous use, and physiological dependence.
Most widely used substance and most widely abused substance
Caffeine, more than 80% of the population use it daily
Alcohol, the most widely abused substance
Genetic
metabolism, sensitivity, and heritability~0.50
drug-specific receptors
A pattern of drinking alcohol that brings blood alcohol concentration to 0.08 percent or higher
Binge Drinking (5 or more drinks for males and 4 or more for females in 2 hours)
Nicotine
Increases alertness, stimulates release of epinephrine and endorphins
physiological dependence leads to tolerance and withdrawal: insomnia, cramps, lowered heart rate, irritability, nervousness, and fatigue
Impaired Control
using more and more, unsuccessful efforts to cut back, increased time
Top reasons for drug abuse among college students
influence by peers: 96.6%, curiosity: 93.3%, search for fun: 93.3%, school-related stress: 86.6%, living away from family: 80%, media influence: 56.6%
Neurobiological
reward system: pleasure, reward, desire; activation by drug and cues
reward deficiency syndrome: brain harbors low dopamine -> takes more dopamine to experience positive effects -> repeated exposure can alter reward system function
Definition of a psychoactive substance
A chemical compound that alters mood, perception, or behavior
Legal or illegal
Cannabis/Marijuana
Functional impairment: paranoia, irritability, issues with cognition
longer-term consequences: impact on the developing brain, increased risk for schizophrenia (beginning in adolescence), and lung damage.
~10% of people who use it struggle with addiction
Social/Occupational Problems
Neglecting responsibilities and
relationships
Giving up on activities that were
once enjoyable
Inability to complete tasks at
home, work, or school
Demographic factors
males > females
highest rate: ages 18-25
American/Alaska natives: highest rate
*Same patterns generally true for general "use"
Psychological
Classical Conditioning: cues for use, cravings
Cognitions/Narrative: positive expectations about drug use increase the likelihood of use
Addiction cycle and gauging severity
Addiction cycle: binge-intoxication leads to withdrawal-neg. affect leads to preoccupation-anticipation leading back to binge-intoxication
Severity: At risk, mild, moderate, and severe. In this order
Alcohol
Inhibits brain activity and slows the central nervous system
Chronic, heavy use: increased risk for liver disease, some forms of cancer, coronary heart disease, and neurological disorders
Functional impairment: physiological effects, withdrawal: hallucinations and seizures
Hazardous Use
Using in risky settings, and continuing to use despite knowing the risks
Difference between substance use, substance intoxication, and substance
dependence
substance use: ingestion of psychoactive substances
substance intoxication: physiological reaction; depends on the day, amount, and biological reaction
substance dependence: physiological dependence on a substance to the extent of tolerance, withdrawal, and craving
Sociocultural
Social Selection: Normed use through peer group
Perception of social norms
Prevalence and Treatment stats
94% of people 12 or older with a substance use disorder did not receive any treatment
60.2% of Americans 12 or older currently abuse drugs (alcohol and tobacco included)
14.5% past year prevalence, highest alcohol (any substance use disorder)
Opioids
Causes: decreased pain, increased pleasure, changes in heart and breathing rates
Functional impairment: withdrawal, and long-term effects
Physiological Dependence
Tolerance, withdrawal, and cravings
Psychoactive substance categories, examples and affects
Depressants: alcohol; behavioral sedation
Stimulants: caffeine and nicotine; elevated mood and increased alertness
Opioids: heroin and fentanyl; reduced pain and euphoria
Hallucinogens: weed; alter sensory perception
Treatment
motivation is key
Stigma: increases defensiveness and denial, addiction vs. substance dependence
DARE
Don't be a lab rat
Comorbidity
Causality?
Especially anxiety-related, mood, & personality disorders; other forms of substance dependence
withdrawal, other disorders are stressful leads to substance use, related to severe stress in general