Substance-Related Disorders: Causes, Types, and Treatments, Slides of Abnormal Psychology

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Slides & Handouts by Karen Clay Rhines, Ph.D.Northampton Community College

Substance Related Disorders

Substance-Related Disorders

• What is a drug?
  • Any substance other than food that affects our bodies or minds - Need not be a medicine or illegal
  • Current language uses the term “substance” rather than “drug” to overtly include alcohol, tobacco, and caffeine

Substance-Related Disorders

• Substances may cause temporary changes in

behavior, emotion, or thought

• May result in substance intoxication (literally, “poisoning”), a temporary state of poor judgment, mood changes irritability, slurred speech, and poor coordination
• Some substances such as LSD may produce a particular form of intoxication, sometimes called hallucinosis, which consists of perceptual distortions and hallucinations

Substance-Related Disorders

• Substances can also produce long-term problems:
  • Substance abuse: a pattern of behavior in which a person relies on a drug excessively and chronically, damaging relationships, affecting work functioning, and/or putting self or others in danger
  • Substance dependence: a more advanced pattern of use in which a person abuses a drug and centers his or her life around it - Also called “addiction” - May include tolerance (need increasing doses to get an effect) and withdrawal (unpleasant and dangerous symptoms when substance use is stopped or cut down)

Substance-Related Disorders

• About 10% of all teens and adults in the U.S. display substance abuse or dependence - The highest rates of substance abuse or dependence in the U.S. is found among Native Americans (19%), while the lowest is among Asian Americans (4.3%) - White Americans, Hispanic Americans, and African Americans display rates between 9 and 10% - Only 26% receive treatment

Substance-Related Disorders

• Many drugs are available in our society
  • Some are naturally occurring; others are produced in a laboratory
  • Some require a physician’s prescription for legal use; others, like alcohol and nicotine, are legally available to adults
  • Still others, like heroin, are illegal under all circumstances

Substance-Related Disorders

• Recent statistics suggest that drug use is a

significant social problem

• 28 million people in the U.S. have used an illegal substance within the past year
• 20.4 million are using one of them currently
• Almost 22% of all high school seniors have used an illegal drug within the past month

Substance-Related Disorders

• There are several categories of substances

used and studied:

• Depressants
• Stimulants
• Hallucinogens
• Cannabis
• Polydrug use

Depressants

• Depressants slow the activity of the central nervous system (CNS) - Reduce tension and inhibitions - May interfere with judgment, motor activity, and concentration
• Three most widely used depressants:
  • Alcohol
  • Sedative-hypnotic drugs
  • Opioids

Depressants: Alcohol

• The World Health Organization estimates that

2 billion people worldwide consume alcohol

• In the U.S., more than half of all residents

drink alcoholic beverages from time to time

Depressants: Alcohol

• When people consume 5 or more drinks in a single occasion, it is called a binge-drinking episode - 23% of all people in the U.S. over the age of 11 binge-drink each month - Men account for 81% of binge-drinking episodes
• Nearly 7% of people over age the age of 11 are heavy drinkers, having 5 drinks on at least 5 occasions per month - Among heavy drinkers, the ratio of men to women is 4: (around 8% to 4%)

Depressants: Alcohol

• All alcoholic beverages contain ethyl alcohol
• It is absorbed into the blood through the stomach

lining and takes effect in the bloodstream and CNS

• Short-term: alcohol blocks messages between neurons
• Alcohol helps GABA (an inhibitory messenger) shut down neurons and “relax” the drinker

Depressants: Alcohol

• The first brain area affected is that which controls

judgment and inhibition

• Next affected are additional areas in the CNS, leaving

the drinker even less able to make sound judgments, speak clearly, and remember well

• Motor difficulties increase as drinking continues, and

reaction times slow

Depressants: Alcohol

• The extent of the effect of ethyl alcohol is determined by its concentration (proportion) in the blood - A given amount of alcohol has a lesser effect on a large person than on a small one
• Gender also affects blood alcohol concentration
  • Women have less alcohol dehydrogenase, an enzyme in the stomach that metabolizes alcohol before it enters the blood
  • Women become more intoxicated than men on equal doses of alcohol

Depressants: Alcohol

• Levels of impairment are closely tied to the

concentration of ethyl alcohol in the blood:

• BAC = 0.06: Relaxation and comfort
• BAC = 0.09: Intoxication
• BAC > 0.55: Death
  • Most people lose consciousness before they can drink this much

Depressants: Alcohol

• The effects of alcohol subside only after

alcohol is metabolized by the liver

• The average rate of this metabolism is 25% of an ounce per hour
• You can’t increase the speed of this process!

Depressants: Alcohol

• Though legal, alcohol is one of the most

dangerous recreational drugs

• Its effects can extend across the life span
  • Alcohol use is a major problem in high school, college, and adulthood

Depressants: Alcohol

• In any given year, 6.6% of the world’s population will fall into a pattern of abuse or dependence - 13.2% experience one of the patterns sometime during their life
• 7.6% of all adults in the U.S. (almost 19 million people) display an alcohol use disorder - In their lifetime, between 9% and 18% of adults will display one of these patterns, with men outnumbering women 2:

Depressants: Alcohol

• The prevalence of alcoholism in a given year is about the same (7% to 9%) for White Americans, African Americans and Hispanic Americans - The men in these groups show strikingly different age patterns

Depressants: Alcohol

• Generally, Asians have lower rates of alcohol disorders than do people from other cultures - As many as one-half of these individuals have a deficiency of alcohol dehydrogenase; thus, they have a negative reaction to even modest alcohol use

Depressants: Alcohol

• Alcohol abuse
  • In general, people who abuse alcohol drink large amounts regularly and rely on it to enable them to do things that would otherwise make them anxious - Eventually the drinking interferes with work and social functioning
  • Individual patterns of alcohol abuse vary

Depressants: Alcohol

• Alcohol dependence
  • For many people, the pattern of alcohol misuse includes dependence - They build up a physiological tolerance and need to drink greater amounts to feel its effect - They may experience withdrawal, including nausea and vomiting, when they stop drinking - A small percentage of alcohol-dependent people experience a dramatic and dangerous withdrawal syndrome known as delirium tremens (“the DTs”) - Can be fatal!

Depressants: Alcohol

• What is the personal and social impact of

alcoholism?

• Alcoholism destroys families, social relationships, and careers - Losses to society total many billions of dollars annually - Plays a role in suicides, homicides, assaults, rapes, and accidents - Has serious effects on the children (some 30 million) of alcoholic parents

Depressants: Alcohol

• What is the personal and social impact of alcoholism? - Long-term excessive drinking can seriously damage physical health - Especially damaged is the liver (cirrhosis) - Long-term excessive drinking can cause major nutritional problems - Example: Korsakoff’s syndrome - Women who drink alcohol during pregnancy place their fetuses at risk from fetal alcohol syndrome (FAS)

Depressants:

Sedative-Hypnotic Drugs

• Sedative-hypnotic (anxiolytic) drugs produce

feelings of relaxation and drowsiness

• At low doses, they have a calming or sedative effect
• At high doses, they function as sleep inducers or hypnotics
• Sedative-hypnotic drugs include barbiturates

and benzodiazepines