Term
| When considering whether substance use is a problem there are several important considerations, |
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Definition
| such as who is taking the drug (a 10-year-old drinking vodka is very different to a 35-year-old drinking vodka); why they are taking the drug; when and where the drug is used; how much is used; and how the drug is used. |
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Term
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Definition
Alcohol occupies a significant place in Australian culture and is consumed in a wide range of social circumstances. However, unhealthy or dangerous drinking habits can lead to serious problems. One of these being alcohol abuse. Whilst alcohol abuse symptoms do vary, in many cases it can cause serious health conditions.
Statistics
In Australia, 82% of Australians over 18 years old had consumed alcohol in the past year (87% males, and 77% females). Only 9% had never consumed alcohol. Alcohol is both a CNS stimulant and depressant (Australian Bureau of Statistics, 2013).
Short-term effects
Low-to-moderate doses cause disinhibition, euphoria, increased sociability, aggression and hostility as well as interference with motor activity.
Moderate quantities cause slightly increased heart rate, dilated blood vessels in arms, legs and skin as well as moderately lower blood pressure. It stimulates and increased production of gastric secretions and urine.
Higher doses cause difficulty walking, talking, thinking, drowsiness and sleep. It can cause a lack of co-ordination, confusion and disorientation, stupor, anaesthesia, coma and death. The lethal level of alcohol is between 0.4% and 0.6% by volume in the blood.
Chronic effects
Light or moderate drinking does little permanent harm (except it can cause foetal alcohol syndrome to an exposed unborn foetus). Heavy drinking can:
seriously damage the heart, kidney and liver
cause mental disorders, irreversible damage to the brain and peripheral nervous system
lower resistance to pneumonia and other infectious diseases
irritate the gastrointestinal tract
cause Wernicke-Korsakoff's syndrome, which is the combined presence of Wernicke's disease and Korsakoff's psychosis. |
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Definition
Cannabis use
As evident in the following graph, cannabis is the most frequently used illegal drug, with 34% of Australians reporting using it in their life-time. The effects of cannabis use vary widely with the quality and quantity of the cannabis, the user's personality, current mood, previous experience, expectations, and the social setting in which the cannabis is used.
For a minority of users, cannabis use can cause psychosis (cannabis psychosis) which can be misdiagnosed as schizophrenia |
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Term
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Definition
| Substance abuse and substance dependence are key terms which are often used, but there are slight differences in meaning. Substance abuse is characterised by generally excessive, potentially hazardous or functionally impactful use. |
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Term
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Definition
Substance dependence is generally more severe and includes physiological need.
Substance dependence is characterised by three basic processes:
1. Tolerance—repeated exposure to a substance results in reduced effect.
2. Physical dependence—withdrawal syndrome, whereby cessation of substance use leads to adverse psychological and physiological symptoms.
3.Psychological dependence—observable behaviour of frequently using drugs—reinforcement is thought to play a role. |
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Definition
Addictive behaviours
Addictive behaviours are characterised by an acquired drive and pathological need for a substance. The brain's mesocorticolimbic dopaminergic system is important in signalling reward and reinforcing stimuli and behaviours associated with reward signalling. Addictive substances activate these areas of the brain, and over time change the brain's ability to regulate these pathways. The user loses control over, and lies about, their use, while more and more time is spent mulling over intrusive thoughts about it. Substance use continues despite loss of health, family, or job, or until a serious accident or fatal overdose occurs. It is one of the most difficult problems to treat. |
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Term
| affect mental functioning in the central nervous system (CNS) |
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Definition
| The most commonly used problem substances are those that affect mental functioning in the central nervous system (CNS)—psychoactive substances: alcohol, nico- tine, barbiturates, tranquilizers, amphetamines, heroin, Ecstasy, and marijuana. |
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Definition
| Substance abuse generally involves an excessive use of a substance resulting in (1) potentially hazardous behavior such as driving while intoxicated or (2) con- tinued use despite a persistent social, psychological, occupational, or health problem |
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Definition
| Substance dependence includes more severe forms of substance use disorders and usually involves a marked physiological need for increasing amounts of a sub- stance to achieve the desired effects. Dependence in these disorders means that an individual will show a tolerance for a drug and/or experience withdrawal symptoms when the drug is unavailable. |
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Term
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Definition
| Tolerance—the need for increased amounts of a sub- stance to achieve the desired effects—results from bio- chemical changes in the body that affect the rate of metabolism and elimination of the substance from the body. |
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Term
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Definition
| Withdrawal refers to physical symptoms such as sweating, tremors, and tension that accompany absti- nence from a drug. |
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Definition
| alcohol abuse is associated with over 40 percent of the deaths suffered in automobile accidents each year (Chou et al., 2006) and with about 40 to 50 percent of all murders (Bennett & Lehman, 1996), 40 percent of all assaults, and over 50 percent of all rapes (Abbey et al., 2001). About one of every three arrests in the United States is related to alco- hol abuse, and over 43 percent of violent encounters with the police involve alcohol |
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Term
| ALCOHOL’S EFFECTS ON THE BRAIN |
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Definition
| ALCOHOL’S EFFECTS ON THE BRAIN Alcohol has complex effects on the brain. At lower levels, alcohol acti- vates the brain’s “pleasure areas,” which release endoge- nous opioids that are stored in the body (Braun, 1996). At higher levels, alcohol depresses brain functioning, inhibit- ing one of the brain’s excitatory neurotransmitters, gluta- mate, which in turn slows down activity in parts of the brain (Koob et al., 2002). Inhibition of glutamate in the brain impairs the ability to learn and affects the higher brain centers, impairing judgment and other rational pro- cesses and lowering self-control. |
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Term
| alcohol withdrawal delirium (formerly known as delirium tremens |
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Definition
| Among those who drink excessively for a long time, a reaction called alcohol withdrawal delirium (formerly known as delirium tremens) may occur. This reaction usu- ally happens following a prolonged drinking spree when the person enters a state of withdrawal. Slight noises or suddenly moving objects may cause considerable excite- ment and agitation. The full-blown symptoms include (1) disorientation for time and place, in which, for example, a person may mistake the hospital for a church or jail, no longer recognize friends, or identify hospital attendants as old acquaintances; (2) vivid hallucinations, particularly of |
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Term
| A second alcohol-related psychosis is alcohol amnestic disorder (formerly known as Korsakoff’s syndrome) |
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Definition
| People with this disorder may not recognize pictures, faces, rooms, and other objects that they have just seen, although they may feel that these people or objects are familiar. Such people increasingly tend to fill in their memory gaps with confab- ulations that lead to unconnected and distorted associa- tions. These individuals may appear to be delirious, delusional, and disoriented for time and place, but ordi- narily their confusion and disordered actions are closely related to their attempts to fill in memory gaps. |
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Term
| Biological Causal Factors in Alcohol Abuse and Dependence |
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Definition
two important factors are clearly involved. The first is the ability of most, if not all, addictive substances to activate areas of the brain that produce intrinsic pleasure and some- times immediate, powerful reward.
The second factor involves the person’s biological makeup, or constitution, including his or her genetic inheritance and the environ- mental influences (learning factors) that enter into the need to seek mind-altering substances to an increasing degree as use continues. |
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Term
| THE NEUROBIOLOGY OF ADDICTION |
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Definition
| The mesocorticolimbic dopamine pathway (MCLP) is the center of psychoactive drug activation in the brain. The MCLP is made up of neuronal cells in the middle por- tion of the brain known as the ventral tegmental area (see Figure 11.2) and connects to other brain centers such as the nucleus accumbens and then to the prefrontal cortex. |
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Term
| Pre-alcoholic Personalities |
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Definition
| —individuals who are at high risk for sub- stance abuse but who are not yet affected by alcohol. An alcohol-risk personality has been described as an indi- vidual who has an inherited predisposition toward alco- hol abuse and who is impulsive, prefers taking high risks, and is emotionally unstabl |
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Term
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Definition
| Although cultural factors may also play a role, the relatively lower rates of alcoholism among Asian groups might be related to the extreme discomfort associated with the alcohol flush reaction |
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Term
| PSYCHOLOGICAL VULNERABILITY |
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Definition
| PSYCHOLOGICAL VULNERABILITY In recent years, substantial research has focused on the link between alcohol- related disorders and such other disorders as antisocial personality, depression, and schizophrenia to determine whether some individuals are more vulnerable to sub- stance abuse disorders. About half of those with schizo- phrenia have either alcohol or drug abuse or dependence as well (Kosten, 1997). In addition, antisocial personality disorder, alcohol, and aggression are strongly associated (Moeller & Dougherty, 2001), and in a survey of eight alcohol treatment programs, Morganstern and colleagues (1997) found that 57.9 percent of those in treatment had a person- ality disorder, with 22.7 percent meeting the criteria for antisocial personality disorder. Considerable research also has suggested that there is a relationship between depres- sive disorders and alcohol abuse, and there may be gender differences in the association between these disorde |
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Definition
Addictions have been described as “diseases of denial”
Overall, less than one-third of those with alcohol use disorders receive treatment, and available treatments for alcohol-related disorders show modest effects
Treatment objectives usually include detoxification, physical rehabilitation, control over alcohol abuse behavior, and the individual’s realizing that he or she can cope with the problems of living and lead a much more rewarding life without alcohol. |
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Term
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Definition
| Antabuse makes you vomit when drinking alcholo -In fact, the primary value of drugs of this type seems to be their ability to interrupt the alcohol abuse cycle for a period of time during which therapy may be undertaken |
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Term
| dopamine theory of addiction |
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Definition
| dopamine theory of addiction suggests that addiction is the result of a dysfunction of the dopamine reward pathway (Diana, 2011; Wise, 1980). This pathway, also called the “pleasure pathway,” as mentioned earlier in our discussion of alcohol addiction |
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Term
| reward deficiency syndrome |
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Definition
| The reward deficiency syndrome hypothesis suggests that addiction is much more likely to occur in individuals who have genetic deviations in components of the reward path- way, which leads them to be less satisfied by natural rewards (e.g., from food, sex, drugs, and other pleasurable activities), which in turn leads them to overuse drugs and related experiences as a way to adequately stimulate their reward pathway |
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Term
| Addiction Associated with Psychopathology |
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Definition
approximately 70 percent of people who abuse opioids have other psycho- logical diagnoses, 50 percent have other forms of substance abuse, and 36 percent have a history of trauma.
Moreover, people who abuse opioids are significantly more likely than nonabusers to use the full range of medical services (e.g., mental health visits, ED visits, hospital stays |
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Term
| Drug Treatments and Outcomes |
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Definition
Treatment for opiate addiction is initially similar to that for alcoholism in that it involves restoring physical and psy- chological health and providing help through the with- drawal period (typically in a hospital)
t involved the use of the drug methadone in conjunction with a rehabilita- tion program (counseling, group therapy, and other proce- dures) directed toward the “total resocialization” of addicts.
Methadone hydrochloride is a synthetic narcotic that is related to heroin and is equally addictive physiologically. Its usefulness in treatment lies in the fact that it satisfies an addict’s craving for heroin without producing serious psy- chological impairment, if only because it is administered as a “treatment” in a formal clinical context and can result in reduced drug use and improved cognitive performance |
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Term
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Definition
Despite cocaine’s addictive potential, psychological interventions have proven to be quite effective in success- fully treating cocaine dependence
hat both CBT (described earlier) and contin- gency management (CM) approaches are effective treat- ments for substance use disorders |
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