Substance Use Disorders Problems associated with
using and abusing drugs or substances which alter the way people think, feel, and behave.
Substance dependence Maladaptive pattern of substance use that leads to
clinically significant impairment or distress Substance abuse
Recurrent and significant adverse consequences related to substance use
Abnormal Psychology, 11/e by Sarason & Sarason © 2005
Substance Dependence Tolerance Withdrawal Ingestion of more than intended Persistent desire or unsuccessful effort to use less Spending a lot of time on obtaining, using, or
recovering from the substance Reduced social, occupational, or recreational
activities due to use of substance Continued use despite knowledge of the
psychological and/or physical problems caused Presence of 3 or more of the above in a 12-month
period
Abnormal Psychology, 11/e by Sarason & Sarason © 2005
Substance Abuse Recurrent substance use leading to failure to
fulfill work, school, home obligations Recurrent substance use in hazardous
situations, like driving Recurrent substance-related legal problems, like
arrests Continued substance use despite persistent
social or interpersonal problems caused by using the substance, such as getting in fights
The presence of three or more of the above within a 12-month period
Abnormal Psychology, 11/e by Sarason & Sarason © 2005
Substance Intoxication
Disturbances of perception wakefulness attention thinking judgment motor behavior interpersonal behavior
Abnormal Psychology, 11/e by Sarason & Sarason © 2005
Substance Intoxication Level of intoxication depends on
the substance the dose history of use person’s tolerance (related to body size,
gender, history of use) person’s expectation of use environment or setting in which substance is
ingested
Abnormal Psychology, 11/e by Sarason & Sarason © 2005
The effects of alcohol Ethyl alcohol (a CNS depressant), or ethanol, is the
alcohol in beer, wine, hard liquor Alcohol blocks messages between nerve cells First affects frontal lobes where reasoning, memory,
judgment, and inhibitions take place Next affects cerebellum, seat of motor and muscle
control, balance, five senses Finally affects the spinal cord and medulla, which
governs breathing, heart rate, and body temperature Blood alcohol content of 0.5% or more can lead to
death
Abnormal Psychology, 11/e by Sarason & Sarason © 2005
Alcohol use and risks
70% of Americans drink occasionally 21- to 34-year olds drink the most Half of all alcohol is consumed in binge sprees (5 or
more drinks at a time) Alcohol use in US implicated in
40% of traffic fatalities 50% of deaths from falls 52% of fire-related deaths 38% of drowning deaths 20% of health-related expenditures
Abnormal Psychology, 11/e by Sarason & Sarason © 2005
Models of Alcohol Disorders Biological
Metabolic, genetic, and neural processes Psychodynamic
Effort to change negative emotional states Behavioral
Learned from modeling and social reinforcement Cognitive
Expectations about effects of alcohol Interactional
Stress precipitates use in people with predisposition to use
Abnormal Psychology, 11/e by Sarason & Sarason © 2005
Treatment of Alcohol Disorders Biological
Drug Management of withdrawal symptoms
Psychodynamic Psychotherapy provides little benefit unless family
contexts of drinking explored Cognitive-behavioral
Aversive conditioning Covert sensitization Controlled drinking Relapse prevention
Community-based treatment Alcoholics Anonymous most widely used
Abnormal Psychology, 11/e by Sarason & Sarason © 2005
Alcohol-related Disorders: Risk Factors Poverty Neighborhood disorganization Childhood behavior problems Poor family management practices Family conflict Lack of family cohesion Academic failure Social pressure to use Alienation and rebelliousness Rejection by peers
Abnormal Psychology, 11/e by Sarason & Sarason © 2005
Barbiturates and Tranquilizers
Depressing effect on central nervous system Dangerous in combination with alcohol Barbiturates often prescribed to relieve
anxiety and prevent convulsions Tranquilizers can lead to tolerance and thus
overuse
Abnormal Psychology, 11/e by Sarason & Sarason © 2005
Opioids Drugs from the opium class; with morphine-like effect
that bind to brain’s opioid receptors Sometimes called narcotics Heroin and morphine most commonly used Endorphins, enkephalins, and polymorphins are
body’s endogenous opioids Cause change in mood, sleepiness, mental clouding,
constipation, slow respiratory system Withdrawal can be severe Methadone maintenance is most widely used
treatment
Abnormal Psychology, 11/e by Sarason & Sarason © 2005
Cocaine Produced from leaves of coca plant Stimulates CNS and decreases appetite Can produce mania, paranoia, and impaired
judgment Crack is more potent distilled form and is
highly addictive Treatment focuses on self-help and social
support (AA-type programs)
Abnormal Psychology, 11/e by Sarason & Sarason © 2005
Amphetamines Psychomotor stimulants
Affect central nervous system and cardiovascular system
Moderate use Wakefulness, alertness, elevated mood
High dosage Nervousness, dizziness, confusion, elevated blood
pressure Tolerance develops rapidly Methamphetamines
Chemically similar but has greater CNS impact
Abnormal Psychology, 11/e by Sarason & Sarason © 2005
Hallucinogens
Also known as psychedelics CNS action produces alterations in
consciousness Natural hallucinogens (e.g., Mescaline,
Psilocybin) Synthetic hallucinogens (e.g., STP, LSD) Abuse leads to respiratory or cardiovascular
collapse and psychotic behavior Treatment consists of support groups of
enhancing social skillsAbnormal Psychology, 11/e
by Sarason & Sarason © 2005
Phencyclidine (PCP)
Synthetic chemical Causes disorientation and hallucination User may feel dissociated Users may develop severe depression or
psychosis Effects may be irreversible
Abnormal Psychology, 11/e by Sarason & Sarason © 2005
Inhalents
Volatile substances or organic solvents (gasoline, spray paint)
Produce changes in perception Use may lead to withdrawal from social,
occupational, or recreational activities More commonly used by young people Use can lead to dependence with tolerance
and withdrawal symptoms
Abnormal Psychology, 11/e by Sarason & Sarason © 2005
Cannabis Sativa (Marijuana/ Hashish) Most often used in marijuana form Hashish is the solidified resin of the cannabis
plant Major active ingredient in cannabis is THC Marijuana use
Impairs motor coordination and perception Affects short-term memory and learning
Treatment Relapse prevention Social support groups Legalized in some countries (e.g Holland)
Abnormal Psychology, 11/e by Sarason & Sarason © 2005
Nicotine CNS stimulant found in tobacco Stimulates acetylcholine receptors Increases heart rate and blood pressure Can be highly addictive Cessation requires
commitment to change implementation of change relapse prevention
Nicotine gum and patch may be helpful if used with counseling.
Note that the negative effects are not limited to nicotine addiction, but other effects of smoking
Abnormal Psychology, 11/e by Sarason & Sarason © 2005
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