Diagnosing Substance Use Disorders
Divided into 10 classes
Alcohol, Caffeine, Cannabis, Hallucinogens, Inhalants, Opioids, Sedatives, Hypnotics and anxiolytics, Stimulants, Tobacco, Other unknown substances)
Individual can receive a diagnosis for one or more of these classes.
Refers to recurrent use of one of these specific substances that leads to adverse consequences
DSM - 5 Diagnosis of Alcohol Use Disorder
Problematic pattern of alcohol use leading to clinically significant impairment or distress, as manifested by at least two of the following symptoms occurring within a 12 month period
1) Impairment of Control Over Use: Taking the substance in greater amounts for longer than intended
2) Social Impairment: Failure to fulfill major role obligations at work, home or school, continues use despie clear negative consequences on realtionships and reduction of other involvement give priority to using the substance
3) Risky Use: Used in situations in which it might be hazardous, such as driving or operating machinery
4) Pharmacological Dependence - Tolerance: Person needs increased amounts of the substance to achieve the same effect. Withdrawal experience unpleasant and sometimes dangerous symptoms
Polysubstance Use Disorder
Simultaneous misuse or dependence upon two or more substances. Appears to be on the rise and is more common in young people
Alcohol
“World’s number one psychoactive substance”.
Uni students more likely to consume larger amounts of alcohol on a singular occasion (binge drinking)
Researchers suggest there is a direct relationship between overall level of consumption within a population and number of people suffering alcohol use disorder
Alcohol Use Disorders Identification Test (AUDIT) - 10 question screen tool administered to estimate risk level
Ethyl Alcohol
Effective chemical compound in alcoholic beverages. Reduces anxiety, produces euphoria and creates sense of well being.
Also reduces inhibition which adds to perception that alcohol enhances social and physical pleasure, sexual performance, power and social assertiveness.
Short Term Effects
At lower dose, effects of alcohol is stimulating, resulting in pleasant feelings
At higher dose, alcohol acts as a depressant, and many may experience dysphoria (high doses can also produce unconsciousness and death)
Long Term Effects
Chronic alcohol consumption is related to many diseases
Comes in contact with every organ, directly or indirectly affecting every part of the body. Factors related to severity of damage include an individual’s genetic vulnerability, frequency and duration of drinking, severity and spacing of binges
Heavy alcohol use has been associated with damage to the heart muscle, high blood pressure, and stroke
Fetal Alcohol Spectrum Disorder
Relationship between maternal drinking and birth defects
Genetic Factors (Addiction)
Twin studies confirmed that male monozygotic twins are more similar than dizygotic twins in their tendencies to develop problems with alcohol abuse and dependence.
Another genetic factor that may be involved in alcohol use disorders is the ability to metabolize alcohol
Neurobiological Influences (Addiction)
EEG’s have been used to link certain responses in parts of the brain (the P3000 trigger) to people with substance abuse disorders, as well as lower production of certain neurotransmitters
Psychological Factors (Addiction)
Strong association with trait of behavioural disinhibition - people with alcohol use problems tend to have greater difficulty inhibiting behavioural impulses
Tension Reduction Theory - Suggests that drinking is reinforced by it’s ability to reduce tension, anxiety, agner, depression and other unpleasant emotions
Alcohol Expectancy Theory - Proposes that drinking behaviour is largely determined by the reinforcement that an individual expects to receive from it
Sociocultural Factors (Addiction)
People who are introduced to drinking as a rite of passage in an environment where drinking is socially accepted face an increased risk for developing alcohol problems
Treatment (Addiction)
Minnesota Model; Pharmacological Model; Psychological Method of Treating Alcohol Disorders
Minnesota Model
12 step approach much like AA. Treats alcohlism like a physical disease which needs to be cured
Pharmacological Model
Antagonist drugs have been used to block pleasurable affects of alcohol from the brain, and antagonist drugs have been used to reduce cravings while not replicating the intoxicating effects
Psychological Method of Treating Alcohol Disorders
Behavioural treatments (treating it like a bad behaviour that can be cognitively restructured), relapse prevention (targeting the self defeating thoughts that cause relapses) and marital and family therapy (targeting the root causes of why someone feels the need to abuse substances)
Barbiturates and Benzodiazepines
Considered depressants as they limit neurotransmitter activity in the CNS causing lowered anxiety, better sleep and sedative qualities
Difference Between Substance Use and Intoxication
Intoxication is more harmful - has mood cogntiion, judhemt, functioning effects
