Substance Use Disorder
A problematic pattern of substance use leading to clinically significant impairment or distress, as manifested by at least two of the following, occurring within a 12 month period
Tolerance
- Increased amount of drug needed for desired effect
- diminished effect of same amount of drug
Full remission
At least one month without any of the criteria being met
- early 3-12 months
- sustained 12+ months
Substance intoxication
The development of a reversible substance specific syndrome due to a recent investigation of (or exposure to) a substance
Substance Withdrawal
The development of a substance-specific syndrome due to the cessation of (or reduction in) substance use that has been heavy or prolonged
Alcohol
- 2 billion ppl consume alcohol
- 6.6% of the world population have a alcohol dependence or abuse
- binds to the GABA receptors and decreases neuronal excitation
- inhibits frontal lobe function
- inhibits motor control
- inhibits sensory areas
- inhibits cognitive functions
- blood concentrations
- toxic effects(FAS, Korsakoff’s syndrome)
Alcohol Intoxication
- Recent ingestion of alcohol
- clinically significant maladaptive behavior or psychological changes
Alcohol Withdrawal
- cessation of opioid use that has been heavy and prolonged
- nausea, muscle aches, lacrimation, sweating, dysphoric mood, diarrhea, yawning, fever, etc.
Cocaine
clinically significant behavioral or psychological changes (anxiety/depression, ideas of reference, fear of losing one’s mind, paranoid ideation, impaired judgment
Polysubstance Use Disorder
individual repeatedly uses at east 3 groups of substances, but no single substance predominates
Causes of substance-related disorders
- Stressful socioeconomic areas
- lack of appropriate nurturance leads to increased dependency on others and other external sources of comfort and care
- genetics
- increased use of drugs reduced the brains release the associated neurotransmitters
Treatment
- aversion therapy(pairing drug use with an aversive stimulus)
- rewards given to drug free behavior
- patients track their own drug use behavior
- teach appropriate coping strategies
- drug maintenance therapy
- residential treatment programs
