Substance Abuse General

Terms Substance Use - Use of a substance that causes no immediate harm Substance Misuse - Use of a substance resulting in the person experiencing social, physical, legal or psychological problems Substance Abuse - Use of a substance that causes harm

Four Categories of Harm from Substance Abuse Failure to fulfill important family, school or work obligations  Repeatedly using the substance in dangerous situations, eg Driving Repeated problems involving the law and frequent arrests  Social problems with friends/family

There are no agreed definitions of Substance abuse, One definition from West is 'a behaviour over which the individual has impaired control with harmful consequences'

AddictionWhere a substance, natural or synthetic, has been used repeatedly, resulting in the user being preoccupied with the substance, maintaining a supply and likely to relapse if attempts are made to stop taking the drug.  The user is likely to be both physically and psychologically dependent on the drug

Physical DependenceDependence comes about when the body needs a substance to bring it back to a ‘normal’ state; in other words it is concerned with avoiding an unpleasant state

Effect on the Brain  Psychoactive drugs affect a persons behaviour or mood by acting on neurotransmitters in the brain (Pinel)  Addictive behaviour is associated with reward centers in the brain, the addict is trying to stimulate these areas   Dopamine is the neurotransmitter most associated with addictive behaviuor 

Olds and Milner Rats had electrodes placed on septal brain area, they had a lever for self stimulation. The rats pressed the lever rapidly for extended periods of time, some pressed it until exhausted and unable to press anymore. Stimulating the septal area was pleasurable or rewarding for rats  

PhillipsFound that stimulating this area of the brain increases levels of Dopamine. Suggests Dopamine is the neurotransmitter associated with feeling of excitement and pleasure

CarlsonAll substances that are abused appear to cause an increase in the level of dopamine in the brain

The Basis of addiction is the pleasurable experience associated with the use of a psychoactive substance

Dependence When the body gets used to the presence of a psychoactive substance, the bodies chemistry changes and the person becomes physically dependentDependence is concerned with avoiding an unpleasant state while addiction is concerned with promoting a pleasant state

Two Types of Dependence Physical Dependence, the body needs the substance to function normally, suffers withdrawal symptomsPsychological Dependence, people believe they need the substance, can cause people to relapse even after withdrawal symptoms are gone    

Six Components of Addictive Behaviour  The behaviour becomes the most important thing in the persons life Behaviour is associated with a rush of excitement  Addict has to increase the behaviour to get the same effect When the addict stops the behaviour, there are withdrawal symptoms Negative effect on people around them Relatively high risk of relapse when the addict stops the behaviour

Psychological DependenceThe emotional and cognitive compulsion to use a drug (Straub)

CompulsionAn uncontrollable urge or desire to repeat the behaviourThe drug manifests itself as an emotional and conscious compulsion and dictates many of the addicts daily activities

Craving A motivational state that involves want or desire, often overwhelming. Varies from drug to drug

ToleranceThe body has adapted to the use of the drug over time, it can be seen in 2 ways. It can also be conditioned (Siegal) The same amount of the substance has less of an effect More of the substance is needed to have the same effect (Pinel)

SiegalRats were given heroine and built up tolerance, then half the rats were put in a new place and some stayed on their normal place. They were all given a potentially lethal dose of heroine. 55% of the rats in the new environment died while only 30% of the ones that didn't move died.Shows environment can have an effect on tolerance

WithdrawalWithdrawal can be effected by the drug being used, the level of abuse, whether stopping is a gradual or immediate process.  Often is just the opposite to the effects of the substance 

Solvent AbuseSimilar to the effects of alcohol, achieved by inhaling the vapour of solvents at room temperature, 21% of 15-16 year olds say they have tried it

Field and SmithInvestigated trends in substance abuse by looking at the number of deaths due to solvent abuse. The highest number of deaths was 152 in 1990, since then there has been a significant decrease, in 2000 there was only 64. A campaign aimed at parents in 1992 was taken to be a success by the fall in the number of deaths 

Male-Female80% of under 18s that die from solvent abuse are male however equal numbers of males and females use the substance

Tobacco and NicotineResponsible for Millions of deaths, Very few convictions for selling tobacco to minors, unskilled manual group are the highest smokers and the 20 - 34 age group

NicotineThe addictive substance in tobacco, a mild stimulant that turns to a vapour when burnt, stays in the blood stream for 30 minutes

4 Types of Smoker  Habitual - Smoke as a matter of habit, take little pleasure from smoking and are often unaware they are doing it Positive Emotion - Smoke to relax and feel good Negative Emotion -  Smoking reduces anxiety and stress Addictive - Aware when they are smokig but also aware when they are not

Factors in the Decision to Start Smoking Personal factors - Beliefs about smoking and the consequences Socio cultural Factors - the influence of friends and family members  Environmental factors - such as cost and availability of cigarettes

Nicotine Regulation ModelPeople smoke continuously to keep a certain level of Nicotine in the bloodstream (Schachter) 

SchacterSmokers smoked low nicotine cigarettes for one week and high nicotine cigarettes for one week, they smoked about 25% more low nicotine cigarettes 

AlcoholIn low doses it can act as a stimulant but in moderate to high doses its is a depressant, it is absorbed into the bloodstream and tolerance is built up

Positive/Nagative EffectsLight to moderate drinking can reduce coronary heart diseaseCirrhosis of the liver, some cancers, Korsakoff's Syndrome 

Korsakoff's SyndromeA memory disorder common in long term heavy drinkers, they have great difficulty in remembering recent things and have an inability to learn new things

Alcohol Withdrawal Symptoms Shaking, sweating, anxiety, nausea, stomach cramps etc, occurs after a few hours Convulsions or seizures, 2nd or 3rd day Hallucinations (DTs) fever and irregular heart beat may develop

StimulantsStimulate the CNS, result in energy and feelings of happiness 

CocaineShort lived effects, no tolerance, people can develop dependence, withdrawal effects aren't very serious, typically uses in a cycle of use and recovery. Relatively easy to stop but risk of relapse is very high 

AmphetaminesSimilar effects to cocaine but longer lasting 

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