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Abnormal
Psychology PSY404
VU
Lesson
37
ALCOHOLISM
AND SUBSTANCE RELATED
DISORDERS
Why do we
need to study drug
use?
1-We
take aspirin to reduce
headache.
2-We
take an antibiotic to fight an
infection.
3-We
take
tranquilizer
to
calm
ourselves
after
facing
a
trauma.
4-
We drink coffee or tea in the morning to
get going.
5-
Smoke a cigarette to relax
our nerves.
Examples
1-
Sherlock Holmes a famous detective, a
fictional character
who
took drug stimulants to
keep
himself
alert.
2-
Sportsmen take drugs to
enhance their performance
but in the long run their
body develops drug
dependence.
The
term drug applies to any substance
other than food that
changes our bodily and
mental
functioning.
There are many substances
that are capable of harming
the body or adversely affecting
the
behavior
and mood. The misuse of
drugs has become one of the
most disabling problems of the
society.
Drug misuse may lead to a
temporary mental syndrome such as
intoxication but chronic
excessive
use of drugs can lead to a
substance use disorder.
Substance
use disorder can take two
forms
1-
Substance abuse
2-
Substance dependence
1-
Substance abuse
A
pattern in which people rely heavily on a drug and
they structure their lives around a
drug.
2-
Substance dependence
In
which people show all
symptoms of substance abuse
plus physical dependence on the
drug.
It
is believed that approximately 7 % of all
adults in United States currently
display some form of
substance
use disorder.
Substance
Dependence, the
more severe in these two
forms, refers to a pattern of repeated
self-
administration
of increased amounts of the drug to
achieve intoxication; withdrawal,
unpleasant
physical
and psychological effects
that the person experiences
when he or she tries to stop
taking the
drug;
and compulsive drug-taking
behavior.
The
Concept of Substance
Dependence
Many
psychological features or problems
are associated with
dependence on chemical substances.
One
such
feature involves craving.
Craving
is a forceful urge to use
drugs, but the relationship between
craving and drug use is
actually
very
complex. People who are
dependent on drugs often say
that they take the drug to control
how they
are
feeling. Some clinicians refer to this
condition as psychological
dependence. As the
problem
progresses,
it is not unusual for the
person who abuses drugs to
try to stop. Unfortunately,
efforts at
self-control
are typically short-lived
and usually failed. Tolerance and
withdrawal are usually
interpreted
as
evidence of physiological
dependence.
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The
explanation for drug abuse can be done by
using the following
perspectives
1-
Biological
2-
Psychodynamic
3-
Behavioral
4-
Socio-cultural
·
The
biological view or perspective
suggests that that people
inherit a predisposition to drug
addiction
based on their research of
twin and adoptee
studies.
·
The
psycho dynamic perspective
view that people who turn to
drugs have an
inordinate
dependency
needs and they turn to
drugs.
·
Behavioral
perspective suggests that drug
use is reinforced because it reduces
tension and raises
spirits.
·
Socio-cultural
perspective suggests that the people
most likely to develop a pattern of drug
abuse
are
those where societies create
stress and their families
tolerate drug abuse.
Integrated
Systems
·
We
can conclude that alcoholism
and other forms of addiction
clearly result from an
interaction
among
several types of
systems.
·
Various
social, psychological, and
biological factors influence the person's
behavior at each stage
in
the
cycle, from initial use of
the drug through the eventual onset of
tolerance and withdrawal.
The
drugs that we will focus in
this chapter fall into three
categories
1-
Depressants are
substances which slow the
activity of central nervous
system they include
·
Alcohol
·
Sedative-Hypnotic
drugs
·
Opioids.
2-
Stimulants are
substances that increase the
activity of the central nervous
system, resulting in the
increased
blood pressure, heart rate,
intensified activity, thought
processes and
alertness.
The
important stimulants
are
·
Cocaine
·
Amphetamines
·
Nicotine
·
Caffeine
3-
Hallucinogens are
substances that cause
changes primarily in sensory
perception.
They
include
·
LSD
·
Cannabis
drugs
1-
Depressants
a-
Alcohol
·
Alcohol
affects virtually every
organ and system in the
body.
·
After
alcohol has been ingested, it is
absorbed through membranes in the
stomach, small intestine,
and
colon.
·
The
rate at which it is absorbed is
influenced by many variables, including
the concentration of
alcohol
in the beverage, the volume and rate of
consumption, and the presence of food in
the
digestive
system.
·
After
it is absorbed, alcohol is distributed to
all the body's organ
systems.
·
Almost
all the alcohol that a person
consumes is eventually broken down or
metabolized in the
liver.
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·
According
to DSM-IV-TR, the symptoms of alcohol
intoxication include slurred speech,
lack of
coordination,
an unsteady gait, nystagmus
(involuntary to-and-fro movement of the
eyeballs
induced
when the person looks upward or to the
side), impaired attention or memory, and
stupor
or
coma.
·
The
prolonged use and abuse of
alcohol can have a devastating
impact on many areas of a
person's
life.
i-
The disruption of relationships with
family and friends can be
especially painful.
ii-
Regular heavy use of alcohol is
also likely to interfere
with job performance.
iii-
Many heavy drinkers encounter
problems with legal
authorities.
iv-
On a biological level, prolonged exposure
to high levels of alcohol can
disrupt the functions of
several
important organ systems,
especially the liver, pancreas,
gastrointestinal system,
cardiovascular
system, and endocrine
system.
In
fact, over an extended
period of time, alcohol dependence has
more negative health
consequences
than abuse of any other
drug, with the exception of
nicotine.
v-
The misuse of alcohol leads to an
enormous number of severe injuries and
premature deaths in
every
region of the world.
b-
Sedative-hypnotic Drugs
This
group of depressants includes
Barbiturates and
Benzodiazepines.
Barbiturates
i-
They relax the muscles
ii-
Produce feeling of well being
and
iii-
They are used to induce
sleep.
Example
Marilyn
Monroe's death is attributed to
excessive use of alcohol and
barbiturates.
Benzodiazepines
or Antianxiety drugs
They
reduce anxiety.
Example:
valium.
c-
Opioids
·
These
include Opium and drugs derived
from it such as heroine and
morphine.
·
Opium
is a substance derived from the sap of
the opium poppy seed.
·
It
was widely used in the past
because of its ability to
reduce both physical and
emotional pain.
·
Morphine,
its name is derived from
Morpheus the Greek god of
sleep.
·
It is an
effective pain reliever and helps to
put person to sleep.
·
In
USA its use accelerated
during civil war when wounded
soldiers received its injections
but it
soon
became clear that its
repeated administrations lead to
addiction.
·
Heroine
·
Morphine
was converted into a new pain reliever
called heroine for years heroine
was viewed as the
wonder
drug.
·
Used
as medicine but due to its
addictive qualities it is illegal in USA under
all circumstances.
·
The
various Opioid drugs are
known collectively as narcotics.
·
Narcotics
can be smoked, inhaled and
injected.
·
Worries,
tensions and pain subside
but the person becomes
unconcerned about the food
and bodily
needs.
·
The
person becomes lazy and
lethargic.
2-
Stimulants
Stimulants
are substances that increase
the activity of the central nervous
system, resulting in the
increased
blood pressure, heart rate,
intensified activity, thought
processes and
alertness.
Some
important stimulants
are
a-
Cocaine
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b-
Amphetamines
c-
Nicotine tobacco products such as
cigarettes.
d-
Caffine such as in coffee,
chocolate and many soft
drinks.
a-
Cocaine
·
Cocaine
is the central active ingredient of the
coca plant it is the most
powerful natural stimulant.
People
use to chew coca leaves
for energy and
alertness.
·
Processed
cocaine is an odorless, fluffy
white powder.
·
It
can be inhaled or injected
·
Smoking
coca base in pipe or
cigarette.
·
Serious
side effects the users can
become irritable, depressed, paranoid
and unable to control
their
emotions.
·
It
can even create fatal heart
problems heart beating
rapidly and
irregularly.
·
It
can even cause the breathing
function and heart function
to come to sudden halt.
b-
Amphetamines
·
Amphetamines
are stimulant drugs. They
were first used in treatment of
asthma.
·
These
drugs soon became popular
amongst people trying to loose
weight.
·
Athletes
seeking an extra bust of
energy.
·
Soldiers,
truck drivers and pilots
trying to stay awake.
·
Students
studying for exams throughout
night.
·
Amphetamines
are most often taken in
pill or capsule or injection
form.
·
People
using amphetamines reduce
their appetite and weight.
c-
Nicotine
·
Nicotine
is the active ingredient in tobacco,
which is its only natural
source.
·
Nicotine
is almost never taken in its
pure form because it can be
toxic.
·
The
effects of nicotine on the peripheral
nervous system include increases in
heart rate and
blood
pressure.
d-
Caffeine
·
It is
called the gentle stimulant used by
some 90% of the people.
·
It is
found in tea, coffee and
cola drinks.
i-
It elevates mood
ii-
Reduces fatigue
iii-
When denied it causes headaches,
drowsiness and unpleasant
mood.
·
In the
central nervous system,
nicotine has pervasive
effects on a number of neurotransmitter
systems.
·
Nicotine
has a complex influence on subjective
mood states.
·
Nicotine
is one of the most harmful
and deadly addicting
drugs.
3-
Hallucinogens
·
Hallucinogens
are substances that cause
changes primarily in sensory
perception.
·
The
sight, sound, smell,
feelings and even taste
are distorted sometimes in dramatic
ways when in
under
the effect of Hallucinogens.
·
They
include
a-
LSD
b-
Cannabis drugs
a-
Lysergic acid diethylamide or
LSD
Lysergic
acid diethylamide or LSD it is a naturally occurring
derivates of the grain fungus but it
can
be
synthetically produced. It causes a profound
perceptual changes and
hallucinations.
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b-
Cannabis
·
Cannabis
is a hemp plant from where
we get hashish and
marijuana.
·
Both
impair motor and cognitive
functions.
·
It
contributes to lung disease.
Treatment
for substance abuse
disorders
Treatment
for substance abuse
disorders include
1-Biological
therapy
2-Insight
therapy
3-Behavioral
techniques (Aversive therapy and Relapse
prevention training)
4-
Self help groups
5-Therapeutic
communities
The
goals of treatment for substance
use disorders are a matter
of controversy.
1-
Some clinicians believe that
the only acceptable goal is
total absence from drinking
or drug use.
2-
Others have argued that, for
some people, a more
reasonable goal is the moderate
use of legal drugs.
1-
Biological Therapy
a-
Detoxification
·
Alcoholism
and related forms of drug abuse
are chronic conditions and
their treatment is typically
accomplished
in a sequence of stages, beginning
with a brief period of
detoxification--the
removal
of a drug on which a person has
become dependent--for 3 to 6
weeks.
b-
Medications
·
Following
the process of detoxification, treatment
efforts are aimed at helping
the person to
maintain
a state of remission.
·
Several
forms of medication are used to help the
person refrain from
drinking.
·
If a
person who is taking
medicine consumes even a
small amount of alcohol, he or she
will
become
severely ill.
2-
Insight Therapy
·
Insight
therapies try to help the
clients become aware of and
address the psychological factors
that
contribute
to their pattern of drug use.
3-
Behavioral Techniques
a-
Cognitive Behavior Therapy
·
Cognitive
behavior therapy teaches people to
identify and respond more
appropriately to
circumstances
that regularly precipitate drug
abuse.
·
One
element of cognitive behavior therapy
involves training in the use of
social skills, which
might
be
used to resist pressures to
drink heavily.
·
Most
people who have been
addicted to a drug will say
that quitting is the easy
part of treatment.
·
The
more difficult challenge is to maintain
this change after it has been
accomplished.
b-
Relapse Prevention
Model
·
Alan
Marlatt, a clinical psychologist at the
University of Washington, and his
colleagues have
proposed
a cognitive behavioral view of the
relapse process.
·
The
relapse prevention model addresses
several important issues
that confront the addict in
trying
to
deal with the challenges of
life without drugs.
·
Another
important feature of the relapse
prevention model is concerned with the
guilt and
perceived
loss of control that the
person feels whenever he or
she slips and finds himself
or herself
having
a drink (or a cigarette or
whatever drug is involved) after an
extended period of
absence.
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c-
Aversive Therapy
Aversive
conditioning in which an unpleasant
stimulus is paired with the drug
that the person is
taking.
4-Self-Help
Groups:
Alcoholics
Anonymous
·
Alcoholics
Anonymous (AA) is maintained by alcohol
abusers for the sole purpose
of helping other
people
who abuse alcohol become and
remain sober.
·
AA is
not officially associated
with any other form of
treatment or professional organization.
·
The
viewpoint espoused by AA is fundamentally
spiritual in nature.
·
In this 12
step procedure in which the
first step is the person
must acknowledge that he or
she is
powerless
over alcohol and unable to
manage his or her
drinking.
·
The
remaining steps involve spiritual and
interpersonal matters such as accepting
"a Power greater
than
ourselves" that can provide
the person with direction;
recognizing and accepting
personal
weaknesses;
and making amends for previous
errors, especially instances in
which the person's
drinking
caused hardships for other
people.
5-
Therapeutic communities
·
Therapeutic
communities or residential therapeutic
communities where addicts
live, work and
socialize
in a drug free environment.
·
There is
social and cultural disapproval and
unacceptability for drinking, smoking and
use of drugs
because
it has become one of the
most disabling problems of the
society.
·
Just
say no to drugs.
·
It
feels good.
·
YOU
can get help in saying no to
drugs from your own
self, family, friends and
others.
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