© 2011 mcgraw-hill higher education. all rights reserved. substance use and abuse chapter thirteen

. © 2011 McGraw-Hill Higher Education. All rights reserved.

Substance Use and Abuse

Chapter Thirteen


Drugs

• The use of drugs for both medical and social purposes is widespread in America

• The most serious consequences are abuse and addiction

• Psychoactive drugs can alter a person’s state of mind or consciousness

• Psychoactive drugs can cause intoxication, a state in which physical and emotional changes occur

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What Is Addiction?

• Addictive behavior is any habit that has gotten out of control, resulting in a negative effect on one’s health

• General characteristics associated with addictive behaviors include:

• Reinforcement• Compulsion or craving• Loss of control• Escalation• Negative consequences

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The Development of Addiction• Addiction often starts when a person does something to bring

pleasure or avoid pain

• Many common behaviors are potentially addictive, but most people who engage in them do not develop problems

• Potential factors:• Personality• Lifestyle• Heredity• Social and physical environment• Nature of the substance or behavior• Some studies have found genetics play a role

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Examples of Addictive Behaviors

• Compulsive or Pathological Gambling• Compulsive Buying or Shopping• Internet Addiction• Other examples:

• Exercising

• Eating

• Watching TV

• Working

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Drug Use, Abuse, and Dependence

• Drug Abuse, as defined by the APA, involves one or more of the following:• Recurrent drug use, resulting in a failure to fulfill

responsibilities• Recurrent drug use in potential physically hazardous

situations• Recurrent drug-related legal problems• Continued drug use despite social and interpersonal

problems caused by or worsened by the effects of the drug

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Drug Dependence

1. Developing tolerance to the substance

2. Experiencing withdrawal3. Taking the substance in

larger amounts or over a longer period than intended

4. Expressing a persistent desire to cut down on or regulate substance use

5. Spending a great deal of time obtaining the substance, using the substance, or recovering from its effects

6. Giving up or reducing important school, work, or recreational activities because of substance use

7. Continuing to use the substance in spite of recognizing that it is contributing to a psychological or physical problem

Involves three or more of these seven symptoms:Involves three or more of these seven symptoms:

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Who Uses (and Abuses) Drugs?

• The use and abuse of drugs occurs at all income and education levels, all ages and ethnic groups

• Characteristics that place people at higher-than-average risk are:

• Being male• Being young• Having frequent exposure to drugs• Being disinterested in school• Having a risk-taking personality

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Psychoactive Drugs and Their Potential for Producing Dependence (Table 13.2)

Potential for DependenceDrug Physical Psychological

Alcohol Possible PossibleAmphetamine Possible HighBarbiturates High ModerateChloral hydrate Moderate ModerateCocaine Possible HighCodeine Moderate ModerateCrack cocaine High HighHashish Unknown ModerateHeroin High HighIce (smoked High High

methamphetamine)LSD None UnknownMarijuana Unknown ModerateMethaqualone High HighOpium High HighPCP Unknown HighPsilocybin None Unknown

SOURCES: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration. 2007. Drugs of Abuse (http://ncadi.samhsa.gov/govpubs/rop926; retrieved May 26, 2009). Beers, M. H., et al. 2006. The Merck Manual of Diagnosis and Therapy, 18th ed. New York: Wiley.

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Treatment for Drug Abuse and Dependence

• Signals suggesting drug dependence:• Sudden withdrawal or emotional distance• Rebellious or unusual behavior• Loss of interest in usual activities• Decline in school performance• Sudden change in groups of friends• Changes in sleeping or eating habits• Frequent borrowing of money

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Treatment for Drug Abuse and Dependence

• There is no single best method of treatment but different types of programs are available

• Treatment programs include:• Drug substitution

• Treatment centers

• Self-help groups

• Peer counseling

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Preventing Drug Abuse and Dependence

• The best solution to drug abuse and dependence is prevention

• Specific approaches include:• Building self-esteem• Improving academic skills• Increasing recreational opportunities• Providing honest information about the effects of

drugs1212


The Role of Drugs in Your Life

• Before you try a psychoactive drug, consider the following questions:• What are the risks involved?• Is using the drug compatible with your goals?• What are your ethical beliefs about drug use?• What are the financial costs?• Are you trying to solve a deeper problem?

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Alcohol

• Ethyl alcohol is the psychoactive ingredient in alcoholic beverages

• The concentration of alcohol is indicated by the term, “proof” (two times the percentage of alcohol)

• When consumed, alcohol is absorbed into the bloodstream from the stomach and small intestine

• The main site of alcohol metabolism is the liver

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Figure 13.2 Immediate effects of alcohol use

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Table 13.3 Effects of Alcohol Blood Alcohol Hours RequiredConcentration (%) Common Behavioral Effects Alcohol to Metabolize

0.00–0.05 Slight change in feelings, usually relaxation 2–3and euphoria; decreased alertness.

0.05–0.10 Emotional instability with exaggerated 3–6feelings and behavior; reduced social inhibitions; impairment of reaction time and fine motor coordination; increasing impairment while driving. Legally drunk at 0.08% in all states.

0.10–0.15 Unsteadiness in standing and walking; loss of 6–10peripheral vision. Driving is extremely dangerous.

0.15–0.30 Staggering gait; slurred speech; impairment of 10–24pain perception and other sensory perceptions.

More than 0.30 Stupor or unconsciousness; anesthesia. Can More than 24 result from rapid or binge drinking with few earlier effects. Death possible at 0.35% and above.

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Effects of Chronic Alcohol Use

• Cirrhosis is a disease in which the liver is severely damaged by alcohol, other toxins, or infection

• Fetal Alcohol Syndrome (FAS) describes birth defects due to excessive alcohol consumption by the mother, including facial deformities, heart defects, and physical and mental impairments• Full-blown FAS occurs in up to 15 out of every 10,000

live births in the United States

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Alcohol Abuse

• Alcohol abuse is the recurrent alcohol use that has negative consequences.

• Alcohol dependence is a pathological use of alcohol, characterized by tolerance and withdrawal symptoms; alcoholism)

• Alcoholism is a chronic psychological disorder characterized by excessive and compulsive drinking

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Problem with Alcohol

• Warning signs:• Drinking alone

• Using alcohol deliberately and repeatedly to perform or get through difficult situations

• Feeling uncomfortable on certain occasions when alcohol is not available

• Escalating alcohol consumption beyond an already established drinking pattern

• Consuming alcohol heavily in risky situations

• Getting drunk regularly or more frequently than in the past

• Drinking in the morning or at other unusual times

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Binge Drinking• Binge drinking is periodically drinking alcohol to the point of

severe intoxication• 5 or more drinks in a row for men• 4 or more drinks in a row for women

• NIAAA report:• 80% of all college students drink• 60% of students 18-20• More than 40% of college students binge drink

• Binge drinking affects both drinking and non-drinking students negatively• 1,700 deaths• 100,000 cases of sexual assault• 600,000 injuries• 700,000 assaults

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Tobacco

• According to the U.S. Surgeon General, smoking is the leading preventable cause of illness and death in the United States

• Tobacco in any form, is unsafe• Each year 440,000 Americans die prematurely from

smoking-related causes• Surveys indicate that many smokers underestimate

the dangers of smoking and are misinformed about smoking cessation tools and success rates

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Table 13.4 Who Smokes?

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Nicotine Addiction

• Nicotine is a poisonous, addictive substance found in tobacco and responsible for many of the effects of tobacco

• Nicotine addiction can start after just a few cigarettes

• Addicted tobacco users must keep a steady amount of nicotine circulating in the blood and going to the brain

• If the amount falls below a certain level, withdrawal symptoms are experienced

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Figure 13.4 The short-term effects of smoking a cigarette

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Long-Term Effects of Smoking

• Long-term effects falls into two categories:• Reduced life expectancy• Reduced quality of life

• Cigarette smoking increases risk for the following:

• Cardiovascular disease and cancers• Tooth and gum disease• Reproductive problems• Motor vehicle crashes and fire-related injuries

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Other Forms of Tobacco Use

• Cigars and pipes

• Clove cigarettes and bidis

• Spit (smokeless) tobacco• Snuff

• Chewing tobacco

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Environmental Tobacco Smoke• Environmental tobacco smoke (ETS) is smoke that

enters the atmosphere from the burning end of a cigarette, cigar, or pipe as well as the smoke that is exhaled by smokers

• There are two types of ETS• Mainstream smoke is smoke that is inhaled by a smoker

and then exhaled into the atmosphere• Sidestream smoke is smoke that enters the atmosphere

from the burning end of a cigarette, cigar, or pipe

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Avoiding ETS

• Strategies:• Speak up tactfully• Don’t allow smoking in your home or room• Open a window• Sit in the nonsmoking section in restaurants and

other public areas• Fight for a smoke-free work environment• Discuss quitting strategies

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Smoking and Pregnancy

• Smoking almost doubles a pregnant woman’s chance of having a miscarriage

• Smoking during pregnancy is linked to the following:• Ectopic pregnancy

• Sudden infant death syndrome (SIDS)

• Low birth weight

• In infants and children—developmental delays, hyperactivity, short attention span, learning problems

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Giving Up Tobacco

• There are many strategies to use to quit using tobacco products

• No single method works for everyone, however, many options are available:

• Behavioral therapy• Nicotine replacement products• Anti-depressant medications• Support groups

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SUBSTANCE USE AND ABUSE

Chapter Thirteen

© 2011 mcgraw-hill higher education. all rights reserved. substance use and abuse chapter thirteen

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