Substance Misuse, Eating Disorders, and Sexual Disorders Flashcards
Screen Time by Age
0-2 years: None
3-5 years: 1 hour of TV per day
6-12 years: 2 hours of TV per day
13-18 years: 2 hours per day of TV, handheld devices, and video games (limited to 30 min)
Never online violent video games or pornography
Psychoactive substance
Affects your state of mind (i.e., caffeine), alters Central Nervous System
Substance Use Disorders
Patterns of maladaptive behavior involving the use of psychoactive substances
Substance Induced Disorders
Disorders caused by the use of psychoactive substances, including: intoxication, withdrawal symptoms, Mood Disorders, etc.
Other Psychoactive Drugs
Anything that alters your mind
Substance Dependence: Theory & Therapy
- Impaired control over the use of psychoactive drug
- Continued, or even increased, use despite knowing that the substance is having a negative effect
What influences alcohol tolerance?
Exposure
Marijuana
- Being smoked more than ever before
- Medical benefits: seizures, developmental disorders (autism spectrum), calming people down
- Lowers testosterone, decreases drive, affects cognitive functioning
- Legalized in some states but not federally
- Oil, food, lotion
- CBD: no THC to get you high, reduces anxiety
Substances & Forensics
In 2002
- 68% of jail inmates reported symptoms in the year before going to jail that met substance dependence or abuse criteria
- 16% of convicted jail inmates said that they committed their offense to get money for drugs
- 63% of inmates who met substance dependence or abuse criteria had participated in substance treatment or other programs
Substance Abuse & Violence
- Drug and alcohol addiction - more than any other mental illness - is associated with violence
- Nearly three quarters of male wife-abusers meet the criteria for alcohol depedence
- Disinhibition of CNS
Substance Abuse and Mental Illness
- 50% of individuals with severe mental illnesses will develop a substance use disorder at some point in their lives
- Half will exhibit current substance abuse or dependence
Substance Abuse vs. Dependence
Dependence - body can’t function without it, withdrawal and need for more
Abuse - affecting life
Substance Use Disorder - General diagnostic criteria
- Impaired control
- Social impairment
- Risky Use - behavior, sexual behavior
- Pharmacological criteria
What decreases risk for substance abuse in kids?
For every year a kid does not use substances at all, more likelihood they won’t have a problem with it
Impaired Control
- Take more of the substance over time
- Time getting the substance
- Daily activities revolve around getting the substance
- Cravings
Social Impairment
- Failure to fulfill major life obligations
- Continued use despite its impact on social, work, and recreational activities
- Important social, occupational, or recreational activities are given up because of use
Risky Use
- Using in risky situations which may be physically dangerous
- More fentanyl (opioid) coming across the border than marijuana
Pharmacological Criteria
- Tolerance: marked increase of the substance in order to achieve the desired effect
- Withdrawal: is a syndrome that occurs when blood or tissue concentration of a substance declines
Harm Reduction
A set of practical strategies and ideas aimed at reducing negative consequences associated with drug use
Societies number one drug problem is…
Alcohol
Alcohol
- Social cost - 185 billion a year (med. exp., lost productivity)
- 1 in 4 children younger than 18 is exposed to alcohol abuse or dependence in the family
- 1995 - 52% of Americans aged 12 or older used alcohol
- 1995 - 6% were heavy drinkers. Had 5 or more drinks on the same occasion on at least 5 different days in a month
- Alcohol and Suicide (1/3rd of completed suicides)
- Related to violence towards self or others
Blood Alcohol Level
BAC = amount of alcohol in relation to a specific volume of blood
.05 - lowered alertness; usually good feeling; release of inhibitions; impaired judgment
.08 (NY) - impaired driving, legally intoxicated
.10 - Less caution; impaired motor function
.15 - Large, consistent increases in reaction time
.20 - Marked depression in sensory and motor capability, decidedly intoxication
.25 - Severe motor disturbance, staggering; sensory perceptions greatly impaired
.30 - Stuporous, but conscious - no comprehension of world around them
.35 - Equivalent to surgical anesthesia
.40 - Probable lethal dose
Alcohol Dependence
The Personal Cost of Alcohol Problems:
- Vast majority of men killed in car accidents were drunk at the time. 73% were chronically heavy drinkers
- Most widely used anxiolytic
- “relieves tension” (individuals who are suffering in some way turn to alcohol to numb symptoms, PTSD - Vietnam)
- “social lubrication”
- Highly correlated with ASPD, depression, and anxiety
Alcohol Physiologically
- Slows down brain functioning that control, organize, and inhibit mental processes
- Loss of self control
- Executive functioning
- Lots of substance abuse post 9/11 (FDNY)
- ANS (sympathetic nervous system) - fight or flight
Consequences of habitual use
- Stomach ulcers
- Hypertension
- Heart failure
- Cancer
- Brain damage - shrinking in frontal lobe
- Early onset of dementia
- Cirrhosis of the liver (resistant to damage, can rebuild)
- Delirium tremens - seizures
- Korsakoff’s psychosis - deficiency in Thiamine (anterograde amnesia and confabulation)
Groups at Risk for Alcohol Abuse
- Higher income = more likely to drink
- College degree = 68% drink
- Context = Alcohol use increased in NYC following 9/11
- 60% of men vs 45% of women use
- 32% of men vs. 11% of women use to excess
- Women more often combine alcohol with other substances (e.g., tranquilizers)
- Ethnic group at highest risk .- Native Americans
- In 2010, Native Americans had the highest rate of drug-induced death (17.1%)
Treatment of Alcohol Dependence
Medical Detoxification
- Getting alcohol out of the person’s system (dehydration - nutritional deficiency) –> IV, multivitamins
- Can be done outpatient - utilize a tranquilizer to prevent seizures (risky)
- 700,000 people in US receive treatment daily
- ANTABUSE: take voluntarily, makes you nauseous if you drink alcohol
Support Groups: Alcoholics Anonymous
- Once an alcoholic, always an alcoholic
- You can never go back to normal drinking
- Less than 10% who start, continue
- Sponsor
- “If you hang out in a barber shop long enough you are bound to get a haircut”
Relapse Prevention
- Narcan - in the nose, quick pump (3-4 times) for individuals high on opiates
- Relapse begins with high risk situations:
- Being in a situation that may make you lose control (e.g. running into an “x” at a party)
- Increasing confidence to protect from relapse
Control drinking
Only drinking X amount each time; doesn’t work very well
Nicotine Dependence
A lot less people smoking than ever before
- Uptake of e-cigarettes
- Stimulates and relaxes you at same time
- One out of every four American adults is a smoker
- More have died from than all the wars and car accidents
- Withdrawal can lead to depression and anxiety
- Nicotine - paradoxical effect on nervous system
- The Antismoking Movement
- Learning or Addiction? No evidence of tolerance.
Other Psychoactive Drugs
- Marijuana
- Stimulants
- Cocaine
- Sedatives/tranquilizers
- Hallucinogens (including LSD)
- Opiates (including heroin)
- Any illegal drug
- Alcohol
- Cigarettes