Transcript Defining substance

Defining substance abuse
Health Psychology
Introduction to Substances
Definitions of Substance
Use/Abuse/Dependence
Abuse

A maladaptive pattern of substance use,
leading to a clinically significant
impairment or distress, as manifested by
one (or more) symptoms occurring at any
time in the previous 12 months
Abuse: Symptom 1

Recurrent substance use resulting in a
failure to fulfill major role obligations at
work, school, or home.
Abuse: Symptom 2

Recurrent substance use in situations in
which it is physically hazardous.
Abuse: Symptom 3

Recurrent substance use-related legal
problems.
Abuse: Symptom 4

Continued substance use despite having
persistent or recurrent social or
interpersonal problems caused or
exacerbated by the effects of the substance.
Dependence

A maladaptive pattern of substance use,
leading to a clinically significant
impairment or distress, as manifested by
three (or more) symptoms occurring at any
time in the previous 12 months
Dependence: Symptom 1

Tolerance as defined by either:

A need for markedly increased amounts of the
substance to achieve intoxication or the desired
effect

Markedly diminished effect with continued use of
the same amount of the substance
Dependence: Symptom 2

Withdrawal as manifested by either:

The characteristic withdrawal syndrome for the
substance

The same or closely related substance is taken to
relieve withdrawal symptoms
Dependence: Symptom 3

The substance is often taken in larger
amounts than intended
Dependence: Symptom 4

There is a persistent desire or unsuccessful
effort to cut down or control substance use
Dependence: Symptom 5

A great deal of time is spent in activities
necessary to:



Obtain the substance,
Use the substance, OR
Recover from its effects
Dependence: Symptom 6

Important social, occupational, or
recreational activities are given up or
reduced because of substance use
Dependence: Symptom 7

The substance use is continued despite
knowledge of having a persistent or
recurrent physical or psychological problem
that is likely to have been caused by the
substance
Developmental
Considerations

Basic Theory and Support:

A number of researchers have suggested that occasional drug
use may be best understood as a manifestation of
developmentally appropriate experimentation.”

In a longitudinal study by Shelder and Block (1990), at age 18,
relative to Experimenters, both Heavy Users and Abstainers
appeared to be less psychologically healthy.

Evidence of suboptimal personality development and parenting
were found at ages 7 and 11, thus predating any drug use.
Gateway Theory of Drug Use

Basic Features:

Sequencing implies that there is a fixed relationship between 2
substances, such that one substance is regularly initiated before the
other.

Association implies that initiation of one substance increases the
likelihood of initiation of the second substance.

Causation implies that use of the first substance actually causes use
of the second substance (Causation is not supported by the gateway
theory).

Strongest argument that can possible be made: “Use of a drug at a
lower stage may be a necessary but not a sufficient condition for
progressing to a higher stage” (Kandel, a gateway theory
researcher).
Properties of drugs
Physical
Dependence
Psychological
Dependence
Tolerance
Cocaine
Limited
Yes
No
Amphetamines
Limited
Yes
Yes
Alcohol
Yes
Yes
Yes
Marijuana
Mixed support
Yes
Little
Narcotics (opium,
morphine, heroin)
Yes
Yes
Yes
Synthetic/designer
(LSD, MDMA)
No
Yes
Yes
Hallucinogens
(Mescaline,
No
Yes
Yes
Nicotine
Yes
Yes
No
Theories

Theories that have been developed to
explain addictions and addictive behaviours,
include:
– Moral Models, which regard an addiction as a result of
weakness and lack of moral fibre;
– Bio Medical Models, which see an addiction as a disease;
and
– Social learning theories, which regard addicted behaviours
as behaviours, which are learned according to the rules of
learning theory.
Withdrawal

Withdrawal refers to unpleasant physical
and psychological symptoms people
experience when they discontinue using a
substance on which the body has become
physically dependent. The symptoms
experienced depend on the particular
substance used, and can include anxiety,
irritability, intense cravings for the
substance, hallucinations, nausea, headache
and tremors.
Substance abuse

(according to Rosenhan and Seligman,
1984)
– Existence of a clear pattern of pathological use, such as
heavy daily use and an inability to stop or decrease using
it.
– Heightened problems in social or occupational functioning
resulting from substance use, as when a person loses
friends or jobs repeatedly because of it.
– The existence of pathological use for at least a month.
The end