Features and Epidemiology

Causes and Prevention

Assessment and Treatment

Features and Epidemiology

Causes and Prevention

Assessment and Treatment

Features and Epidemiology

Causes and Prevention

Assessment and Treatment

The repeated use of substances that lead to recurring problems

impairment of functioning video

Substance Abuse:

Features and Epidemiology

Causes and Prevention

Assessment and Treatment

Emotions

Cognitions

Behaviors

Normal

Stable mood.

No concern about substance use.

Occasional but appropriate alcohol use or use of medication.

Mild discomfort about the day, feeling a bit irritable or down.

Thoughts about the difficulty of the day. Worry that something will go wrong at work.

Drinking a bit more than usual; relying on medication to sleep.

Features and Epidemiology

Causes and Prevention

Assessment and Treatment

Emotions

Cognitions

Behaviors

NormalMild

Considerable stress and sadness (note that oppositeemotions occur when drug is used).

Dwelling on negative aspects of the day; worry aboutthreats to one’s job or marriage. Thoughts about waysto hide substance abuse.

Drinking alcohol regularly at night; occasionallymissing work on Mondays; heavy use of medication.

Features and Epidemiology

Causes and Prevention

Assessment and Treatment

Emotions

Cognitions

Behaviors

NormalMildModerate

Intense stress, sadness, and feelings of emptiness;agitation about not having access to a specificdrug or drugs.

Frequent thoughts about using substances andworry about harm to personal health.

Regular intoxication such that many days aremissed from work; arguments with spouse aboutsubstance use; arrests for impairment.

Features and Epidemiology

Causes and Prevention

Assessment and Treatment

Emotions

Cognitions

Behaviors

NormalMildModerateSubstance-Related Disorder – Less Severe

Features and Epidemiology

Causes and Prevention

Assessment and Treatment

Emotions

Cognitions

Behaviors

NormalMildModerateSubstance-Related Disorder – Less SevereSubstance-Related Disorder – More Severe

Extreme stress, sadness, and feelings of emptiness.Extreme agitation when drug is not available.

Thoughts focused almost exclusively on druguse and self-destruction of one’s lifestyle.

Very frequent intoxication; loss of job or marriage;physical addiction to a drug; seeking to secureor use drugs most of the time.

Features and Epidemiology

Causes and Prevention

Assessment and Treatment

Substance Dependence

Substance Withdrawal

Tolerance

withdrawal video

Features and Epidemiology

Causes and Prevention

Assessment and Treatment

Alcohol

• Increases levels of GABA (gamma aminobutyric acid) in the brain

• Low levels: disinhibition– GABA inhibits the inhibitory brain

systems• High levels: depressant

– At high levels, GABA inhibits the excitatory brain systems

Features and Epidemiology

Causes and Prevention

Assessment and Treatment

Epicanthal folds Underdeveloped upperpart of ear

Small palpebral

fissures

Flat nasal

bridgeUpturned nose

Smoothphiltrum

Thin upper lip

Features and Epidemiology

Causes and Prevention

Assessment and Treatment

Prefrontal cortex

Nucleus accumbus

Ventricle tegmental area

Brain features

• Prefrontal cortex also responsible for decision-making and impulse control

• brain images and addiction

Features and Epidemiology

Causes and Prevention

Assessment and Treatment

Features and Epidemiology

Causes and Prevention

Assessment and Treatment

Substance-related disorder

Genetic predisposition, Impulsive personality, Deviant peers, Culture, Family conflict, Parental drug use, Drug/learning experiences

Proximal factorsActivation of mesolimbic pathway, Daily stress and depression, Peer pressure, Positive expectancies about drug use, Availability of drugs

ReinforcersMood enhancement, Relief from stress, Belonging to a peer group, Avoidance of withdrawal symptoms

PunishersIll physical effects, Legal problems, Cognitive decline, Divorce and loss of jobs, Tolerance

Distal factors

Features and Epidemiology

Causes and Prevention

Assessment and Treatment

Features and Epidemiology

Causes and Prevention

Assessment and Treatment

Agonists

Antagonists

Partial agonists

Aversives

Features and Epidemiology

Causes and Prevention

Assessment and Treatment

Features and Epidemiology

Causes and Prevention

Assessment and Treatment