Defining substance abuse Health Psychology. Introduction to Substances

Defining substance abuseDefining substance abuse

Health Psychology

Introduction to Substances

Definitions of Substance Definitions of Substance Use/Abuse/DependenceUse/Abuse/Dependence

AbuseAbuse

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 1Abuse: Symptom 1

Recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home.


Recurrent substance use in situations in which it is physically hazardous.


Recurrent substance use-related legal problems.


Continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance.

DependenceDependence

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 1Dependence: 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


Withdrawal as manifested by either:

The characteristic withdrawal syndrome for the substance

The same or closely related substance is taken to relieve withdrawal symptoms


The substance is often taken in larger amounts than intended


There is a persistent desire or unsuccessful effort to cut down or control substance use


A great deal of time is spent in activities necessary to:

Obtain the substance, Use the substance, OR Recover from its effects


Important social, occupational, or recreational activities are given up or reduced because of substance use


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 Developmental ConsiderationsConsiderations

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 UseGateway Theory of Drug UseBasic 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).

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

Properties of drugs

TheoriesTheories

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.

WithdrawalWithdrawalWithdrawal 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 abuseSubstance 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 endThe end

Documents

Defining substance abuse Health Psychology. Introduction to Substances