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Summary Substance Abuse in Abnormal Psychology
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This is a summary of all the Substance related disorders related to Abnormal Psychology
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Learning Unit 7Substance Related and Addictive
Disorders
Substance – Levels of Involvement
Each substance has unique effects. There are
similarities in the ways they are used and how
people who abuse them are treated.
Substance Substance Use Substance
A psychoactive substance, or Substance use is the
Intoxication
substance, is any chemical consumption – for example by
compound that exerts an effect ingestion or inhalation – of
Our physiological
on the central nervous system psychoactive substance in reaction to consumed
and alters experience, thinking, moderate amounts that does not substances – drunkenness
ideas, motivations and significantly interfere with or getting high – is
behaviours. Psychoactive social, educational or substance intoxication.
substances are typically occupational functioning.
characterized by their ability Substance intoxication is
to produce strong and virtually Drinking a cup of coffee in the defined as the
immediate reward. morning to wake up or smoking a
predictable,
cigarette and having a drink
The chemical compound exerts its with a friend to relax are
characteristic,
effect on the CNS and produces a examples of substance use, as substance-specific
predictable set of direct, is the occasional ingestion of syndrome of maladaptive
pharmacological effects across substances such as cannabis, behavioural,
all domains of mental cocaine or opioids. psychological and
functioning. Substance Abuse physical manifestations
that emerges following
Pharmacological, here, refers to Definition: maladaptive pattern
the interaction of a chemical the availability of
of psychoactive substance use
moiety and a neural system. sufficient dose or amount
manifested by recurrent and
significant adverse of a psychoactive
Some domains of mental substance. Intoxication
consequences affecting all
functioning, notably mood and may, or may not, be
domains of functioning, while
motivation, are more markedly
the use continues despite associated with delirium
affected. knowledge of its adverse and perceptual
Substance not only implies effects. disturbances.
cocaine and heroin but includes
Defining substance abuse by how For a person to become
a more commonplace-and legal –
much of a substance is ingested
substances such as alcohol, the intoxicated depends on
is problematic.
nicotine found in tobacco, the which substance is taken,
caffeine in coffee and The DSM-5 defines substance how much is ingested and
cooldrinks and chocolate. abuse as the degree or the person’s individual
significance to which it biological reaction.
These apparently innocuous
substances also effect feelings
Substance dependence (Usually described as
Tolerance: need for increased amounts of a substance
addiction) to achieve the desired effect, and a diminished
affect with continued use of the same amount.
It is best to consider substance dependence as a Pharmacological tolerance is called Tachyphylaxis
cluster of cognitive, behavioral and physiological
phenomena emerging after habitual use of a
psychoactive substance that is characterized by
tolerance and predicable, substance-specific Withdrawal: predictable substance-specific
withdrawal syndrome upon cessation or significant syndrome characterized by unpleasant
reduction in intake of the habitually used psychological experiences and physiological
responses and physiological responses that
substances. emerges following cessation of use of the
offending psychoactive substance or precipitous
Dependence is considered as physiological or
reduction of its intake, which can be alleviated
psychological. Two phenomena characterize by resumed used of the same or a similar
physiological dependence: tolerance and withdrawal.
With time and exposure to the substance, an ever -
, Six Categories of Psychoactive Substances
1. Depressants 2. Stimulants 3. Opioids
Depressants: Psychoactive Cocaine: stimulant agent derived
substances that result in The major effect of these
from the cocoa plant that produces substances is to produce
behavioral and cognitive vasoconstriction (narrowing of
inhibition, including alcohol and analgesia, or pain relief, and
arteries) and can cause euphoria, cause euphoria. Examples include
the sedative, hypnotic and agitation, increased motoric
anxiolytic drugs heroin, opium, codeine and
behaviour and alterations in morphine.
thinking, thoughts and perception.
Alcohol: strictly, ethanol, or It is usually snorted in powder
ethyl-alcohol, as other alcohols Opiates: Naturally occurring
form. psychoactive substances derived
exist chemically, is the product
of the fermentation of yeasts, from the opium poppy, for
Amphetamine: stimulant agent used example opium and morphine, that
sugar and water: the most commonly medicinally to treat narcolepsy,
used and abused depressant produce euphoria, sleep and
attention deficit hyperactivity analgesia.
substance. disorder and certain forms of
refractory depression. Opioids: Psychoactive substances
These substances result in Amphetamines also cause euphoria,
behavioral sedation and can induce derived from chemically
agitation, increased mobility, analogues to, the extract of the
relaxation. They include alcohol disturbances in thinking, thought
and the sedative and hypnotic opium poppy, such as morphine,
and perception. codeine and the synthetic and
substances in the families of
barbiturates and benzodiazepines. semi-synthetic compounds like
These substances increase heroin, pethidine, methadone and
Most recently, the non- lateness, attention and activity
benzodiazepine class of hypnotics, codeine that cause temporary
and may elevate mood. Included in euphoria and analgesia (Pain
this group are amphetamines and reduction) with high abuse
5. Hallucinogens
4. Cannabinoids 6. Others
The prototypical hallucinogen is
Cannabis causes euphoria, alters lysergic and diethylamide (LSD) Other substances that are abused
experience, including sensory and psilocybin (magic mushrooms). but do not fit neatly into one
perception, promote hunger and can The ‘designer drugs’ such as of the categories here include
produce paranoia, delusions and Ecstasy are often considered as inhalants (for example,
hallucinations. hallucinogens, although they also aerosols, gases, petroleum
share features with stimulants. hydrocarbons and nitrates),
Cannabis: Dried flowers and leaves anabolic steroids and other
Phencyclidine (angel dust or PCP)
of the hemp plant; the most widely over-the-counter and
and ketamine have hallucinogenic
used illegal substance. prescription medications, mostly
properties, although they are
pharmacologically related to the anti-histamines and combination
dissociative anesthetics. analgesics. Whilst combination
analgesics are dependency-
Hallucinogen: Any psychoactive producing due to their opiate-
substance, such as LSD, constituent, typically codeine
phencyclidine, psilocybin and phosphate, abuse and dependence
mescaline, that alters sensory on dependence on apparently non-
perception, can induce psychoactive substances like
hallucinations and alter thinking paracetamol, aspirin and
and thoughts diclofenac are recognized
LSD (d-lysergic acid
diethylamide): Prototypical
hallucinogenic substance; a
synthetic version of the grain
fungus ergot.
Hallucinogen use disorder: any
maladaptive use of hallucinogenic
substances that causes
intoxication with cognitive,
emotional behavioral, social and
physical problems, and may cause
persistent psychological and
behavioral disturbances.
, 1. Depressants – alcohol and sedatives, hypnotics
or anxiolytic agents
These substances result in behavioral
sedation and can induce relaxation.
They include alcohol (ethyl alcohol
or ethanol) and the sedative and
hypnotic substances in the families
of barbiturates, barbiturate-like
agents (for example, phenobarbitone
and methaqualone – a barbiturate-like
constituent of Mandrax) and
benzodiazepines. More recently the
non-benzodiazepine class of
hypnotics, known as cyclopyrrolones,
has come to the fore in clinical care
Depressants: depressants primarily decrease CNS activity. Their principal effect is to
reduce our levels of physiological arousal and help us relax. Included in this group
are alcohol and the sedative, hypnotic and anxiolytic agents, such as those prescribed
for insomnia. These substances are among those most likely to produce symptoms of
Depressants:
physical dependence, tolerance and withdrawal. Psychoactive
Alcohol substances that
result in
behavioural and
cognitive
DSM-5 criteria for Alcohol use Alcohol-Related Disorders inhibition,
disorder including alcohol
and the sedative,
DSM-5 recognises and codes for the following Alcohol:
A. A problematic pattern of alcohol use leading
alcohol-related disorders: alcohol use disorder; Strictly, ethanol,
to clinically significant impairment or
distress, as manifested by at least two of the
alcohol intoxication; alcohol withdrawal; other or ethyl-alcohol, as
alcohol induced disorders and unspecified alcohol- other alcohols exist
following, occurring within a 12-month period. chemically, is the
1. Alcohol is often taken in larger amounts related disorder. product of the
or over a longer period than was intended fermentation of
2. There is a persistent desire or Alcohol – often regarded as the prototypical yeasts, sugar and
water; the most
unsuccessful efforts to cut down or psychoactive substance – has been widely used
commonly used and
control alcohol use throughout history. Alcoholic drinks, especially abused depressant
3. A great deal of time is spent in beer, have a very long history in Africa. substance.
activities necessary to obtain alcohol,
Alcohol-
use of alcohol or recover from its effects
Ethanol, or ethyl-alcohol is produced when certain related
4. Craving, or a strong desire or urge to use
alcohol
yeasts react with sugar and water and fermentation disorders:
5. Recurrent alcohol use resulting in a takes place. Historically, we have been creative cognitive,
about fermenting alcohol from just about any fruit emotional,
failure to fulfil major role obligations behavioural, social
at work, school or home or vegetable, or any food containing sugar. and physical
6. Continued alcohol use despite having
persistent or recurrent social or
interpersonal problems caused or Clinical description: The process of alcohol
exacerbated by the effects of alcohol through the body:
7. Important social, occupational or Although a depressant, apparent
recreational activities are given up or stimulation is the initial Alcohol affects many parts of
reduced because of alcohol use intoxicating effect of alcohol. the body. After it is ingested,
8. Recurrent alcohol use in situations in We generally experience a it passes through the
which it is physically hazardous
feeling of well-being, our oesophagus (1) and into the
9. Alcohol use is continued despite knowledge
of having a persistent or recurrent
inhibitions are reduced and we stomach (2), where small
physical or psychological problem that is become more outgoing. This is amounts are absorbed. From
likely to have been caused or exacerbated because the inhibitory centres there, most of it travels to
by alcohol in the brain are initially the small intestine (3), where
10. Tolerance, as defined by either or both of inhibited or ‘depressed’. it is easily absorbed into the
the following: bloodstream. The circulatory
a. A need for markedly increased amounts With continued drinking, system distributes the alcohol
of alcohol to achieve intoxication or however, alcohol depresses more throughout the body, where it
desired effects. contacts every major organ,
areas of the brain, which
b. A markedly diminished effect with including the heart (4). Some
continued use of the same amount of impedes the ability to function
of the alcohol goes to the
alcohol properly.
lungs, where it vaporizes and
11. Withdrawal, as manifested by either of the is exhaled, a phenomenon that
following: Motor co-ordination is impaired
is the basis for the
a. The characteristic withdrawal syndrome (staggering gait, slurred
breathalyzer test that measures
for alcohol (refer to Criteria A and B speech), reaction time is
of the criteria set for alcohol levels of intoxication by
slowed, judgement becomes traffic law-enforcers. In the
withdrawal)
impaired, confusion sets in and liver (5), alcohol is
b. Alcohol (or a closely related
substance such as benzodiazepine) is
even vision and hearing can be metabolized, or broken, in two
negatively affected, all of steps by means of the enzymes
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