Substance Use and Addiction

Question 1

What is substance abuse and substance dependence?

Answer 1

• Substance abuse refers to the ongoing misuse of a substance, which can lead to problems in daily life but not necessarily dependence.
• Substance dependence, on the other hand, involves tolerance to the effects of a substance, meaning the need for increasing amounts to produce the same effect, and withdrawal symptoms when the substance is stopped.

Question 2

What are depressants and stimulants?

Answer 2

• Depressants are drugs that slow down the central nervous system (CNS), which can cause a decrease in brain functioning and lower blood pressure. Examples of depressants include alcohol and sedative-hypnotics. Alcohol enhances GABA activity (inhibitory) and increases dopamine. Binge drinking, which is defined as having 5 or more drinks on one occasion, can lead to alcohol-related injuries, which account for 1/3 of the global disease burden.
• Stimulants, on the other hand, speed up the CNS and can make a person feel euphoric, alert, energetic, confident, and hypersensitive to their surroundings. Examples of stimulants include cocaine, amphetamine, nicotine, caffeine, opioids, hallucinogens, and cannabis. Chronic use of these substances can cause damage to serotonin neurons, and can result in symptoms such as restlessness, irritability, higher heart rate, loss of appetite, and paranoia.

Question 3

What is behavioural addiction?

Answer 3

• Behavioural addiction refers to excessive engagement in a particular behaviour, such as gambling, shopping, social network use, video games, cell phone use, eating, or exercise.
• It is characterized by failure to resist or stop the behaviour, problems in daily functioning, personal distress, and risk of harm (physical or emotional) to oneself or others.

Question 4

What is addiction and are we all addicted? Do we all have a psychiatric disorder?

Answer 4

• Addiction is a condition where an individual engages in compulsive substance use or behaviour, despite the negative consequences associated with it. Not everyone is addicted, but some individuals may have a higher risk of developing an addiction due to a combination of genetic, environmental, and psychological factors.
• Not everyone has a psychiatric disorder, but substance use disorders and addictive disorders are generally comorbid with mood and anxiety disorders, PTSD, ADHD, and personality disorders.

Question 5

What is the DSM Substance use and addictive disorders?

Answer 5

• The DSM Substance use and addictive disorders categorize addiction as mild, moderate, or severe, depending on the number of symptoms exhibited.
  o Mild addiction involves 2-3 symptoms, moderate addiction involves 4-5 symptoms, and severe addiction involves 6 or more symptoms.
• symptoms:
  1. individuals displays maladaptive patterns of substance abuse leading to significant impairment or distress (must have)
  2. at least 2 of the following substance- produced symptoms within a 1 year period:
  -large amounts of substance taken
  -unsuccessful attempts to reduce/ control substance intake
  -significant time spent on trying to obtain/ use/ recover from effects of substance
  -failure to fulfil obligations
  -cont. use despite interpersonal problems
  -reduction of imp. activities
  -cont. use in dangerous situations
  -cont. use despite worsening psychological or physical problems
  -craving
  -tolerance
  -withdrawal

Question 6

What are gambling and gaming disorders?

Answer 6

• Gambling disorder is a condition where an individual engages in persistent, repeated gambling despite negative consequences.
• Gaming disorder, on the other hand, is a condition where an individual engages in persistent, repeated video game playing despite negative consequences. Gaming disorder is only recognized by the ICD-11.

Question 7

What is the biological perspective on substance abuse?

Answer 7

• The biological perspective on substance abuse suggests that drugs influence the activity of neurotransmitters in the brain, which can lead to the brain making adjustments in the production of that neurotransmitter.
• Over time, individuals can become more reliant on the drug, and when they stop taking the drug, they can experience withdrawal symptoms because the brain is not supplying these neurotransmitters.
• Dopamine, a neurotransmitter associated with the reward pathway in the brain, is also involved in addiction.
• The Reward Deficiency Syndrome Theory suggests that addiction may happen because an individual compensates for too little dopamine in the brain.
• Incentive-sensitization theory suggests that addictive substances increase an individual’s sensitivity to dopamine, making the individual more likely to desire the substance.
• Treatment for substance abuse can include detoxification, preventing relapse by prescribing another drug, or drug replacement treatments.

Question 8

What is the psychodynamic perspective on substance abuse?

Answer 8

• The psychodynamic perspective on substance abuse suggests that unconscious conflicts stemming from childhood, attachment problems, and difficulty recognizing and regulating emotions can lead to substance abuse.
• According to this perspective, substance abuse is a defensive strategy against overwhelming and unbearable negative emotions about self and relationships.
• Treatment for substance abuse from a psychodynamic perspective involves accepting, experiencing, and expressing emotions, and understanding that substance abuse is ineffective in dealing with emotions.

Question 9

What is the cognitive-behavioral perspective on substance abuse?

Answer 9

• The cognitive-behavioral perspective on substance abuse suggests that drugs are reinforcers and that dysfunctional thinking and poor problem solving can contribute to substance abuse.
  o Example therapies/treatments from this perspective include aversion therapy, contingency management, social skills training, and relapse prevention training.
   Aversion therapy involves using aversive drugs to discourage substance use.
   Contingency management provides rewards for staying away from the drug, while social skills training teaches appropriate social skills for positive social interactions.
   Relapse prevention training teaches individuals how to handle situations that would tempt drug use and increase self-efficacy.

Question 10

What is the humanistic perspective on substance abuse?

Answer 10

• The humanistic perspective on substance abuse involves motivational interviewing (MI), which is a technique used to help individuals recognize and do something about pressing problems.
• MI is often combined with the transtheoretical model of change.
• The five aims of MI are to express empathy, develop discrepancy, avoid argumentation, roll with resistance, and support self-efficacy.
• The transtheoretical model of change involves five stages: precontemplation, contemplation, preparation, action, and maintenance

Question 11

What is the sociocultural perspective on substance abuse?

Answer 11

• The sociocultural perspective on substance abuse involves cross-cultural and social justice considerations.
• Substance abuse can occur in individuals of high and low socioeconomic status.
• Social support is also important in preventing substance abuse.
• Programs like Reclaiming Futures in the United States provide easy access to treatment, mentorship, and community-based programs to help kids who have drug-related legal problems turn their lives around before it becomes a bigger problem.
• The systems perspective also highlights the role of family and family support in intervention with youth who have substance abuse problems.