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).

Physical Dependence Psychological Dependence Tolerance CocaineLimitedYesNo AmphetaminesLimitedYes AlcoholYes MarijuanaMixed supportYesLittle Narcotics (opium, morphine, heroin) Yes Synthetic/designer (LSD, MDMA) NoYes Hallucinogens (Mescaline, NoYes NicotineYes No Properties of drugs

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.

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