2.  1.A maladaptive pattern of substance use leading to significant impairment or distress. 2.Presence of two or more of the following symptoms within a 12-month period. Substance Use Disorder

3.   Subst. is taken in larger amounts or longer pd. than intended.  Excessive time spent trying to obtain, use, or recover from effects of the subst.  Persistent desire or unsuccessful efforts to reduce or control subst. use.  Failure to fulfill major roles as a result of recurrent use.  Continued use despite social probs.  Cessation of important activities because of use.  Recurrent use is sits where use poses physical hazards.  Continued use despite awareness that it is causing physical or psychological probs.  Tolerance.  Withdrawal.  Cravings.

4.   Depressants  Stimulants  Opiates  Hallucinogens  Other drugs of abuse  Inhalants  Anabolic steroids  Medications Drug Classifications

5.   Effects of Chronic Alcohol Use  Tolerance  Withdrawal  Delirium tremens  Reduction in brain mass in the temporal lobes  Dementia  Wernicke’s disease: confusion, loss of coordination, unintelligible speech  Cirrhosis of liver: The Depressants: Alcohol Use Disorders

6.  Statistics on Use and Abuse  Lifetime prevalence of alcohol abuse:  Binge drinking: >5 drinks in short period of time  About 20% of those with severe substance use spontaneously remit.

7.   Nature of Stimulants  Most widely consumed drug (US)  Increase alertness and energy  Examples:  Amphetamines  Cocaine  Nicotine  Caffeine Stimulants: An Overview

8.   Marijuana  Tolerance:  Withdrawal and dependence:  Effects:  LSD and Other Hallucinogens  Tolerance:  Withdrawal symptoms:  Variable Reactions: Hallucinogens: An Overview

9.   biological influences genetic influence pleasure centers (James Olds)  psychological dimensions operant conditioning opponent process theory (Solomon, 1980) – increase in positive feelings will be followed by increase in negative feelings Possible Causes of Substance Abuse

10.   expectancies  cravings  social and cultural influences Possible Causes of Substance Abuse

11.   agonist substitution: provide a safe drug with a similar chemical makeup - Methadone, nicotine gum  antagonist treatment: - block or counter the effects - Naltrexone – opiate antagonist  aversive treatments - Antabuse Treatment of Substance Abuse

12.   Twelve-Step programs - Alcoholics Anonymous  controlled drinking  contingency management: reward self for making changes Treatment of Substance Abuse

13.  Non-Substance-Related Disorders--Pathological Gambling  Need to gamble greater amounts of $ to get same effect  Restless or irritability when trying to stop  Repeated, unsuccessful attempts to stop  Preoccupation w/ gambling  Frequent gambling when feeling distressed  Frequent return to try to recoup losses  Lying to conceal extent of gambling  Jeopardizing or loss of significant relationship, jog, or ed opportunity as a result of gambling  Reliance on others for $ to relieve financial problems related to gambling