1. Alcohol and Other Drugs
Definition
How Do Drugs Work?

2. Drug Intake Pathways Injection Inhalation Intranasal Ingestion
Intravenous
Inunction (subcutaneous)
Inhalation
Intranasal
Ingestion
Others, not used for drugs of abuse
Intramuscular, Transdermal, Implantation
Pathway determines onset and duration

3. Continuum of Use Abstinence Use Addiction (“addict”)?
Alcoholism (“alcoholic”)?

4. DSM Categorization Substance Intoxication Substance Abuse
Affects Functioning
Substance Dependence
Tolerance
Withdrawal
Substance Seeking Behavior or Thoughts
Psychological Dependence

5. Classes of Drugs Depressants Stimulants Opioids Hallucinogens
Cannabinoids
Inhalants

6. Alcohol
Most adults in the U.S. consider themselves light drinkers or abstainers
Over 50% of the U.S. (> 12 years age) report current use
Alcohol use is highest among Caucasian Americans
Men use and abuse alcohol more than women
Violence is associated with alcohol
Alcohol alone does not cause aggression
15 million Americans are alcohol dependent
20% with alcohol problems experience spontaneous recovery

7. Stimulants Effects Substances Euphoria (Intense Rush)
Increased Activity Level/Decreased Fatigue
Subsequent crash
Decreased Appetite
Cause Release and Block Reuptake of Dopamine and/or Norepinephrine
Substances
Amphetamines/Methamphetamines
Cocaine/Crack
Nicotine
Caffeine

8. Opioids Effects Substances Euphoria Analgesic Drowsiness
Activate body’s enkephalins and endorphins (“natural opiates”)
Substances
Opium
Heroine
Morphine
Pain Killers (Darvon, Percocet, etc.)
Codeine

9. Hallucinogens Effects Substances
Sensory and Perceptual Alterations, Including Hallucinations
Synesthesia
Substances
LSD
PCP
Psyllocybin (Mushrooms)
Peyote (Cactus)
“Designer” Drugs
Others

10. Cannabinoids Effects Substances Mild Euphoria and “Mellowing”
Increased Appetite
Hallucinogenic in very high doses
Substances
Marijuana
Hashish
THC

11. Inhalants Effects Substances “Head Rush” (Dizziness)
Perceptual Distortions
Substances
Aerosols
Solvents
Nitrous Oxide

12. Causal Factors Biological Psychological Pleasure Centers in the Brain
Dopamine
GABA suppression
Inhibition of Negative Affect/Anxiety
Psychological
Positive Reinforcement
Negative Reinforcement
Self-medication Hypothesis
Expectancy Effects

13. Causal Factors Familial Social and Cultural Genetics Psychosocial
Positive and Negative Influence

14. Additional Concepts
Denial
Addictive Thinking
Value of Group Therapy

15. FIGURE 10.6  An integrative model of substance-related disorders.15

16. Treatment Controlled Use vs. Abstinence Biological
Agonist Substitution
e.g., Methadone
Antagonist
e.g., Naloxone
Aversive Treatment
Antabuse
Ineffective Alone

17. Treatment Psychosocial Prevention Individual and Group
Hospitalization vs. Outpatient Treatment
12-step Programs (e.g., AA)
Relapse Prevention
Abstinence Violation Effect
Prevention
Primary, Secondary, Tertiary

18. Impulse-Control Disorders
Intermittent Explosive Disorder
Kleptomania
Pyromania
Pathological Gambling
Trichotillomania