Substance Use Disorders III April 6, 2011 PSYC 2340: Abnormal Psychology Brett Deacon, Ph.D. - PowerPoint PPT Presentation


PPT – Substance Use Disorders III April 6, 2011 PSYC 2340: Abnormal Psychology Brett Deacon, Ph.D. PowerPoint presentation | free to download - id: 4224bd-Njk4Y


The Adobe Flash plugin is needed to view this content

Get the plugin now

View by Category
About This Presentation

Substance Use Disorders III April 6, 2011 PSYC 2340: Abnormal Psychology Brett Deacon, Ph.D.


Substance Use Disorders III April 6, 2011 PSYC 2340: Abnormal Psychology Brett Deacon, Ph.D. War on Drugs 2. Illicit drug use is unhealthy, uncontrollable, and ... – PowerPoint PPT presentation

Number of Views:48
Avg rating:3.0/5.0
Slides: 43
Provided by: BrettD7
Learn more at:


Write a Comment
User Comments (0)
Transcript and Presenter's Notes

Title: Substance Use Disorders III April 6, 2011 PSYC 2340: Abnormal Psychology Brett Deacon, Ph.D.

Substance Use Disorders III April 6, 2011 PSYC
2340 Abnormal Psychology Brett Deacon, Ph.D.
From Last Class
  • Disease model
  • Alcoholics Anonymous/Twelve Steps
  • Note Exam 3 is Friday 4/8

In the News
  • Actress Ashley Judd on the Today Show
  • Sought treatment at Shades of Hope in Texas for
  • Twelve Step Model used for all disorders
  • Covert sexual abuse in childhood
  • Repressed memories of childhood sexual abuse

Motivational Interviewing
  • Chapter 7 (Mood Disorders)
  • Major depressive and manic episodes
  • Nature, causes, and treatment of
  • Major depressive disorder
  • Bipolar disorder
  • Suicide

Exam Review
  • Chapter 8 (Eating Disorders)
  • pp. 256-282 only (not Sleep Disorders section)
  • Anorexia
  • Bulimia
  • Causes
  • Treatment

Exam Review
  • Chapter 11 (Substance-Related Disorders)
  • Not pp. 413-414 (Impulse Control Disorders)
  • Substance abuse and dependence
  • Alcohol effects, cultural patterns, disease
  • Addictive properties of different substances
  • Properties and effects of different substances
  • Treatments

Addictive Properties of Common Drugs
Drug Addictiveness
  • Which of the following drugs is most addictive?
  • 1. Nicotine
  • 2. Heroin
  • 3. Cocaine
  • 4. Alcohol
  • 5. Caffeine
  • 6. Marijuana

Addictive Properties of Common Drugs
Brief Review of Different Substances
  • Sedative, Hypnotics, Anxiolytics
  • Stimulants
  • Opioids
  • Hallucinogens
  • Other Drugs of Abuse

Fetal Alcohol Syndrome
  • CDC estimates rate of 2.7/1000 live births
  • Fetal growth retardation, cognitive deficits,
    behavior problems, learning difficulties
  • Occurs in 2-10 of children of alcohol abusers
  • More common in African Americans and Native
    Americans than Caucasians

Fetal Alcohol Syndrome
  • Effects of low-moderate maternal alcohol
    consumption (lt 1 drink per day average) on the
  • Henderson et al. (2007) http//www3.interscience.w
  • Combined results from 46 studies
  • Examined effects on miscarriage, stillbirth,
    intrauterine growth restriction, prematurity,
    birthweight, small for gestational age at birth
    and birth defects including fetal alcohol
  • Findings This systematic review found no
    convincing evidence of adverse effects of
    prenatal alcohol exposure at lowmoderate levels
    of exposure. At lowmoderate levels of
    consumption, there were no consistently
    significant effects of alcohol on any of the
    outcomes considered.

Fetal Alcohol Syndrome
  • Plenty of evidence that repeated abusive heavy
    drinking is associated with FAS and related
  • FAS usually occurs with chronically alcoholic
    mother who binged during pregnancy
  • Third variable problem smoking, malnutrition,
    poor health care

Sedative, Hypnotic, or Anxiolytic Substance use
  • Drugs in this class
  • Sedatives calming (e.g., barbiturates)
  • Hypnotic sleep inducing
  • Anxiolytic anxiety reducing (e.g.,

Sedative, Hypnotic, or Anxiolytic Substance use
  • Effects similar to large doses of alcohol
  • Synergistic effect when combined with alcohol
  • Adverse effects
  • Dependence, tolerance, withdrawal, overdose

  • Nature of stimulants
  • Most widely consumed class of drug in the US
  • Drugs increase alertness and increase energy
  • Examples include amphetamines, cocaine, nicotine,
    and caffeine

Stimulants Amphetamines
  • Used for all-nighters, weight control, and high
  • Effects
  • Elation, vigor, reduce fatigue
  • Followed by extreme fatigue and depression
  • Ecstasy and Ice
  • Produces effects similar to speed, but no
  • Used by 2 of college students
  • Very high risk of dependence

Stimulants Nicotine
  • Approximately 25 of Americans smoke
  • Effects
  • Stress relief, relaxation, wellness, pleasure
  • Withdrawal depression, insomnia, irritability,
    anxiety, increased appetite
  • Highly addictive and extremely difficult to quit
  • Cues that elicit urges to smoke are ubiquitous
  • Users dose themselves frequently

Stimulants Caffeine
  • Used regularly by 90 of Americans
  • Effects of the gentle stimulant
  • Found in tea, coffee, cola drinks, and cocoa
  • Small doses elevate mood and reduce fatigue
  • Regular use can result in tolerance and dependence

Opioids An Overview
  • Opiate narcotic-like chemical in opium poppy
  • Examples heroin, opium, codeine, and morphine
  • Effects
  • Pain relief, euphoria, drowsiness, slowed
  • High doses can be fatal
  • Withdrawal symptoms can be lasting and severe
  • Elevates risk for HIV
  • High mortality rates for addicts

Hallucinogens An Overview
  • Substances that alter perceptions of the world
  • Examples Marijuana, LSD
  • Effects
  • Delusions, paranoia, hallucinations, and/or
    altered sensory perception

Hallucinogens Marijuana
  • Active chemical is tetrahydrocannabinol (THC)
  • Effects
  • Heightened sensory experiences, mood swings,
    paranoia, hallucinations
  • Varies greatly from person to person
  • Amotivational syndrome?
  • Minimal tolerance, withdrawal, dependence
  • Medicinal uses

Hallucinogens LSD
  • Derivative of ergot fungus
  • Effects
  • Perceptual changes, depersonalization,
  • Very rapid tolerance
  • Withdrawal symptoms are rare
  • Can produce psychotic reactions

Other Drugs of Abuse Steroids
My lawyers have advised me that I cannot answer
these questions without jeopardizing my friends,
my family and myself. -Mark McGwire
Other Drugs of Abuse Steroids
"I did take a banned substance. And for that, I
am very sorry and deeply regretful. -Alex
Other Drugs of Abuse Steroids
  • Synthesized from testosterone
  • Legitimate medical uses asthma, anemia, breast
    cancer, men with inadequate sexual development
  • Used illegally to increase body mass
  • Do not produce a high
  • Long-term mood disturbances and physical problems

Causes of Substance-Related Disorders
  • Exposure/access to drug is necessary, but not
    sufficient, for abuse and addiction
  • Use depends on social and cultural expectations
  • Drugs are used because of pleasurable and/or
    reinforcing effects
  • Reasons for drug abuse are complex

Biological Influences
  • Drugs affect the pleasure or reward centers in
    the brain
  • Biological changes occur with repeated drug use
  • Unlike substance use, substance abuse and
    dependence has a genetic component

Psychological Influences
  • Positive and negative reinforcement
  • Pleasurable effects
  • Self-medication (cope with negative affect)
  • Expectancy effects
  • Expectancies influence drug use and relapse

Social and Cultural Influences
  • Exposure to drugs is a prerequisite for use
  • Media, family, peers
  • Parents and the family appear critical
  • Cultural factors
  • Influence the manifestation of substance use and

Social and Cultural Influences
  • The importance of context
  • 42 of Vietnam war soldiers used heroin
  • Half became dependent in Vietnam
  • Three years after returning home, only 12 were
    still using heroin

Social and Cultural Influences
  • Societal views about drug abuse
  • Moral weakness
  • Biological disease model (Twelve Steps)
  • War on drugs

American Culture and Drug Use
  • Assumptions of Americas War on Drugs
  • 1. Illicit drug use is bad. How bad?
  • Criminal Offense Average Prison Sentence
  • Murder/manslaughter 153 months
  • Drugs 78 months
  • Rape 67 months
  • Burglary 51 months
  • Aggravated Assault 50 months
  • Source U.S. Bureau of Justice Statistics

War on Drugs
  • 2. Illicit drug use is unhealthy, uncontrollable,
    and addictive
  • 3. Prevention and treatment programs work
  • Project DARE
  • Lynam et al. (1999)
  • 10-year follow-up of 1,000 10-year olds
  • Received either DARE or standard drug ed
  • Long-term outcomes

American Cultural and Drug Use
  • 4. People are unable to choose whether or not to
    take drugs or to regulate their use
  • Thus, prohibition is necessary
  • 5. There is an end to the drug war
  • When is it over exactly?

Biological Treatments
  • Agonist substitution
  • Substitute safer drug with similar chemical
  • Examples methadone, nicotine gum/ patch
  • Antagonistic treatment
  • Blocks or counteracts pleasurable drug effects
  • Examples - naltrexone for opiate and alcohol

Biological Treatments
  • Aversive treatment
  • Makes drug use extremely unpleasant
  • Examples - Antabuse for alcoholism
  • Efficacy of biological treatment
  • Largely ineffective when used alone

Psychosocial Treatment
  • Inpatient vs. outpatient care
  • Comparable efficacy, not cost
  • Controlled use (Sobell study)
  • Project MATCH
  • Compared 12 sessions of twelve step facilitation,
    CBT, or motivational enhancement
  • No differences in outcome
  • No control group

Psychosocial Treatment
  • Community support programs
  • Alcoholics Anonymous and related groups
  • Extremely popular but little evidence of benefits
  • From a 2006 literature review No experimental
    studies unequivocally demonstrated the
    effectiveness of Alcoholics Anonymous or 12-Step
    approaches for reducing alcohol dependence or

  • Confrontation by family and friends
  • Element of surprise, often humiliating
  • Intended to break down denial and persuade
    client to enter treatment
  • Confronts individuals with cataclysmic
    consequences if they do not enter treatment
  • Why isnt this approach used with depression,
    anxiety, etc.?

  • Miller and Sovereign (1989)
  • Two groups 1) confrontational strategies 2)
    client-centered motivational interviewing
  • Clients in confrontational group exhibited MORE
    resistance to treatment than in client-centered
    group and were more likely to be drinking a year
  • G. Alan Marlatt, Ph.D Once you have the person
    on board and involved and you have a good
    continued care program, things will happen in a
    good way. But if you say, Do this or else, you
    take away a persons choice and the consequences
    are negative.

Analysis of Intervention Programs
  • Not empirically supported
  • Studies show high rate of entry into treatment
    following an Intervention, but
  • High rate of dropout
  • Higher relapse following treatment (Loneck,
    Garrett, Banks 1996)