I. Substance Abuse Disorders
A. Introduction
B. Alcohol Abuse and Dependence : Fun Facts
C. Criteria for all substance abuse and substance dependence disorders
1. Criteria for Psychoactive Substance Abuse:
a. A maladaptive pattern of psychoactive substance use
b. some symptoms have persisted for at least a month or repeatedly over a longer period of time.
c. does not meet criteria for dependence.
2. Criteria for Psychoactive Substance Dependence:
a. At least 3 of the following:
(1) substance often taken in larger amounts or over longer period than person intended
(2) persistent desire or one or more unsuccessful efforts to cut down or control the use
(3) a great deal of time spent in activities to get the substance
(4) frequent intoxication or withdrawal symptoms
(5) impairment in functioning
(6) continued substance abuse despite having knowledge of problems associated with the abuse
(7) marked tolerance
(8) characteristic withdrawal syndromes; e.g., delirium tremens
(9) substance often taken to avoid withdrawal symptoms
b. some symptoms persisted for at least one month or have occurred repeatedly over longer period of time
D. The Various Psychoactive substances that can result in diagnoses
E. Effects of alcohol
1. Short-term--
a. Effects depend upon concentration and absorption
b. Sex Differences
c. Depressant, but also has a stimulating effect
d. Actual or Placebo Effect?
2. Cognitive Effects: Depend on whether one is getting drunker or sober:
3. Long-term effects--
a. malnutrition: Korsakoff's syndrome-- associated with severe memory problems.
(1) Profound anterograde amnesia
(2) Selective retrograde amnesia
b. cirrhosis of the liver
c. Fetal alcohol syndrome.
F. Jellinek's four Stages of alcoholism
1. Pre-Alcoholic
2. Prodromal
3. Crucial
4. Chronic
G. Theories of Alcoholism
1. Physiological -- Genetics
2. Psychological theories
a. Psychoanalytic -- oral fixation
b. Personality theory: search for the alcoholic personality
c. Tension reduction hypothesis
H. Treatments
1. AA
2. Aversion Rx:
3. Controlled Drinking