A.P. Chapter 9

• 1. Prealcohlic symptomatic
• 2. prodromal (early) alcoholism
• 3. crucial alcoholism
• 4. Chronic alcoholism
• 5. Death

person is exposed to alcohol and learns the tension-reducing effects of social drinking. continued drinking leads to tolerance. Person often discovers "hidden" alcohol in household products (e.g. nighttime cold medications) for additional consumption.

blackouts begin. frequent but mostly inconspicuous drinking, growing preoccupation with drinking as well as more time needed to recover from use, and verbalized rationalizations and/or denial of alcohol consumption. Person is likely irritable and depressed, has sleep disturbances, experiences some guilt, and breaks numerous promises to self to cut down or stop behavior. psychologically dependent. (likely meets criteria for subtance abuse)

person frequently and openly consumes alcohol to total intoxication. pronounced dterioration in family, social, and occupational functioning (if these roles still exist for the person). psychological symptoms include severe depression with suicidal ideation and Korsakoff's Syndrome (deterioration in memory and confabulation); physical dterioration includes advanced liver disease, hypertension, muscle/bone diseases, oral/esphageal cancers, and brain damage.

depending on overall health status, functioning levesl prior to alcoholism, and pattern of alcohol addiction, life expectancy is shortened by approximately 8-12 years.

• 1. pattern of use (abuse or dependence)
• 2. type of substance(s) used

• - recurrent, maladaptive pattern of use leading to significant distress or impairment
• - at least 1 of the following occuring within 12 months.
• * recurrent use leads to impaired functioning
• * recurrent use in physically hazardous circumstances
• *recurrent substance-related legal problems
• * despite difficulties, inability to refrain from use

• maladaptive use leading to significant distress or impairment
• at least 3 of the following
• - marked tolerance
• - marked withdrawal
• - take larger amounts over longer periods than intended
• - persitent desire or unsuccessful efforts to control use
• - considerable time spent obtaining, using or recovering

• - Intoxication- poisoning
• - Halluncinosis

• - speed up activities of ANS, CNS
• - decrease appetite, speed up metabolism
• - increase feelings of elation, grandosity
• - in higher dosages = nervous, jittery, restless
• - feel exhausted afterwards
• - highly addictive, overuse = tolerance and possibly psychosis

• Caffeine
• nicotine
• amphetamines
• cocaine

• - induce mind alterations, changes in perception and emotion
• - magnify mood
• - dependency not documented, abuse does occur
• - can produce paranoia, panic, amotivational syndrome (lazy)

• phencyclidine (PCP)
• lysergic acid diethylamide (LSD)
• estasy
• marijuana
• inhalants - 'huffing'

Narcotics

- mimic endorphin effects: initial rush of pleasure followed by drowsiness, lathargy, and inactivity

• morphine
• codeine
• heroin
• opium
• perscriptions containing narcotics ( vicodin, oxycontin, percocet)

• - slow activities of CNS, ANS
• - exert depressive effects by mimicking GABA
• - overuse leads to decrease REM sleep, seizures, hallucinations, depression
• - combining sedatives produces synergistic effects

since drugs are both depressants, they drop the heart rate dangerously low, where it can stop, as well as blood pressure, respirations etc.

• - benzodiazepines - calm, non-drowsy
• - barbiturates- calm, drowsiness
• - alcohol

• genetics (eg. familial alcoholism)
• deficits of DA, GABA, and/or gutamate (reward deficiency)
• A1+ allele of D2 receptor gene
• opponent-process theory

• (Solomon & Corbit)
• people dont use the drug to get high anymore. but to feel normal because they dont get high or happy when using it

• oral fixation
• unresolved dependency/aggressive conflicts
• personality profile: impulsive, antisocial (rules that appy to others dont apply to me), depressive, hostile

found substance "experimenters" exhibited best personal adjustment (had great outcomes, marriage, college, etc. were experimenters when younger)

• classical condtioning (learned association)
• operant conditioning (reward, tension reduction)
• social learning (modeling)

substance use atuomatically linked to environmental cues/triggers; its not strong cravings but cues that maintain use

• gender role expectations
• cultural norms
• media influences
• numerous lifestyle stressors(leading cause of relapse)

• well liked "pet"
• positive attention
• smiles, laughs,
• popular

• "chief enabler"
• keeps secrets
• takes care of family (member)

• "little adult"
• takes on household responsibilities (mini parent)

• "invisible"
• quiet, stays in room

• "problem child"
• everyone blames this kid
• they act up to be bad kid in order to take the attention off of drunk parents

• low perceived control in life
• irrational beliefs and illogical problem -solving

in high-risk situations will likely use again, causing persons to feel weak, powerless, and guilty; increases likelihood of full relapse

• the two-phase approach:
• detoxification (usually in-patient)
• longterm sobriety programs (AA,NA)

• * naltrexone or antabuse (disulfiram) - alcoholics
• * methadone or clonidine- heroin addicts
• * nicotine replacements (NRT)- smokers

• 1. aversion therapy- eg emetics with alcohol
• 2. covert desensitization-eg. imagine feces in drink
• 3. rapid use- eg 1 puff every 6 sec til sick
• 4. behavioral self-control - eg identify triggers (driving, eating)
• 5. relaxation trainiing/systematic desensitization

• 1. increase perceptions of self-control
• 2. challenge irrational beliefs that prompt use
• 3. teach healthy self-talk for high-risk situations (Glantz's calm)

• C= connect to consciousness (aware of feelings and thoughts)
• A= alleviate anxiety response ( control frantic urge to use)
• L= logically examine liabilities (think about consequences)
• M= mobilize and move one (leave triggering environment)

that the A1= gene may be a causal mechanism for substance dependence