Substance Abuse Power Point

Abnormal Psychology
Seventeenth Edition
Chapter 11
Substance-Related
Disorders
Copyright © 2017, 2014, 2013 Pearson Education, Inc. All Rights Reserved
Learning Objectives (1 of 3)
11.1 Describe the characteristics of alcohol abuse and

dependence.
11.2 Explain the biological, psychosocial, and sociocultural
factors involved in alcohol abuse and dependence.
11.3 Discuss the treatment of alcohol-related disorders.
11.4 List the psychoactive drugs most commonly

associated with abuse and dependence.
11.5 Describe the commonly used opiates and their effects
on the body.
11.6 Discuss the different types of stimulants and their
effects.
11.7 Describe the effects of sedatives on the brain.

11.8 List four different types of hallucinogens.
11.9 Explain whether there are addictive disorders other
than alcohol and drugs.
Introduction
Substance abuse
• Excessive use
Substance dependence
• Physiological need for increasing amounts
Tolerance
• Biochemical changes in the body
Withdrawal
• Physical symptoms from abstinence
Examples of Abuse of Substances
• Nicotine
• Alcohol
• Barbiturates
• Tranquilizers
• Amphetamines
• Heroin
• Ecstasy
• Marijuana
Alcohol-Related Disorders
Ancient cultures
• Excessive, frequent alcohol use
• Egyptians first made beer in 3000 BCE
• Italians made first wine
• Problems with alcohol use first observed
The Prevalence, Comorbidity, and Demographics
of Alcohol Abuse and Dependence
• Alcohol abuse cuts across all age, educational,

occupational, and socioeconomic boundaries
• Lifetime prevalence for alcohol abuse in U.S. is 13%
• Enormous detrimental physical effects
• Linked to accidents, violent crime
• More common in men
• More than 37% of alcohol abusers suffer from at least
one coexisting mental disorder
The Clinical Picture of Alcohol-Related
Disorders (1 of 5)
• At higher levels, alcohol depresses brain functioning

• At lower levels, alcohol stimulates certain brain cells and
activates brain’s “pleasure areas”
Figure 11.1 Commonly Observed Changes over Time in
Blood Alcohol Concentration (BAC, Dashed Line) and
Alcohol Hangover Severity
Hangover severity is most pronounced when blood alcohol concentration
reaches 0 (in this example at 12–14 hours after the start of alcohol
consumption).
(Adapted from Verster et al., 2010.)
Disorders (2 of 5)
• Excessive drinking progression of alcohol-related

disorder
• Early stage
• Middle stage
• Late-stage
Disorders (3 of 5)
Physical effects of chronic alcohol use

• Malnutrition
• Cirrhosis of liver
• Stomach pains
Disorders (4 of 5)
Psychosocial effects of alcohol abuse and dependence

• Chronic fatigue
• Oversensitivity
• Depression
• Impaired reasoning
• Personality deterioration
Disorders (5 of 5)
Psychoses associated with severe alcohol abuse

• Alcohol withdrawal delirium
– Disorientation, hallucinations
– May last 3-6 days
• Alcohol amnestic disorder
– Memory loss, disorientation
– Untreated, can lead to irreversible brain damage
Causal Factors in the Abuse of and
Dependence on Alcohol
Causal factors
• Biological
• Psychosocial
• Sociocultural
Biological Factors in the Abuse of and
Dependence on Alcohol
Neurobiology of addiction
• MCLP center of psychoactive drug activation
• (Mesocorticolimbic Dopamine pathway)
Genetic vulnerability
• Alcohol-risk personality
• Exposure and learning
Figure 11.2 The Mesocorticolimbic Pathway
The MCLP, Running from the
Ventral Tegmental Area to the
Nucleus Accumbens to the
Prefrontal Cortex, Is Central to
the Release of the
Neurotransmitter Dopamine
and in Mediating the
Rewarding Properties of Drugs.
(Adapted from Office of Technology Assessment, 1993.)
Psychosocial Causal Factors in Alcohol
Abuse and Dependence
• Failures in parental guidance

• Psychological vulnerability
• Stress, tension reduction and reinforcement
• Expectations of social success
• Marital or relationship crisis
Sociocultural Causal Factors
Causal factors
• Religion
• Cultural tradition of aggression
• Geographic location
Use of Medications in Treating Alcohol
Abuse and Dependency
Medications to block desire to drink

• Disulfiram (Antabuse)
• Naltrexone
Medications to lower side effects of acute withdrawal
• Valium
Psychological Treatment Approaches
Group therapy
• Person is forced to confront problem
Environmental intervention
• Halfway houses
Behavioral and cognitive-behavioral therapy
• Aversive conditioning, skills training, self-control
Treatment of Alcohol-Related
Disorders (1 of 2)
Other approaches
• Controlled drinking rather than abstinence
• Alcoholics Anonymous
Treatment of Alcohol-Related
Disorders (2 of 2)
Success rates of alcoholism treatments

• “Project MATCH” success rates
• Motivational enhancement therapy success
• Relapse prevention programs
• ~50% of people relapse within 3 months of treatment
• Matching Alcoholism Treatments to Client Heterogeneity

Drug Abuse and Dependence
Psychoactive drugs most commonly associated with

abuse and dependence
• Narcotics
• Sedatives
• Stimulants
• Anti-anxiety drugs
• Pain medications
• Hallucinogens
Opium and Its Derivatives
Opium
• Morphine
• Heroin
• Codeine
Biological Effects of Morphine and
Heroin (1 of 2)
Immediate effects of narcotics

• Alleviation of physical pain
• Relaxation and pleasant reverie
• Alleviation of anxiety and tension
• Euphoric spasm
Biological Effects of Morphine and
Heroin (2 of 2)
Long-term effects
• Physiological craving for the drug
• Withdrawal symptoms
• Gradual deterioration of well-being
Social Effects of Morphine and Heroin
Other characteristics
• Maladaptive behaviors
• Antisocial personality
• Narcotics subculture
Causal Factors in Opiate Abuse and
Dependence
• Pleasure
• Curiosity
• Peer pressure
• Stress relief
• Personal maladjustment
• Sociocultural conditions
Neural Bases for Physiological Addiction
Bind to opiate receptors

• Heroin plugs in, replacing natural endorphins
Dopamine theory of addiction
• Addiction is dysfunction of dopamine reward pathway
Reward deficiency syndrome
• Addiction result of genetic deviations in reward pathway
Addiction Associated with Psychopathology
Comorbities
• 50% have other forms of substance abuse
• 36% have a history of trauma
• Depression
• Anxiety
• Other
Treatments and Outcomes (1 of 2)
Treatment
• Initially similar to that for alcohol addiction
• Methadone and buprenorphine program
Stimulants
Cocaine and amphetamines

• Increase feelings of alertness and confidence
• Decrease feelings of fatigue
Cocaine (1 of 2)
Blocks presynaptic dopamine transporter

• Increases availability of dopamine
• Euphoric state
• Chronic abuse leads to hallucinations
Long-term amphetamine use
• Psychologically and physically addictive
• May result in brain damage and psychopathology
Cocaine (2 of 2)
Treatment
• Medications
– Naltrexone
– Methadone
• Outcomes
– Cognitive-behavior treatment (CBT)
– Contingency management (CM)
Amphetamines (1 of 2)
Amphetamines
• “Wonder pills” to stay awake, alert
• Weight loss
• Schedule II drug
Amphetamines (2 of 2)
Abuse
• Leads to hazardous fatigue
• Psychologically and physically addictive
• Brain damage, “amphetamine psychosis”
Treatment
• Withdrawal from drug
• May lead to depression, GI symptoms, personality
deterioration
Methamphetamine (1 of 2)
Methamphetamine
• Highly addictive stimulant drug
• Increases level of dopamine in brain
• Known by some as “poor people’s cocaine”
Methamphetamine (2 of 2)
Rate, prolonged use, and treatment

• Substantial increased use in last 10 years
• Structural changes in brain with prolonged use
• Treatment resistant to treatment; relapse common
Stimulants: Caffeine and Nicotine
Problematic for many reasons

• Easy to abuse
• Readily available
• Addictive properties
• Difficult to quit
• Withdrawal symptoms
• Health problems and side effects
Sedatives
Barbiturates
• Central nervous system depressants that are similar to
depressant effects of alcohol
• Once widely used to induce sleep
Causal Factors in Barbiturate Abuse and
Dependence
Barbiturate use outcomes

• Physiological and psychological dependence
• Lethal overdoses
Treatments and Outcomes (2 of 2)
Barbiturate users and withdrawal

• Dependence tends to be middle-aged people
• Withdrawal is a key treatment issue
Hallucinogens
Hallucinogens
• LSD
• Mescaline
• Psilocybin
• Ecstasy
LSD
LSD experience
• Changes in sensory perception (approx. 8 hours)
• Range of experiences: pleasurable, terrifying
• Flashback at some later point
• Popularity has waned, but part of “wave culture”
Mescaline and Psilocybin
Reality distortion
• Mescaline
– Peyote cactus
• Psilocybin
– Mushrooms
Ecstasy (1 of 2)
• Hallucinogen and stimulant

• Chemically similar to meth-amphetamine
Ecstasy (2 of 2)
• Ecstasy results and popularity

• “Rush” and well-being And serious adverse
consequences
• Increasingly popular among young adults
Marijuana (1 of 3)
Effects
• Euphoria
• Increased feelings of well-being
• Heightened perceptual acuity
• Relaxation
• Hallucination
Marijuana (2 of 3)
Treatment
• Psychological treatment methods
Marijuana (3 of 3)
Synthetic cannabinoids
• Mimic effects THC, active plant-derived substance in
marijuana
• “Spice,” “K2,” “Blaze”
• Serious adverse side effects
Synthetic cathinones
• Mimic cocaine and amphetamines
• “Bath salts”
• Serious adverse side effects
Gambling Disorder
Similar to chemical addiction in several ways

• Personality factors
• Difficulties attributable to compulsive gambling
• Treatment problems
Unresolved Issues
• Is the use of methadone effective in the treatment of

heroin, or does it simply exchange one addiction for
another?
• What other approaches are being evaluated?
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Abnormal Psychology

11.1 Describe the characteristics of alcohol abuse and

11.4 List the psychoactive drugs most commonly

11.7 Describe the effects of sedatives on the brain.

• Alcohol abuse cuts across all age, educational,

• At higher levels, alcohol depresses brain functioning

(Adapted from Verster et al., 2010.)

• Excessive drinking progression of alcohol-related

Physical effects of chronic alcohol use

Psychosocial effects of alcohol abuse and dependence

Psychoses associated with severe alcohol abuse

(Adapted from Office of Technology Assessment, 1993.)

• Failures in parental guidance

Medications to block desire to drink

Success rates of alcoholism treatments

• Matching Alcoholism Treatments to Client Heterogeneity

Psychoactive drugs most commonly associated with

Immediate effects of narcotics

Bind to opiate receptors

Cocaine and amphetamines

Blocks presynaptic dopamine transporter

Rate, prolonged use, and treatment

Problematic for many reasons

Barbiturate use outcomes

Barbiturate users and withdrawal

• Hallucinogen and stimulant

• Ecstasy results and popularity

Similar to chemical addiction in several ways

• Is the use of methadone effective in the treatment of

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