Summary Clinical psychopathology Chapter 9

9 Substance Use Disorders

LEARNING GOALS
10. Recognize the symptoms of substance use disorders, using the available diagnostic criteria
Develop a working definition of addiction

11. Apply the theories that may help explain substance use disorders (onset and maintenance)

12. Describe the different classes of commonly abused substances, their characteristic biological
and psychological effects, and their effects on physical and mental health

13. Discuss the use of the psychological and biological interventions available to people with
substance use disorders


DrugA substance that has a physiological effect when ingested or otherwise introduced into the
body

bath salts1Bath salts’ is the name for an emerging group of drugs containing synthetic chemicals
related to cathinone, which is an amphetamine-like stimulant found in the khat plant.




9.1 DEFINING AND DIAGNOSING SUBSTANCE USE DISORDERS

-2 categories of substance/drug use
substance abuseA pattern of drug or substance use that occurs despite knowledge of the
negative effects of the drug, but where use has not progressed to full-blown dependency.

substance dependenceA cluster of cognitive, behavioural and physiological symptoms indicating
that the individual continues use of the substance despite significant substance-related problems

substance use disorder (SUD)Where an individual has at least one substance disorder diagnosis,
whether it is a general diagnosis of substance dependency or abuse, or a more specific substance
category disorder

social impairmentWhen persistent substance use results in failure to fulfil major role
obligations at work, school, or home.

risky useRecurrent substance use in situations in which it is physically and psychologically
hazardous

4 General criteria for substance use disorders
1)Impaired control

,  craving
2)Social impairment
3)Risky use
4)Pharmacological criteria
 increasing doses
 withdrawal symptoms

DSM-V criteria of substance use disorder
A problematic pattern of substance use leading to clinically significant impairment or distress, as
manifested by at least two of the following, occurring within a 12-month period:
1. The substance is often taken in larger amounts or over a longer period than was intended
(impaired control)
2. There is a persistent desire or unsuccessful efforts to cut down or control substance use
3. A great deal of time is spent in activities necessary to obtain the substance, use the
substance, or recover from its effects
4. Craving, or a strong desire or urge to use the substance

Basic terminology in the study and treatment of substance use disorders
1)Addiction
 Drug use to the point where the body’s 1normal’ state is the drugged state (so the body
requires the drug to feel normal)
2)Psychological dependence
 dependence
 The user’s tendency to alter their life because of the drug, and to centre their activities
around the drug
3)Craving
 A strong subjective drive to use the substance
4)Tolerance
 The need for greater amounts of the drug or substance to achieve intoxication (or the
desired effect) or a markedly diminished effect with continued use of the same amount of
the drug or substance
5)Withdrawal
 A maladaptive behavioural change, with physiological and cognitive concomitants, that
occurs when blood or tissue concentrations of a substance or drug decline in an individual
who has previously maintained prolonged heavy use of the substance or drug
6)Substance
 A drug of abuse, a medication, or a toxin

Addiction as discontrol
 Substance used more than intended
 Unsuccessful efforts to cut down
 Strong desire

Addiction=brain disease?


9.2 THE PREVALENCE AND COMORBIDITY OF SUBSTANCE USE DISORDER