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Lectures GGZ2029 Addiction

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Lectures GGZ2029 Addiction

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November 5, 2020
Number of pages
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Written in
2019/2020
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Lectures Addiction

Lecture 1
What is addiction
● WHO
○ Repeated use of a psychoactive substance or substances, to the extent
that the user (referred to as an addict)
■ Is periodically or chronically intoxicated
■ Shows a compusion to take the preferred substances(s)
■ Has great difficulty in voluntarily stopping substance use
■ Exhibits determination to obtain psychoactive substance(s)
○ Tolerance is prominent and withdrawal syndrome frequently occurs when
substance use is interrupted
○ The life of the addcit is dominated by substance use to the exclusion of all
other activities and responsibilities
● Central to definition of addiction
○ Addictive substances
○ Getting high
○ Severe negative consequences
■ Individual
■ Social
○ Compulsion
○ Loss of control, unable to stop
● 3 aspects of addiction
○ Appetite
○ Lack of control
○ Harm

Substances
● What are addictive substances?
○ Substances with a rewarding effect, i.e. substances that will make you feel
good (euphoria etc.)
○ Substances that make some people think about it and long for it and log
after they used it (craving)
○ Substances that make people lose control
● Psycholeptica
○ Substances that supress CNS
○ Alcohol, benozdiazepinen, GHB, opiates
● Psychoanaleptica
○ Substances that stimulate CNS

, ○ Nicotine, coffee, cocaine, amphetamine, XTC
● Psychodysleptica
○ Substances that cause hallucinations (“tripping”)
○ LSD, paddo’s, cannabis
→ Although the effects are different, the outcome is the same to people:
pleasure

At one point of time, the pleasurable effects of the drugs on the addicts will decrease.
That’s the point, when they should stop taking the drugs.

Harm (model Nutt):
● Physical harm
○ Suffer an illnes or even mortality
■ Direct
● E.g. stroke because of taking drugs, death as a result of
taking drugs
■ Indirect
● Psychological
○ Dependence of the drug
● Social
○ Loss of tangibles
○ Loss of relationships

, Individual harm
● Based on this research the most harmfull substances to the user:
○ Alcohol
○ Heroine
○ Crack

Social harm
● Based on this research the most harmful substances to the social network
○ Alcohol
○ Tabaques
○ Crack

Societal costs
● Costs of society
○ Health insurance
○ People are suffering many diseases which casuses lots of money on
societal level

From contact to addiction
● Contact with substance
○ People can still easily quit
● Experimental behavior
○ People can still easily quit
● Excessive use/ problematic use
○ People can quit, but harder
● Addiction

How big is the problem?
● Addiction is highly comorbid
● Most occurring addiction: alcohol
● Prevalentie
○ 19,1% has had an addiction troughout their lifetime

Diagnosis
● Addiction is a popular term among public, therapists, …
● However not in DSM-IV
○ Substance abuse
■ A maladaptive pattern of substance use leading to clinically
significant impairment or distress as manifested by 1 or more of the

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