RL CP SUMMARY 2018 1
CP SPECIALIZATION - ADDICTIONS SUMMARY
Renée Lipka 2018
Chapter 1: The nature of addiction
- It is not just the act of taking a drug that causes problems, but also the behavioral
consequences associated with it
- Problems with drug use are characterized by:
> A strong desire to take alcohol/drugs
> Difficulty controlling use
> Health, behavioral and social problems attributed to use
- A key feature is that the desire to take the drug is overpowering and hard to resist
1.1 What is a drug?
- Chemical agent other than food that affects biological functioning in humans/animals
- Psychotropic drugs act on the brain to alter mood, though processes, or behavior
1.2 Effects of drugs
- Each class of drugs has different short-term and long-term effects; and these can vary across
people depending on their size, frequency of use, potency of the drug taken, and their health
status
- People use drugs for many reason, but most frequently to feel better
Drug Short term Long term
Alcohol Loss of inhibition, coordination Coma, respiratory- or heart failures
Nicotine Increased pulse and blood pressure, Reduced sense of smell/taste, face wrinkles,
acid in stomach increased risk for colds, bronchitis and cancers
Cannabis Increased talking/laughing, sleepiness, Dependence, respiratory diseases, decreased
loss of concentration learning and memory abilities, decreased
motivation
Heroin Euphoria, relief of pain, well being Lowered sex drive, impotence, infertility, AIDS
(injections), death by overdose
Cocaine Increased blood pressue, hearth rate, Sleeping disorder, secual problems, heart
breathing, body temperature, dialated attacks, strokes
pupils, sexual arousal
Amphetamies Euphoria, restlesness, sleeplessness, Sleeping problems, appetite suppression,
irritability irregular heart beat, psychosis
Ecstasy Euphoria, self-confidence, lack of Depression, memory and cognitive impairments
inhibition, sweating
,RL CP SUMMARY 2018 2
1.3 What are the causes of problems with alcohol and other drugs?
- People who have recovered from addiction mainly see it as a chronic disease which makes
them lack willpower and can only be cured by complete abstinence
- Modern learning theories by contrast, view addiction as the consequence of chronic alcohol or
drug use
> Heavy use is determined by interplay of genes and environment
> Once person develops pattern of heavy use, risk of addiction increases
- DSM defines dependence as a compulsion to drug use that was not medically necessary and is
accompanied by impaired health and social functioning (was used as synonym for addiction)
- Edwards 7 major symptoms of alcohol dependence
1. Narrowing of behavioral repertoire (only drinks one type of drink to same amounts on all
days)
2. Salience of drinking/drug use: greater priority to substance than other activities
3. Subjective awareness of compulsion: loss of control
4. Increased tolerance: needs more for same effect
5. Repeated withdrawal symptoms: e.g. fatigue, teary eyes
6. Relief or avoidance of withdrawal symptoms by further drinking
7. Reinstatement of dependent drinking after abstinence
1.4 Diagnosing problems
- DSM 5 sees substance related disorders on continuum with graded severity, proposed to
remove the legal criterion (3rd one in abuse) and to incorporate criterion assessing craving
Diagnosing abuse
- A: maladaptive pattern of substance use leading to significant impairment as manifested by one
of the following occurring within 12-month
(1) Recurrent abuse leads to failure to fulfill role obligations at work, home, school
(2) Recurrent substance use in situations in which its physically hazardous (driving)
(3) Substance-related legal problems (arrests)
(4) Continued use despite persistent/recurrent social problems
- B: symptoms have never met criteria for substance dependence
Diagnosing dependence
- At least 3 of 7 key symptoms have to be met over past year
- A: maladaptive pattern of substance abuse leading to significant impairment as manifested by
three of the following in the same 12-month period
(1) Tolerance; defined by either increased amounts or diminished effect
(2) Withdrawal; manifested either by symptoms or substance taken to relieve symptoms
(3) Substance is taken in larger amounts over longer time than was intended
(4) Persistent desire or unsuccessful attempts to cut down
(5) Great deal of time spent on activities related to obtaining/using/recovering
(6) Social, occupational, recreational activities are given up/reduced due to substance
(7) Substance use continued despite knowledge of physical/psychological problems
, RL CP SUMMARY 2018 3
- The experience of dependence and abuse can look very different: dependence is usually longer
and abuse can be sporadic
1.5 Cultural factors and attitudes to drugs
- Drinking/drug taking behavior depends on social norms, attitudes and values (Moslem
countries forbid alcohol, in France it is expected)
- Cultural variations in what is an acceptable level are reflected in guidelines for healthy drinking
published in governments (Australia recommends max. 20g, and Spain recommends max. 70g
of ethanol per day for men and women)
CP SPECIALIZATION - ADDICTIONS SUMMARY
Renée Lipka 2018
Chapter 1: The nature of addiction
- It is not just the act of taking a drug that causes problems, but also the behavioral
consequences associated with it
- Problems with drug use are characterized by:
> A strong desire to take alcohol/drugs
> Difficulty controlling use
> Health, behavioral and social problems attributed to use
- A key feature is that the desire to take the drug is overpowering and hard to resist
1.1 What is a drug?
- Chemical agent other than food that affects biological functioning in humans/animals
- Psychotropic drugs act on the brain to alter mood, though processes, or behavior
1.2 Effects of drugs
- Each class of drugs has different short-term and long-term effects; and these can vary across
people depending on their size, frequency of use, potency of the drug taken, and their health
status
- People use drugs for many reason, but most frequently to feel better
Drug Short term Long term
Alcohol Loss of inhibition, coordination Coma, respiratory- or heart failures
Nicotine Increased pulse and blood pressure, Reduced sense of smell/taste, face wrinkles,
acid in stomach increased risk for colds, bronchitis and cancers
Cannabis Increased talking/laughing, sleepiness, Dependence, respiratory diseases, decreased
loss of concentration learning and memory abilities, decreased
motivation
Heroin Euphoria, relief of pain, well being Lowered sex drive, impotence, infertility, AIDS
(injections), death by overdose
Cocaine Increased blood pressue, hearth rate, Sleeping disorder, secual problems, heart
breathing, body temperature, dialated attacks, strokes
pupils, sexual arousal
Amphetamies Euphoria, restlesness, sleeplessness, Sleeping problems, appetite suppression,
irritability irregular heart beat, psychosis
Ecstasy Euphoria, self-confidence, lack of Depression, memory and cognitive impairments
inhibition, sweating
,RL CP SUMMARY 2018 2
1.3 What are the causes of problems with alcohol and other drugs?
- People who have recovered from addiction mainly see it as a chronic disease which makes
them lack willpower and can only be cured by complete abstinence
- Modern learning theories by contrast, view addiction as the consequence of chronic alcohol or
drug use
> Heavy use is determined by interplay of genes and environment
> Once person develops pattern of heavy use, risk of addiction increases
- DSM defines dependence as a compulsion to drug use that was not medically necessary and is
accompanied by impaired health and social functioning (was used as synonym for addiction)
- Edwards 7 major symptoms of alcohol dependence
1. Narrowing of behavioral repertoire (only drinks one type of drink to same amounts on all
days)
2. Salience of drinking/drug use: greater priority to substance than other activities
3. Subjective awareness of compulsion: loss of control
4. Increased tolerance: needs more for same effect
5. Repeated withdrawal symptoms: e.g. fatigue, teary eyes
6. Relief or avoidance of withdrawal symptoms by further drinking
7. Reinstatement of dependent drinking after abstinence
1.4 Diagnosing problems
- DSM 5 sees substance related disorders on continuum with graded severity, proposed to
remove the legal criterion (3rd one in abuse) and to incorporate criterion assessing craving
Diagnosing abuse
- A: maladaptive pattern of substance use leading to significant impairment as manifested by one
of the following occurring within 12-month
(1) Recurrent abuse leads to failure to fulfill role obligations at work, home, school
(2) Recurrent substance use in situations in which its physically hazardous (driving)
(3) Substance-related legal problems (arrests)
(4) Continued use despite persistent/recurrent social problems
- B: symptoms have never met criteria for substance dependence
Diagnosing dependence
- At least 3 of 7 key symptoms have to be met over past year
- A: maladaptive pattern of substance abuse leading to significant impairment as manifested by
three of the following in the same 12-month period
(1) Tolerance; defined by either increased amounts or diminished effect
(2) Withdrawal; manifested either by symptoms or substance taken to relieve symptoms
(3) Substance is taken in larger amounts over longer time than was intended
(4) Persistent desire or unsuccessful attempts to cut down
(5) Great deal of time spent on activities related to obtaining/using/recovering
(6) Social, occupational, recreational activities are given up/reduced due to substance
(7) Substance use continued despite knowledge of physical/psychological problems
, RL CP SUMMARY 2018 3
- The experience of dependence and abuse can look very different: dependence is usually longer
and abuse can be sporadic
1.5 Cultural factors and attitudes to drugs
- Drinking/drug taking behavior depends on social norms, attitudes and values (Moslem
countries forbid alcohol, in France it is expected)
- Cultural variations in what is an acceptable level are reflected in guidelines for healthy drinking
published in governments (Australia recommends max. 20g, and Spain recommends max. 70g
of ethanol per day for men and women)
