-developed tolerance (larger doses need to produce the desired effect or the effects becoming less when usual amount taken)

-withdrawal symptoms (negative physical and psychological effects)

-more/longer use of substance than intended

-person recognizes excessive use

-much time spent trying to obtain substance/recover from its effects

-use continued despite psychological or physical problems caused by drug

-gives up/cuts back participation in many activities b/c of substance use

-less serious than substance dependance

-must experience one of the following as result of drug:

-failure to fulfill major obligations

-exposure to physical dangers

-legal problems

-persistent social or interpersonal problems

-tolerance or withdrawal reactions

-those who begin drinking early in life develop first withdrawal symptoms in 30s/40s

-anxious, depressed, weak, restless, unable to sleep

-tremors of muscles, elevated BP and temp

-possible delirium

-levels of alcohol in body unusually low for amount drank

-unable to cut down/stop

-may suffer blackouts, go on binges

-negative social and occupational effects

-does not show tolerance, withdrawal, or compulsive drinking

-often part of polydrug abuse

-80-85% of alcohol abusers are smokers

-initially stimulating

-begins to act as a depressant

-impaired motor coordination, balance, speech, vision

-stimulates GABA receptors

-increases levels of serotonin and dopamine

-inhibits glutamate receptors

-malnutrition

-memoryy gaps

-development of cirrhosis of the liver (potentially fatal)

-damage to endocrine glands and pancreas, heart failure, hypertension, stroke, capillary hemorrhages

-destroy brain cells

-reduces effectiveness of immune system, increases susceptibility to infection and cancer

-fetal alcohol syndrome (FAS)

-growth of fetus is slowed; cranial, facial, limb anomalies produced

-many young people begin substance abuse this way

-peak age is 14-15 years

-behaviours include: sniffing, huffing, bagging

-most act as depressants

-nicotine is addicting agent of tobacco

-stimulates receptors in brain

-causes more than 47,000 deaths annually in Canada

-most preventable cause of premature death

-risks: lung cancer, emphysema, cancer of the larynx and esophagus, cardiovascular diseases, erectile problems

-most harmful components: nicotine, carbon monoxide, tar

-health risks decline greatly over a period of 5-10 years after quitting

-aka environmental tobacco smoke (ETS)

-2/3 of smoke from cigarettes is not inhaled by smoker

-2nd hand smoke has at least 2x the nicotine and tar as the smoke inhaled by the smoker

-dried and crushed leaves and flowering tops of the hemp plant Cannabis sativa

-smoked, chewed, prepared as tea or in baked goods

-Hashish : stronger than marijuana

-rapid shifts in emotion, dull attention, fragment thoughts, impair memory

-sometimes hallucinations and panic

-average decrease of 4.1 IQ points among heavy users

-impairments in encoding, storage, manipulation, retrieval mechanisms

-impairment of complex psychomotor skills and manipulation of flight simulators

-short term: blood-shot, itchy eyes

-dry mouth and throat

-increased appetite

-reduced pressure w/in eye

-somewhat raised BP

-impairs lung functioning (coughing, wheezing, bronchitis, injury to airway tissue)

-may be addictive

-"reverse tolerance"

-experienced smokers need only a few hits to become high

-can reduce the nausea and loss of appetite that accompany chemo

-sedatives (aka downers) slow the activities of the body and reduce its responsiveness

-opiates(opium, heroin, morphine, codeine), synthetic barbiturates and tranquilizers (secobarbital and diazepam)

-stimulants (aka uppers) act on the brain and the sympathetic nervous system to increase alertness and motor activity

-cocaine, synthetic stimulants (amphetamines)

-addictive sedatives

-relieve pain, induce sleep

-opium: principle drug in Sumerian civilization

-morphine: alkaloid

-morphine can be converted into heroin

Psychological and Physical Effects

-euphoria, drowsiness, reverie, lack of coordination

-heroin: above plus warm, suffusing ecstasy

-very addictive

-withdrawal: muscle pain, sneezing, sweating, tearing, yawning -> muscle twitching, cramps, chills and flushing, rise in HR and BP

-inability to sleep, vomiting, diarrhea

-barbiturates synthesized as sleeping aids

-addictive

-benzodiazepines frequently used and abused today

-relax the muscles, reduce anxiety, produce slightly euphoric state

-speech can become slurred, balance unsteady

-impairment of judgment, concentration, ability to work

-loss of emotional control

-large doses can be fatal

-prolonged use increases tolerance

-stimulating

-control mild depression and appetite

-sometimes used to treat ADHD

-release norepinephrine and dopamine

-wakefulness heightened, intestinal functions inhibited, appetite reduced

-heart rate quickens, blood vessels constrict

-alert, euphoric, outgoing, energy

-larger doses: nervous, confused, palpitations, headaches, dizziness, sleepiness

-tolerance develops rapidly

-reduces pain

-blocks reuptake of dopamine

-facilitation of neural transmission, result of positive feelings

-increases sexual desire, slef-confidence, well-being, indefatigability

-OD: chills, nausea, insomnia, paranoid breakdown, hallucinations

-chronic use: changes in personality (heightened irritability, paranoid thinking, disturbances in eating and sleeping)

-severe withdrawal symptoms

-hallucinations

-hallucinogens: mescaline, psilocybin, MDA, MDMA

-mescaline: alkaloid

-psilocybin: crystalline powder from a mushroom

-ecstasy (MDA and MDMA):

-designer drug, enhances intimacy & insight, improves interpersonal relationships, elevates mood, muscle tension, REM, nausea, faintness, chills/sweating, anxiety, depression, confusion

-lasting side effects: paranoia, confusion, memory complaints

-possible "bad trip"

-can develop into full-blown panic attack

-flashbacks: recurrence of psychedelic experiences after effects have worn off

-person must first have a positive attitude toward substance, begin to experiment w/ it, use regularly then heavily, abuse/become physically dependent

-difficult

-admitting the problem

-"contemplation stage"

-traditional hospital treatment

-detoxification

-takes ~1 month

-tranquilizers sometimes given

-carbohydrate solutions, B vitamins, sometimes anticonvulsants

-biological treatments

-disulfiram: drug causes violent vomiting if alcohol is ingested

-alcoholics anonymous

-emotional support, understanding, close counseling

-couples/family therapy

-detoxification

Biological Treatments

-heroin substitutes

-heroin antagonists (prevent the high)

-clonidine may ease withdrawal from a variety of drugs

Psychological Treatments

-cognitive: learn to avoid high-risk situations, recognize lure of drug, develop alternatives

-operant: modelled after token economy

-motivational interviewing: CBT & humanistic principles

Biological

-nicotine in gum/patches/inhaler

-antidepressants

Psychological

-rapid smoking treatments

-cognitive: develop coping skills

-scheduled smoking (time intervals, amount of cigarettes allowed per day)

Relapse Prevention

-most w/in a year of quitting

-denormalization belief: belief that society does not approve

-media and advertisements

-tax (on cigarettes or alcohol)

-peer-pressure resistance training

-correction of normative expectations

-inoculation against mass-media messages

-info about parental and other adult influences

-peer leadership

-affective education, self-image enhancement