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Substance Abuse Disorder



Three Categories  of Substances : 


 Dependency on alcohol, medication and illegal drugs can lead to substance abuse disorders.
Individuals who develop a substance abuse problem can be at a high risk of developing a mental health condition.
Some problems that result from substance abuse are impairment or a negative impact on one’s social or occupational responsibilities; e.g. work or school.
The user becomes a danger to self or others.
Run-ins with the law or criminal activities can become common, such as the sale of illegal drugs or stealing to support a drug habit.
The individual experiences an inability to refrain from using the drug in spite of the negative effects it has on one’s body. 

 Substance Dependency Diagnosis: 
The user experiences a constant desire and an inability to cut down or control use of the substance despite the knowledge of resulting physical or psychological problems.
The substance is taken in large quantities over a longer period of time than intended.
The user may show evidence of withdrawal or distress, or impairment in social, occupational, physical and emotional areas.
The user has a strong desire to take the substance, to the extent that recreational activities are given up because of substance abuse.
Evidence of tolerance: an increased dose of the substance is needed in order to achieve the desired effect, such as a high.
A lot of time is spent in activities necessary to obtain the substance (e.g. visiting different doctors).

Three Categories of Substances:
A) Depressants or Sedatives: Depressants or sedatives depress the central nervous system and slow down responses. They reduce anxiety and stress, and help the individual feel calm and relaxed. The user also becomes sociable because of a lessening of interpersonal inhibitions. There is a high potential for abuse and the development of tolerance for these drugs. Some examples of sedatives are alcohol, narcotics, heroin, barbiturates and benzodiazepines.
i. Alcohol-Use Disorders
Individuals who abuse and become dependent on alcohol are known as alcoholics and the disorder becomes known as alcoholism.
Possible reasons that alcohol is abused include the desire for relaxation and sociability, and that it is relatively cheap.
Alcohol is the most recurrent abuse substance among young adults.
An individual may use alcohol on a daily basis to function.
The person may abstain from alcohol for a period of time; however, once resumed the drinking becomes uncontrollable.
Excessive drinking can lead to deterioration in relationships, job loss, family conflicts and violent behavior.
Once alcohol is swallowed it is absorbed into the blood without being digested.
When it reaches the brain, the short-term physiological effect is to depress central nervous system functioning.
If the alcohol in the blood stream (blood alcohol level) reaches 0.1 percent, which is equal to five (5) glasses of beer, it will result in muscle coordination problems. 
The drinker may have problems walking a straight line or pronouncing certain words. 
If blood alcohol level (b.a.l.) reaches 0.5 percent the person may lose consciousness or die.
Short-term physiological effects of alcohol for a specific person depend on the following: Body weight, amount of food in the stomach, drinking rate over time, prior drinking experience, heredity, personality factors, environment and culture. 
Drinking alcohol can lead to feelings of happiness, loss of inhibitions, poor judgment, and reduced concentration.
Most people drink in social situations, as alcohol relieves tension. Tolerance levels may increase over a period of months or years. 
Stress, inability to cope, or biological predisposition to alcoholism can cause some drinkers to be thinking of alcohol all the time.
They may discreetly drink a large amount of alcohol, and experience a feeling of guilt after drinking.
Drinking a large quantity of alcohol may lead to blackouts, when at times the individual may not remember doing certain activities.
The long-term physiological effects of alcohol consumption include an increased tolerance, physical discomfort, anxiety and hallucinations.
Chronic alcoholism destroys brain cells and is frequently accompanied by poor nutritional habits and physical deterioration.
Excessive drinking can lead to liver diseases such as cirrhosis.
Cirrhosis is when an excessive amount of fibrous tissue develops and impedes the circulation of blood, leading to heart failure and hemorrhaging of the capillaries, particularly those on the sides of the nose, as well as cancers of the mouth and throat.
Alcohol consumption in a pregnant woman can lead to fetal alcohol syndrome (FAS)—children who become mentally and physically retarded/deformed.

ii. Narcotics (Opiates)
Narcotics include opium and its derivatives morphine, heroin, and codeine; these depress the central nervous system.
They are used medicinally to relieve pain, anxiety, and tension, and can become addictive.
There is high potential for abuse and dependency.
There is Narcotics cause feelings of euphoria, restlessness, nausea, or drowsiness.
Tolerance builds rapidly and withdrawal symptoms are severe.
Opiates such as heroin are administered intravenously (through injections), causing scars (tracks).
Some indications of possible narcotics use are loss of appetite, scars caused by injections, drowsiness, bent spoons, needles, sniffles, etc.
Due to dependency, users are unable to have normal relationships with family and friends or even have a career/job.
Their main aim is to have access to the drug by any possible means.
When narcotics are being used for non-medicinal purposes they are illegal; as a result, addicts get involved in criminal activities to obtain the drugs and support their habits.
iii. Barbiturates
Known as “downers” or “sleepers,” barbiturates are powerful depressants of the central nervous system.
Taken orally, barbiturates are used to cause euphoria, and induce relaxation and sleep. 
They are very dangerous and illegal drugs that can lead to physical and psychological dependency.
Some short-term effects are slurred speech, memory impairment, and emotional instability.
Long-term effects are tiredness, vision problems, dizziness, and breathing problems. 
Excessive use of barbiturates can be fatal. 
The combination of barbiturates with other drugs such as alcohol, heroin, or Demerol can be especially dangerous.
Withdrawal symptoms include headaches, anxiety, nausea, weakness, hallucination, vomiting, etc. 

iv. Benzodiazepines
Valium is a member of this category.
Valium is a central nervous system depressant.
It is prescribed to induce sleep, relieve anxiety, relieve muscle spasms, etc.
Some of the side effects that may occur are drowsiness, skin rash, nausea, and depression.
Some people use valium as a way of coping with stress, hence abusing it can be dangerous.
If tolerance develops while using the drug then dependency may also increase.

B) Stimulants: These are substances that enhance activity of the central nervous system. Stimulants produce a range of different effects, which vary according to the substance being used. Some of the effects of stimulants are alertness, grandiosity, hyperactivity, agitation and. A lot of stimulants can also relieve anxiety and produce the feeling of euphoria. Stimulants are also referred to as “uppers.” Stimulants that are commonly used are amphetamines, caffeine, nicotine, and cocaine/crack. 
i. Amphetamines
Amphetamines—also known as “uppers”—affect the central nervous system and the autonomic nervous system.
Some of the effects of using this type of drug are alertness, energy, confidence, feelings of euphoria, agitation, and restlessness.
They increase the absorption of the neurotransmitter dopamine in the synapses. This exposes the postsynaptic cells to high levels of dopamine.
They restrain appetite and sleep, and some are used as appetite suppressants.
They are used as diet pills to treat obesity and cause weight loss, and may become addictive.
They are taken orally, intravenously or nasally (“snorting”).
Methamphetamine, also known as meth, is one of the most commonly used illegal amphetamines.

ii. Caffeine
Caffeine is the most widely used legal stimulant in the world.
It is found in coffee, chocolate, tea, and soft drinks.
Caffeine can become intoxicating after ingesting about two or more cups of coffee.
Symptoms include restlessness, nervousness, excitement, insomnia, and rambling speech.
There is also an increase in energy and mental alertness.
Withdrawal symptoms can include headaches, fatigue and irritability.

iii. Nicotine 
This is another widely used legal stimulant.
Dependency is associated with cigarette smoking.
There are many adverse health consequences resulting from cigarette smoking, hence the rejection of this activity by health professionals.
Nicotine dependency consists of the following:
a) Trying to stop or reduce using tobacco on a permanent basis has been unsuccessful; 
b) Attempts made to stop smoking have led to withdrawal symptoms such as craving, irritability, difficulty sleeping, lack of concentration, and restlessness; 
c) Using tobacco continues even though the smoker knows that it is causing a serious illness which is aggravated by its usage.

iv. Cocaine/ Crack  
Cocaine is a powerfully addictive drug.
This is a substance that has been extracted from the coca plant.
It causes feelings of euphoria and self confidence in users.
Cocaine is often used by professional athletes, film stars and political figures.
Cocaine can be administered in the following ways: eaten, snorted, inhaled, or injected intravenously.
Snorting is the inhaling of cocaine powder through the nose; it then goes into the bloodstream. 
Intravenous usage requires a needle to release the drug into the blood stream; it also leaves needle marks and can cause possible infection. 
Smoking involves inhaling cocaine vapor or smoke into the lungs, which leads to quick absorption into the bloodstream.
The drug reaches the brain quickly and then goes to other tissues throughout the body. 
When cocaine is inhaled it leaves the feeling of euphoria and confidence.
Heart rate, blood pressure increase and fatigue and appetite are reduced, according to users.
The continuous need for and usage of cocaine can lead to social and occupational impairment.
The high cost of cocaine can result in users committing crimes to supply their habits.
A side effect of cocaine can be the feeling of depression, especially when the drug wears off.
It can also lead to weight loss, paranoia, nervousness, fatigue and hallucinations.
Due to the stimulation of the sympathetic nervous system, using cocaine produces premature ventricular heartbeat and death may occur. 
Crack: Crack is sold as small solid pieces or rocks.
It is a purified and potent form of cocaine which is produced by heating cocaine to a free base for smoking.
The term “crack” refers to the crackling sound heard when the mixture is heated.
When crack is smoked it produces quick and marked euphoria followed by depression.
Smoking crack can trigger paranoia in users. 

C) Hallucinogens: These are substances that produce hallucinations, clear sensory awareness, heightened alertness, out of body experiences, or distortion of reality. The use of hallucinogens does not lead to physical dependence, but psychological dependence may occur. It affects the way people see, taste, and smell, and their mood and thoughts. Common hallucinogens are marijuana, LSD, and PCP.  

i. Marijuana
Marijuana is the mildest and most commonly used hallucinogen.
It is also known as “pot” or “grass.”
It is normally smoked in a cigarette or “joint.”
Marijuana causes feelings of euphoria, tranquility and passivity.
Short-term effects are increased heart rate, bloodshot eyes, dry mouth, and reduced concentration.
Long-term effects are reduced concentration and motivation, paranoia and psychosis, impaired learning and short-term memory, psychological dependency and tolerance. 
Marijuana is used to treat some physical disorders such as glaucoma.

ii. Lysergic Acid Diethylamide (LSD)
LSD was discovered in 1938 and is one of the most powerful mood-    changing chemicals.
It is manufactured from lysergic acid, which is found in ergot, a fungus which grows on rye. 
LSD or “acid” gained notoriety in the mid-1960s.
It is sold on the street in capsules and occasionally in liquid form.
It is odorless, colorless, has a slightly bitter taste, and is commonly used orally.
LSD produces distortions of reality and hallucinations.
Effects of LSD are higher body temperature, increased heart rate and blood pressure, sweating, loss of appetite, dry mouth, sleeplessness, and dilated pupils.  
Users refer to using LSD as a “trip.” 
“Good trips” are the experiences of sharpened visual and auditory perception, heightened sensation and feelings of ecstasy.
“Bad trips” consist of fear and panic due to distortion of sensory experiences, severe depression and delusions.
Some LSD users experience flashbacks suddenly and without warning.

iii. Phencyclidine (PCP)
PCP is also known as “angel dust,” “crystal,” “superweed” and “rocket fuel.”
It is considered a very dangerous street drug. 
Originally developed as a pain killer, it comes in the form of tablets, capsules and colored powder.
Common names for PCP when it is combined with marijuana are “killer joint” and “crystal supergrass.”  
PCP is a hallucinatory drug that causes perceptual distortions, euphoria, nausea, confusion and delusions.
It can lead to aggressive behavior, violence and even death. 
With higher doses, breathing, pulse and blood pressure often slow down.
There can also be loss of balance, dizziness, seizures, and comas.
Long-term effects are memory loss, speech difficulties, depression, and weight loss.  
The drug is illegal; however, it is commonly used.

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