Module 11: Substance-Related and Addictive Disorders – Fundamentals of Psychological Disorders

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• olerance to these drugs builds quickly, thus resulting in an increased need of the medication to produce desired effects. This rapid tolerance is also likely responsible for opioids’ highly addictive nature.

• Repeated use of these substances or frequent substance intoxication can develop into a long-term problem known as substance abuse. Abuse occurs when an individual consumes the substance for an extended period or must ingest large amounts of the substance to get the same effect a substance provided previously.

• The need to continually increase the amount of ingested substance is known as tolerance.

• Sometimes, there is a desire to reduce or abstain from substance use; however, cravings and withdrawal symptoms often prohibit this from occurring. Common withdrawal symptoms include, but are not limited to, cramps, anxiety attacks, sweating, nausea, tremors, and hallucinations.

• ubstance use disorder, is a “…cluster of cognitive, behavioral, and physiological symptoms indicating that the individual continues using the substance despite significant substance-related problems” (

• For a diagnosis of substance intoxication, the individual must have recently ingested a substanc. Immediately following the ingestion of this substance, significant behavioral and/or psychological change is observed. In addition, physical and physiological symptoms present as a direct result of the substance ingested.

• his said, the most common changes involve disturbances of perception, wakefulness, attention, thinking, psychomotor behavior, interpersonal behavior, and judgment

• Finally, substance withdrawal is diagnosed when there is cessation or reduction of a substance that has been used for a long period of time. Individuals undergoing substance withdrawal will experience physiological and psychological symptoms within a few hours after cessation/reduction. These symptoms cause significant distress or impairment in daily functioning

• depressants, stimulants, and hallucinogens/cannabis/combination.

• Depressants. Depressants include alcohol, sedative-hypnotic drugs, and opioids are known to have an inhibiting effect on one’s central nervous system; therefore, they are often used to alleviate tension and stress.

• Opioids are naturally occurring, derived from the sap of the opium poppy. In the early 1800s, morphine was isolated from opium by German chemist Friedrich Wilhelm Adam Serturner.

• Stimulants. The two most common types of stimulants abused are cocaine and amphetamines

• creasing the activity in the central nervous system. Physiological changes that occur with stimulants are increased blood pressure, heart rate, pressured thinking/speaking, and rapid, often jerky behaviors. Because of these symptoms, stimulants are commonly used for their feelings of euphoria, to reduce appetite, and prevent sleep.

• . More commonly, cannabis has been known to have stimulant and depressive effects, thus classifying itself in a group of its own due to the many different effects of the substance.

• t is not uncommon for substance abusers to consume more than one type of substance at a time. This combination of substance use can have dangerous results depending on the interactions between substances.

• Researchers believe that substance abuse disorders are often secondary to another mental health disorder, as the substance abuse develops as a means to “self-medicate” the underlying psychological disorder. In fact, several large surveys identified alcohol and drug dependence to be twice as more likely in individuals with anxiety, affective, and psychotic disorders than the general public

• imilar to other mental health disorders, substance abuse is genetically influenced.  With that said, it is different than other mental health disorders in that if the individual is not exposed to the substance, they will not develop substance abuse.

• Unique to substance abuse is the fact that both genetic and familial influence are both at play. What does this mean? Well, biologically, the individual may be genetically predisposed to substance abuse; additionally, the individual may also be at risk due to their familial environment where their parents or siblings are also engaging in substance abuse.

• Most of the research on the brain reward system has focused on the mesocorticolimbic dopamine system, as it appears this area is the primary reward system of most substances that are abused.

• dopamine, opioid peptides, GABA, serotonin, and endocannabinoids. More specifically, dopamine is less involved in opioid, alcohol, and cannabis. Alcohol and benzodiazepines lower the production of GABA, while cocaine and amphetamines decrease dopamine. Cannabis has been shown to reduce the production of endocannabinoids.