Substance Use Disorder

Symptoms #

Impaired control:

• Using more of a substance than intended, or for longer than intended
• Trying to cut down but are unable to

Physical dependence:

• Cravings or urges to use substance
• Need more to get desired effect (builds up tolerance)
• Withdrawal symptoms when not using substance

Social problems:

• Spends significant time obtaining and using substances, and recovering
• Neglects responsibilities due to substance use
• Continuing to use substances when they cause relationship issues
• Gives up important social/recreational activities

Risk use:

• Uses substances in risky situations that put individual in danger (e.g. driving)
• Uses substances when they cause issues in physical and mental health

Heavy drinking criteria #

female or >65 years old: 7 drinks per week or >3 per occasion male: 14 drinks per week or >4 per occasion

3 Key Pathways: Etiological Models #

Etiological model = causal pathway

• Example of equifinality due to multiple different pathways all leading to the same result (substance use problems)

Deviance Proneness Pathways:

• Disinhibited temperament as a result of family problems
• ineffective parenting leads to child being behaviorally uncontrolled
• Child is exposed to ‘deviant peers’ who introduce them to substances
• Learn norms promoting substance use (peer pressure)

Stress and Negative Affect, Internalizing Pathways:

• Main idea: substances are used to cope with stressful situations
• Often seen in families with substance use problems: family dynamic is a constant source of chronic stress that creates deficits in executive functions

Alcohol Effects Pathways

• Main idea: children of parents with a history of alcoholism have increased sensitivity to alcohol that makes it more appealing to use

Why are teens more sensitive? #

• Increased reward sensitivity