2. A substance is any natural or
synthesized product that has
psychoactive effects—it changes
perceptions, thoughts, emotions, and
behaviors.
3. (1) central nervous system depressants, including
alcohol, barbiturates, benzodiazepines, and
inhalants
(2) central nervous system stimulants, including
cocaine, amphetamines, nicotine, and caffeine
(3) opioids, including heroin and morphine
(4) hallucinogens and phencyclidine (PCP)
(5) cannabis
Five categories of abused
substances
5. Substance intoxication: Experience of
significant maladaptive behavioral and
psychological symptoms due to the effect
of a substance on the central nervous
system.
Substance withdrawal: Experience of
clinical significant distress in social,
occupational, or other areas of functioning
due to the cessation or reduction of
substance use.
6. Substance abuse: Diagnosis given when
recurrent substance use leads to significant
harmful consequences.
Substance dependence: Diagnosis given
when substance use leads to physiological
dependence or significant impairment or
distress.
6
8. Impaired centre control
1. The substance is taken in increasingly large
amount or over period of time than originally
intended.
2. The substance user craves the use of the
substance.
3. The substance user feels an ongoing desire to
cut down or control substance abuse.
4. Much time is spent in obtaining, using or
recovering from the substance.
Criteria for Substance Use Disorder
9. Social impairment
5. The ongoing use of the substance often
results in an inability to meet responsibilities
at home, work or school
6. Important social, work-related or
recreational activities are abandoned or cut
back because of substance use.
7. Ongoing substance use despite recurring
social or relationship difficulties caused or
made worse by the effects or the substance.
Criteria for Substance Use Disorder
10. Risky use
8. Ongoing substance use in physically
dangerous situations such as driving car
or operating machinery.
9. Substance use continues despite the
awareness of ongoing physical or
psychological problems that have likely
arisen or been made worse by the
substance.
Criteria for Substance Use Disorder
11. Pharmacological Criteria
10. Changes in the substance user’s tolerance of the
substance is indicated by the need for increased
amounts of the substance to achieve the desired effect
or by a diminished experience of intoxication over
time with the same amount of the substance.
11. Withdrawal is demonstrated by the characteristic
withdrawal syndrome of the substance and or taking
the same or similar substance to relieve withdrawal
symptoms.
Criteria for Substance Use Disorder
12. DSM-5
Substance abuse and dependence may be
combined in one diagnosis to be called
substance-use disorder.
Diagnostic criteria for substance-use disorder
will include:
continued use of substances despite negative social,
occupational, and health consequences
evidence of tolerance or withdrawal.
“Craving the substance” will be added because
it is a common symptom of abuse/dependence
“Legal problems” will be removed from the
criteria
13. Depressants
Depressants slow the central nervous
system.
In moderate doses, they make people
relaxed and somewhat sleepy, reduce
concentration, and impair thinking and
motor skills.
Includes alcohol, benzodiazepines,
barbiturates, and inhalants.
1. DEPRESSANTS
20. cause decrease in blood pressure,
respiratory rate and heart rate.
(overdose) can cause respiratory arrest or
cardiovascular collapse
Benzodiazepines and Barbiturates
21. Benzodiazepines and Barbiturates
Benzodiazepines (such as Xanax, Valium,
Halcion, and Librium) and barbiturates (such as
Quaalude) are legally manufactured and sold
by prescription, usually for the treatment of
anxiety and insomnia.
Two common patterns of abuse can develop
with these substances:
1. adolescents using them for recreational purposes
2. people (particularly women) using initially under
physician’s care but then increasing doses as
tolerance develops
22. 2. STIMULANTS
Activate the central nervous system, causing feelings
of energy, happiness, and power, a decreased desire
for sleep, and a diminished appetite
Include cocaine and the amphetamines (including the
related drugs methamphetamines)
Impart a psychological lift or rush
Cause dangerous increases in blood pressure and heart rate,
alter the rhythm and electrical activity of the heart, and
constrict the blood vessels, which can lead to heart attacks,
respiratory arrest, and seizures
Caffeine and nicotine
Prescription stimulants, including Dexedrine and
Ritalin
23. white powder extracted from coca
plant; one of the most addictive
substances known.
people snort or inject it intravenously.
Cocaine
24. Crack- freebase cocaine usually smoked
in a water pipe or mixed in tobacco or
marijuana cigarette.
produces instant rush intense euphoria;
heightened self-esteem; alertness; energy;
feelings of competence and creativity.
Cocaine
25. When taken repeatedly:
grandiosity, impulsiveness,
hyper sexuality, compulsive
behavior, agitation and anxiety
reaching to the point of panic and
paranoia.
26. Stimulants: Amphetamines
Used to combat depression or fatigue or boost
energy and self-confidence; also in diet drugs
Cause the release of dopamine and
norepinephrine and block reuptake
Symptoms of intoxication are similar to cocaine
intoxication
27. Stimulants: Cocaine
Symptoms include:
– behavioral changes (e.g., euphoria or
affective blunting; impaired judgment)
– rapid heartbeat, dilation of pupils, elevated
or lowered blood pressure
– weight loss, nausea or vomiting
– muscular weakness
– slowed breathing, chest pain, confusion
– seizures, coma
27
29. Stimulants: Nicotine
•No DSM-V diagnosis for the symptoms, but
nicotine operates on both the central and peripheral
nervous system
•Results in the release of several biochemicals that
may have direct reinforcing effects on the brain,
including dopamine, norepinephrine, serotonin, and
the endogenous opioids
29
30. Stimulants: Nicotine (continued)
• Withdrawal Symptoms
•dysphoria or depressed mood
•insomnia
•irritability
•frustration or anger
•anxiety
•difficulty concentrating
•restlessness
•decreased heart rate
•increased appetite or weight gain
31.
32. Stimulants: Caffeine
•The most heavily used stimulant drug
•75% of caffeine ingested through coffee
•The average American drinks about
two cups of coffee per day; a cup of
brewed coffee has about 100 milligrams
of caffeine
•Caffeine stimulates the central nervous
system increasing levels of dopamine,
norepinephrine, and serotonin
33. Stimulants: Caffeine (continued)
•Symptoms: Restlessness, nervousness,
excitement, insomnia, flushed face, frequent
urination, stomach upset, muscle twitching,
rambling flow of thought or speech, rapid
heartbeat, periods of inexhaustibility,
psychomotor agitation
•Withdrawal Symptoms: Marked fatigue or
drowsiness, increased appetite or weight gain,
marked anxiety or depression, nausea or
vomiting
36. 4. Hallucinogens and PCP
Hallucinogens are a mixed group of
substances including LSD, MDMA
(also called ecstasy), and peyote.
PCP, also known as angel dust, is a
manufactured as a powder to be
snorted or smoked. Although not
classified as a hallucinogen, it has
many of the same effects.
38. 5. Cannabis
The leaves of the cannabis (or hemp) plant can be
cut, dried, and rolled into cigarettes or inserted
into food and beverages. In North America, the
result is known as marijuana, weed, pot, grass,
reefer, and Mary Jane
Cannabis is the most commonly used illegal drug
in the United States, with about 40% of the
population reporting use of it at some time in their
lives, and 6% in the last month
39. About 7% of the population would qualify for a
diagnosis of cannabis abuse, and 2 to 3% for a
diagnosis of cannabis dependence
Occasional use is widespread: 30% of college
students say they have used cannabis in the last
year
Cannabis
41. Inhalants
Inhalants: solvents such as gasoline, glue, paint
thinners, and spray paints.
Greatest users of inhalants are young boys between
10 and 15 years of age.
Chronic users may have a variety of respiratory
irritations and rashes.
Can also cause permanent damage to the central
nervous system, and can lead to organ failure and
death.
42. Inhalants have a variety of effects depending on the
specific drug:
Intoxications Symptoms
Behavioral changes: impaired judgment, belligerence,
assaultiveness, apathy.
Dizziness, Incoordination, Slurred speech, Unsteady
gait, lethargy, depressed reflexes, psychomotor
retardation, tremor, blurred vision, stupor, coma,
euphoria.
