Substance Abuse Related Disorders. this ppt is specially for students who are pursuing Post Graduate Diploma in Guidance and Counseling from GJUS&T Hisar and affiliated colleges. Students can contact me for further discussion and doubts.

1. Substance Related and Addictive Disorders
Dr Rajesh Verma
Asst. Prof. of Psychology
Govt. College Adampur, Hisar, Haryana

2. Definition
Substance-related disorder is a mental illness in
which an individual faces stigma as well as apathy from
the public who consider such individuals to be a nuisance
to the society.

3. Definition of Substances
Substances are any ingested materials that cause temporary
cognitive, behavioral, or physiological symptoms within the
individual. The DSM uses 10 classes of substances: alcohol,
caffeine, cannabis, hallucinogens, inhalants, opioids, sedatives,
stimulants, tobacco, and other (or unknown).
Common Withdrawal Symptoms
Cramps, anxiety attacks, sweating,
nausea, tremors, and hallucinations.

4. Defining Feature
Substance use disorder is a cluster of cognitive, behavioral,
and physiological symptoms indicating that the individual
continues using the substance despite significant substance-related
problems.
In DSM-V ‘addiction’ scope has included not just psychoactive
substances, but also types of behavior such as gambling that shows similarity
in experiences and biology of those addicted to substances like alcohol,
nicotine, heroin, cocaine etc.

5. Categorization of Substance Related Disorders
Substance-related disorders are divided into two groups:
 Substance use disorders and
 Substance-induced disorders which include substance
intoxication and substance withdrawal.
 Substance intoxication occurs when a person has recently ingested
a substance leading to significant behavioral and/or psychological
changes.
 Substance withdrawal occurs when there
is a cessation or reduction of a substance
that has been used for a long period of time.

6. Characteristic of Substance Use Disorders
 An underlying change in brain circuits that may persist
beyond detoxification, particularly in individuals with
severe disorders.
Repeated relapses and intense drug craving when the
individuals are
exposed to
drug-related stimuli.

7. Diagnostics Criteria
Based on a pathological pattern of behaviors related to use of
the substance. The key issue in evaluating this criterion is not the
existence of the problem, but rather the individual's failure to
abstain from using the substance despite the difficulty it is
causing. These disorders occur when a person experiences
significant impairment or distress for 12 months due to the use of
a substance.
Severity of Addiction
 Mild substance use disorder is suggested by the
presence of two to three symptoms,
 Moderate by four to five symptoms, and
 Severe by six or more symptoms.

8. A. Impaired control over substance use
 Criterion 1 - The individual may take the substance in larger
amounts or over a longer period than was originally intended.
The individual may express a persistent desire to cut down or
regulate substance use and may report multiple unsuccessful
efforts to decrease or discontinue use.
 Criterion 2 - The individual may
spend a great deal of time obtaining
the substance, using the substance,
or recovering from its effects

9.  Criterion 3 – In some instances of more severe substance use
disorders, virtually all of the individual's daily activities revolve
around the substance.
 Criterion 4 - Craving is manifested by an intense desire or urge
for the drug that may occur at any time but is more likely when
in an environment where the drug previously was obtained or
used.

10. B. Social Impairment
 Criterion 5 - Recurrent substance use may result in a failure to
fulfill major role obligations at work, school, or home.
 Criterion 6 - The individual may continue substance use despite
having persistent or recurrent social or interpersonal problems
caused or exacerbated by the effects of the substance.
 Criterion 7 - Important
social, occupational, or
recreational activities may be
given up or reduced because
of substance use.

11. C. Risky use of the Substance
 Criterion 8 - This may take the form of recurrent substance use
in situations in which it is physically hazardous.
 Criterion 9 - The individual may continue substance use despite
knowledge of having a persistent or recurrent physical or
psychological problem that is likely to have been caused or
exacerbated by the substance.

12. D. Pharmacological Criteria
 Criterion 10 - Tolerance is signaled by requiring a markedly
increased dose of the substance to achieve the desired effect or a
markedly reduced effect when the usual dose is consumed.
 Criterion 11 - Withdrawal is a syndrome that occurs when blood
or tissue concentrations of a substance decline in an individual
who had maintained prolonged heavy use
 of the substance. After developing
 withdrawal symptoms, the
 individual is likely to consume the
 substance to relieve the symptoms.

13. Types of Substances Abused
The most abused substances will be divided into three
categories based on how they impact one’s physiological state:
 depressants,
 stimulants, and
 hallucinogens/cannabis/combination.

14. 1. 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. Unfortunately, when used in large amounts,
they can also impair an individual’s judgment and motor activity.
The “active” substance of alcohol, ethyl alcohol, is a chemical that is
absorbed quickly into the blood via
the lining of the stomach and
intestine. Once in the bloodstream,
ethyl alcohol travels to the central
nervous system (i.e., brain and
spinal cord) and produces
depressive symptoms such as
impaired reaction time,
disorientation, and slurred speech.

15. 2. Stimulants - The two most common types of stimulants abused are
cocaine and amphetamines. Unlike depressants that reduce the activity of the
central nervous system, stimulants have the opposite effect, increasing 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. The psychological and physiological effects
of cocaine are due to an increase of
dopamine, norepinephrine, and
serotonin in various brain structures.

16. 3. Hallucinogens/Cannabis/Combination - The final category
includes both hallucinogens and cannabis- both of which produce
sensory changes after ingestion. While hallucinogens are known for
their ability to produce more severe delusions and hallucinations,
cannabis also has the capability of producing delusions or
hallucinations; however, this typically occurs only when large
amounts of cannabis are ingested. 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. Common
hallucinogens are Ketamine, LSD,
and Ecstasy.

17. Comorbidity
Substance abuse has a high comorbidity within
itself and with mental health disorders such as
mood, anxiety, PTSD, and personality disorders.