Substance Use
Wars On Drugs
- Roman
catholic church in 1992 issued new universal catechism
- Officially
declared drug abuse and drunk driving are sins
- Usage
among college students increased from 1969 to 1978
- Decreased
significantly by 1989
Can You Use Drugs And Not Abuse Them?
Can You Abuse Drugs And Not Become Addicted To / Dependent On Them?
Can You Be Dependent
On Drugs And Not Abuse Them?
“Substance”
“Substance Use “
“Substance
Intoxication “
“Substance Abuse “
“Substance
Dependence“
- What
are the two requirements?
Etiology
Genetic
Predisposition
- Drug
must be available
- Person
must choose to use drug
- Does
not automatically lead to dependence
- Chromosome
11 Gene “DRD2”
- 2/3
alcoholics have gene but only 1/5 of nonalcoholics
- Not
sufficient for cause, but may interact
Positive/negative
reinforcement
Sociocultural effects
- Media
- Ethnic
customs, etc.
Integrative model
(see handout)
Treatment
1) Agonist
substitution
- Methadone
- Nicotine
patches/gum
2) Antagonist
drugs
3) Aversive
treatments
- Antabuse
- Prevents
breakdown of acetaldehyde
- Causes
feelings of illness
4) Inpatient
hospital treatment
- Research
shows no difference between in and outpatient tx
5) Alcoholics
Anonymous
6) Controlled
use
- Sobell & Sobell, 1978
- 40
men, abstinence vs. controlled drinking
- 98%
followed over 2 years
- 2 yr
post-tx, controlled doing well 85% of the days
- abstinence
group only 42% of the days
- Rebuttal
- 1982,
article in Science contacted subjects after 10 years
- found
only 1 in controlled group continued a controlled drinking pattern
- PROBLEM
- no data on abstinence group
- controlled
drinking widely accepted as tx in United
Kingdom