ADDICTION DISORDERS

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ADDICTION DISORDERS

• JACK L. BODDEN, PH.D.

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Drugs can make us do weird and strange things,
but sometimes it doesnt even take drugs to bring
on strange behavior. Watch this.
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Substance Related Disorders
DSM IV uses the above classification for the
disorders our text includes under the title of
Addiction Disorders. IN DSM there are two
subcategories 1. Substance Use Disorders (e.g.
Alcohol Dependence) and Substance Induced
Disorders (e.g. Alcohol or nicotine
intoxication). We will only cover disorders that
DSM calls Substance Use disorders.
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ESSENTIAL TERMINOLOGY

• Addictive Behavior behavior based on a
  pathological need for a substance or activity.
  DSM IV does not recognize addictive behaviors
  such as pathological gambling but instead refers
  to them under the heading of Impulse Control
  Disorders.

• Substance Abuse involves a pattern of
  pathological use resulting in potentially
  hazardous behavior or persistent use despite
  adverse social, legal, or health problems.

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• Substance Dependence involves a marked
  physiological need for increasing amounts of the
  substance (tolerance) as well as withdrawal
  symptoms that accompany abstinence from the drug.

• Psychoactive Substance drugs that affect
  mental functioning

• Intoxication a reversible state cause by
  ingestion/exposure to a substance causing
  maladaptive behavioral or psychological changes
  due to the effect of the drug on the central
  nervous system.

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How can a behavior (e.g. gambling) become an
addiction?
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The Neurobiology of Addiction
The Mesocorticolimbic Dopamine Pathway (MCLP) is
the so-called pleasure pathway in the brain (see
Fig. 12.1 in text). Alcohol and other addiction
causing substances appear to stimulate this
region of the brain, which in turn creates strong
pleasurable responses. Animal studies appear to
demonstrate that behavior which stimulates this
same area has the potential to create addictive
behavior patterns in much the same way as the
drugs. Apparently the pleasurable reactions
created by the drug or the behavior act as
reinforcers that rapidly establish durable habit
patterns.
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Learning and Addictions

• Behaviors or substances which reduce aversive
  emotional states (e.g. stress, anxiety, or
  boredom) reinforce (operant conditioning) those
  behaviors (or the act of using the drug). The
  pleasurable state acts as the reinforcement that
  establishes the habit pattern. Once established
  other physiological changes in the brain occur
  which create the condition we call an
  addiction. So in a sense addictions are
  learned.

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CATEGORIES OF ABUSABLE SUBSTANCES
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CAUSAL FACTORS IN ADDICTIONS
Biological Factors - MCLP differences in how
etoh is metabolized in the body
Genetics very important but not the whole story
Poor parental models guidance
Learning stress reduction, pleasure
reinforcement
Racial, cultural religious influences
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Continued next time with guest speaker, Sharon
Sandifer-Bethea of Scott White Clinic
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