DRUG ADDICTION
AND ALCOHOLISM
Yard. Doç. Dr. N. Berfu Akbaş
Yeditepe Üniversitesi
Psikiyatri Anabilim Dalı
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DEPENDENCE:
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A maladaptive pattern of substance use, leading to clinically
significant impairment or distress, manifested by TOLERANCE,
WITHDRAWAL, PERSISTANT DESIRE, a great time and activity
spent, social activities given up, use is continued despite knowledge
of harms.
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ABUSE: recurrent substance use in a failure to fulfill
major role obligations, use in situations physically
hazardous, recurrent legal problems, continued use
despite social and interpersonal problems
INTOXICATION: the development of a reversible
substance-specific syndrome due to recent exposure (
clinicaly significant maladaptive behavioral or
psychological changes on central nervous system )
WITHDRAWAL: the development of a reversible
substance-specific syndrome due to the cessation of
substance
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ALCOHOL RELATED DISORDERS
%0.05 in blood: thought, judgment, restraint loosened
% 0.1 : voluntary motor actions clumsy
% 0.3
: confusion and stupor
0.5 promil: 0.5gr alcohol in 1lt blood: %0.063 alcohol
Intoxication: inappropriate behaviour, mood lability, impaired
judgement, slurred speech, incoordination, nystagmus,
impaired attention amd memory, coma
Withdrawal: autonomic hyperactivity, hand tremor, insomnia,
nausea-vomitting, hallusinations, illusions, psychomotor
agitation, anxiety, grand mal seizures
Delirium Tremens: Alcohol ıntoxication delirium, mortal %20.
ın 1 week after alcohol cessation. Hallusinations, delusions,
tachycardia, diaphoresis, fever, hypertension,
hyperexcitability or lethargy
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Wernicke-Korsakoff Sydrome: alcohol-induced
persisting amnestic disorder. Thiamine deficiency.
Wernicke’s Encephalopaty: alcoholic encephalopaty,
ataxia, confusion, nystagmus, gaze palsy, anisocoria.
Reversible if treated, if not→ Korsakoff’s Sydrome:
chronic amnestic sydrome.
Marciafava-Bignami Syndr: demyelination of corpus
callosum, optic tracts, cerebellar peduncles.
Medical complications of alcohol use:
Liver damage, peptic ulcer, pancreatitis
Peripheral neuropathies, myopathy, hepatocerebral
degeneration, cerebellar degeneration,
HT, stroke cardiomyopathy, anemia, electrolyte
imbalances
Ca of mouth, pharynx, liver, breast
Idiosyncratic alcohol intoxication: small
amounts, agression
 Pathological jealosy
 Alcoholic hallusinosis: auditory
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AMPHETAMINE-RELATED DISORDERS
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Ice, crystal, speed, XTC, adam,
eve...psychostimulants.
Metamphetamine, ephedrine,
pseudoephedrine
A single dose ( 5mg): ıncrease
the sense of well-being, elation,
euphoria, friendliness, improve
attention, increase performance,
anorexia
Severe hypertension, myocardial
infarction, cerebrovascular
infarction, ischemic colitis,
seizures, coma.
CAFFEINE RELATED DISORDERS
A cup of coffee: 100-150mg. Caffeine ( methylxanthine)
 Low doses: + reinforcer, doses > 300mg: increased
anxiety and mild dysphoria.
 Global cerebral vasoconstriction
 Intoxication:restlessness,nervousness, excitement,
muscle twitching, cardiac arrhytmia
 Withdrawal: fatique, drowsiness, anxiety and depression,
nausea and vomitting
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CANNABIS-RELATED DISORDERS
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Hashish ( flower),
marijuana ( leaves)
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Red eye, tachycardia,
increased appetite,
hypotension, long term
use; cerebral atrophy,
seizures, chromosomal
damage, decreased
testesterone,
amotivational
syndrome
COCAINE-RELATED DISORDERS
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Produces
euphoria→personality
changes, impulsive
behaviour, weight loss,
insomnia,nasal congestion,
cerebrovascular, cardiological
disorders ( arritymia, MI,
CMP )seizures, death crash
syndrome ( post
intoxication depression)
formication ( cocaine
bugs)
Hallucinogen Related Disorders:
mushrooms( psilocybin), mescaline (
cactus),LSD
 “hallucinogen persisting perception
disorder”- “flashbacks”
 Inhalant Related Dısorders:
solvents, glues, thinners, paints
 Maladaptive behavioral and
psychological changes
 Nicotine related disorders:improved
attention,learning, reaction time,
skeletal muscle relaxation→long term
use decrease CBF
 Toxication.: nausea, vomit, abdominal
cramps, confusion, HT, tremors
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Opioid Related Disorders:
morphine, heroin, fentanyl,
codeine.
 Euphoric high ( rush )→ sedation,
respiratory depression, pinpoint
pupils, smooth muscle contraction,
anaphylactic shock, arrithmia,
constipation,HT...
 Sedative-hypnotic Related
Disorders:benzodiazepines,
barbiturates
 Anabolic Steroid abuse:
testesterone analogs
 İnitially induce euphoria and
hyperactivity→ anger, irritability,
hostility, anxiety, depression,
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