Chapter
13
Misuse
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Addictive Behavior
 Psychoactive Drugs
 Alcohol
 Tobacco

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Drug: Any chemical, other than
food, intended to affect the
structure or function of the body
 Psychoactive drug: A drug that can alter
a person’s state of mind or consciousness
 Intoxication: The state of being
mentally affected by a chemical (literally,
a state of being poisoned)

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
Addictive behavior: Any habit that
has gotten out of control resulting
in a negative effect on one’s health
 Originally, addiction applied only to habitual
use of a drug that produced a chemical
change
 Some scientists now believe that certain
activities can be addictive
▪ Trigger release of chemicals causing euphoria and
lead to psychological and physical dependence
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Addiction: Psychological or
physical dependence on a substance
or behavior characterized by a
compulsive desire and increasing
need for the substance or behavior
 Dependence: Result of physiological
or psychological adaptation that
occurs in response to frequent use
of a substance; typically associated
with tolerance and withdrawal

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
Substance misuse or abuse:
Use of any substance despite
adverse social, psychological,
or medical consequences; the
use may be intermittent and
with or without tolerance
and physical dependence
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Tolerance: Lower sensitivity to a drug,
so that a given dose no longer exerts the
usual effect and larger doses are needed
 Withdrawal: Physical and psychological
symptoms that follow the interrupted
use of a drug on which a user is
physically dependent; symptoms
may be mild or life-threatening

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 American Psychiatric Association: refers to
two forms of substance (drug) disorders:
▪ Substance abuse and substance dependence
▪ Recurrent drug use that results in failure to
fulfill major responsibilities; poses a physical
hazard; is associated with legal problems; or
causes or exacerbates interpersonal problems
▪ Pattern of drug abuse may be constant or
intermittent, and physical dependence may or
may not be present
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
Drug or substance dependence
involves at least three of seven symptoms
 Developing tolerance to the substance
 Experiencing withdrawal
 Taking the substance in larger amounts or
over a longer period than originally intended
 Expressing desire to cut down
or regulate substance abuse
(Continued on next slide)
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
Drug or substance dependence
 Spending a great deal of time
obtaining the substance, using the
substance, or recovering from its effects
 Giving up or reducing important school,
work, or recreational activities because of
substance abuse
 Continuing to use the substance in spite
of recognizing that it is contributing
to a psychological or physical problems
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
Addictive behaviors typically
share some general characteristics
 Reinforcement
 Compulsion or craving
 Loss of control
 Escalation
 Negative consequences
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Addiction often starts when a person
does something to bring pleasure or
avoid pain
 Potential for addiction determined by:

 Personality
 Lifestyle
 Heredity
 Social and physical environment
 Nature of the substance or behavior
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Compulsive gambling
 Compulsive buying
 Internet addiction
 Other behaviors like exercise, eating,
watching TV, and working out can also
become addictive

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
Psychoactive drugs include legal
compounds such as caffeine, tobacco,
and alcohol as well as illegal substances
such as heroin, cocaine, and LSD
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
Drug use and abuse occur at all income
and education levels, among all ethnic
groups, and across all age groups
 Brain chemistry or metabolism
 Psychological risk factors
 Social factors
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
Characteristics of people who are higherthan-average risk for trying illegal drugs:
 Being male
 Being young
 Having exposure to drugs through
family members or peers
 Troubled adolescents
 Having a risk-taking-personality
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No single best method
 Treatment must:

 Deal with the reasons
behind the abuse
 Help individuals change
their attitudes and
behaviors and develop
a social support system
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
Signals that suggest drug dependence:
 Sudden withdrawal or emotional distance
 Rebellious or unusually irritable behavior
 Loss of interest in usual activities or hobbies
 Decline in school performance
 Sudden change in group of friends
 Changes in sleeping or eating habits
 Frequent borrowing of money
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Creative efforts are needed
to stop the demand for drugs
 The best solution is prevention

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
Before trying a psychoactive drug, ask
yourself:
 What are the risks involved?
 Is using the drug compatible with your goals?
 What are your ethical beliefs about drug use?
 What are the financial costs?
 Are you trying to solve a deeper problem?
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
Ethyl alcohol: Intoxicating
ingredient in fermented liquors;
a colorless, pungent liquid
 Proof value: Two times the percentage of
alcohol in a beverage, measured by volume;
a 100-proof beverage contains 50% alcohol
 One drink: Amount of a beverage that
typically contains about 0.6 ounce
of alcohol; also called a standard drink
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
Blood alcohol concentration (BAC):
Amount of alcohol in the blood in
terms of weight per unit volume;
used as a measure of intoxication
 If a person drinks slowly, blood
alcohol concentration (BAC) remains low
 Consuming more than is
metabolized causes BAC to
rise and results in intoxication
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
Low levels of alcohol induce
relaxation and release inhibitions
 Higher levels can result in:
▪ Reduction of motor coordination,
intellectual functioning, and judgment
▪ Flushing and sweating
▪ Decreased sexual performance
▪ Disturbed sleep patterns
▪ “Hangover”
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
Legal limit for BAC in all states is 0.08%
 Many states have “zero tolerance” laws for
drivers under age 21
 Alcohol impairs the user even at much lower
BACs than 0.08%
 Learn to be alert to erratic driving from
impaired drivers
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
Alcohol abusers have a life expectancy
15 years shorter than that of nonabusers
 Cirrhosis: Disease in which liver is severely
damaged by alcohol, other toxins, or
infection
 Fetal alcohol syndrome (FAS):
Characteristic group of birth defects caused
by excessive alcohol consumption by the
mother
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Alcohol misuse: Use of alcohol
to a degree that causes physical
damage, impairs functioning, or
results in behavior harmful to others
 Alcohol use disorder: Chronic
psychological disorder characterized by
excessive and compulsive drinking, and
measured as mild, moderate, or severe

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
Warning signs for alcohol abuse:
 Drinking alone or secretively
 Repeatedly using alcohol to cope with





problems
Discomfort at social events without alcohol
Drinking more than usual
Heavy drinking in risky situations
Getting drunk regularly or more frequently
Drinking in the morning or at unusual times
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
Binge drinking: Periodically drinking
alcohol to the point of severe
intoxication
 4 drinks in a row for men or 3 drinks in a
row for women within 2 hours
▪ 2009 survey: 24% of people over
age of 12 were binge drinkers
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
Characterized by tolerance
and withdrawal symptoms
 When alcoholics stop drinking, they
experience withdrawal symptoms
that can be life-threatening
▪ DTs (delirium tremens): State of confusion
brought on by the reduction of alcohol
intake in an alcohol-dependent person;
other symptoms are sweating, trembling,
anxiety, hallucinations, and seizures
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Examine drinking behavior and motives
for drinking and staying in control
 Drink in a way that keeps BAC
low and behavior under control

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
U.S. Surgeon General: Smoking is the
leading preventable cause of illness and
death in the U.S.
 440,000 Americans die prematurely from
smoking-related causes
 All forms of tobacco are unsafe, including
pipes, chewing tobacco, and clove cigarettes
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
Nicotine: Poisonous, addictive substance
found in tobacco and responsible for
many of the effects of tobacco
 If addicted tobacco user does not
have a steady amount of nicotine
circulating in the body and going to
the brain, s/he experiences such
withdrawal symptoms as muscular
pain, nausea, insomnia, and headaches
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
Smoking has profound
negative effects
 Chemicals in tobacco include
carcinogens, cocarcinogens,
agents that irritate
respiratory tissue,
and carbon monoxide
 Nicotine can either
excite or tranquilize
the nervous system
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Smokers lose about 14 years of life on
average.
 Smoking linked to:

 CVD
 Lung disease
 Cancer
 Tooth decay and gum disease
 Menstrual disorders
 Motor vehicle crashes
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
Cigars and pipes
 Cigar and pipe smokers at risk for many
health problems faced by cigarette smokers
 Cigars contain more nicotine and tar than do
cigarettes
 Cigar smokers who don’t inhale have a sixtimes greater risk of throat cancer than
nonsmokers
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
Clove cigarettes and bidis
 Clove cigarettes contain chopped cloves
and about twice as much tar, nicotine, and
carbon monoxide as conventional cigarettes
 Bidis, or “beadies,” are small cigarettes
imported from India
▪ Tobacco is different from that used in U.S.
cigarettes
▪ Contain up to four times more nicotine
and twice as much tar as U.S. cigarettes
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
Spit (Smokeless) Tobacco
 Spit (smokeless) tobacco can
be used as snuff or chewing tobacco
 Chewing tobacco increases
the risk of oral cancer
 Snuff increases the risk
of cheek and gum cancer
 Both lead to nicotine addiction
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
E-Cigarettes
 Battery-powered device that
resembles a real cigarette
▪ Uses changeable filter that contains
one or more chemicals, such
as nicotine and flavorings
▪ FDA warns consumers that the same
carcinogens are present in these products
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
Environmental tobacco smoke (ETS):
Smoke from the burning end
of a cigarette, cigar, or pipe,
and smoke exhaled by smokers;
also called secondhand smoke
 Mainstream smoke: Smoke inhaled by a
smoker and exhaled into the atmosphere
 Sidestream smoke: Smoke from the
burning end of a cigarette, cigar, or pipe
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
Known human carcinogen and causes
3,400 lung cancer deaths annually
 Contributes to heart disease and
aggravates such respiratory
conditions as allergies and asthma
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
Infants and children breathe more quickly
and weigh less than adults, so they inhale
higher concentrations of pollutants
 ETS increases incidence of bronchitis,
pneumonia, asthma, reduced
lung function, and ear infections
 ETS results in 15,000
hospitalizations annually
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 Speak up tactfully
 Don’t allow smoking in you home or room
 Open a window
 Sit in the nonsmoking section in
restaurants and other public areas
 Fight for a smoke-free work environment
 Discuss quitting strategies
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
Fetuses are even more vulnerable:
 Smoking nearly doubles risk of miscarriage
 Increases the risk of ectopic pregnancy,
premature delivery (and death),
problems with the placenta, and
sudden infant death syndrome (SIDS)
▪ 16% of pregnant women still
smoke throughout their pregnancy
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
Fetuses are even more vulnerable:
 Children of mothers who smoke
more than two packs per day:
▪ Perform poorly on
developmental tests
just after birth
▪ Later in life exhibit
hyperactivity, short
attention span, and
lower language scores
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
Action Against Tobacco
 Tobacco consumption in the
U.S. is declining among some groups
▪ Local ordinances that have
banning smoking in public places
▪ Restricting advertising
▪ Lawsuits against the tobacco industry
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
Giving Up Tobacco
 Quitting means breaking physical
and psychological dependence
 There are several methods to use
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