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Pharmacological Treatment for Substance Related Disorders

Overview. Brief history and definitions of Substance-Related DisordersSummary of the DSM-IV criteria for Substance-Related DisordersReported trends and facts related to substance useDescription of specific substances, and current pharmacological treatmentsAlcoholCocaineHallucinogens. Substan

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Pharmacological Treatment for Substance Related Disorders

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    1. Pharmacological Treatment for Substance Related Disorders Claudia Flato Texas A&M University

    2. Overview Brief history and definitions of Substance-Related Disorders Summary of the DSM-IV criteria for Substance-Related Disorders Reported trends and facts related to substance use Description of specific substances, and current pharmacological treatments Alcohol Cocaine Hallucinogens

    3. Substance Abuse and Dependence DSM IV Definition of Substance Abuse Brief history the transition of Substance Abuse Diagnosis across the DSMs Substance abuse vs. substance dependence The validity of Substance Dependence The validity of Substance Abuse DSM IV Substance-related Disorders Substance Use Disorders Substance abuse: misuse of a substance followed by social or occupational consequences but without physiological processes (withdrawal, tolerance and compulsive use) Substance dependence: compulsive use of the substance with or without physiological consequences Substance Induced Disorders

    4. Substance Abuse and Dependence Substance Abuse A maladaptive pattern of substance use failure to fulfill major obligations continued use under hazardous conditions multiple legal problems recurring social and interpersonal problems. Sans tolerance, withdrawal or a pattern of compulsive use of the substance Symptoms have never met criteria for dependence Substance abuse does not apply to nicotine and caffeine.

    5. Substance Abuse and Dependence Substance Dependence Addiction to a substance except caffeine Cognitive, behavioral and physiological symptoms Three of the 7 criteria specified must have occurred within the same 12 months Criteria for this disorder include tolerance, withdrawal, reduced involvement in pleasurable activities, and compulsive use of the substance Does not apply to caffeine Specify: With or Without Physiological Dependence

    6. Substance-Induced Disorders (Differential Diagnosis) The Substance Induced Disorders Intoxication Reversible, maladaptive, and not due to a GMC (NA for nicotine) Withdrawal Problems after cessation or reduction of a substance NA for caffeine, cannabis, hallucinogens, inhalants, and PCP Substance Induce Disorders that share phenomenology with other mental disorders Substance-Induced Delirium Persisting Dementia Persisting Amnestic Disorder Psychotic Disorder Mood Disorder Anxiety Disorder Sexual Dysfunction Sleep Disorder

    7. Substance Abuse Facts and Treatment Trends

    8. Substance Abuse Facts and Treatment Trends

    9. Alcohol (Ethanol) Background

    10. Alcohol (Ethanol)

    11. Drug mechanisms Alcohol Metabolism

    12. Drug mechanisms

    13. Alcohol and Treatment

    16. Drug mechanism Cocaine Mechanism: Cocaine attaches to dopamine transporter causing dopamine to build-up in the synapse.

    18. Cocaine and Treatment

    20. Hallucinogens Background Hallucinogens produce transient psychotic states LSD, PCP, Ketamine, Dextromethorphan Known to affect the serotonin system Mescaline, psilocybin, and ibogaine Often used in religious and cultural rituals In natural form (peyote) availability is limited LSD synthetic compound No unique criteria for Hallucinogen Dependence and Abuse in DSM-IV No withdrawal syndrome

    22. Hallucinogens and Treatment

    23. Websites http://www.nida.nih.gov/NIDAHome.html http://www.samhsa.gov/ http://www.niaaa.nih.gov/ http://nhsn.med.miami.edu/ http://www.bnl.gov

    24. References American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders (4th Ed). Washington, DC: Author Johnson, B., & Ait-Daoud, N. (1999). Medications to treat alcoholism. Alcohol Research & Health, (23), 99 -106. www.niaaa.nih.gov Moras, K. (1997). Outcome measurement considerations: Pharmachological treatments for substance abuse. Nida Research Monograph, (175), 118 -136 Preston, J.D., ONeal, J.H., & Talaga, M.C. (2004). Handbook of clinical psychopharmachology for therapists (4th ed.). Oakland, CA: New Harbinger Publications Swift, R., & Davidson, D. (1998). Alcohol hangover: Mechanisms and mediators. Alcohol Research & Health, (22), 54 - 60. www.niaaa.nih.gov Tapert, S.F., Tate, S. R., & Brown, S.A. (2001). Substance abuse: An overview. In P. B. Sutker, & H. E. Adams (Eds.), Comprehensive handbook of psychopathology (3rd ed.). New York, NY: Kluwer Academic/Plenum. Carlson, N. R. (2004). Physiology of behavior (8th ed.). Boston, MA: Allyn and Bacon.

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