Module 25 REVIEW

• 25-1 What are substance use disorders?

• Those with a substance use disorder experience continued substance craving and use despite significant life disruption and/or physical risk.
• Psychoactive drugs are any chemical substances that alter perceptions and moods.

• 25-2 What roles do tolerance and addiction play in substance use disorders, and how has the concept of addiction changed?

• Psychoactive drugs may produce tolerance — requiring larger doses to achieve the desired effect — and withdrawal — significant discomfort, due to strong addictive cravings, accompanying efforts to quit.
• Addiction prompts users to crave the drug and to continue use despite known adverse consequences. Psychologists try to avoid overuse of “addiction” to label driven, excessive behaviors. However, there are some behavior addictions (such as gambling disorder) in which behaviors become compulsive and dysfunctional.

• 25-3 What are depressants, and what are their effects?

• Depressants, such as alcohol, barbiturates, and the opiates (which include narcotics), dampen neural activity and slow body functions.
• Alcohol disinhibits, increasing the likelihood that we will act on our impulses, whether harmful or helpful. It also impairs judgment by slowing neural processing, disrupts memory processes by suppressing REM sleep, and reduces self-awareness and self-control. User expectations strongly influence alcohol’s behavioral effects.
• Alcohol can shrink the brain in those with alcohol use disorder (marked by tolerance, withdrawal if use is suspended, and a drive to continue problematic use).

• 25-4 What are stimulants, and what are their effects?

• Stimulants — including caffeine, nicotine, cocaine, the amphetamines, methamphetamine, and Ecstasy — excite neural activity and speed up body functions, triggering energy and mood changes. All are highly addictive.
• Nicotine’s effects make smoking a difficult habit to kick, yet repeated attempts to quit seem to pay off.
• Cocaine gives users a fast high, followed shortly by a crash. Its risks include cardiovascular stress and suspiciousness.
• Amphetamines stimulate neural activity. Use of methamphetamines may permanently reduce dopamine production.
• Ecstasy (MDMA) is a combined stimulant and mild hallucinogen that produces euphoria and feelings of intimacy. Its users risk immune system suppression, permanent damage to mood and memory, and (if taken during physical activity) dehydration and escalating body temperatures.

• 25-5 What are hallucinogens, and what are their effects?

• Hallucinogens — such as LSD and marijuana — distort perceptions and evoke hallucinations (sensory images in the absence of sensory input), some of which resemble the altered consciousness of near-death experiences.
• The user’s mood and expectations influence the effects of LSD, but common experiences are hallucinations and emotions varying from euphoria to panic.
• Marijuana’s main ingredient, THC, may trigger feelings of disinhibition, euphoria, relaxation, relief from pain and chemotherapy-related nausea, and intense sensitivity to sensory stimuli. Marijuana use is predictive of increased risk of traffic accidents, chronic bronchitis, psychosis, social anxiety disorder, and suicidal thoughts; and likely contributes to impaired attention, learning, memory, and possibly to academic underachievement.

Multiple-Choice Questions

1. Which of the following represents drug tolerance?
   1. Hans has grown to accept the fact that his wife likes to have a beer with her dinner, even though he personally does not approve of the use of alcohol.
   2. José often wakes up with a headache that lasts until he has his morning cup of coffee.
   3. Pierre enjoys the effect of marijuana and is now using the drug several times a week.
   4. Jacob had to increase the dosage of his pain medication when the old dosage no longer effectively controlled the pain from his chronic back condition.
   5. Chau lost his job and is now homeless as a result of his drug use.
2. After taking a psychoactive drug for many years, Carl stops taking it. He finds withdrawal to be physically painful, because the drug that he had been taking caused his brain to stop producing its own endorphins. Which drug was he taking?
   1. Nicotine
   2. Marijuana
   3. Cocaine
   4. Methamphetamine
   5. Heroin
3. Which stimulant causes high energy, emotional elation, dehydration, and damage to serotonin-producing neurons?
   1. Barbiturate
   2. Nicotine
   3. Ecstasy
   4. Caffeine
   5. LSD
4. Which of the following statements is true of alcohol?
   1. Alcohol is a hallucinogen, because it makes people believe things that are not true.
   2. Alcohol is a depressant, because it causes people to feel sad when under its influence.
   3. Alcohol is a stimulant, because people do foolish things while under its influence.
   4. Alcohol is a depressant, because it calms neural activity and slows body function.
   5. Alcohol is a stimulant, because it increases the heart rate as consumption increases.
5. What can be expected in someone who is a frequent user of marijuana?
   1. There will be an increased production of dopamine in the brain.
   2. They will need to consume larger doses of the drug to feel its effects.
   3. They will experience a dangerously elevated heart rate.
   4. They will experience vivid hallucinations.
   5. They will require less of the drug to feel its effects as the drug builds up in their system.

Practice FRQs

1. Explain alcohol use disorder by using the following terms:
   • Tolerance
   • Craving
   • Withdrawal

Answer

1 point: A person who regularly consumes alcohol develops tolerance—they need to consume more and more alcohol to achieve the same pleasurable effects. Tolerance increases the risk of developing alcohol use disorder Pages 254, 255

1 point: A person with alcohol use disorder will crave the drug, even when use is accompanied by aversive consequences. Pages 253, 254

1 point: A person with alcohol use disorder will suffer the negative symptoms of withdrawal when they stop drinking. Pages 254, 255

2. Many teens believe that recreational use of drugs does not have negative long-term effects. Explain a negative long-term effect, other than addiction, for each of the following drugs:
   • Alcohol
   • Marijuana
   • Nicotine

(3 points)