SUBSTANCE-RELATED

and
IMPULSE-CONTROL
DISORDERS
 SUBSTANCE-RELATED
DISORDER
Substance-related disorders are disorders of intoxication,
dependence, abuse, and substance withdrawal caused by
various substances, both legal and illegal.

Poly-Substance Use - using multiple substances

Psychoactive Substance - substance such as drug that can
alter humans mood and behavior
 SUBSTANCE-RELATED
DISORDER
The DSM-V recognizes substance-related disorders resulting from
the use of 12 separate classes of drugs:
1. Alcohol
2. Caffeine
3. Cannabis
4. Hallucinogens
5. Inhalants
6. Opioids
7. Sedatives
8. Hypnotics
9. Anxiolytics
10. Stimulants
11. Tobacco
12. and other Unknown substances.
PERSPECTIVES ON SUBSTANCE-RELATED DISORDERS

Levels of Involvement
1. Substance Use
- Ingestion of psychoactive substances in moderate amounts that does not
significantly interfere the persons functioning.

2. Substance Intoxication
- The physiological reaction to ingested substances.

3. Substance Abuse
- In DSM-V, it defines that in terms of how significantly it interferes with the
users life.

4. Substance Dependence
- It is usually described as ADDICTION.
Tolerance
Withdrawal
Can people use drugs and not abuse them?

But dependence can be present without abuse.

 Diagnostic Issues:
DEPRESSANTS
Depressants substances result in behavioral sedation and can induce relaxation.

This include alcohol (Ethyl Alcohol), sedative, hypnotic and anxiolytic drugs in the
families of barbiturates (Seconal) and benzodiazepines (Valium and Halcion)

Alcohol Use Disorders

> Dementia
> (FAS) Fetal Alcohol Syndrome
 Diagnostic Issues:
STIMULANTS
Stimulants substances that cause people to be more active and alert and it can
elevate mood.

1. AMPHETAMINE 2. COCAINE 3. NICOTINE 4. CAFFEINE

 Diagnostic Issues: OPIOIDS
Opioid Use Disorder Criteria:
1. Taking the opioid in larger amounts and for longer than intended
2. Wanting to cut down or quit but not being able to do it
3. Spending a lot of time obtaining the opioid
4. Craving or a strong desire to use opioids
5. Repeatedly unable to carry out major obligations at work, school, or home due to opioid
use
6. Continued use despite persistent or recurring social or interpersonal problems caused or
made worse by opioid use
7. Stopping or reducing important social, occupational, or recreational activities due to opioid
use
8. Recurrent use of opioids in physically hazardous situations
9. Consistent use of opioids despite acknowledgment of persistent or recurrent physical or
psychological difficulties from using opioids
10. *Tolerance as defined by either a need for markedly increased amounts to achieve
intoxication or desired effect or markedly diminished effect with continued use of the same
amount. (Does not apply for diminished effect when used appropriately under medical
supervision)
11. *Withdrawal manifesting as either characteristic syndrome or the substance is used to
avoid withdrawal (Does not apply when used appropriately under medical supervision)

*This criterion is not considered to be met for those

individuals taking opioids solely under appropriate
medical supervision.
 Diagnostic Issues: HALLUCINOGENS
LSD and other HALLUCINOGENS MARIJUANA

DSM CRITERIA OF CANNABIS

INTOXICATION:
1. Significant Maladaptive Behavior /
Psychological change (Euphoria,
Anxiety)
2. Bloodshot eyes, increased appetite,
dry mouth, increased heart rate.
 CAUSES OF SUBSTANCE-RELATED DISORDERS
1. NEUROBIOLOGICAL FACTORS 2. PSYCHOLOGICAL DIMENSION

Complex and fascinating studies POSITIVE REINFORCEMENT

- The feelings that result from using
include the brain appears to have a
psychoactive substances are pleasured
natural pleasure pathway that in some way, and people continue to
mediates the experience of take the drugs to recapture the
reward, it helps us remove pleasure.
unpleasant experiences. NEGATIVE REINFORCEMENT
- Reduce unpleasant feelings through
All abused substances seem to negative reinforcement
affect this internal reward center. - To escape from unpleasantness in
their life.
Other drugs appear to increase the - Many drugs provide escape from
availability of dopamine. Physical Pain, Stress and for Panic and
Anxiety.
 TREATMENT OF SUBSTANCE RELATED DISORDERS
BIOLOGICAL TREATMENTS PREVENTION

Agonist substitution RELAPSE PREVENTION

- Providing the person with a safe drug - Extending therapeutic progress by
that has similar chemical make up used teaching the client how to cope with
as a treatment for substance future troubling situations.
dependence.

Antagonist
substitution
- Medication that blocks or counteracts
the effects of a psychoactive drug.
IMPULSE-CONTROL
DISORDERS
Intermittent Explosive Disorder
KLEPTOMANIA
PYROMANIA
Pathological Gambling
TRICHOTILLOMANIA