Substance-related Disorders and Addictive Disorder

00:01 Now, we'll be reviewing substance disorders.

00:04 Substance disorders, basically the essential feature is a cluster of cognitive, behavioral, and physiological symptoms indicating that an individual continues using the substance despite significant disturbance to their lives caused by the substances. Let's talk a little bit about the assessment of a substance abuse problem.

00:28 You're looking for an individual who has shown a failure to fulfill obligations at work, school, or home.

00:36 In addition, they're using their chosen substance in dangerous situations.

00:40 They have a recurrent substance-related legal problem, and there's continued use despite social or interpersonal problems due to the substance use.

00:52 Now, this is different from substance dependence which is defined as follows: having tolerance, withdrawal, using the substance more than originally intended, persistent desire to cut down or unsuccessful attempts to reduce their intake, an individual who spends a significant amount of time seeking out the substance, decreased social or occupational activities because of time spent using substances instead of engaging with others, and continued use despite physiological problems, this is such as medical illnesses, or physical problems like incurring falls or accidents related to substance use. Let's define tolerance versus withdrawal.

01:41 Tolerance is the need for markedly increased amounts of a substance in order to achieve intoxication or the desired effect and/or diminished effect with the continued use of the same amount of a substance.

01:55 Now, this is different from withdrawal which is actually a condition whereby a characteristic syndrome for a particular substance occurs after diminished use of that substance. 20% of people in the United States have a substance use disorder and men tend to be affected more than women.

02:16 Let me ask you, what are the most commonly abused substances? Well, here they are, caffeine, alcohol, and nicotine.

02:29 These are actually the most widely abused substances and depression is very common as a co-morbidity in people who abuse substances.

02:40 So what is the most important vitamin you can give to a person who let's say has an alcohol dependence issue and why do you need to give them this vitamin? This is very important to know for your exams.

02:53 You actually need to treat somebody with an alcohol use disorder by giving them thiamine and this vitamin will actually protect that individual from developing a very dangerous syndrome of Wernicke's or Korsakoff's syndrome.

03:08 There are 4 syndromes associated with alcohol withdrawal and because alcohol is such a highly abused substance we're gonna talk about it first.

03:18 So there can be minor withdrawal, withdrawal seizures, alcohol hallucinosis, and delirium tremens.