2. WHY A COURSE ON ADDICTIVE BEHAVIORS? Study of Drug Use and Misuse Important A part of life in our culture - pervasive Affects everyone: we all have choices to make about what we do and don’t do, what we ingest and what we avoid Can have harmful consequences for individual, family, community, and society Substance use disorders are both preventable and treatable We are constantly being presented with information about licit and illicit substances and activities - how do we evaluate it?

3. OVERARCHING PRINCIPLES Study of Drug Use and Misuse has Experiential and Scientific Basis The Continuum: Drug Use, Misuse, and Dependence All Drugs and Potentially Addictive Behaviors Have a History and Cultural Context: Drugs neither good nor bad per se e.g., religious, spiritual usage; use for health / medical reasons

8. Influences on Drug Use Figure 1-4 1-5

9. (a) Relationship of Risk Factors (b) Relationship of Protective Factors Figure 1-3 1-4

10. Drug Use, Misuse, and “Addiction” What is a drug? What is an addiction? An addict? ___________ Themes associated with “addiction” ______________________________ ______________________________ ______________________________

11. Moral / Temperance Model*Addiction as Sin or Crime Personal Irresponsibility Disease Model *Genetic and Biological Factors ** 12-Step Framework; Abstinence Education as Treatment Behavioral and Cognitive- Conditioning and Reinforcement Behavioral Models * Social Learning and Modeling Drug Expectancies and other Cognitive Factors / RP Family ModelsFamily Disease Family Systems Behavioral Marital/Family Tx Psychological / PsychoanalyticDisordered /Addictive Personalities Sociocultural ModelsCultural Factors Socioeconomics/ Social Policy Drug Subcultures Public Health ModelAgent, Host, Environment Interactions THE BIOPSYCHOSOCIAL MODEL:AN INTEGRATION MODELS OF ADDICTION: A SUMMARY Moral / Temperance ModelAddiction as Sin or Crime Personal Irresponsibility Disease Model Genetic and Biological Factors 12-Step Framework; Abstinence, Education as Treatment Psychological / PsychoanalyticDisordered /Addictive Personalities Behavioral and Cognitive-Conditioning and Behavioral Models Reinforcement Social Learning / Modeling Drug Expectancies and other Cognitive Factors / RP Family ModelsFamily Disease Family Systems Behavioral Marital/Family Therapy Sociocultural ModelsCultural Factors Socioeconomic Factors Drug Subcultures Social Policy (e.g., drug control) Public Health ModelInteractions between Agent Host Environment THE BIOPSYCHOSOCIAL MODEL: AN INTEGRATION MODELS OF ADDICTION: A SUMMARY

12. Psychological / PsychoanalyticDisordered /Addictive Personality Sociocultural ModelsCultural Factors Socioeconomics/ Social Policy Drug Subcultures Public Health ModelAgent, Host, Environment Interactions THE BIOPSYCHOSOCIAL MODEL: AN INTEGRATION MODELS OF ADDICTION: A SUMMARY

13. SUBSTANCE USE DISORDERS DSM-IV CRITERIA FOR SUBSTANCE DEPENDENCE - need at least 3 of the following within 12-month period -symptoms present at least 1 month or occur repeatedly over time  _______________________________

14. >SUBSTANCE USE DISORDERS CRITERIA FOR SUBSTANCE DEPENDENCE  _________________________________ _________________________________ _________________________________  Substance use is continued despite: _________________________________ _________________________________ _________________________________

15. >SUBSTANCE USE DISORDERS NEW DSM-V CRITERIA FOR SUBSTANCE ADDICTION (DEPENDENCE)

16. DSM-V SUBSTANCE CLASSES (p. 482 in DSM-5) DSM-V SUBSTANCE CLASSES (p. 482 in DSM-5) Diagnoses Associated with Substance Class PsychoticBipolarDepressiveAnxiety OCD & related SleepSexualDelirium Neuro- cognitive Sbst. useIntoxicationWithdrawal AlcoholI/W I/W/PXXX CaffeineII/WXX CannabisIII/WIXXX Hallucinogens PhencylidineIIIIIXX Other Hallucinogens I*IIIIXX InhalantsIIIII/PXX OpioidsI/WW XXX Sedatives, hypnotics, or anxiolyticsI/W W I/W/PXXX Stimulants**II/W IXXX TobaccoWXX OtherI/W I/W/PXXX X = category is recognized in DSM-5 I = specifier "with onset during intoxication" may be noted for the category W = specifier "with onset during withdrawal" may be noted for the category I/W = either of the above specifiers may be noted P = the disorder is persisting *also hallucinogen persisting perception disorder (flashbacks) **includes amphetamine-type substances, cocaine, & other or unspecified stimulants