WHY A FOCUS 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?

OVERARCHING PRINCIPLES Study of Drug Use and Misuse has Experiential and Scientific Basis Drugs are Neither Good Nor Bad: Context The Continuum: Drug Use, Misuse, and Dependence All Drugs and Potentially Addictive Behaviors Have a History and Cultural Context e.g., religious, spiritual usage; use for health / medical reasons

Drug Use, Misuse, and “Addiction” What is a drug? What is an addiction? An addict? ___________ Themes associated with “addiction” Conceptions and definitions vary

Drug Use by High School Seniors Figure 1-1 1-2

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 Tolerance (physical dependence present) Withdrawal Substance taken in larger amounts or over a longer period than intended (loss of control) Persistent desire, or unsuccessful efforts, to cut down or control substance use

CRITERIA FOR SUBSTANCE DEPENDENCE (con’t) Much time spent in activities needed to obtain, use, and recover from the substance Important social, family, school, work, or recreational activities are given up or reduced because of the substance use Substance use is continued despite knowing that physical or psychological problems are likely to be caused or exacerbated by the substance

College binge drinking Harvard College Alcohol Study: 43% binge drank in prior 2 weeks (48% men; 39% women) about 65% of the members of frats/sor. Binged Reasons for drinking 1993 1997 “get drunk” 39% 52% READ: Alcohol in the Lives of College Women