What is the differences between the classifications: substance abuse, dependence and tolerance? What type of behaviors are associated with each? Explain the factors determining addiction or dependence. Provide DSM classification for substance abuse disorder.
1. What is the differences between the classifications: substance abuse, dependence and tolerance? What type of behaviors are associated with each?
1. ABUSE: Persistent use of a pharmacologically active substance despite objective evidence of detrimental effects on the user.
2. DEPENDENCE: The pharmacological phenomenon of dependence and withdrawal.
a. TOLERANCE: Increased dosage required to achieve the same effect
i. Metabolic Tolerance: Increased production of metabolic enzymes ------> increased and more rapid metabolism and excretion of drug.
ii. Neuronal Tolerance: Down or up regulation of neuronal receptors involved in mediating the effect of the drug.
i.e., Alcohol Tolerance ------> overstimulation of GABA (hypnotic) receptors ------> down regulation of GABA receptors.
WITHDRAWAL: Observable rebound response when the drug is removed.
ADDICTION: Drug seeking behavior. Going to all ends (enduring discomfort, breaking the law) to assure a ready supply of the drug. It quickly follows dependence, although context of drug use does make a difference (medicinal -vs- recreational).
Factors determining addiction:
a. RISK-TAKING behavior (Cluster B personalities) are at increased risk for trying the drug initially, which is a factor in addiction to illicit drugs -- but not to alcohol.
b.CONTEXT: Analgesic use of opiates is not associated with increased risk of drug-seeking behavior.
c.DRUG PROPERTIES: Highly euphoriant drugs with short-half lives (Heroin, Cocaine) induce the strongest addiction the quickest. They result in almost instantaneous development of tolerance and withdrawal.
d. Risks of Dependency: Alcoholics are at increased risk if they can tolerate the adverse effects of alcohol when young. ...
This solution explains the difference between substance abuse, dependence and tolerance in terms of behavior symptoms and the factors determining addiction or dependence. Provides DSM classification scheme.