ABNORMAL PSYCHOLOGYABNORMAL PSYCHOLOGY(ABD7043)(ABD7043)

SUBSTANCE RELATED DISORDERSUBSTANCE RELATED DISORDER

KAMAL HASSAN BIN IBRAHIM (3140192)

MOHD ZUL HUSNI BIN CHE HUSSAIN (3140194)

EMIRUL HAFIZI BIN ROSLAN (3140193)(MASTER DEGREE, SPECIALTY PROGRAM FOR ALCHOHOL AND DRUG ABUSE)MASTER DEGREE, SPECIALTY PROGRAM FOR ALCHOHOL AND DRUG ABUSE)

(UNIVERSITI SAINS ISLAM MALAYSIA(UNIVERSITI SAINS ISLAM MALAYSIA)

Table of contentTable of content

• Introduction – meaning• Types of Substance Related Disorder• Impulse Control Disorder• Causes of Substance Related Disorder• Treatment of Substance Related Disorder• Islamic Perspective Regarding the Disorder• Movie Review – Up In Smoke (1978)Up In Smoke (1978)

INTRODUCTIONINTRODUCTION

• SubstanceSubstance – related disorders – related disorders are the disorder which are associated with the abuse of drugs such as alcohol, cocaine, and heroin and with a variety of other substances people take to alter the way think, feel, and behave.

• Impulse – control disorders Impulse – control disorders are the disorder which represent a number of related problems that involve the inability to resist acting on a drive and temptation.

Introduction…• Roman cothalic church declared drug abuse

and drink driving to be sins.• Celebreties died because of drug abuse. Eg:

Jimi hendrix, Janis Joplin, Micheal Jackson, heath Ledger, Kurt Kobain.

• Poly substance use – using multiple substances

• Psychoactive substances - alter mood and behavior to become intoxicated or high.

THE TYPES OF SUBSTANCE USE THE TYPES OF SUBSTANCE USE DISORDERSDISORDERS

• Alcohol use disorders• Sedative, hypnotic, or anxiolytic Substance

Use disorders• Amphetamine Use disorders• Cocaine Use Disorders• Nicotine use disorders• Caffeine use disorders• Opioid use disorders• Hallucinogens use disorders

ALCOHOL USE DISORDERSALCOHOL USE DISORDERS• Alcohol is depressent – decrease central nervous

system activity. eg: beer, wine, liquor• The principal effect is to reduce our level physiological

arousal and help us relax.• The long term effects (withdrawal) – hand tremors,

nausea, vomiting, anxiety, trancient hallucinations, agitation, insomnia.

• Withdrawal delirium – a condition that can produce frightening hallucination and body tremors.

• Fetal alcohol syndrome (FAS) – a combination problems that can occur in a child whose mother drank while she was pregnant.

SEDATIVE, HYPNOTIC, OR ANXIOLYTIC SEDATIVE, HYPNOTIC, OR ANXIOLYTIC SUBSTANCE USE DISORDERSUBSTANCE USE DISORDER

• Sedative (calming), Hypnotic (sleep – inducing), anxiolytic (anxiety reducing).

• Eg of drugs - barbiturates and benzodiazepines• barbiturates -to help people sleep. It relaxes the

muscles and produce a mild feeling.• In high dose, barbitures can relax the diaphgram

muscles so much and can cause death by suffocation.• Benzodiazepines – to reduce anxiety. It is used to calm

an individual and induce sleep. It is much safer than barbiturates.

AMPHETAMINE USE DISORDERAMPHETAMINE USE DISORDER• Amphetamines is a stimulant. It can induce feelings of

elation and vigor and can reduce fatigue.• Amphetamine use in medical as a treatment to asthma,

to lose weight, to people with narcolepsy and to treat ADHD children.

• Behavioral symptoms - euphoria, sensitivity, anxiety, tension, anger, impaired judgment.

• Physiological symptoms – heart rate/ blood pressure change, perspiration, nausea, vomiting, seizures, coma.

• Overdose – hallucinations, panic, agitation, paranoid delusions.

COCAINE USE DISORDERCOCAINE USE DISORDER• Cocaine is a group of stimulants.• In small amount, Cocaine increases alertness,

produce euphoria, increase blood pressure, cause insomnia and loss of appetite.

• In high dose, it will lead to paranoid, experiencing exaggerated fears – (cocaine – induced paranoia).

• Use of cocaine by pregnant woman affect their baby such as more irritable, have long bouts of high pitched crying, decrease birth weight.

• Withdrawal of cocaine – rapid heart beat, tremors, nausea, feelings of apathy and boredom.

NICOTINE USE DISORDERNICOTINE USE DISORDER• The nicotine in tobacco is a psychoactive substance. • In small doses, it can relieve stress and improved

mood. But it also can cause high blood pressure and increase the risk of heart disease and cancer.

• In high doses, it can blur a vision, cause confusion, lead to convulsion, and some times even cause death.

• Dependent on nicotine will increase the risk of becoming depressed.

CAFFEINE USE DISORDERCAFFEINE USE DISORDER

• Caffeine is the most common psychoactive substance. It also called “gentle stimulants”.

• The least harmful of all addictive drugs.• In small doses, caffeine can elevate mood and

decrease fatigue.• In larger doses, it can make someone feel

jittery and can cause insomnia.• Withdrawal symptoms – headaches,

drowsiness, and unpleasent mood

OPIOID USE DISORDEROPIOID USE DISORDER• Opiate refers to the natural chemicals in the opium

poppy that have narcotic effect.• Opioids refers to the family of substances that includes

natural opiates, synthetic variations, and the comparable substances that occur naturally in brain.

• Eg of opioid – morphine, codeine and heroin.• Opiates induce euphoria, drowsiness, slowed breathing,

and relive pain.• High doses can lead to death if respiration is completely

depressed. • Symptoms (reduce intake) – excessive yawning, nausea,

vomiting, chills, muscle aches, diarrhea and insomnia.

HALLUCINOGENS USE DISORDERHALLUCINOGENS USE DISORDER• A person under the influence of hallucinogens

substance will perceives the world differently from the normal.

• The sights, sound, feelings, taste, and smell are distorted in dramatic ways.

• Eg of drug – Marijuana and LSD.• Marijuana is the name given to the dried parts of the

cannabis or hemp plant.• People who smoke marijuana experience altered

perceptions of the world. • Reaction to marijuana usually include mood swings.

HALLUCINOGENS USE DISORDERHALLUCINOGENS USE DISORDER

• Normal experiences – extremely funny, enter a dreamlike state in which time seems to stand still.

• Small doses – heightened sensory experiences, seeing vivid colors, appreciating the subtleties of music.

• Large doses – paranoia, hallucinations, and dizziness.• Chronic users who stop taking marijuana report a

period of irritability, restlessness, appetite loss, nausea and difficulty sleep.

• Long term use of smoke marijuana may contribute to lung cancer.

HALLUCINOGENS USE DISORDERHALLUCINOGENS USE DISORDER• LSD (d – lysergic acid diethylamide) is the common

hallucinogenic drug. It is produced synthetically in laboratories.

• DSM- IV- TR diagnostic criteria for hallucinogens intoxication are similar to those for marijuana.

• For most hallucinogens, no withdrawal symptoms are reported.

• But there is the possibility of psychotic reactions.• Hallucinogen produces greater risk than being drunk

or under the influence of any other drugs.

IMPULSE CONTROL DISORDERIMPULSE CONTROL DISORDER• Intermittent explosive disorder – people with

this disorder have episodes in which they act on aggressive impulses that result in serious assaults or destruction of property.

• Kleptomania – the person begins to feel a sense of tension just before stealing, which is followed by feelings of pleasure or relief while the theft is committed.

• Pyromania – an impulse – control disorder that involves having an irresistible urge to set fire.

IMPULSE CONTROL DISORDERIMPULSE CONTROL DISORDER

• Pathological gambling – people have addiction with gambling.

• Trichotillomania – the urge to pull out one’s own hair from anywhere on the body including scalp, eyebrows and arms. This behavior results in noticeable hair loss, distress, significant social impairments.

CAUSES OF CAUSES OF SUBSTANCE-RELATED SUBSTANCE-RELATED

DISORDERSDISORDERS1. Biological Dimensions

2. Psychological Dimensions

3. Cognitive Factors

4. Social Dimensions

5. Cultural Dimensions

6. An Integrative Model

Biological DimensionsBiological Dimensions

1. Familial and genetic influences– Genetic risk factors cut across all mood-altering drugs.

– The use of illegal drugs was primarily influenced by environmental factors, whereas abuse and dependence may be influenced primarily by genetic factors.

– Genetic research – substance abuse in general is affected by our genes but no one genes causes substance abuse or dependence.

– Genetic factors may affect how people experience certain drugs, who will or will not become abusers.

2. Neurobiological influences– The pleasurable experiences reported by people who use

psychoactive substances partly explain why people continue to use them.

– Pleasure pathway – internal reward centre.

– Certain brain areas were stimulated with electricity including the dopaminergic system and its opioid-releasing neurons,

– Neurotransmitters (dopamine, serotonin, and norepinephrine) involved in brain’s reward system.

Biological DimensionsBiological Dimensions

Psychological DimensionsPsychological Dimensions

1. Positive reinforcement– The feelings that result from using psychoactive substances

are pleasurable in some way, and people will continue to take the drugs to recapture the pleasure.

– All psychoactive drugs provide a pleasurable experience.

– Positive reinforcement in the use and the situations surrounding the use of drugs contributes to whether or not people to try to continues using drugs.

Psychological DimensionsPsychological Dimensions

2. Negative reinforcement– How drugs help reduce unpleasant feelings through

negative reinforcement.

– Substance use among adolescents as a way to reduce stress.

– Complex interplay stressors, negative feelings, other psychological disorders, and negative reactions to the drugs themselves as causative factors in psychoactive drug use.

Cognitive FactorsCognitive Factors

• What people expect to experience when they use drugs influences how they react to them.

• Influence of how we think about drug use has been labeled an expectancy effect and received considerable research attention.

• Expectancies develop before people actually use drugs, perhaps as a result of parents’ and peers’ drug use, advertising, and media figures who model use.

• Adolescents may begin drinking partly because they believe will have positive effects.

Social DimensionsSocial Dimensions

• Many ways of people are exposed to these substances – through friends, media, and so on.

• Many children are exposed to alcohol as preschoolers, It seems that they learn about alcohol from relatives and acquaintances rather than television one.

• Drug-addicted parents spend less time monitoring their children than parents without drug problems.- early adolescent substance use.

• No parents supervision.

Cultural DimensionsCultural Dimensions

• Pervasive factor – how people adapt to new cultures can be either a source of strength or a stress that can impact drug use.

• Each culture has its own preferences for acceptable psychoactive drugs, as well as its own prohibitions for substances it finds unacceptable.

• Cultural norms affect the rates of substance abuse and dependence in important ways.

• In certain cultures, including Korea, people are expected to drink alcohol heavily on certain social occasions.

An Integrative ModelAn Integrative Model

TREATMENT OF SUBSTANCE TREATMENT OF SUBSTANCE RELATED DISORDERRELATED DISORDER

PHARMACOLOGICAL TREATMENT

AGONIST SUBSTITUTIONAGONIST SUBSTITUTION

• Safe drug- chemical make up similar to the addictive drug.

• Example:Methadone

Buprenorphine

Nicotine – gum, patch, inhaler, nasal spray Replace smoking

Bupropion (Zyban) – treatment for smoking (agonist for nicotine) as antidepressant.

Substitute the HEROINHEROIN

ANTAGONIST TREATMENTANTAGONIST TREATMENT

• Block / counteract the effect of psychoactive drugs.

• Example: Naltrexone – remove euphoria effect of opiates.

Acamprosate – decrease cravings of alcohol.

AVERSIVE TREATMENTAVERSIVE TREATMENT

• Block the euphoric effects of psychoactive drugs.

• Example :Disulfiram (antabuse) – treatment for alcoholic

Silver nitrate – treatment for smoking (lozenge or gums)

OTHER PSYCHOLOGICAL APPROACHES OTHER PSYCHOLOGICAL APPROACHES

• Medication prescribed to help people with the often disturbing symptom of withdrawal.

• Example :Clonidine – treatment for hypertension

Benzodiazepines – minimize discomfort withdrawal other drug such as alcohol.

TREATMENT OF SUBSTANCE TREATMENT OF SUBSTANCE RELATED DISORDERRELATED DISORDER

PSYCHOSOCIAL TREATMENT

INPATIENT FACILITIESINPATIENT FACILITIES

• Established firstly in 1935 at Kentucky, US• Managed by government/privately• Very costly• Malaysia has run this facilities in late 80’

– Known as Cure and Care Rehabilitation Center– Treating people problems with drug abuse

ALCHOHOLIC ANONYMOUS AND ITS ALCHOHOLIC ANONYMOUS AND ITS VARIATIONSVARIATIONS

• ALCOHOLIC ANONYMOUS– popular on 12 steps of substance abuse

treatment.

• COCAINE ANONYMOUS• NARCOTICS ANONYMOUS• MILLATI ISLAMI– Introduced the 12 steps programs on treatment

substance abuse which related to Tawheed.

COMPONENT TREATMENTCOMPONENT TREATMENT

• Covert sensitization Covert sensitization – counteract the positive associations with substance use with the negative associations e.g brief electric shock during drink.

• Contingency ManagementContingency Management – clients and clinician together select the behaviors that the clients need to change and decide on the reinforcers that will rewards reaching certain goals e.g money, voucher or other rewards.

Continue….

• Community Reinforcement ApproachCommunity Reinforcement Approach– Avoiding client to relapse– Involving the spouse, friends or relative– By giving job, education, finances or other social

services– Involve new recreation to reduce stress

OTHERS…OTHERS…

• MOTIVATIONAL INTERVIEWINGMOTIVATIONAL INTERVIEWING– Proposed that behavior change in adults is more

likely with empathic and optimistic counseling– Focus on personal connection with the clients

core values. (E.g drinking and the consequences)

• COGNITIVE BEHAVIOR THERAPY (CBT) COGNITIVE BEHAVIOR THERAPY (CBT) – For example : relapse prevention – looked at the

learned aspect of dependence and sees relapse as a failure of cognitive and behavioral coping skills.

– Change the positive minds about drug to negative.

PREVENTIONPREVENTION

• Wide-ranging approaches including changes in the laws concerning drug possession and use and community-based intervention.

• NIDANIDA – Principles of drug prevention • PPDaPPDa – Program Pendidikan Pencegahan

Dadah

ISLAMIC PERSPECTIVE ON ISLAMIC PERSPECTIVE ON SUBSTANCE RELATED DISORDERSUBSTANCE RELATED DISORDER

إ ىل ى إ م مك دكي إ كي ب ىأ مقاو ا إ ل مت ه ىو ىل ل ل ٱل بلي ف ي ىس مقاو ا ف ىو ىأفنة مل ىك إ ه ت ل ةٱ مل ىك إ ه ت ل نلي ىنٱ س إ ح مم إ ل ب ٱ ح مكي ل ىه ن ٱل إ مناو ا س إ ح ىو ىأ

And spend in the way of Allah and cast not yourselves to perdition with your own handsperdition with your own hands, and do

good (to others); surely Allah loves the doers of good. (2:195)

Continue…

• Prophet Muhammad P.B.U.H said:“ Cannot harm (yourself) and giving harm (others)

(Ahmad, Malik, Ibn Majah and Dar-Quthni)

ISLAMIC PERSPECTIVE REGARDING THE ISLAMIC PERSPECTIVE REGARDING THE DISORDERDISORDER

• According to the Muzakarah Jawatankuasa Fatwa Kebangsaan Bagi Hal Ugama Islam Malaysia Kali ke-3 (1982): – Any abuses including drug abuse is HARAM HARAM – DRUG DRUG can only used for medical purpose only

which in accordance to Syara’.

• Muzakarah Kali ke-76 (2006):– Syabu and new types of drug still HARAM HARAM not only

take it but have it also HARAMHARAM.

Continue..

• Muzakarah kali ke 37 (Mac 1995) : (Nicotine)– Smoking the cigarette is HARAM – HARAM – according to

Imam Asy-Syafie ; taking something ( eating, drinking, inhaling, snorting etc.) that make us drunk/high is HARAM.

• Muzakarah on Julai 2013 : – Smoking the shisha is HARAMHARAM

Continue…

• By taking drug it will due to the disorder that destruct ourselves.

• Therefore Islam inhibit us abuse all these kind of drug.

• Wallahu’lam

ONE OF THE MOVIE THAT CAN BE REVIEWONE OF THE MOVIE THAT CAN BE REVIEW