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Health and medicine
Course: Health and medicine > Unit 14
Lesson 1: Drug abuse and drug addictions- Drug abuse and drug addiction
- Overview of psychoactive drugs
- Psychoactive drugs: Depressants and opiates
- Psychoactive drugs: Stimulants
- Psychoactive drugs: Hallucinogens
- Routes of drug entry
- Drug dependence and homeostasis
- Reward pathway in the brain
- Tolerance and withdrawal
- Risk factors for drug use and drug abuse
- Substance use disorders
- The development of substance use - Why do people use legal and illegal substances?
- Why do some people but not others develop substance use problems?
- Treatments and triggers for drug dependence
- How does substance use develop into substance abuse
- Drug use prevention - school programming and protective factors
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The development of substance use - Why do people use legal and illegal substances?
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Want to join the conversation?
- Why are cigarettes legal if they're really bad?(7 votes)
- As long as cigarettes, alcohol, and other legal substances are legal, the government is able to levy a "Sin Tax" which is a tax designed to discourage things seen as immoral through societies eyes. However they do happen to make a considerable amount of Mr. Green with this tax. I'm sure if cannabis was legalized throughout the US this tax would be applied to it. Sin Tax applies to gambling as well as tobacco and alcohol considering it is also "harmful to society." Hope this answered some questions.(11 votes)
- Are legal substances more abused then illegal ones? Or is it the other way around?(6 votes)
- Legal substances (think alcohol and tobacco, for example) are abused much more than illegal substances.(10 votes)
- What's the chance of becoming addicted to alcohol when you use it the first few times?(2 votes)
- Usually it depends on the genes of the person & what kind of environment they're in.
People who are surrounded by others who do drink alcohol are more likely to drink, but it does depend a lot on the persons genetics on whether they'll drink compulsively.(1 vote)
- Say a friend of someone's takes drugs. Why would they do that even if nothing wrong was going on in their life, or they weren't trying to be cool, or wanted to be like everyone else?(1 vote)
- Some people just like the way it makes them feel at the time.
Think about being out on a nice summer day. That warm sunshine feels really good at the time that you are enjoying your favorite outdoor activity. It is not until later that you realize now you have a terrible sunburn.(2 votes)
- At around, she says that negative reinforcement is the result of a bad thing becoming better like a pain going away, but actually would it be positive reinforcement and negative reinforcement would just be like punishment so it changes the behavior in the other way around? Just like in animal behavior training? 2:00(1 vote)
- I was just wondering if anyone else on here has actually taken a CD Assessment & been diagnosed as having Substance Use Disorder. Am I the ONLY one?(1 vote)
- I don't entirely understand the positive bonding thing. How is it positive when you're doing drugs for the sake of social bonding?
That seems very wrong to me. Could someone care to explain it to me?(1 vote)- Using drugs with others is a form of social bonding and can enhance the experience. It can also deepen relationships with others via shared experiences.(1 vote)
- Why don't people all over the world raise the price of even the legal substances to such a high that people won't use it any more?(0 votes)
- That's not how it works - if the prices of drugs become too high for people to afford, there will just be an even bigger black market, and people will go out of their way to find drugs they can afford.(4 votes)
- If one is caught with illegal drugs and gets arrested for it will they do it again if they are addicted to the frog(0 votes)
Video transcript
- [Instructor] In order to understand substance abuse disorders,
we first have to understand why people start using
substances in the first place, and there seem to be four main reasons. The first is that substances feel good. They can elevate someone's
mood or induce euphoria, and these are things that people like. The second reason is that sometimes people take certain
drugs to calm them down. So they can help people find relief from things like anxiety and pain. Substances can also provide
some kind of enhancement. So someone might take substances to help them concentrate better at work or to increase alertness, so they can stay up all night studying. And lastly, substances can be involved in important social functions, things like peer bonding and other types of social facilitation, or even peer pressure. And so these four things
can help us understand why people start using substances, but we also want to know why
they keep using substances. And we can think about
that question as it relates to a number of different
psychological theories, or psychological models. And the first way, and maybe the simplest
way to talk about this, has to do with operant conditioning, and all this is really saying is that we are likely to
continue to do things that have been rewarded in the past. And the simplest way of
thinking about this is with positive conditioning. So someone takes a substance,
it feels really good, and so they will want to
do it again in the future. Or maybe they take
substances with friends, and it produces a very
positive social interaction. It brings them closer together or gives them a reason to come together, and this would reinforce
substance use in the future. Another part of operant conditioning is negative reinforcement, and this is slightly more complicated than positive reinforcement. So let's say that you
have a terrible headache, and in response to that,
you take a painkiller. And that makes the headache go away. This is what negative
reinforcement is all about. It says that something that
takes away something bad is likely to be repeated in the future. So our person here, will
probably take a painkiller the next time that they have a headache. So negative reinforcement tells us that when an action takes away
something bad in our environment, that action is likely to be repeated. So let's say that we do have someone, and maybe they're in a lot of pain. They don't just have a headache. Maybe they just had surgery. And so in response to this,
they take a substance, either one that's
prescribed by their doctor or maybe one that isn't. And when they take that substance,
it takes away their pain. Or maybe let's say that someone is getting in trouble at work for
falling asleep on the job, and so the next time that
individual is dozing off, maybe they'll take a substance
to help keep them awake. And because this substance
allows them to do a job and because it means that
they don't get in trouble, they're likely to use it when they find themselves
dozing off again. And as you can tell, these models are really
simple, and I actually think that there's something really
nice about that simplicity. But maybe because it's so simple, this model also leaves a few things out. In particular, this model seems to ignore all of the negative consequences that can come along with drug use, even before it develops into addiction. And the fact that this is a problem is actually supported
by operant conditioning. Because aside from saying that behaviors that are rewarding will be repeated, operant conditioning also
says that actions that have negative consequences are
not likely to be repeated. And there are a lot of
negative consequences that can come along with drug use, imprisonment, losing friends, family, losing a job or financial
security, or your health. All of these are very serious things. So why should feeling good
for a little bit trump all of the punishments that can
come along with drug use? One reason for this might be that studies on operant conditioning show
that timing is very important. The reward of the drug, the
high, is felt immediately or fairly close to immediately, but the punishments for drug
use, the negative consequences, probably won't show up until much later. So let me squeeze the word future in here because it's really future punishments that we're talking about. So what we might actually be seeing here, is that immediate reinforcers are stronger than future punishments. Another problem with these models though, and really with all of these models, is that they're really
focused on people's behaviors. They're not really taking
things like cognition or conscious decision-making
or individual differences. They're not really taking
those things into account, and honestly, those things seem like they would be really important. And so I want to shift focus for a minute and talk about some cognitive
models for substance use. One of these models is called
the self-awareness model, and this model states that
once drug use is started, it is maintained because the substance makes us less self-aware over time. And it does this by decreasing
our negative feedback. So for example, here, we have Tim, and Tim has some negative
feelings about himself. He thinks that he isn't
smart or funny or likable. And these thoughts might
keep him from interacting with people in the way that he wants to, or maybe they keep him
from going to parties or from meeting new people. And so by reducing these
thoughts, certain substances might make people feel
better about themselves, which would then reinforce
the use of the drug. But the problem is that the
effects of the substance don't typically end there. As well as making someone less self-aware, substances can also inhibit
normal decision-making, or they can make people less cautious. They can also inhibit memory formation. So if someone does something embarrassing while they're on a substance,
they might not remember it. And so substances could lead individuals to be less critical of
themselves in general, and so they might lose
the ability to reflect on how drug use is negatively
impacting their lives or the lives of friends and family. A similar model is called the
tension-reduction hypothesis, and this theory holds that
individuals use substances because they reduce the
stress in their lives. So let me redraw Tim, and let's say that Tim has
a lot of stress in his life. Maybe he's really stressed out from all of the work he does in college. He's worried about his relationship with his significant other. And maybe someone he knows is sick. Maybe his parent is ill. And so the tension-reduction
hypothesis would say that all of these things together would lead Tim to use substances as a way to reduce that stress in his life, or at least to make him feel less affected by the stress in his life. And I think that these
two models are useful in figuring out why people
might keep using substances, but these models break down a bit when we think about their predictions. So both of these models,
both the self-awareness model and the tension-reduction hypothesis, seem to predict that individuals
who would benefit the most from reduced self-awareness
or reduced tension, they predict that these
individuals would be most likely to use and abuse drugs. But that doesn't actually
seem to be the case. It just isn't supported by the research. Another reason why people
might keep using substances after their initial use
is because of modeling, and we're going to call this
a social learning model. And this model says that
drinking and drug use are learned behaviors. So we know, for example, that people tend to adjust
their level of drinking to match the level of those around them. So if someone is in a social group where substance use is normalized and part of social bonding, that individual is likely to model the behaviors from that group. And I want to take a minute
to point out something that these three cognitive
models have in common, and that is that they all seem to assume, at least on some level, that people's actions will
follow their attitudes. So someone wishes to be less self-ware because of negative cognitions,
and as a result, they drink. Or someone is really stressed out by the things that are
going on in their life, and so they'll drink
to reduce that tension. Or maybe they see their
friends using substances. Maybe they see their
friends drinking at a party, and so they want to join
in and drink as well. And so it seems pretty clear that people's actions do follow
their thoughts and beliefs, but that might not always be the case. We know from years of
psychological research that people will often base
their attitudes and beliefs on the actions that they perform and not the other way around, and this is a theory known
as cognitive dissonance. So let's say that our guy, and we'll say his name is still Tim, he's in college, and he goes to a party where he sees lots of
people who he admires. And these people are all drinking. And let's say that at this point, Tim has never had alcohol before. In fact, he really doesn't
believe in underage drinking. But he's at this party, and he sees the people
who he admires drinking. And so he decides that he's just going to have a little bit of beer as well. But when Tim finds himself thinking about the situation later, he might find himself in a
state of cognitive dissonance. His stated beliefs, that he doesn't think that people who are underage should drink, doesn't go along with his actions. It doesn't match the fact
that he drank at this party. And it turns out that as
humans, we don't really like it when our actions and
beliefs don't match up. It's kind of uncomfortable, and that is what Tim is feeling right now. But the thing is, is that
Tim can't go back in time to change his actions. He can't go back and
not drink at that party. He's already done it. And so in order to reduce the dissonance between his beliefs and behaviors, he might respond by changing his beliefs, which are the only thing
that he can change. So if someone drinks or uses a substance because of peer pressure or even just peer bonding,
they might try to deal with the inconsistency in their behavior by deciding that using that
substance isn't all that bad. They'll address the
inconsistency of their actions by deciding that those
actions are consistent with their personal beliefs,
and this opens the door to continued substance use in the future.