3.1. SUBSTANCE ADDICTION
Alcohol, tobacco, heroin and many other drugs can be found in our society. While illness, death, low productivity, and crime are associated with drug addiction, it has an overall immeasurable emotional and social cost. Psychologists and psychiatrists define addiction as a neuropsychiatric disorder characterized by a recurrent desire to continue taking the drug despite harmful consequences. (Goldstein and Volkow, 2002). Concrete diagnostic criteria for substance abuse (or drug addiction (Camí J, Farré M 2003)) are set in the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) or the International Classification of Diseases and Related Health Problems (ICD-10) and are used to diagnose addiction and
Addiction can be defined as the loss of control over drug use or the behavior of seeking and taking drugs despite negative consequences (Nestler, 2001). a neuropsychiatric disorder characterized by a recurrent desire to continue taking drugs (Goldstein & Volkow, 2002) This drug-seeking behavior is associated with craving and loss of control (Shaffer et al., 1999) Addiction results from acts of drug use and is often requires repeated drug exposure.This process is strongly influenced by both a person's genetic makeup and the psychological and social context in which drug use occurs.
DSM-V – 2013 In general, the diagnosis of a substance use disorder
Criteria A: Development of a substance-specific syndrome due to recent ingestion of a substance.
Criteria B: Changes to the physiological effects of the substance on the central nervous system
Criteria C: Substance-specific syndrome causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
Criterion D: Symptoms other than cannot be attributed to a medical condition and is not better explained by another mental disorder.
3.2. DIAGNOSIS OF SUBSTANCE ADDICTION
In general, a drug addiction or substance use disorder can be diagnosed after thorough evaluation by a clinical psychologist, psychiatrist, or licensed alcohol and drug counselor. Current diagnostic criteria are included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) (DSM V, 2013). These include:
Taken in larger amounts or for longer than intended;
A persistent desire or unsuccessful effort to reduce or control the use of the drug/substance;
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Spent a lot of time in activities necessary to obtain and use drugs/substances or to recover from their effects;
Croing or a strong desire or urge to use the drug/substance;
Repetitive use resulting in failure to fulfill important role obligations at work, school, or home;
Continued to use despite persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of drugs;
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Withdrawal or reduction of important social, occupational, or recreational activities due to drug/substance use;
Repeated use, even when physically dangerous;
Potential drug-induced or exacerbated Continuing drug/substance use despite knowledge of a persistent or recurrent physical or psychological problem;
Tolerance, defined by one of the following: (a) intoxication or the need for a markedly increased amount of the drug/substance to achieve the desired effect hearing, (b) effect markedly diminished by continued use of the same amount of drug/substance;
Withdrawal as manifested by any of the following: (a) withdrawal syndrome characteristic for the drug/substance, (b) drug/substance , taken to alleviate or prevent withdrawal symptoms.
These 11 criteria include impaired control over the substance (criterion 1-4), social impairment (criterion 5-7), risky use (criterion 8-9), and pharmacological as criteria (criterion 10-11) can be divided into subgroups. It should be noted, however, that different types of drugs meet different sets of withdrawal criteria, and therefore specific diagnoses should refer to drug-specific sets of withdrawal criteria.
SECTION 4
4.1. SUBSTANCE ADDICTION AND CHILDHOOD TRAUMA
there is ample evidence (Kendler et al., 2000; Molnar et al., 2001; Nelson et al., 2006; Sinha, 2001, 2008). Exposure to stress during childhood and adolescence can alter the development of brain regions responsible for regulating emotional and behavioral stress responses, decision making, reward behaviors, and impulsivity, including the prefrontal cortex (Blanco et al., 2015; Heinrichs, 2005; McCrory et al. , 2012; Sinha, 2008). There may also be interactions between childhood trauma and lack of parental or social support, maladaptive coping skills, and daily stress levels that contribute to drug addiction later in life (Sinha, 2001). Trauma experienced in adulthood is also associated with the risk of substance abuse. For example, cocaine-dependent individuals report significantly more types of lifetime trauma than cocaine-dependent individuals (Afful et al., 2010). In addition, studies (Miranda et al., 2002) revealed that 60-70% of women enrolled in substance abuse treatment reported a history of partner violence in which substances could be used as a coping method (Lincoln et al., 2006). However, there is solid evidence of an association between war-related post-traumatic stress disorder (PTSD) and subsequent substance abuse (Bremner et al., 1996; Davis and Wood, 1999; McFall et al., 1991; Seal et al. , 2012). In addition, PTSD and substance use disorder comorbidity is extraordinarily high (Brady et al., 2004), especially opioid addiction (Fareed et al., 2013). traumatic event As PTSD (American Psychiatric Association, 2013; Reddy, 2013) has proven, chronic stress can trigger chronic stress, for which medication is often used to escape from distressing emotions and traumatic memories (Brady et al., 2004). This hypothesis can be extended to include trauma survivors who recover from trauma without a clinical diagnosis of PTSD and then start using drugs to cope with non-traumatic distress in daily life, leading to a cycle of addiction (Bremner et al., 1996; Charney et al., 1993). ).
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