Someone with polysubstance dependence is psychologically addicted to being drunk with no preference for one particular substance. Although a combination of three drugs may be used, research shows that alcohol is generally used with other substances. This is supported by a study of the use of polysubstansi that separates participants who use many substances into groups based on the drugs they like. The three substances are cocaine, alcohol, and heroin, which implies that they are very popular. Other studies have found that opiates, marijuana, amphetamines, hallucinogens, inhalants and benzodiazepines are often used in combination as well. The results of long-term or longitudinal studies on substance use made the investigators observe that excessive use or dependence on one drug increases the likelihood of overuse or over-reliance on other drugs.
Video Polysubstance dependence
Epidemiology
There are not many studies that examine how often polysubstance dependence occurs or how many people depend on several substances. However, according to a study analyzing the results of the National Epidemiological Survey on Alcohol and Related Conditions, approximately 215.5 of a total of 43,093 people in the United States (0.5%) met the requirements for polysubstance abuse/dependence. Another study shows that the number of new cases of polysubstance dependence has increased. This idea is supported by a study that took place in Munich, Germany. A group of researchers chose to view responses to the survey using M-Composite International Diagnostic Interview (M-CIDI). M-CIDI is a version of the Composite International Diagnostic Interview (CIDI). The researchers collected data from 3,021 participants, all between ages 14 and 24, to estimate the prevalence, or the total number of cases, drug abuse/dependence and abuse/polysubstance dependence. The results of this study indicate that of 17.3% who say they regularly use drugs, 40% say they use more than one substance, but 3.9% specifically report using three or more substances, suggesting that there are many overlapping in the use of different substances. The researchers compared their results with previous German studies and found that substance dependence appears to be increasing, at least in Germany.
Maps Polysubstance dependence
Diagnosis
According to DSM-IV, the diagnosis of polysubstance dependence should include people who have used at least three different substances (excluding caffeine or nicotine) indiscriminately, but have no preference for specific. In addition, they must show at least three of the following symptoms listed below, all in the last twelve months. There is a clear distinction between a person who has three separate dependence problems and Polysubstance has a dependency major difference is the dependence of the polysubstance means that they are not specifically addicted to a particular substance. This is often confusing with some of the special dependencies that are present at the same time. To elaborate, if a person is addicted to three separate substances such as cocaine, methamphetamine and alcohol and depending on all three then they will be diagnosed with three separate dependent disorders that exist together (cocaine dependence, methamphetamine dependence and alcohol dependence) instead of dependency polysubstance. In addition to using three different substances without a preference for one, there must be a certain degree of dysfunction in one's life to qualify for the diagnosis of polysubstance dependence. One of the biggest challenges that often occur when trying to diagnose is the fact that people do not always report what they take because they are afraid of getting a legal problem. When encoding Polysubstance Dependency in DSM-IV it will be a diagnosis of multiaxial 304,80-Polysubstance Dependence ", in addition to classification, it is accompanied by a list of other types of substance dependence (eg" 305.00 Alcohol Abuse "or" 305.60 Cocaine Abuse ").
DSM-IV requires at least three of the following symptoms that arise during a 12-month period for the diagnosis of substance dependence.
- Tolerance: Use higher amounts of a substance or they find the same amount less and less effective (the amount should be at least 50% more than the original amount required.)
- Withdrawal: The withdrawal symptoms when the drug stops being used or the drug is used to prevent withdrawal symptoms.
- Loss of control: Recurrent use of more drugs than planned or use of drugs in a longer time period than planned.
- Inability to stop using: Unable to try to reduce or stop using drugs or persistent desire to stop using.
- Time: Spends a lot of time studying drugs, getting drugs, using drugs, being under the influence of drugs, and recovering from the effects of drugs.
- Interference with activities: Surrender or reduce the amount of time involved in recreational activities, social activities, and/or work activities due to the use of medicines.
- Harm to self: Continuous use of drugs despite physical or psychological problems caused by or aggravated by the use of drugs.
DSM-5 eliminates interference of polysubstance; there are medications to be determined, among other related changes.
Cause
Biological
There is data to support that some genes contribute to substance dependence. Several studies have focused on the discovery of genes that affect people to rely on marijuana, cocaine, or heroin by studying genes that control dopamine receptors and opioid ones, but no conclusive findings are reported. Other researchers found a link between dopamine receptor gene and dependence on a substance. A potential problem with this study is that alcohol is generally used with other substances, so the results of the study may not be caused by dependence on a single substance. This means that some substances may have contributed to the results, but the researchers suggest that further research should be done.
However, there have been studies that have found evidence of the effect of genes on susceptibility to substance dependence. These studies often use genotypes, or genetic information found on a person's chromosome, and a phenotype, consisting of visible features of a person, to see the genetic pattern. One study examined the phenotype and genotype of 1,858 participants from 893 families to see differences in the three genes of nicotinic acetylcholine receptors found in these individuals. The researchers found a significant association between receptor gene for nicotine dependence and polysubstance, which suggests that differences in these genes may create risks dependent on some substances.
Psychological
A 1989 study conducted by Khantzian and Treece found that nearly 60% of their opioid-dependent samples met the criteria for Axis II diagnosis. In the same study, 93% of the samples had comorbid disorders, implying that comorbid disorders play some role in addiction. It has also been shown that depression dependence and polysubstance are often present at the same time. If a person is genetically predisposed to depression then they are at a higher risk of having a polysubstance dependence.
The most likely cause of addictions is the self-medication hypothesis, which views drug addiction as a form of coping with stress through negative reinforcement, temporarily reducing awareness or worry over stressors. Users learn the substance that the effects of each type of medication work to relieve or heal the better state. They use drugs as a form of self-medication to overcome the difficulties of self-esteem, relationships, and self-care. Individuals with substance use disorders are often overwhelmed with emotions and painful situations and switch to substances as a coping method.
Sociocultural
The sociocultural causes are areas in a person's life that may have influenced their decision to start and continue to use many substances. The sociocultural causes can be divided into social causes and cultural causes.
- Social Causes: Several studies have shown that adolescents have one of the highest levels of polysubstance dependence. According to one study, this population, aged 12-25 years, represents about half of the country's illegal drug users. Of these illicit drug users, half of them have started using substances at the end of grade 12. This can be attributed to peer social expectations, peer pressure to adapt them, or how to silence their emotions. Some of these young people start trying different drugs initially to adjust, but then after a while they begin to develop tolerance to these substances and are withdrawn if they do not have enough substances in their system and eventually become dependent on the effect. substance dependence. With tolerance comes the desire for additional drugs to get high, the constant need for that feeling is the dependence of polysubstance.
- In older generations, substance dependence has been attributed to additional considerations such as personality disorder, homelessness, bipolar disorder, major depressive disorder and so on. Medical care that is so expensive and difficult to obtain long term has been linked to the dependence of polysubstansi. Those in need of psychological help sometimes use some substances as a type of self-medication to help manage their mental illness.
Related cognitive destruction
Cognition refers to what happens in the mind, such as mental functions such as "perception, attention, memory, language, problem solving, reasoning, and decision making." Although many studies have looked at cognitive disorders of individuals who rely on one drug, there are some researchers who have tried to pinpoint problems with cognitive function caused by dependence on various substances. Therefore, what is known about the effects of polysubstance dependence on mental abilities is based on the results of several studies.
Learning ability
The influence of polysubstance dependence on learning ability is one of the areas of interest to researchers. A study involving 63 women depending on polysubstance and 46 controls (participants who did not use drugs) used Visual Benton (BVRT) Retention Test and California Verbal Learning Test (CVLT) to view visual memory and verbal ability. This study showed that in women depending on polysubstance, the ability to learn verbally decreased significantly, although the visual memory was not affected. In addition, the use of alcohol and cocaine leads to more severe problems with verbal learning, withdrawal, and recognition.
Memory, reason and decision making
Sometimes the study of specific groups in the general population can be informative. One study decided to test the cognitive abilities of participants on the rave side who used many substances. To do this, they compared 25 rave party participants with 27 control participants who did not use drugs. The results of this study show that in general, rave seeker groups do not perform also on tasks that test the speed of information processing, working memory, knowledge of the equation between words, the ability to attend tasks with background noise, and decision making. Certain medications are associated with certain mental functions, but the researchers suggest that disorders for memory and work reasons are caused by the abuse of some substances.
Another study attempted to find the distinction between the effects of certain drugs focused on polysubstance users seeking treatment for marijuana, cocaine, and heroin addiction. They studied a group of users of polysubstanti and a group that did not rely on any drugs. Since alcohol is a common substance common to almost all groups of users of polysubstantiation, it is difficult to know exactly which drugs are affecting certain cognitive functions. The researchers found that differences in the performance levels of the two groups on executive function, or higher level cognitive processing tasks consistently showed that the polysubstance group scored lower than the control group. In general, this means that some negative substances affect the cognitive function of the polysubstance group. More specifically, the researchers found that the amount of marijuana and cocaine affects the verbal part of working memory, reasoning tasks, and decision making, while cocaine and heroin have similar negative effects on visual and spatial tasks, but marijuana greatly affects visual and spatial work memory. These results suggest that combined use of marijuana, cocaine, and heroin further harms more severe cognitive functioning than when used separately.
The negative effects of alcohol on learning, spatial ability and memory have been shown in many studies. This raises the question: does using alcohol in combination with other substances interfere with more cognitive function? One study decided to try to determine whether polysubstance users who also abuse alcohol would show worse performance in verbal learning and memory tests than those who specifically abused alcohol. The California Verbal Learning Test (CVLT) is used because of its ability to "measure small changes in verbal and memory learning" by evaluating errors made during the tests and strategies used to make the mistakes. The results of this study indicate that the polysubstance group and alcoholics perform poorly on recall and CVLT recognition tests compared to alcohol abuse groups, which implies that alcohol and drug abuse interferes with the memory and learning of the group of polysubstanti and alcohol abusers in a different way than the effects of alcohol alone can explain.
Does the length of abstinence take effect?
Does abstinence for long periods of time help individual dependent polysubstans to restore cognitive function? To test this question, a group of researchers tested 207 men depending on polysubstance, of whom 73.4% were dependent on three or more drugs. Researchers are interested in 6 areas of cognitive function, which include visual memory, verbal memory, knowledge of words, abstract reasoning, inhibition, and attention. This study uses Visual Benton Retention Test (BVRT) to test visual memory, California Verbal Learning Test (CVLT) for verbal memory, Wechsler Adult Intelligence Scale vocabulary section for word knowledge, Book Type Test for abstract reasoning, Stroop Neuropsychological screening for inhibition , and Traceability Tests for attention. The results showed that neuropsychological ability did not improve with increasing abstinent time. This suggests that the dependence of polysubstansi leads to serious irreversible damage over a period of one year.
Gender differences
Women and men differ in different ways when it comes to addiction. Studies have shown that women are more likely to depend on polysubstant. It has been noted that a greater percentage of the abuse of legal female drugs (such as sedatives, sedatives, and stimulants). On the other hand, men are more likely to abuse illegal drugs such as cocaine, meth, and other street drugs. It's also interesting to note, as confirmed by research, that women addicts more often have a family history of drug abuse. When asked to describe the onset of their addiction, women more often describe their addiction as a sudden when men describe it gradually. Women have a higher percentage of fat tissue and lower body water percentage than men. Therefore, women have a slower rate of drug absorption. This means these substances are at higher concentrations in the female bloodstream. Women addicts are known to have a greater risk for fatty liver disease, hypertension, anemia, and other disorders.
Comorbidities of mental disorders
For most of these disorders, in relation to polysubstanti dependence, there is a vicious circle that has dependence. First, ingesting a drug creates a need for more, which creates a dopamine spike, which then creates fun. When dopamine subsides, pleasure adds to emotional and physical pain and triggers the stress transmitter, which in turn creates desires, which must then be treated, and thus the cycle begins again. However, other times they use more drugs to be used to get the same level of poisoning.
Depression
Scientists have hypothesized that the use of good drugs causes mood disorders such as depression or at least attributes to pre-existing ones. In addition, substances used by people with depression can be a method of self-medication that is misdirected to manage their depression. This is the classic chicken or egg hypothesis, whether pre-existing conditions cause dependence or does dependence cause a condition? Underlying mental illness needs to be identified and treated together by treating polysubstanti dependence to improve treatment success rates and reduce the likelihood of relapse. One particular study focuses on alcohol and depression, because they are so commonly interconnected. Researchers have found that depression continues for several weeks after a patient is rehabilitated and those who relapse develop depression. This means that the onset of depression occurs after alcohol dependence occurs, which means that alcohol is a major contributor to depression.
Feeding disorders
One study showed that patients who had recovered from addiction, who had an eating disorder in the past, often used food to try to replace substances they no longer get. Or they are obsessed with controlling their weight and appearance. Some rehabilitation centers have licensed nutritionists to help patients develop healthy eating habits to help them cope while recovering from their addictions. It is important that those with previous eating disorders are taught how to eat healthily, so they do not keep switching from one addiction to another.
Treatment
Treatment for polysubstituted dependence has many important aspects. Drug rehabilitation is a long and difficult process. Treatment should be individualized and last long enough to ensure the patient has kicked the addiction and ensures relapse prevention. The most common forms of treatment for polysubstanti dependence include: inner and outpatient care centers, behavioral counseling and care, and medications. It is important that care is done throughout the patient's lifetime to prevent relapse. It is a good idea that recovering addicts continue to attend social support groups or meet with counselors to make sure they do not recur.
Inpatient care center
Inpatient care centers are care centers where addicts move to the facility while they are undergoing treatment. Inpatient care centers offer a safe environment where patients will not be exposed to potentially harmful situations during their treatment as outside. Inpatient care centers see a much higher success rate than alternative outpatient treatment. Inpatients usually undergo a detoxification process. Detox involves the removal (usually medically) of all medicinal substances from the body. After detox completion, withdrawal symptoms will begin (2-3 days later). These symptoms include, but are not limited to: nausea, depression, anxiety, panic attacks, anxiety, and drug cravings. During their stay in a nursing facility, patients learn to manage and identify their drug addiction and look for other ways to cope with whatever the cause of their addiction.
Outpatient care
Outpatient care includes many of the same activities offered at inpatient care facilities, but patients are not protected by a safe and secure environment from inpatient care centers. For this reason, they are significantly less effective. Patients usually continue to do the work and go to care every night.
Twelve-step program
Both inpatient and outpatient care can offer an introduction to the 12-step program. The recommended 12-step program is Alcoholics Anonymous (AA) and Anonymous Narcotics (NA). They offer regular meetings where members can discuss their experiences in non-judgmental and supportive places.
Cognitive behavioral therapy
Also offered to the patient are one-on-one counseling sessions and cognitive behavioral therapy (CBT). When looking through a cognitive-behavioral perspective, addiction is the result of learned behavior developed through positive experiences. In other words, when a person uses a drug and receives the desired result (happiness, stress reduction, etc.) That may be the preferred way to achieve that result, which leads to addiction. The goal of CBT is to identify the need that addictions are used to meet and to develop alternative skills and ways of meeting those needs. The therapist will work with patients to educate them about their addiction and give them the skills they need to change their cognition and behavior. Arrest will learn to identify and correct problematic behavior. They will be taught how to identify dangerous thoughts and cravings for drugs. CBT is an effective treatment for addiction.
Drugs
Drugs can be very helpful in the long-term treatment of polysubstanti dependence. Drugs are a useful aid in helping prevent or reduce drug addiction. Another benefit of Drugs is to help prevent relapse. Because drug addiction affects brain function, medications help restore normal brain function. Abuse of polysubstance requires a cure for every substance they are addicted to, since current drugs do not treat all addictions simultaneously. Drugs are a useful aid in care, but are not effective when they are the only method of treatment.
Drugs that help treat dependency
- Methadone: treatment for heroin addiction.
- Naltrexone: Reduce opiate and addiction to alcohol.
- Disulfiram: induces nausea after drinking alcohol.
- Acamprosate: normalizes brain chemicals that are interrupted by the cessation of alcohol and helps in the abstinence of alcohol.
- Buprenorphine/naloxone: Both drugs together reduce cravings and block the pleasure of opiates.
More resources
- Good resource for more information: http://www.nida.nih.gov/nidahome.html
- 24/7 drug aid hotline: (877) 865-6592
See also
- Self treatment
- Poly drug use
References
Source of the article : Wikipedia
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