Abnormal Psychology, the science and treatment of psychological disorders by A. M. Kring, S. L. Johnson, G. C. Davison and J. M. Neale (thirteenth edition) – Chapter 10

The incentive sensitization theory states that drugs stimulate the dopamine system (reward system), which produces rewards in the form of pleasurable feelings. This leads to the dopamine system becoming sensitive to the drug, resulting in incentive salience. Cue sensitivity leads to wanting of the drug and a dissociation between wanting and liking the drug develops.

The general development process of a substance use disorder (SUD) follows the following pattern: a positive attitude towards the drug (1), experimentation with the drug (2), regular use of the drug (3), heavy use of the drug (4), dependence or abuse of the drug (5). After this, there is either maintenance of the disorder (6) or recovery with the chance of relapse (7).

Tolerance is indicated by larger doses of the substances being needed to produce the desired effects. Withdrawal refers to the negative physical and psychological effects that develop when a person stops taking the substance or reduces the amount of substance being taken. People with a substance use disorder value immediate rewards more than delayed rewards. It recruits different brain regions and it can be hypothesised that both brain regions compete with each other when trying to make a decision.

Stimulants act on the brain and the sympathetic nervous system. Cocaine blocks the reuptake of dopamine in mesolimbic areas. Hallucinogens have no withdrawal symptoms, but tolerance develops quickly.

The gateway theory states that marijuana is a gateway drug. It often precedes other drug use, but does not cause it.

There is a heritable component in substance use disorder. Mood alteration (1), expectancies about drugs and alcohol (2) and personality factors (3) play a role in the development and maintenance of substance use disorder. Neuroticism and low constraint are personality factors that play a role in substance use disorder.

There are cultural differences in the prevalence of substance use disorder. This is due to cultural rituals (1), the popularity of the substance (2), the definition of problematic functioning (3), genetic differences (4), social networks (5) and family networks (6).

There is tension reduction in alcohol because of alcohol myopia. Alcohol reduces cognitive capacity, leading to a focus on immediate distractions, resulting in less tension. If there are no immediate distractions, then it leads to increased tension. The ability to reduce tension may be due to the stimulation of GABA receptors. Delirium tremens refers to becoming delirious, tremulous and having hallucination due to alcohol levels suddenly dropping. Motivation is necessary for treatment.