Substances have different effects on different people, and their effects will vary
according to how they are used. When evaluating the substance-related disorders, the
practitioner evaluates the different factors affecting use. List and briefly describe the
factors associated with use of a substance.
What will be an ideal response?
Suggested response:
? Route of administration - how a substance is taken determines the effect it
will have (for example, people "snort" cocaine because the nasal mucosa
absorb it more rapidly into the bloodstream than, say, swallowing it; the
more rapid absorption also results in a more intense high or intoxication);
? Duration of effects - some substances are relatively short acting (for example,
they leave the body quickly), and others linger in a person's system,
dissipating very slowly;
? Use of multiple substances - substances may act in uncharacteristic ways
when taken with other substances and sometimes a person will use multiple
agents to achieve a desired effect; for example, one who is dependent on
cocaine may also use sedating substances such as alcohol or marijuana to
counteract the cocaine-induced anxiety;
? Associated laboratory findings – laboratory analysis of blood and urine can
help determine recent use and the specific substances involved; keep in mind
that a negative test does not by itself rule out a particular diagnosis;
? Development and course – considers use patterns (use is seen as a cluster of
behavioral, cognitive, and psychological symptoms) while intoxication is
usually the initial substance use pattern (with substance specific symptoms),
and withdrawal (also indicated by specific symptoms) when a substance has
been taken over a considerable amount of time.
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