Question

Case Study - Joey Joey is an undergraduate psychology student attending a local college. His grades are adequate but increasingly he has been having behavioural issues at school - he showed up intoxicated on two occasions to his class and one time to his lab. School administrators asked Joey to see a counsellor as a condition of not being expelled. He agreed to do so. To the counsellor, Joey admitted that he was a "party-animal" when he was younger, having tried various types of illicit drugs on a regular basis. But after entering college, he stopped most of his drug use and now only consumes alcohol (six to eight beers per week), smokes cigarettes (1 package a day), and occasionally, consumes magic mushrooms (once per month). Joey indicated that he has grown concerned about his alcohol use and had signed up for a treatment program. Unfortunately, on the night before entering treatment, he had decided to have one last blast. Thinking about the prospects of never being able to drink again, he became anxious and could not sleep, so he decided to drink himself into oblivion. The next day, when he went to the program to be admitted, he was turned away because he was hung-over, smelled of alcohol and his hands were shaking. Further he displayed signs of visible sweating, tremors, and insomnia The in-take staff had also measured his heart rate - it was elevated. The staff asked him to come back in a month with at least 48 hours of complete sobriety. When the counsellor asked whether he thinks about alcohol or ruminates about it, he replied in the affirmative: "I often find myself thinking of when I can have my next drink." After a short pause, he said "I suspect I smoke cigarettes as a way to handle the anxiety of not being able to drink." Exploring his use of cigarettes, the counsellor asked Joey to describe what happens when he attempts to lessen or quit smoking. He laughed. He acknowledged that he has noticed some problems resulting from his smoking, namely, being out of breath when hiking or playing hockey. When he has tried to quit, he can go about a day or two without smoking but after that, "I'm irritable, aggressive, and I feel like I want to punch someone!" He indicated his friends made fun of him when he told them that he had signed up for three classes that ran back-to-back. They mocked him as they said he wouldn't be able to sit still for six hours of course work without having a cigarette. "They are probably right," he said. "The longer I go without a smoke, the more I think about having one, how it tastes, and how it will help me to relax and be calm." As the topic turned to magic mushrooms, Joey rolled his eyes and said, "It's not a big deal. I don't use regularly." When the counsellor asked why Joey related a story in which he and his friends, one weekend, consumed a significant amount of mushrooms and then proceeded to go for a drive down the backroads in the country. Joey stated, "everything was fine until the double lines on the highway turned into snakes and attacked the windshield - we rolled our car into a ditch!" Fortunately, aside from damage to his car, there were no injuries to himself or his friends. He vowed after this event to cut down on his use of magic mushrooms and to date, has been able to do so. Unlike alcohol and nicotine, Joey indicated that he rarely thinks about using magic mushrooms nor has he ever felt an urgency to use them As the session ended, the counsellor asked Joey if he would like to enter a treatment program offered by the college. Joey sighed, nodded his head, and said "Yes, I'll give it a try."

Answer 1

i)

Three drugs wre being spoken about in the case study which are alcohol, nicotine and magic mushrooms. Among them alcohol is a depressant, nicotine is a stimulant while magic mushrooms are hallucinogens.

ii)

In short, 'Stimulants' creates a sense of excitement and pleasure feeling, 'depressants' slows the person's movement and decision making and 'hallucinogens' leads to altered perception such as hallucinations.

Though alcohol creates a sense of relaxation and stimulation after intake but it general it works as a depressant. This is because alcohol has an inhibitory effect on the functioning of the brain and also slows down the neural connections and activities. Prolonged and high intake of alcohol can also lead to certain depressive characteristics such as slowness and fatigue.

Nicotine can serve as both stimulant and depressant but in general, it is mainly known as a stimulant. This is because, nicotine enters the system of the brain very rapidly and also activates the reward systems such as of dopamine which makes the person feel excited and pleased.

Magic mushrooms work as a hallucinogens as it leads to alteration of perception of the person and also leads to various kinds of auditory as well as visual hallucinations. There are also certain kinds of emotional affects of these substance but hallucinations are prominent.

Drugs and their addictions usually leads to "Physical dependency" and "Psychological dependency". Physical dependence on a particular substance means that the person's body has been used to the substance and the body can't perform well or normally without the substance. This can lead to various symptoms such as breathing problems, body aches, tremors of hand, shaking of legs, mouth getting dry etc.

Psychological dependence on a particular substance can be referred as a state when the person can't function psychologically or emotionally and intellectually without the substance. The symptoms can be of feeling of restlessness, agitation, sadness, anhedonia, lack of appetite etc.

In case of Joey, we can say that he was psychologically and physically dependent on alcohol on the basis of certain signs, which are as follows:

• Couldn't stop himself from drinking even though he wanted to.
• Signs of tremor, sweating, insomnia and elevated heart rate accompanied with drinking.
• Feeling of Anxiety when he thinks about quitting alcohol.
• The thought of quitting alcohol gets so apprehensive and tough to handle that he tries to cope with it through cigarettes.

There are signs of Joey's psychological and physical dependence on Nicotine and these are:

• Feeling of irritation and aggression while trying to quit smoking.
• Not being able to function or focus on something for long time without cigarettes.
• Always thinking about the next smoke and the taste of it and feeling associated with it.

Though, Joey have been exposed to magic mushrooms but from his reports it is not evident that he is physically and psychologically dependent on magic mushrooms. This is because he makes it clear that he decided not to use it after the car incident and neither he thinks about using them nor he feels any sort of urgency or cravings for them.