Relation+to+Substance+Abuse

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**__Substance Abuse__** Antisocial Personality Disorder and its developmental precursor, conduct disorder are commonly associated with substance use disorders (Mariani et al., 2008). In fact, clinical studies have shown high rates of co-occurrence of adult ASPD and substance use disorders (Grella, Joshi & Hser, 2003).

People with drug dependencies who were involved in treatment programs were shown to have a 44% lifetime prevalence rate of Antisocial Personality Disorder (Compton, 2000).

Rates of those presenting with ASPD and substance abuse are (Compton, 2000):


 * African American men 49%
 * African American women 26%
 * Caucasian men 52%
 * Caucasian women 39%

Studies have also shown that the rates of comorbidity of antisocial personality disorder with substance use disorders differ by gender (Grella et al., 2003). For instance, men with ASPD are 3x more likely to abuse alcohol and 5x more likely to abuse drugs as men without ASPD (Grella et al., 2003). Furthermore, women with ASPD are 13x times more likely to abuse alcohol and 12x more likely to abuse drugs compared to women without ASPD (Grella et al., 2003).

Some factors which may increase a person with ASPD's vulnerability to substance abuse are as follows (Richards & Ries, 1996):
 * Style of cognition
 * Emotional temperament
 * Level of activity
 * Tolerance for severe emotions

= __**Alcohol**__ =

Alcohol-related aggression has been found to be associated with people who have ASPD than those without (Dougherty & Moeller, 2001). People with ASPD have been found to have a higher dependence rate on alcohol and more problems from it than those without ASPD (Dougherty & Moeller, 2001).

A study of 577 people studying people with ASPD and how it relates to alcohol showed that people with ASPD prior to beginning drinking had more alcohol-related problems. They also consumed a great deal more drinks each day and had greater social impairments such as jail time or getting fired (Dougherty & Moeller, 2001).

Therefore, there is more alcohol dependence within the ASPD population as well as greater alcohol abuse and alcohol-related problems (Dougherty & Moeller, 2001).

One noteworthy point research suggest is that antisocial personality disorder type impairs the functions of certain brain chemicals. These include the serotonergic system and activities of higher reasoning or executive functioning brain regions such as parts of the cerebral cortex (Dougherty & Moeller, 2001).

= __**Cannabis**__ =

In 1992 a study was done which focused on ASPD and marijuana use or dependence. The subjects included 1,874 monozygotic twins. An important specification was that they were male veterans from the Vietnam war. Individuals were randomly selected from each pair (Scherrer et al., 1996). The findings were that in 8 out of 10 cases, ASPD symptoms were greater in those who had a history of cannabis use than those who didn't. However, there were only 2 ASPD symptoms that were greatly increased in the twins who abused marijuana in comparison to their non-abusing twins (Scherrer et al., 1996). The first symptom was a " failure to conform to social norms." The second was a" reckless regard for own or other's personal safety"(Scherrer, et al., 1996).

An important fact to consider is that ASPD cannot be diagnosed prior to the age of 18. Also, in order to receive a diagnosis of ASPD, a person must have had Conduct Disorder during childhood (Earlywine, 2002).

So, if one were to use marijuana before being diagnosed with ASPD, but after being diagnosed with Conduct Disorder, two conclusions can be made. The first one being that cannabis contributed to the development of ASPD (Earlywine, 2002). The second one being that using marijuana is simply a symptom of Conduct Disorder (Earlywine, 2002). To reframe, although use of marijuana may have come before a diagnosis of ASPD it does not necessarily mean that the cannabis use caused ASPD. It may simply be a case of being unable to diagnose ASPD prior to age 18 (Earlywine, 2002).

= **__Methamphetamine__** =

Methamphetamine is a stimulant that produces effects such as euphoria and invincibility. It works on the sympathetic nervous system and creates symptoms such as rapid breathing, increased heart rate, and hyperthermia. The high can last from 8-24 hours (Levinthal, 2012). In severe cases, use of methamphetamines can result in amphetamine psychosis, which is extreme irritability, paranoia, and the possibility of violent behaviour (Levinthal, 2012).

One study on participants who indicate their drug of choice to be methamphetamine shows that there is a positive correlation between scores on the Chemical Scale and Antisocial Tendencies scale (Semple, 2005). This indicates that there is a positive correlation between methamphetamine abuse and antisocial tendencies within the study.

Studies also show that individuals with a diagnosis of antisocial personality disorder and whom have a substance abuse problem were more likely to have, “an earlier onset of an addiction, a more rapid onset of dependence, a more severe course of addiction, and greater social, legal and physical consequences of use” (Semple, 2005). A study on meth users in prison showed they were more likely to report being involved in psychiatric treatment, being suicidal, violent and angry, and show symptoms of depression (Semple, 2005).

According to Harper (2010), the brain chemical serotonin was shown to be reduced in long-term methamphetamine abuse. This is similar to those with ASPD using alcohol. This could indicate similar symptoms that may occur as with alcohol, including increased aggression and social impairments.



= **__Cocaine__** =

According to Leal, Ziedonis and Kosten (1994) antisocial personality is commonly associated with cocaine dependence as they discovered close to 80% of patients entering methadone maintenance treatment are cocaine abusers with ASPD.

Research findings present an association between excessive cocaine use and severe Axis I and Axis II disorders (Ford, Gelernter, DeVoe, Zhang, Weiss, Brady, Farrer & Kranzler, 2009). Similarly, cocaine use is often linked with psychiatric disorders such as Antisocial Personality Disorder, showing to affect about 24% of cocaine users (Ford et al., 2009).

One research study found that severity of cocaine dependence and heavy periods of cocaine use was linked to antisocial personality disorder (Ford et al., 2009). Similarly, another study on ASPD and substance abuse found that individuals with ASPD had the highest rate of lifetime polysubstance use with the main drug of choice being cocaine (Mueser et al., 2006). Thus, it is suggested that "severe psychiatric disorders" such as ASPD is "associated with extended periods of heavy cocaine use" (Ford et al., 2009).

= **__Heroin__** =

Opioids drugs consist of both natural and synthetic substances. natural opioids (opiates) include opium, morphine. Heroin is synthesized from opium and is the most abused (Mental Disorders, 2012).

Synthetic opiates made in laboratories are commonly prescribed for pain but are also used as cough suppressants, anti-diarrhea medications, and include codeine, fentanyl (Demerol) and oxycodone (OxyContin). Heroin is usually injected, snorted or smoked. Other opioids also are injected or taken orally (Mental Disorders, 2012).

Social and behavioral characteristics common among heroin users and not the general population are a family history of excessive drug and alcohol abuse, personality disorders (mainly ASPD) or both (comorbidity) (Mental Disorders, 2012). Early life health issues, behavioral problems beginning in childhood, low self-confidence, and anti-authoritarian views are also significant factors (Mental Disorders, 2012).

A "heroin behavior syndrome" consisting of depression (anxiety), impulsiveness, fear of failure, low self-esteem, low frustration tolerance, limited coping skills and relationships based primarily mutual drug use are the norm in social life (Mental Disorders, 2012).

Lack of self control, impulsiveness and aggression are major characteristics of ASPD and most prevalently among heroin addicts, especially in males, resulting in poor treatment compliance and harm to themselves and society. (Mental Disorders, 2012).

Neural biochemical mechanisms in substance abuse and mental disorders always involve dopamine, serotonin, and norepinephrine neurotransmitter systems (Yang, 2011). Present, on going research shows receptor, transporter and metabolic enzyme genes related to these systems show an association to substance use disorders and/or mental disorders which point to a significant genetic comorbid susceptibility concerning ASPD and heroin (Yang, 2011).