6 Substance Disorders Flashcards
Illicit drug use is __.
Mostly due to __ use.
increasing
marijuana
First time users start in their __
teens
__% of the 2.8 million new users in 2013 were under 18
54
Drug use is highest among people in their __ and __
teens, 20’s
Around 1 in __ 25 year olds reported using an illicit substance in the past month
5
Drug use is increasing among people in their __’s
50’s
Dependence is the repeated use of a substance, with or without __ dependence
physical, an example is cocaine. It has psychological dependence but no physical dependence
Physical dependence indicates an altered __ state caused by repeated administration of a substance
physiologic
Cessation of a substance causes a __ __
specific syndrome
Cocaine has a __ dependence, but not a __ dependence
psychological
physical
What three substances are life threatening when you withdraw?
Benzos
Barbituates
Alcohol
Why does someone who is an alcoholic need a higher dose of benzodiazepines?
b/c they have a cross tolerance with CNS depressants
Drugs in the __ __ can create a cross tolerance
same class
What does this describe?
After repeated administration, a given dose of drug produces a decreased effect or increasingly larger doses must be administered to obtain the desired effect
tolerance
what is cross-tolerance?
it is the ability of one drug to be substituted for another. For example: alcohol and benzo. They both depress the CNS so in order for benzo to work, its dose must increase to overcome those from the alcohol.
What is codependence?
It refers to family members, significant others affected by or influencing the behavior of the substance abuser.
How does the codependence family member facilitate the abuser’s addictive behaviors? (2)
denial and providing money or drugs.
____ is an ____ part of substance dependence.
denial, integral
What does denial do to the substance abuser’s situation? (2)
fuels the addiction, and minimizes the problem.
what is substance use disorder?
Pathological pattern of behaviors related to the use of a substance
In substance use disorder, the underlying change in brain circuits caused what 2 things?
Repeated relapses
Intense drug craving
Substance use disorder occur in a broad range of …
a broad range of severity from mild to severe
Substance interferes with what?
an individual’s ability to fulfill role obligations
what happen to patient with substance use disorder?
the individual would like to cut down or control use but cannot
what is one characteristic of substance abuser?
Excessive amount of time spent procuring the substance or recovering from effects
what is an addiction?
tolerance develops and increased amounts are necessary
what is intoxication?
Development of a reversible substance-specific syndrome due to the ingestion of a substance
what is withdrawal?
it occurs upon abrupt reduction or discontinuation of a substance.
What are the 9 classes of psychoactive substances?
Alcohol Caffeine Cannabis Hallucinogens Inhalants Opioids Sedative-hypnotics Stimulants Tobacco
what are the 7 predisposing factors for a person to develop substance abuse?
Genetics Biochemical Developmental influences Personality factors Social learning Conditioning Cultural and ethnic influences
how many percentage of American aged 12 and over reported using alcohol in the US?
52.2%
what percentage of those 12 and over are binge drinkers?
22.9%
What percentage of the US population is 18-25 year olds binge drinker?
37.9%
What is the percentage rate of alcohol use in 12 – 17 year olds?
11.6%
alcohol equivalencies: 12 fl oz of regular beer has how many percentage of alcohol?
5%
alcohol equivalencies: 8-9 fl oz of malt liquor has how many percentage of alcohol?
about 7%
alcohol equivalencies: 5 fl oz of table wine has how many percentage of alcohol?
about 12%
alcohol equivalencies: 1.5 fl oz shot of 80-proof spirits (hard liquor) has how many percentage of alcohol?
about 40%
what are the 3 types of alcohol- related disorders?
alcohol use disorder
alcohol intoxication
alcohol withdrawal
what is an alcohol use disorder?
It is a problematic pattern of alcohol use leading to clinically significant impairment or distress
What are the cluster of behavioral and physical symptoms of alcohol use disorder? (3)
- Withdrawal (develops 4-12 hours after reduction of intake)
- Tolerance
- Craving
what is 12 month prevalence rate of alcohol use disorder among 12 - 17?
4.6%
what is 12 month prevalence rate of alcohol use disorder among adults 18 and over?
8.5%
rates of alcohol use disorder is higher or lower in adult males compared to adult females?
higher, male is 12.4% and female is 4.9%
Does the prevalence rate of alcohol use disorder varies markedly across race and ethnic subgroups?
yes
What are 4 things about the course of alcohol use disorder?
- Variable course periods of remission and relapse
- First episode of intoxication likely to occur in mid-teens
- Most people develop disorder before 40
- 10% have later onset
what are 4 genetic factors of alcohol use disorder?
- Alcohol use disorders run in families
- Rates 3-4 times higher in close relatives
- 4-fold increased risk in children
- Low risk phenotypes
what are the 5 phychological theories related to the use of alcohol?
- To reduce tension
- Increase feelings of power
- Decrease effects of psychological pain
- Decreases feelings of anxiety
- Helps to cope with stress
what are the 2 socio-cultural factors of alcohol use disorder?
- Social learning (effects of modeling, imitation, identification)
- Factors within the individual’s culture help to establish patterns of use
about what percentage of individuals aged 12 and over report being current alcohol users?
50%
what percentage of the US population binge drink?
23%
alcohol use is the ___ leading cause of preventable deaths
third
Heavy alcohol use contributes to the 3 leading causes of death. What are the 3 diseases?
heart disease, cancer and stroke
Alcohol induces a _____ of the CNS
general, nonselective reversible depression
___ of a single dose of alcohol is absorbed ____ into the bloodstream
20%, immediately
Blood carries the alcohol directly to the brain’s _____
central control areas
Moments after alcohol is consumed it can be found in ____.
all tissues, organs and secretions of the body
Absorption of alcohol is influenced by ____
food, rate of drinking, type of alcohol
Chronic alcohol abuse results in ____ impairments
multi-system
What are the 5 Peripheral Neuropathy related to alcohol pathologies?
- Peripheral nerve damage
- Result of deficiencies in B vitamins particularly Thiamine
- Result of poor nutrition
- Toxic effects of alcohol result in mal-absorption of nutrients
- Process reversible with abstinence
What are the 6 symptoms of alcoholic myopathy?
- Acute or chronic
- Muscle pain, swelling, weakness
- Reddish tinge in urine caused by myoglobin break down
- Lab studies show elevated CPK, LDH, AST
- Thought to be a result of vitamin B deficiency
- Improvement with abstinence and nutrition and vitamin supplements (Thiamine)
what is Wernicke’s Encephalopathy?
Most serious thiamine deficiency in alcoholics
What are the symptoms of Wernicke’s encephalopathy?
paralysis of ocular muscles, diplopia, ataxia, somnolence, stupor
What is the treatment of Wernicke’s Encephalopathy?
Thiamine replacement therapy necessary to avoid death
What is Korsakoff’s Psychosis?
It is the psychotic state encountered in individuals recovering from Wernicke’s
What are the symptoms of Korsakoff’s Psychosis?
Confusion, recent memory loss and confabulation
What is the treatment for Korsakoff’s Psychosis?
parenteral or oral thiamine replacement
What is Alcoholic Cardiomyopathy?
Alcohol causes an accumulation of lipids in the myocardial cells
What results due to Alcoholic Cardiomyopathy?
heart enlargement, CHF, arrhythmia
What are the symptoms of Alcoholic Cardiomyopathy?
decreased exercise tolerance, tachycardia, dyspnea, edema, palpitations, non-productive cough
What will the lab of a pt with Alcoholic Cardiomyopathy show?
Labs show an elevation in CPK, AST, ALT, LDH
What is the treatment for Alcoholic Cardiomyopathy?
abstinence
What is one esophagus condition caused by drinking?
Esophagitis inflammation and pain in the esophagus, result of frequent vomiting