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2.1 HAB > 8 substances of abuse > Flashcards

8 substances of abuse Flashcards

1
Q

What are current numbers of substance abuse (2019)?

A

2019 - estimated 35 million ppl suffer from drug use disorder (with psychoactive substances other than nicotine and alcohol)

107 million people have alcohol use disorder

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2
Q

what are the different types of drinkers that exist?

A

light-to moderate drinkers
binge drinkers
heavy drinkers
problem drinkers (half are alcoholics)

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3
Q

What harm does alcohol cause as a public health agenda?

A
  • dependence
    -> social, economic burden
  • 200 disease and injury conditions
    cancer, tuberculosis, HIV/AIDS
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4
Q

What is alcohol-related harm determined by?

A

the volume of alcohol consumed, the pattern of drinking, and, on rare occasions, the quality of alcohol consumed.

Environmental factors such as economic development, culture, availability of alcohol and the level and effectiveness of alcohol policies are relevant factors in explaining differences and historical trends in alcohol consumption and related harm.

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5
Q

What are some statistics about alcohol consumption (2010)?

A

6.2l pure alcohol pP pD

quarter is unrecorded (homemade, illegally produced, …)

60% of 15+ population had not drunk alcohol in the past 12months

female are more often lifetime abstainers

considerable variance in abstention across regions

economic wealth -> more consumption

16% of 15+ engage in heavy episodic drinking

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6
Q

What are some health consequences of alcohol consumption?

A

2012

3.3mio deaths (6% of all deaths)

more males die

DALYs
5.1% of gobal burden of disease

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7
Q

How can alcohol use harm other individuals?

A

injury

neglect or abuse

default on social role

property damage

toxic effects (fetal alcohol syndrome)

loss of amenity or peace of mind

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8
Q

What are risk factors for alcohol dependency?

A
  • genetics
  • neurobiological factors
  • psychological
    .- environmental
  • social and cultural
  • age and onset
  • gender
  • mental health disorders
  • stressful life events
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9
Q

What is the problem of cigarette smoking?

A

cigarettes release 5000 different chemicals when they burn

carbon monoxide (in smoke) → physiological functioning

nicotine → addicitve, physiological effects

poisonous, at least 70 can cause cancer

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10
Q

What effects does smoking have on health?

A
  • respiratory system
    • pulmonary diseases
      emphysema
      chronic bronchitis
    • respiratory infections
  • impairment of immune functions
  • cancer (lung cancer)
    mouth, oesophagus, kidney, bladder
  • pregnancy impairment
    premature birth
    miscarriages
    perinatal deaths
    risk of complications in general
  • higher risk for diabetes and obesity if mother smoked
  • coronary heart disease (double the risk)
    • aggravated by stress
    • interplay between smoking and major risk factors for CHD physical inactivity, drinking
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11
Q

What are motives for smoking?

A

external, rather than by the substance itself

social validation, social influence

stress relief, boredom relief, enjoyment
improve concentration, stay alert, reduce withdrawal

=> first social desire, then physical addiction

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12
Q

What are different substances you can get addicted to?

A
  • alcohol use disorders
  • opiods
  • cocaine and crack
  • cannabis
  • amphetamines etc
  • sedative-hypnotics
  • hallucinogens
  • PCP/designer drugs/MDMA
  • inhalants
  • nicotine
  • caffeine
  • anabolic-androgenic steroids
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13
Q

What is cannabis?

A

psychoactive substances derived from plant cannabis sativa

used to alter consciousness or physical state

delta-9-tetrahydrocannabiol (THC)

marijuana + hashish
weed, pot, skunk, boom, gangster, kif, ganja

most widely used illegal substance in US

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14
Q

What is the history of cannabis use?

A

chinese culture - 4000-5000 years ago

was grown for its fiber (hemp)
clothing, paper, rope

medicine all over + spiritual properties

“holy” plant

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15
Q

Why is cannabis so disputed today?

A
  • lack of consensus of legal status

(a) lax attitudes toward use of cannabis increasing the probability of use and misuse;

(b) reluctance of the public, scientists, and intervention specialists to consider cannabis a significant drug of abuse which may impede treatment seeking and the allocation of resources for development of effective treatment services;

(c) overly severe penal consequences for possession and use of cannabis; and

(d) the delay of science directed toward exploration of the potential of cannabis and/or its active compounds for treatment of physical and psychiatric disorders

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16
Q

What is the epidemiology of cannabis use?

A

more likely in males

multiracial ethic groups have highest prevalence

Interestingly, rates of past-year and -month use among 18to 25-year-old African Americans are lower than those of Whites, but among those 26 years and older rates are higher among African Americans, accounting for the overall disparity in use

lifetime cannabis dependence of 1 to 4%

conditional dependence = cannabis is less likely to lead to actual dependence (after continuous usage) than other illicit drugs

increase in prevalence over past years

increase in treatment admissions for CUD

17
Q

What are cannabis withdrawal signs and symptoms?

A
  • irritability or anger
  • nervousness or anxiety
  • sleep difficulty - disturbing dreams
  • decreased appetite, weight loss
  • restlessness
  • depressed mood
  • physical discomfort and symptoms
18
Q

What does long-term cannabis use do to the brain?

A

impairs attention, memory, and complex cognitive abilities such as problem solving and mental flexibility

altered brain function in the prefrontal cortex, cerebellum, and hippocampus

greater propensity for risky decision making

=> but reversed following extended abstinence

19
Q

What is the pharmacology behind cannabis use?

A

cannabinoids

90 have been identified
THC is primary component

20
Q

What is the neurobiology of cannabis?

A

endogenous cannabinoud receptor system

two receptor subtypes and five endogenuous ligands have been identified

mediated by activation of CB1 receptor by THC

The CB1 receptor is a presynaptic G protein-coupled receptor, activation of which inhibits adenylyl cyclase and voltage-dependent Ca 2+ channels, and activates K + channels and MAP kinase. The CB1 receptor is abundant throughout the CNS, but is expressed in the brain at the highest concentrations in the basal ganglia (reward, learning, motor control), cerebellum (sensorimotor coordination), hippocampus (memory), and cortex (planning, inhibition, higher order cognition).

THC enhanves dopamine firing in reward pathway
enhances electrical brainstimulation

21
Q

What genetic factors contribute to cannabis use?

A

heritable factors contribute between 30% and 80% to the development of CUDs

common genetic and environmental influences between cannabis and other types of drug dependence

common genetic basis for adolescent substance abuse and conduct problems

22
Q

What environmental risk factors exist for cannabis use?

A
  • availability of the substance
  • policies
  • use of other illicit drugs
  • use of cannabis by close peer network
  • use of cannabis by family member, immediate social environment
  • delinquency
  • abusive home
  • low SES
  • psychopathology
23
Q

What are effective treatments for cannabis dependence?

A

adults:
- CBT
- motivational enhancement therapy
- contingency management

adolescents:
- CBT
- MET
- contingency management
- family therapy (functional, behaviour, brief strategic, multidimensional)
- multisystemic therapy
- community reinforcement approach
- assertive continuing care

24
Q

What are commorbidity rates of cannabis use?

A

studies indicate that individuals with past-year or lifetime CUD diagnoses have high rates of alcohol abuse (18%), alcohol dependence (40%), and nicotine dependence (53%)

who reported cannabis to be their primary drug of concern, 74% reported problematic use of a secondary or tertiary substance: alcohol (40%), cocaine (12%), methamphetamine (6%), and heroin or other opiates (2%) (10). Among those younger than 18 years, 61% reported problematic use of a secondary substance: alcohol (48%), cocaine (4%), methamphetamine (2%), and heroin or other opiates (2%).

⇒ gateway drug

Major Depressive Disorder (11%), any anxiety disorder (24%), and Bipolar I disorder (13%) appear to be the most prevalent DSMIV Axis I disorders, and Antisocial (30%), Obsessive Compulsive (19%), and Paranoid (18%) are the most prevalent Axis II personality disorders among those with a past-year diagnosis of a CUD.

⇒ common explanation: self-medication, symptom coping

25
Q

What are harms of opioid and cocaine use?

A
  • Heroin as the first opioid of abuse has grown significantly in the past decade.
  • Heroin as an initiating opioid now exceeds hydrocodone and oxycodone.
  • Such increases among inexperienced opioid users could lead to increased risk of overdose.

=> increase from 9% to 34% in 10 years (2005-2015)

=> very limited tolerance, dosing imprecision contributes to this
and fatalities

26
Q

How are women´s health and crack cocaine use related?

A

the context of health care
the context of smoking

historical trauma
everyday violence, poverty, inequalities

pain and PTSD

oral health and trauma

issues of addictive drug use practices might be overshadowing pressing health concerns

poverty and lack of income control are risk factors for abuse in relationships with men

27
Q

what latest data about the drug market in the EU is available?

A
  • innovation in drug production and trafficking has resulted in the higher
    availability of both plant-based and synthetic drugs across the EU
  • consumers now have access to a wider variety of high-purity and highpotency products that are both more accessible and, in real terms, cheaper than they have been in the past;
  • Europe is now a major producer of cannabis and synthetic drugs for the EU market and also a global supplier of MDMA;
  • the drug market is becoming ever more globally linked and digitally
    enabled with consumers increasingly able to access drugs through the surface web and darknet and social media applications;
  • production within Europe and changing business models of OCGs
    are increasing competition and leading to increased violence and
    corruption within Europe.
28
Q

What can be said about synthetic drugs in the EU?

A
  • global production and supply of MDMA
  • manufactured from precursors
    chemicals sourced from outside EU
  • netherlands, belgium
  • methamphetamine -> Czechia
  • dutch OCGs
    criminals from turkish origin
    heroin in exchange with synthetic drugs
  • darknet market offers

2.1 HAB (10 decks)

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