Abuse Overview (Beardsley)

Question 1

What includes one or more of the following:

1. Social and interpersonal consequences
2. Physically hazardous to use
3. Legal problems

Answer 1

Substance Abuse

Question 2

What includes 3 or more of the following:

1. Tolerance
2. Withdrawal
3. Can’t Stop
4. Preoccupation
5. Social and Interpersonal Consequences
6. Continued Use Despite Aggravation of Problems

Answer 2

Substance Dependence

Question 3

What includes the following:

1. Stereotypical syndrome (ANS) during abstinence
2. Inferred, altered physiological state
3. Physiological homeostasis now requires drug (cross-dependence)

Answer 3

Physical Dependence

Question 4

What characterizes the ability of a CNS-active drug to produce a positive psychic effect predictive of the risk of addiction?

Answer 4

Abuse Potential

Question 5

What describes abuse potential in a social and public health context and captures not only the abuse potential of a drug but other factors, including ease of synthesis, and drug abuse and diversion history?

Answer 5

Abuse Liability

Question 6

What is a diminished response to a drug dose attributable to experience with the drug?

Answer 6

Tolerance

Question 7

True or False: Drug Tolerance means the magnitude of the initial response is able to be recaptured by increasing the dose.

Answer 7

True

Question 8

What are 3 types of tolerance?

Answer 8

1. Tachyphylaxis
2. Innate
3. Acquired

Question 9

Which type of tolerance is characterized by a very rapid reduction in responsiveness to a drug?

Answer 9

Tachyphylaxis

Question 10

What type of tolerance is genetically-determined and is an atypical insensitivity to a drug?

Answer 10

Innate Tolerance

Question 11

Which type of tolerance is not a “true” tolerance?

Answer 11

Innate Tolerance

Question 12

Which type of tolerance is the “typical” one and is characterized by higher doses being required to produce the desired effect?

Answer 12

Acquired Tolerance

Question 13

What is cross tolerance?

Answer 13

A dose of Drug B has less effect after an experience with Drug A

Question 14

Is acquired tolerance essential for a drug of abuse?

Answer 14

No

Question 15

What are mechanisms through which acquired tolerance may occur?

Answer 15

1. Pharmacokinetic or metabolic
2. Pharmacodynamic or functional
3. Learned or behavioral

Question 16

What are the 3 purposes of the Controlled Substances Act (CSA) of 1970?

Answer 16

1. Combat drug trafficking
2. Assure drug availability for legitimate use
3. Comply with international treaties

Question 17

What established the process by which drugs (including medications) are evaluated and regulated by their abuse potential?

Answer 17

Controlled Subtances Act (CSA) of 1970

Question 18

Classification into the 5 schedules is based upon what?

Answer 18

Abuse potential, toxicity and medical need

Question 19

What are the 8 factors for classification into the 5 schedules?

Answer 19

1. Actual or relative potential for abuse
2. Scientific evidence of pharmacological effects
3. State of current scientific knowledge
4. History / pattern of abuse (and legitimate use)
5. Scope, duration, and significance of abuse
6. Risks to public health
7. Psychic or physiological dependence?
8. Is it a precursor of an already controlled substance?

Question 20

What drug schedule has a high abuse liability, no medical applications, and a lack of accepted safety?

Answer 20

Schedule I

Question 21

What drug schedule has a high abuse liability, medical applications, and severe psychological / physical dependence?

Answer 21

Schedule II

Question 22

What drug schedule has somewhat less drug abuse potential, medical applications, moderate / low physical dependence or high psychological dependence?

Answer 22

Schedule III

Question 23

What drug schedule has lower abuse potential, medical applications, and limited psychological / physical dependence?

Answer 23

Schedule IV

Question 24

What drug schedule has low abuse potential, medical application and low psychological physical dependence?

Answer 24

Schedule V

Question 25

Is the current scheduling of all drugs logical?

Answer 25

No

Question 26

What schedule includes LSD, marijuana, heroin, mescaline, GHB?

Answer 26

Schedule I

Question 27

What schedule includes cocaine, fentanyl, meperidine (demerol), oxycodone, amphetamine, pentobarbital?

Answer 27

Schedule II

Question 28

What schedule includes testosterone, dronabinol, thiopental, buprenorphine, GHB?

Answer 28

Schedule III

Question 29

What schedule includes modafinil, diazepam, zolpidem, methohexital, fospropofol, sibutramine?

Answer 29

Schedule IV

Question 30

What schedule includes certain codeine, opium, & diphenoxylate preparations?

Answer 30

Schedule V

Question 31

Which governmental agency has the following responsibilities: 1. Abuse potential = risk assessment 2. Labeling of abuse / dependence risks 3. No control at level of prescriber, dispenser or patient

Answer 31

FDA

Question 32

What governmental agency has the following responsibilities: 1. LIcenses Cl-II manufactureres; sets quotes 2. Regulates prescribers, dispensing pharmacies 3. Law enforcement

Answer 32

DEA

Question 33

What are four factors that affect drug use and are considered during drug scheduling?

Answer 33

1. Chemical and Pharmaceutical factors (solubility, PK, ease of synthesis) 2. Dstribution (marketing) factors (dosage form, formulation) 3. Psychosocial factors 4. Pharmacological factors

Question 34

What are some specific pharmacological factors affecting abuse liability?

Answer 34

1. Physical dependence 2. Pharmacological equivalence to known abused drugs 3. Reinforcing (self-administration) effects

Question 35

What is inferred when discontinuation of the chronic administration of a drug results in the emergence of a stereotypical withdrawal syndrome?

Answer 35

Physical Dependence

Question 36

The withdrawal signs one sees when a person stops using a drug are the same or the opposite of the effects of the drug itself?

Answer 36

The opposite

Question 37

What are ways pharmacological equivalence can be determined?

Answer 37

1. Structural similarity 2. Biochemical similarity (binding to similar receptor types, effects on neurotransmitter dynamics) 3. Pharmacological similarity

Question 38

What is the most important info when determining abuse potential (according to Dr Beardsley)?

Answer 38

Reinforcing (self-administration) effects

Question 39

What is a laboratory evaluation of whether subjects will volitionally self-administer a test compound?

Answer 39

Self-administration Tests

Question 40

What conclusion can one draw if a laboratory animal will not self-administer a drug?

Answer 40

That drug is not considered a drug of abuse

Question 41

What are some subjective effects measures tests?

Answer 41

1. Visual analog scales 2. Ordinal scales 3. Yes / no and True / False Questions 4. Multiple choice