Addiction

Question 0

What are the levels of usbstacne cuse disorder?

Answer 0

mild
moderate
severe

Question 1

What is substance use disorder?

Answer 1

problematic use of substance

Question 2

What is mild substance use disorder?

Answer 2

“abuse”
ability to self-regulate
generally non-catastrophic harm
lower levels of salience

Question 3

What is mod/severe substance use disorder?

Answer 3

addiction

Question 4

what is biological process of reward?

Answer 4

changes of brain tissues

Question 5

What are behavioral diagnosis?

Answer 5

misuse
abuse
addiction

Question 6

What is psudeo-addiction?

Answer 6

pain condition that was under treated –> tx it? –> give pt analgesic –> STOP addiction behaviors

Question 7

What drugs can causes dependency?

Answer 7

alcohol
benzo
opiates
ssri
snri

Question 8

What neurotransmitter gives reward to the brain?

Answer 8

dopamine

Question 9

What is the ventral tegmental area –> nucleus acumbens?

Answer 9

“warm fuzzy”
very old part of the brain
“imprints” of memories

Question 10

What does addiction mean?

Answer 10

compulsive use despite harm

Question 11

What does salience mean?

Answer 11

stressed –> lean towards the ‘good’ imprints in the brain

Question 12

Salience in tx?

Answer 12

ask: do you miss being high or under the influence?

emotional loading about this issue

Question 13

Drinking?

Answer 13

men 4/day
women 3/day
likely to lead to mild to mod degree of physical dependence in many patients

Question 14

Alcohol?

Answer 14

dopamine reward –> euphoric buzz
changes in the GABA system of the brain
deep physical dependency –> potentially fatal withdrawal

Question 15

Alcohol tx?

Answer 15

abstinence is difficult –> “just drink less”

Question 16

Alcohol withdraw - prognosis?

Answer 16

untreated –> DEATH

Question 17

Alcohol raving reduction?

Answer 17

naltrexone/vivitrol
acamprosatee/campril
topamax
varenciline/chantix
CBT

Question 18

Stimulants?

Answer 18

PROFOUND dopamine release

Question 19

Cannabis?

Answer 19

two main components: THC (intoxicating), CBD (nonintoxicating)
euphorigenic effects from dopamine release
influences HR, appetite, level of consciousness/awareness/cognition
withdrawal sx –> physical dependency

Question 20

Cannabis - YA use for 12 mo?

Answer 20

mental health disorders 20 yrs later

Question 21

Cannabis - heavy use in teen yrs?

Answer 21

8-10 pt IQ reduction

Question 22

Opioids?

Answer 22

pain pills to heroin

cx: abscess, heart valve, brain fxn

Question 23

Narcan?

Answer 23

opioid antagonist

Question 24

Opioids abuse tx?

Answer 24

long term maintenance w/ Methadone or buprenorphine --> MOST PROMISING 
decreases HIV/hepC 
opioid blockers (inject or oral naltrexone/narcan)

Question 25

Conversation between patient and physician?

Answer 25

concerns about substance

advice/support to cut down

Question 26

CAGE?

Answer 26

cut down
annoyed
guilty
eye opener

Question 27

Steps for tx?

Answer 27

step1: assessment by chemical dependency professional
step 2: engagement in tx
step3: completion/non completion of tx
goal: long term engagement in personal program of recovery

Question 28

Components of tx?

Answer 28

group therapy
individual therapy
medical in house or PCP
family therapy
community: AA

Question 29

Challenges to tx?

Answer 29

addiction is survival biology based
other biological hx
learned behaviors are sociologically reinforced
relapse

Question 30

What is abstinence?

Answer 30

commitment to learning how to cope w/out the illusion of chemical comfort

Question 31

Challenges to abstinence?

Answer 31

lifestyle

preparedness to commit

Question 32

Challenges to tx?

Answer 32

survival based behavior
learned and reinforced socially
self treatment of co-occurring conditions
entitlement
permanent neurobiological changes - cell death, receptor downregulation