Addiction Flashcards
What are the levels of usbstacne cuse disorder?
mild
moderate
severe
What is substance use disorder?
problematic use of substance
What is mild substance use disorder?
“abuse”
ability to self-regulate
generally non-catastrophic harm
lower levels of salience
What is mod/severe substance use disorder?
addiction
what is biological process of reward?
changes of brain tissues
What are behavioral diagnosis?
misuse
abuse
addiction
What is psudeo-addiction?
pain condition that was under treated –> tx it? –> give pt analgesic –> STOP addiction behaviors
What drugs can causes dependency?
alcohol benzo opiates ssri snri
What neurotransmitter gives reward to the brain?
dopamine
What is the ventral tegmental area –> nucleus acumbens?
“warm fuzzy”
very old part of the brain
“imprints” of memories
What does addiction mean?
compulsive use despite harm
What does salience mean?
stressed –> lean towards the ‘good’ imprints in the brain
Salience in tx?
ask: do you miss being high or under the influence?
emotional loading about this issue
Drinking?
men 4/day
women 3/day
likely to lead to mild to mod degree of physical dependence in many patients
Alcohol?
dopamine reward –> euphoric buzz
changes in the GABA system of the brain
deep physical dependency –> potentially fatal withdrawal
Alcohol tx?
abstinence is difficult –> “just drink less”
Alcohol withdraw - prognosis?
untreated –> DEATH
Alcohol raving reduction?
naltrexone/vivitrol acamprosatee/campril topamax varenciline/chantix CBT
Stimulants?
PROFOUND dopamine release
Cannabis?
two main components: THC (intoxicating), CBD (nonintoxicating)
euphorigenic effects from dopamine release
influences HR, appetite, level of consciousness/awareness/cognition
withdrawal sx –> physical dependency
Cannabis - YA use for 12 mo?
mental health disorders 20 yrs later
Cannabis - heavy use in teen yrs?
8-10 pt IQ reduction
Opioids?
pain pills to heroin
cx: abscess, heart valve, brain fxn
Narcan?
opioid antagonist
Opioids abuse tx?
long term maintenance w/ Methadone or buprenorphine --> MOST PROMISING decreases HIV/hepC opioid blockers (inject or oral naltrexone/narcan)
Conversation between patient and physician?
concerns about substance
advice/support to cut down
CAGE?
cut down
annoyed
guilty
eye opener
Steps for tx?
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
Components of tx?
group therapy individual therapy medical in house or PCP family therapy community: AA
Challenges to tx?
addiction is survival biology based
other biological hx
learned behaviors are sociologically reinforced
relapse
What is abstinence?
commitment to learning how to cope w/out the illusion of chemical comfort
Challenges to abstinence?
lifestyle
preparedness to commit
Challenges to tx?
survival based behavior
learned and reinforced socially
self treatment of co-occurring conditions
entitlement
permanent neurobiological changes - cell death, receptor downregulation
