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PEL > Addiction > Flashcards

Addiction Flashcards

1
Q

How do we use the term ‘addiction’?

A

Only to extent we describe the underlying ‘disease process’ - there is no diagnosis of ‘addict’ or ‘addiction’

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2
Q

When did people first start thinking about addiction as a medical issue?

A

mid-1800s

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3
Q

What is the terminology around addition in DMS V?

A

‘Use Disorder’ (replaces use/abuse/dependence distinctions)

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4
Q

What is are the two key themes in the DSM V diagnostic criteria for SUBSTANCE USE DISORDER (SUD)?

A
  1. Tolerance (escalation in dosage)

2. Loss of control

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5
Q

How do they measure severity of SUBSTANCE USE DISORDER (SUD) in the DSM?

A

It’s about the number of criteria you meet

2-3 = mild
4-5 = moderate
6+= severe
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6
Q

What % of global drug takers have used MDMA?

A

30%

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7
Q

What % of global drug takers have used cocaine?

A

25%

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8
Q

What % of global drug takers have used amphetamines?

A

21%

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9
Q

What % of global drug takers have used magic mushrooms?

A

20%

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10
Q

What % of global drug takers have used LSD?

A

20%

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11
Q

What % of global drug takers have used opiods?

A

10%

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12
Q

How many Australians use alcohol?

A

80%

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13
Q

How many Australians use tobacco?

A

15%

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14
Q

How many Australians use cannabis?

A

10%

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15
Q

How many Australians use stimulants?

A

2%

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16
Q

How many Australians use cocaine?

A

2%

17
Q

How many Australians use opioids?

A

0.1%

18
Q

What is the main thing that predicts SUBSTANCE USE DISORDER (SUD)?

A

The age you have first use ANY drug (including tobacco)

19
Q

What are the most dependence inducing drugs?

A
  • Tobacco
  • Heroin
  • Cocaine
  • Alcohol
20
Q

What % of people get withdrawal symptoms from coffee, after one cup a day?

A

Basically 100%

21
Q

What is Delirium Tremens?

A

Severe withdrawal from alcohol

hyperadrenergic state, disorientation, tremors, diaphoresis, impaired attention/consciousness, and visual and auditory hallucinations

22
Q

How many people experience withdrawal from cannabis?

A

1/3 in general pop

50-95% of heavy users

23
Q

What are the typical treatments of SUBSTANCE USE DISORDER (SUD)?

A
  • psychotherapy and/our behavioural counselling
  • medication
  • management of withdrawal symptoms
  • evaluation/treatment for co-occurring mental health conditions
  • relapse prevention
  • detoxification (?)
24
Q

Name a typical approach to treating SUBSTANCE USE DISORDER (SUD)

A
  1. Alcoholics/Narcotics - Anonymous
    Group-based treatment based on principles of 12-steps (abstinence)
  2. Behavioural therapy - Contingency management (principles of reinforcement, reward, punishment)
  3. Cognitive behavioural therapy - Recognition of triggers/cues and coping strategies
  4. Harm reduction
  5. Motivational enhancement therapy - Effort to facilitate movement through stages of change
25
Q

When treating SUBSTANCE USE DISORDER (SUD), what er the basic steps of the motivational enhancement…

A

Pre-contemplative stage to contemplative stage

Commit to a plan

Plan making

Plan implementation

26
Q

What are some features of the biological aetiology of SUBSTANCE USE DISORDER (SUD)?

A

Deficits in neural circuitry underpinning

  1. incentive salience,
  2. executive function,
  3. reward/stress resp.

These fuel addiction cycle of binge/intoxication, withdrawal, and preoccupation.

27
Q

How much more likely is a person with the following MHD to have a SUBSTANCE USE DISORDER (SUD), compared with people without a MHD?

A 
Personality disorders - 36%
Bipolar - 23%
SCZ - 22%
Anxiety - 16%
Adjustment - 16%
Depressive - 16%
28
Q

What are the interesting things about the GAMBLING DISORDER (GD) diagnostic criteria?

A
  1. Escalation - more money to get the hit
  2. Chasing one’s losses
  3. Lying to conceal gambling

Same themes as SUD, essentially:

  • Tolerance
  • Withdrawal
  • Loss of control
29
Q

What are the interesting things about the GAMBLING DISORDER (GD) diagnostic criteria?

A
  1. escalation - more money to get the hit
  2. chasing one’s losses
  3. Lying to conceal gambling

Same themes as SUD, essentially:

  • Tolerance
  • Withdrawal
  • Loss of control
30
Q

In terms of effect size, what are the two best treatments for SUBSTANCE USE DISORDER (SUD)?

A
  • Deal with multiple mental health/medical needs of client (d=0.32)
  • Therapeutic community (d=0.36)

PEL (17 decks)

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