Addiction Flashcards
How do we use the term ‘addiction’?
Only to extent we describe the underlying ‘disease process’ - there is no diagnosis of ‘addict’ or ‘addiction’
When did people first start thinking about addiction as a medical issue?
mid-1800s
What is the terminology around addition in DMS V?
‘Use Disorder’ (replaces use/abuse/dependence distinctions)
What is are the two key themes in the DSM V diagnostic criteria for SUBSTANCE USE DISORDER (SUD)?
- Tolerance (escalation in dosage)
2. Loss of control
How do they measure severity of SUBSTANCE USE DISORDER (SUD) in the DSM?
It’s about the number of criteria you meet
2-3 = mild 4-5 = moderate 6+= severe
What % of global drug takers have used MDMA?
30%
What % of global drug takers have used cocaine?
25%
What % of global drug takers have used amphetamines?
21%
What % of global drug takers have used magic mushrooms?
20%
What % of global drug takers have used LSD?
20%
What % of global drug takers have used opiods?
10%
How many Australians use alcohol?
80%
How many Australians use tobacco?
15%
How many Australians use cannabis?
10%
How many Australians use stimulants?
2%
How many Australians use cocaine?
2%
How many Australians use opioids?
0.1%
What is the main thing that predicts SUBSTANCE USE DISORDER (SUD)?
The age you have first use ANY drug (including tobacco)
What are the most dependence inducing drugs?
- Tobacco
- Heroin
- Cocaine
- Alcohol
What % of people get withdrawal symptoms from coffee, after one cup a day?
Basically 100%
What is Delirium Tremens?
Severe withdrawal from alcohol
hyperadrenergic state, disorientation, tremors, diaphoresis, impaired attention/consciousness, and visual and auditory hallucinations
How many people experience withdrawal from cannabis?
1/3 in general pop
50-95% of heavy users
What are the typical treatments of SUBSTANCE USE DISORDER (SUD)?
- psychotherapy and/our behavioural counselling
- medication
- management of withdrawal symptoms
- evaluation/treatment for co-occurring mental health conditions
- relapse prevention
- detoxification (?)
Name a typical approach to treating SUBSTANCE USE DISORDER (SUD)
- Alcoholics/Narcotics - Anonymous
Group-based treatment based on principles of 12-steps (abstinence) - Behavioural therapy - Contingency management (principles of reinforcement, reward, punishment)
- Cognitive behavioural therapy - Recognition of triggers/cues and coping strategies
- Harm reduction
- Motivational enhancement therapy - Effort to facilitate movement through stages of change
When treating SUBSTANCE USE DISORDER (SUD), what er the basic steps of the motivational enhancement…
Pre-contemplative stage to contemplative stage
Commit to a plan
Plan making
Plan implementation
What are some features of the biological aetiology of SUBSTANCE USE DISORDER (SUD)?
Deficits in neural circuitry underpinning
- incentive salience,
- executive function,
- reward/stress resp.
These fuel addiction cycle of binge/intoxication, withdrawal, and preoccupation.
How much more likely is a person with the following MHD to have a SUBSTANCE USE DISORDER (SUD), compared with people without a MHD?
Personality disorders - 36% Bipolar - 23% SCZ - 22% Anxiety - 16% Adjustment - 16% Depressive - 16%
What are the interesting things about the GAMBLING DISORDER (GD) diagnostic criteria?
- Escalation - more money to get the hit
- Chasing one’s losses
- Lying to conceal gambling
Same themes as SUD, essentially:
- Tolerance
- Withdrawal
- Loss of control
What are the interesting things about the GAMBLING DISORDER (GD) diagnostic criteria?
- escalation - more money to get the hit
- chasing one’s losses
- Lying to conceal gambling
Same themes as SUD, essentially:
- Tolerance
- Withdrawal
- Loss of control
In terms of effect size, what are the two best treatments for SUBSTANCE USE DISORDER (SUD)?
- Deal with multiple mental health/medical needs of client (d=0.32)
- Therapeutic community (d=0.36)
