Behavioral science - Intoxication and withdrawal Flashcards
DSM5 criteria for mild moderate or severe substance abuse disorder
Mild = 2-3 criteria Moderate = 4-5 criteria Severe = 6-7 criteria
DSM5 criteria for substance abuse disorder
1) Continuing to use despite negative personal consequences
2) Repeatedly unable to carry out major obligations at work, school, or home due to use of X
3) Recurrent use of X in physically hazardous situations
4) Continued use of X despite persistent or recurring social or interpersonal problems caused or made worse by use of X
5) (Tolerance) as defined by either a need for markedly increased amounts to achieve intoxication or desired effect or markedly diminished effect with continued use of the same amount
6) (Withdrawal) manifesting as either characteristic syndrome or the substance is used to avoid withdrawal
7) Using greater amounts or using over a longer time period than intended
8) Persistent desire or unsuccessful efforts to cut down or control use of X
9) Spending a lot of time obtaining, using, or recovering from using X
10) Stopping or reducing important social, occupational, or recreational activities due to use fo X
11) Consistent use of X despite acknowledgment of persistent or recurrent physical or psychological difficulties from using X
12) Craving or a strong desire to use X
UD-PC UD-IDA UD-PD UD-SC UDAPH UDTC T WD IU DQ RA C
Use despite personal consequences Use despite impaired daily activities Use despite physical danger Use despite social consequences Use despite acknowledged personal harm Use despite time consumed Tolerance Withdrawal Increasing use Desire to quit Reduced activities Cravings
Treatment for alcohol intoxication
Support, restraint, protect airways, ventilate
Treatment for alcohol withdrawal
replace with benzos until vital signs normalize
Treatment for Benzo/barbiturate withdrawal
Benzo taper until vital signs normalize
What is Flumazenil? What is a possible side effect?
GABA-A receptor antagonist
Seizure
T/F overdose of benzos or barbituates can be prevented with flumazenil
False only benzos
How does drug use promote more drug use?
increased dopamine activity from drugs leads to loss of cortical top down control and circuitry/receptor expression changes that enhance lymbic pathway function and decrease PFC function
Which brain regions are involved in inhibiting the desire to become intoxated
Amygdala
orbital prefrontal cortex
Decreased dopamine signaling in the orbitofrontal cortx with chronic drug use results in
impaired assignment of positive and negative emotions (dangerous behavior doesn’t feel bad, healthy behavior doesn’t feel good)
Decreased dopamine signaling in the ventral medical PFC with chronic drug use results in
impaired impulse control
Decreased dopamine signaling in the dorsolateral PFC with chronic drug use results in
impaired executive function (e.g. harm/benefit analysis)
Which brain region is the “final decision maker” that integrates input from cortex regarding emotion/impulse/analysis?
Nucleus accumbens
Treatment for stumulant intoxication / overdose
provide fluids/support, let the drug wash out of system - antipsychotics if hallucinations benzos if agitated
