Ch. 26: Substance-Related & Addictive Disorders

Question 1

What is difference between dependence & addiction?

Answer 1

Dependence - uses despite adverse consequences

Addiction - psychological & behavioural dependence

Question 2

What is detoxification - KNOW

Answer 2

Process of safely & effectively withdrawing a person from an addictive substance

Question 3

What neurotransmitter is involved in the reward pathway? (also in the production of memories & behavioural reinforcement)

Answer 3

Dopamine

Question 4

Substance use disorder is based on what 4 pathologic patterns of behaviour?

Answer 4

1. Impaired control
2. Social impairment
3. Risky use
4. Pharmacologic categories

Question 5

Intoxication increases what neurotransmitter?

Answer 5

Extracellular dopamine

Question 6

What is Motivational Interviewing?

Answer 6

An effective psychosocial treatment for addictive disorders that helps to resolve ambivalence about changing

Question 7

What is the CAGE questionnaire?

Answer 7

A screening method for alcoholism that uses 4 questions.

1. Have you ever felt you need to Cut down on your drinking?
2. Have people Annoyed you by criticizing your drinking?
3. Have you ever felt Guilty about drinking?
4. Have you ever felt you needed a drink first thing in the morning (Eye-opener) to steady your nerves or to get rid of a hangover?

Question 8

What are symptoms of alcohol withdrawal?

Answer 8

changes in VS (increased BP & HR) 
Diaphoresis
Dysrhymias
Adverse GI effects
CNS effects: anxiety, restlessness, agitation, hand tremors or "shakes"

Question 9

What is a common vitamin deficiency in Alcoholics?

Answer 9

Thiamine (Vitamin B1)

Question 10

What are 3 medications to support the treatment of alcohol addiction?

Answer 10

Disulfiram - blocks the effects of aldehyde dehydrogenase & leads to a severely unpleasant reaction when person consumes alcohol (flushing, nausea, vomiting, diarrhea)

Naltrexone - target’s alcohol’s effects on the brain & requires relatively normal liver functions

Acamprosate - ability to curb cravings for alcohol

Question 11

What is dyscoria?

Answer 11

Abnormal pupillary reaction or shape

Cannabis effect

Question 12

Cannabis is an independent risk factor for what psychiatric illness?

Answer 12

Schizophrenia & psychosis

Question 13

What is Ketamine? (‘Special K’)

Answer 13

anaesthetic drug used in “date rape” cases

Question 14

For treatment of Opioid disorders (detoxification management), what three pharmacologic options are available?

Answer 14

Methadone
Buprenorphine
*Physician needs special training
Naltrexone