Ch 7: substance abuse Flashcards
Addiction
a condition produced by repeated consumption of a natural or synthetic psychoactive substance that a person has become physically and psychologically dependent on
Psychoactive effects
altering a person’s mood, cognition and behavior
Physical dependence
when the body has adjusted to a substance and incorporated it into the normal functioning of its tissues
2 characteristics of physical dependence
tolerance and withdrawal
Tolerance
process by which the body increasingly adapts to a substance and requires increasingly larger doses of it to achieve the same effect, eventually reaching a plateau
Withdrawal
unpleasant physical and psychological symptoms people experience when they discontinue or markedly reduce using a substance they have become dependent on
Symptoms experienced in withdrawal
anxiety, irritability, intense cravings for the substance, hallucinations, nausea, headaches, tremors, sweating, insomnia
Psychological dependence
when individuals feel compelled to use a substance for the effect it produces without necessarily being physically dependent on it
Substance-related and addictive disorders in the DSM-5
alcohol, caffeine, cannabis, phencyclidine, other hallucinogens, inhalants, opioids, sedatives, hypnotics, anxiolytics, stimulants, tobacco, other (or unknown) substance, gambling disorder, internet gaming disorder (possibly)
Short-term effects of alcohol
reduced coordination, diminished cognitive ability (e.g. decision-making), aggression and emotionality, accidents
Long-term effects of alcohol
liver damage, cardiovascular disease, various types of cancer, depression, alcohol use disorder, brain damage (e.g. korsakoff syndrome)
Alcohol use disorder
a problematic pattern of alcohol use leading to clinically significant impairment or distress
When is mild, moderate, and severe substance use disorder diagnosed?
when use is accompanied within a year by 2 or more criteria outlined in the DSM-5 for mild, 4 or 5 for moderate, and 6 or more for severe within a 12-month period
What is considered binge-drinking or “problem drinking?”
when one has at least 5 drinks in 1 sitting at least once a month
6 factors of dependence in all addictive substances
reinforcement, avoiding withdrawal, substance-related cues, expectancies, personality and emotions, genetics
Delirium tremens or the DTs
withdrawal symptom for people addicted to alcohol which involves anxiety, tremors, frightening hallucinations when blood alcohol level drops
Substance-related cues
specific internal and environmental stimuli that are regularly present when people use substances and are developed through classical conditioning
Incentive-sensitization theory of addiction
dopamine enhances the salience of stimuli associated with substance use, making them more powerful in directing behavior
Expectancies
ideas about the outcomes of behavior from one’s own experiences and from watching other people
Personality and emotional traits seen in those who use or abuse substances
those who tend to be impulsive, high in risk-taking or sensation-seeking, low in self-regulation, depressed, anxious, and have had adverse childhood experiences
Findings on genetic influence in addiction
(1) smoking and drinking are affected by different genes; (2) social factors are more influential in adolescence while genetic factors are more influential in adulthood; (3) high levels of parental involvement can counteract a child’s high genetic risk for substance use; (4) epigenetic processes are important
What are the primary forces that lead adolescents to begin smoking?
psychosocial factors (e.g. modeling, peer pressure, reinforcement)
Personal characteristics that increase the likelihood of smoking
low self-esteem, concern about body weight, being rebellious and a thrill-seeker
3 biological routes that increase likelihood of smoking
(1) a mother’s smoking during pregnancy; (2) heredity; (3) area of the brain called the insula may control the desire to smoke
What is the deadliest form of cancer in NA?
lung cancer, followed by cancer of the colon or rectum
How does smoking increase the risk for CHD?
smoking often increases under stress, which leads to heightened reactivity
Characteristics of alcoholics
physically dependent or addicted to alcohol, high tolerance, experience blackout periods or substantial memory losses, DTs when they stop drinking
2 ways social factors affect drinking behavior
(1) modelling processes can adjust drinking rate; (2) social drinking creates a subjective norm that the behavior is acceptable and desirable
4 psychosocial differences between moderate drinkers and problem drinkers
(1) heavy drinkers perceive fewer negative and more positive consequences for drinking, (2) experience high levels of stress and live in environments that encourage drinking, (3) form strong substance-related cues while (4) moderate drinkers are more likely to use alcohol control strategies
Fetal alcohol syndrome
impaired nervous system development, cognitive and physical defects in newborn babies due to their mothers drinking during pregnancy
Health risks of long-term heavy drinking
cirrhosis, impaired immune function, development of some forms of cancer, high BP, heart and brain damage
Cirrhosis
liver disease caused by long-term heavy drinking, wherein liver cells die and are replaced by permanent, nonfunctional scar tissue
Benefit of moderate drinking
improvements in cardiovascular risk factors (e.g. blood cholesterol levels)
4 categories of drugs
stimulants, depressants, hallucinogens, narcotics
Personality traits that lead to drug abuse from just drug use
those who tend to be rebellious, impulsive, accepting of illegal behavior, thrill-seeking, less socially conforming and less committed to a religion
3 interventions for alcohol abuse in order of effectiveness
motivational interviewing (consistent and significant effects), CBT (small but significant effect), 12-step programs like AA (inconsistent experimental evidence)
What type of problem drinkers benefit from moderation (vs abstinence)?
those who are young, socially stable, have short history of alcohol abuse, have not experienced severe withdrawal
2 factors substance use prevention programs must consider
when and why individuals start to use the substances
3 focuses of the most effective and common prevention approaches
public policy and legal issues, health promotion and education, family involvement
2 effective public policy methods to prevent alcohol use
increasing the price of alcoholic beverages through taxation and prohibiting underage persons from buying or consuming alcohol
Main prevention approaches for drug use prevention
criminalization of possession, selling, and consumption of drugs; harm reduction instead of abstinence (e.g. through legal supervised drug consumption sites)
2 types of interventions to prevent smoking
social influence approaches that focus on training skills to help individuals resist peer pressure; life skills training approaches to improve social, cognitive, and coping skills
2 factors that lead to reduced substance use and problems over time
developing a romantic relationship with a non-user and changes in the user’s personality (e.g. increased conscientiousness)
What method is more strongly related to successfully quitting smoking?
quitting cold turkey rather than gradually and providing rewards for abstaining
Detoxification
drying out process before treatment ensues to get an addicted person safely through the period of withdrawal from a substance
4 cognitive-behavioral methods to stop substance abuse
bolstering the abuser’s self-efficacy through motivational interviewing, reducing negative reinforcement (e.g. adaptive stress management methods), providing positive reinforcement for stopping or reducing use, cue exposure
Cue exposure
repeated exposure to substance-related cues while not allowing the person to consume the substance
5 behavioral methods for treating substance abuse
self-monitoring, stimulus control, competing response substitution, scheduled reduction, behavioral contracting
Stimulus control method
altering elements of the environment that serve as substance-related cues (e.g. making the substance less available)
Competing response substitution method
performing and rewarding a behavior that’s incompatible with or is not likely to be performed simultaneously with the problem behavior
Scheduled reduction method
a person only uses the substance at specified regular intervals that become increasingly longer across days
Behavioral contracting method
spelling out conditions and consequences regarding the problem behavior in writing
2 basic views of the alcohol anonymous (AA) philosophy
people who abuse alcohol are alcoholics and remain alcoholics for life even if they never take another drink; alcoholics must commit to the goal of permanent and total abstinence
2 critical features of the AA approach
developing a social network that doesn’t support drinking and having a sponsor who guides the process for a new member
What 3 needs does the AA approach emphasize?
the need for spiritual awakening, public confession, and contrition
5 features to be considered in designing multidimensional programs
(1) biochemical analyses to verify self-reports of use; (2) daily phone call to clients; (3) family involvement; (4) physician involvement; (5) supplementing standard treatment with a computer-based intervention
Reasons why people relapse
withdrawal symptoms (e.g. high craving), low satisfaction with the outcome of quitting, decline in self-efficacy after a lapse, high stress levels, negative emotions and poor coping, interpersonal issues (e.g. socializing with substance users and friends that accept substance use), expectation of reinforcement in using the substance again, low motivation
Intrapersonal high-risk situations for relapse
negative and positive emotional states, exposure to alcohol-related stimuli or cues (e.g. ads), non-specific cravings
Interpersonal high-risk situations for relapse
interpersonal conflict, direct and indirect social pressure, exposure to settings and situations that are cues (e.g. passing the bar)
2 factors related to relapse in smoking
lowered perceptions of health risks after relapse and weight gain during abstinence
Relapse prevention method
a therapist-supervised self-management program
3 steps in the relapse prevention method
(1) learn to identify high-risk situations for relapse to occur; (2) acquire competent and specific coping skills through behavioral and cognitive training; (3) practice effective coping skills in high-risk situations
