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mental illness > Chapter 10 > Flashcards

Chapter 10 Flashcards

1
Q

What has drug trade contributed to

A

tremendous wealth and political influence of societies (commodities)

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2
Q

What were the uses of drugs?

A

medicine, spiritual, concerns about addiction and misuse

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3
Q

What are ways of viewing someone struggling with addiction

A
  1. illness
  2. moral failing
  3. lack of control
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4
Q

what is addiction

A

repetitive consumption of a substance, or repetitive engagement in an activity considered problematic

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5
Q

What are the core concepts of addiction even as it evolved over time

A

harmful to the individual and/or the people around them

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6
Q

Why is drug use a better term than addict

A

addict = lacks precision and clarity, stigma
Drug use = transparent, neutral, free of judgement

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7
Q

What are illicit drugs

A

controlled/prohibited substances (heroin, cocaine) and diverted pharmaceuticals (prescription opioids)

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8
Q

What is harmful/problematic/drug misuse?

A

consumption that causes social, psychological or health problems for individuals or society

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9
Q

What is drug dependence?

A
  1. impaired control of use
  2. increased tolerance
  3. continued use despite negative consequences and withdrawal symptoms
    - replaced drug addiction in ICD
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10
Q

Substance use vs Substance abuse

A

subjective distinctions and value judgements based on particular understandings of physiology, psychology, law, and history

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11
Q

When was a distinction made between normal drinking and abnormal drinking

A

18th century

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12
Q

What is inebriety

A

Late 19th century
- concept that likened abnormal drinking to physical illness…

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13
Q

When was the term alcoholism made what does it mean

A

1940’s, problem drinking and physiological dependence

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14
Q

What are the two parallel models of addiction developed in 19th century

A
  1. disease model
    - addiction from physiological or psychological predispositions
    - contributed to theory of individual degeneracy
    -institutionalization and sterilization
  2. Addiction from characteristics of the substance itself
    - temperance movement
    -restrictions or prohibitions

*both impact current responses

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15
Q

What is the temperance movement

A

identified substance as source of problem and advocated for severe restrictions or prohibitions

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16
Q

What are some consequences of medicalization?

A
  • reduce individual responsibility and imperative to improve
  • decrease emphasis on social, economic, cultural contexts
  • less attention to systemic and underlying issues
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17
Q

What do opioids do

A

act on nervous system to relieve pain

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18
Q

what does cannabis do

A

produce feelings of euphoria, lightness of limbs, increased appetite, tachycardia, and impaired judgement

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19
Q

what does cocaine do

A

feelings of elation, exaggerated confidence… acute toxic reactions

20
Q

what are the key components of dependence

A
  1. physiological syndrome involving tolerance
  2. withdrawal
21
Q

What do behavioural addictions have in common with substance use disorders

A

compulsion, loss of control, continued use/behaviour despite negative consequences

22
Q

What are some ways addiction is thought to be medical?

A
  • neurological changes in brain/reward systems
  • hijacked brain model of addiction
23
Q

What are the risks of expanding definition of addiction to behaviours and making it as a disease?

A
  • difficult to view behaviours as diseases
  • downplays personal agency
  • de-emphasizes social factors shaping behaviour
  • need to re-examine the disease model
24
Q

What is the 3 criteria for substance dependence?

A
  1. impaired control
  2. overriding priority
  3. tolerance to / withdrawal symptoms

2/11 within 12 month period

25
Q

What were the Skinner box studies

A

captive, isolated caged rats would repetitively self administer drugs until overdose = concluded addiction due to drugs and therefore drugs addictive to humans

26
Q

True or False - people who use heroin are highly disposed to have serious social problems even before they touch heroin

A

True

27
Q

What kinds of things influence consumption of substances and what does that say about addiction

A

broader trends in culture, patterns of use that evolve

  • a societal problem and issue
28
Q

what does deaths of despair mean?

A

Increases in rates of deaths attributed to drugs, alcohol, and suicide (coined by 2 economists describing increase in manual workers in USA)

29
Q

What are some arguments on deaths of despair

A
  • its a consequence of lacking a meaningful life as a result of social/economic changes
  • low pay/benefit, unemployment, community and family disintegration
  • stress
30
Q

What are the treatment options of addiction

A
  • psychotherapy
  • further work for underlying psychological problems (anxiety, depression, prior trauma)
  • history of adverse childhood experiences increase vulnerability
  • meds to support
  • residential rehab
  • LSD in treatment
  • AA or religious services
31
Q

What is the goal of treatment

A
  1. eliminate illicit substance use
  2. increase social stability
  3. reduce overdose and negative health outcomes (ex: HIV)
32
Q

What is prescription heroin?

A
  • harm reduction
  • prescribed and dispensed in supervised condition
  • reduces health, legal, and social problems from dependency
  • *** not recognized as treatment by abstinence perspectives or narcotics anonymous, due to continued use
33
Q

What are opioid antagonists

A
  • along with detoxification
  • ex: naltrexone
  • blocks effects of opioids
34
Q

What is the war on drugs

A

end international trade in drugs by directing military and police resources to eliminating trade and consumption
- more not have met objectives
- marginalize, criminalize, stigmatize

35
Q

What are the consequences of criminalization

A
  • constrains opportunities for regulation
  • drives many harms stemming from illicit drugs (ex: HIV)
  • interferes with provision of risk reduction efforts
  • marginalization and stigma reduce engagement with healthcare system = poor care experiences and barriers
  • encounters with police
  • violence in drug scenes
  • contaminated drug supply in unregulated market
    engagement in criminal justice system
  • marginalization and stigma
  • high levels of incarceration for non violent drug offences
36
Q

What are lessons from alcohol prohibition

A
  • many unintended consequences
  • did reduce alcohol consumption and alcohol related harm
37
Q

What is Alcoholics Anonymous

A
  • predominant narrative regarding treatment and recovery
  • controversial as frontline response
  • claims people intrinsically predisposed to addiction
  • 12 step process
  • roots in Oxford group
38
Q

What was the Oxford group and what did they do

A

popular religious group focusing on self improvement, self reflection, admitting wrongs, making amends, praying, meditating, preaching message to others
- led to AA

39
Q

who were bill w and dr bob smith

A

created AA

40
Q

What is the basic assumption with disease model

A

vulnerable to addiction because of physiology or psychology, irreversible, no cure

41
Q

What is the basic assumption of temperance movement model

A

Some substances are inherently prone to causing habits, and cannot be allowed to be available

42
Q

How is addiction a social issue

A
  • linked with what we define as acceptable or not
  • certain substances viewed as more harmful than others
  • socioculturally defined what is addiction or not
43
Q

How do dependency and addiction differ

A

addiction = compulsive, loss of control, continued use

dependence doesn’t constitute addiction (can experience withdrawal and tolerance but not display benchmarks of addiction)

44
Q

what are the main components of addiction

A

compulsion
loss of control
continued use besides negative consequences

45
Q

why don’t people view some substances as addiction

A
  1. lower levels of dependence
  2. generally lack risk of severe harms like overdose
46
Q

When does substance use become misuse

A

when ‘problems’ emerge in individuals life

47
Q

what was the role of war on drugs?

A
  1. problems related to drugs stem from criminalized nature
  2. stigma = oppose health/social programs

mental illness (16 decks)

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