Chapter 11 Flashcards

1
Q

Substance-related disorders

A
  • using substances in excessive amounts that result in impairment
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2
Q

Addictive behaviour

A
  • behaviour based on pathological need for a substance
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3
Q

Psychoactive substances

A
  • substances that affect mental functioning in central nervous system
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4
Q

Substance abuse vs. substance dependence

A
  • abuse: excessive use of substance resulting in potentially hazardous behavior; continued use despite problems
  • dependence: more severe forms of substance use disorders
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5
Q

Tolerance

A
  • need for increased amounts of substance to achieve desired effects
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6
Q

Withdrawal

A
  • physical symptoms (like sweating) that accompany abstinence from a drug
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7
Q

Alcohol use disorder

A
  • use of alcohol even though there are detrimental effects associated with it
  • brain shrinkage leads to worsening cognitive abilities
  • found across all age, educational, occupational, and SES backgrounds
  • high comorbidity between alcohol use and mental illness/other substance abuse disorders
  • avg. lifespan is 12y shorter
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8
Q

U.S. Prevalence - Alcohol Use Disorder

A
  • 30% meet diagnostic criteria at least once in their life (nearly 15% in a given year)
  • > 50% 18+ drink alcohol; 27% report binge drinking
  • 2x as common in men
  • Native Americans > Black/whites > Asian Americans
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9
Q

Is alcohol a stimulant or a depressant?

A
  • alcohol is both a nervous system stimulant (low doses) and depressant (high doses)
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10
Q

Rates of alcohol abstainers in US

A
  • 28% of men
  • 50% of women
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11
Q

Alcohol vs heroin withdrawal

A
  • alcohol withdrawal potentially more lethal than opiate withdrawal!
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12
Q

BAC

A
  • 0.08%: no driving
  • 0.5%: pass out
  • 0.55%+: usually lethal
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13
Q

Effects of alcohol on the brain

A
  • low levels stimulate release of dopamine from pleasure centers
  • high levels depress brain function/inhibit glutamate (impairments in judgement, motor coordination, etc)
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14
Q

Development of alcohol dependence

A
  • early-to middle-to late-stage
  • often starts with slight problem drinking behavior, increases in frequency and intensity over time
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15
Q

Physical effects of chronic alcohol use

A
  • 15-30% of heavy drinkers develop cirrhosis of the liver
  • excessive use may lead to malnutrition (may choose substance over food)
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16
Q

Psychosocial effects of alcohol abuse and dependence

A
  • chronic fatigue
  • oversensitivity
  • depression
  • impaired reasoning
  • personality deterioration
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17
Q

Hangovers!

A
  • peaks when BAC approaches 0
  • ppl with these disorders may drink again to avoid hangover
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18
Q

Alcohol withdrawal delirium

A
  • alcohol abuse related psychosis
  • follows prolonged drinking spree when person enters state of withdrawal for 3-6 days
  • hallucinations, acute fear, fever, rapid/weak heartbeat
  • followed by deep sleep
  • increased risk of death
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19
Q

Alcohol amnesiac disorder

A
  • memory defect sometimes accompanied by falsification of events
  • delusions connected to trying to fill in memory gaps
  • symptoms result from malnutrition (lack of vitamin B–treated with thiamine)
  • reversible if treated within the first few days
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20
Q

Biological causes of alcohol use disorder

A
  • addictive drugs activate mesocorticolimbic dopamine pathway (“pleasure pathway”); drugs that activate this are a potential candidate for abuse
  • genetics play a role in vulnerability, not sure exactly how, might be bc of dysfunction in reward pathway
  • 2x risk in late 20s if biological parent has alcohol use disorder
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21
Q

Psychosocial causes of alcohol use disorder

A
  • family dysfunction (lack of stable relationships)
  • exposure to negative models
  • these two might have bidirectional effect
  • often correlated w mental disorders
  • exposure to trauma correlated w alcohol use; ppl might use to reduce stress
  • teens begin drinking bc they think alcohol will increase popularity
  • might begin during crisis periods of relationship; excessive drinking can also contribute to divorce
  • cultural attitudes influence incidence
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22
Q

Medications in Treating Alcohol Abuse and Dependency

A

Meds to block desire to drink:
- Disulfiram (Antabuse) causes vomiting when followed by alcohol
- Naltrexone helps reduce cravings for alcohol
- Acamprosate
Meds to reduce withdrawal side-effects:
- tranquilizers have been used
- Valium in hospitals
- concern this does not promote long-term recovery

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23
Q

Behavioral and Cognitive-Behavioral Therapy (alcohol use disorders)

A

Tools to change behavior
- aversive conditioning methods (condition noxious stimuli with drinking)
- provide life and coping skills to reduce use in future
- self-control techniques aimed at reducing intake

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24
Q

“Controlled drinking”

A
  • highly controversial
  • more successful in people with less severe alcohol problems
  • abstinence associated w greater success (after you’ve had one drink your judgment is impaired, harder to resist another)
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25
Alcoholics Anonymous
- self-help group; spiritual element to it - basic belief that one is an alcoholic for life - rehabilitation lifts burden of personal responsibility
26
Treatment outcomes in alcohol abuse
- not super great outcomes - more severe condition = lower impact of interventions - relapse prevention treatment is important (teach clients to recognize early warning signs of relapse)
27
____% of US population 12+ used at least one illicit drug in the past year
approx. 10%
28
7 psychoactive drugs most commonly associated with abuse (in order)
1. Alcohol 2. Opiates (opium, heroin) 3. Stimulants (cocaine/amphetamines/caffeine/nicotine) 4. Sedatives (barbiturates) 5. Hallucinogens (LSD) 6. Antianxiety drugs (benzodiazepines) 7. Pain medications (OxyContin)
29
Sedatives
Alcohol (ethanol) - reduces tension - facilitates social interaction - "blots out" feelings or events Barbiturates - nembutal, seconal, veronal, tuinal - reduce tension
30
Stimulants
Ampthetamines - Benzedrine, Dexedrine, Methodine, Cocaine - increase feelings of alertness - decrease feelings of fatigue - increase endurants - stimulate sex drive
31
Opiates
Opium and its derivatives - Morphine, Codeine, Heroin - alleviate physical pain - alleviate anxiety and tension Mathadone (synthetic narcotic) - used to treat heroin dependence (less addictive than natural opiates)
32
Hallucinogens
Cannabis - Marijuana, Hashish - induce changes in mood, thoughts, behavior Mescaline (peyote) - Psilocybin (shrooms), LSD, PCP - "expand" one's mind induce stupor
33
Antianxiety drugs (minor tranquilizers)
- Librium, Miltown, Valium (diazepam), Xanax - alleviate tension and anxiety - induce relaxation and sleep
34
Opium and its derivatives
- Opium: mix of about 18 alkaloids, comes from opium poppy, couldn't control potency - Morphine: synthesized from opium, introduced around 1856, used to treat wounded in Civil War - Heroin: more potent, acts more rapidly, more addictive (used to be used to treat pain)
35
Biological effects of morphine and heroin
- rush followed by high during which addict is typically in lethargic state (4-6 hours) - withdrawal symptoms: tearing eyes, perspiration, restlessness, increased respiration rate, intensified desire for drug - continued use >30days leads to physiological craving - withdrawal symptoms usually gone within a week
36
Causal factors in Opiate abuse and dependence
- genes and environments play a role - ppl start using heroin for many reasons (cheap/easy to obtain, desire to escape life stress, personal maladjustment, sociocultural conditions)
37
Neural bases for physiological addiction
- Endorphins: opium-like substances in brain, thought to be involved in pain responses - Dopamine theory of addiction: addiction is result of dysfunction of dopamine reward pathway - Reward deficiency syndrome: addiction more likely in those who have deficient reward pathways (are less satisfied by natural rewards)
38
Opioids and comorbidity
- opioid use is associated w dramatically increased risk of other forms of psychopathology
39
Treatments and outcomes of opioid use
- meds like methadone/buprenorphine help substitute for heroin - meds and therapy combo leads to best results - large relapse rates
40
Cocaine
- plant product discovered in ancient times - more affordable now, "crack" cocaine even cheaper
41
Effects of cocaine use
- increases availability of dopamine creates 4-6 hour euphoric state - feelings of contentment and confidence - high use can lead to psychotic symptoms - acute toxic psychotic symptoms may result from chronic abuse
42
Treatments and outcomes of cocaine abuse
- methadone and naltrexone reduce cravings - CBT and contingency management approaches effective for dependence - psychological treatments associates w decreases in use and other problems
43
Ampthetamines
- psychologically and physiologically addictive - can be used to suppress appetite, treat narcolepsy or ADHS - chronic use leads to tolerance - methadrine (speed) is very potent, can be lethal
44
Effects of amphetamine use
- not energy source - activates pathways to make you more alert/active (feel like you have more energy) -can cause hazardous fatigue - side effects: excitability, sweating, rapid/unclear speech, sleeplessness, tremors, loss of appetite, confusion
45
Treatments and outcomes of amphetamine abuse
- little research - slow withdrawal encouraged
46
Methamphetamine
- form of amphetamine ("crystal meth") - one of most dangerous illegal drugs - produces immediate and long-lasting high - raises levels of dopamine in brain - prolonged use changes brain structure (can cause permanent damage) - highly resistant to treatment, relapse is common
47
Caffeine
- addictive and commonly available - caffeine-related disorder: restlessness, nervousness, insomnia, and muscle twitching
48
Nicotine
- mostly in tobacco, widely used - can lead to nicotine-dependence syndrome - often used to self-medicate anxiety disorders - withdrawal symptoms last several days-weeks
49
Barbiturates
- depressants, slow down actions of CNS - high risk of tolerance, overdose, addiction - can lead to brain damage and personality deterioration
50
Causal factors in barbiturate abuse and dependence
- middle-aged/older ppl suscepible to dependency when using these as sleeping pills - "silent abusers" - often combine w alcohol, can be fatal
51
Treatments and outcomes of barbiturate abuse
- should withdraw slowly to minimize anxiety, tremors - withdrawal symptoms more severe than opiates
52
LSD
- most potent hallucinogen - usually causes 8 hours of changes in sensory perception, mood swings, feelings of depersonalizations/detachment - esp for those w preexisting mental health condition, hallucinations can be traumatic/terrifying - flashback: involuntary recurrence of perceptual distortions/hallucinations weeks or months later
53
Mescaline
- derived from small growths at top of peyote cactus - milder LSD-like effects - distorted reality, altered perceptions
54
Psilocybin
- from "sacred" Mexican mushrooms known as Psilocybe mexicana - milder LSD-like symptoms - distorted reality, altered perceptions
55
Ecstasy (MDMA)
- hallucinogen and stimulant - chemically similar to methamphetamine and mescaline - effects last several hours - releases serotonin+blocks reuptake, causes feelings of euphoria, energy, well-being - short and long term negative psychological and neurocognitive consequences - increased % of ecstasy pills don't have MDMA, but substitutes that affect CNS
56
Marijuana
- comes from hemp plant cannabis sativa - mild hallucinogen, mild euphoria - related to hashish (stringer drug) - effects vary greatly depending on person and context
57
Treatment of marijuana dependence
- some users report withdrawal-like symptoms when abstaining (nervousness, tension, sleep problems) - psychological treatments effective in reducing use - pharmacotherapy treatments largely ineffective
58
Synthetic cannabinoids
- mimic effects of THC - can cause serious side-effects (anxiety, heart palpitations, seizures)
59
Synthetic cathinones
- mimic effects of amphetamines and cocaine - "bath salts" - produce motor activity agitation, violence, psychosis-like effects, heart problems
60
Gambling disorder
- Pathological gambling: addictive disorder, behavior maintained by short-term gains despite long-term disruption of person's life - treatment methods include CBT and Gamblers Anonymous - 1-2% prevalence (men and women)