Chapter 11 - Substance-Related and Addictive Disorders Flashcards
What are the 4 general indicators of substance-related disorders?
Impairment of control
Social impairment
Risky use
Pharmacological dependence
What categorizes impairment of control?
Taking greater amounts or for longer than intended
Unsuccessful attempts @ cutting down
Great time recovering
Strong cravings
What categorizes social impairment?
Not able to manage responsibilities
Relational problems due to use
Giving up important events for use
What categorizes risky use?
Puts individual in danger
Risk of physical and psychological problems
What categorizes pharmacological dependence?
Tolerance: need for more substance for effect
Withdrawal symptoms, relieved by use
What is polysubstance use disorder?
Simultaneous misuse/dependence on 2+ substances
What are synergistic effects?
Effects of mixing substances
Alcohol is known as…
World’s #1 psychoactive substance
What are the 4 categories of drinkers?
Light infrequent drinkers
Light frequent drinkers
Heavy infrequent drinkers
Heavy frequent drinkers
Frequency is determined based on ____________.
If the individual drinks weekly
Light and heavy drinkers are determined based on _________.
If the individual drinks less or more than 5 drinks per occasion
What are the effects of ethyl alcohol?
Reduce anxiety, produce euphoria
Reduce inhibitions
Pass directly into blood from stomach/small intestine
What is the rate that the liver removes ethanol?
7-8mL per hour
What are the short term effects of alcohol?
Biphasic effect
Increased confidence
Memory blackouts
Good sleep
Hangover symptoms
What are the 3 categories of biphasic effect?
Lower dose (stimulation)
Higher dose (dysphoria)
Very high dose (unconsciousness, death)
What are the long term effects of alcohol?
Malnutrition and tissue damage
Reduced protein intake
Cancer
Heart muscle damage and high blood pressure
Wernicke-Korsakoff syndrome
What is Wernicke-Korsakoff syndrome?
Inability to form new memories and loss of contact with reality
What is fetal alcohol spectrum disorder?
Relationship between maternal drinking and birth defects
What are 3 features of fetal alcohol spectrum disorder?
Facial dysmorphology
Growth retardation
CNS dysfunction
What are the genetic factors of alcohol use?
Runs in families
Tolerance
What are the neurobiological influences of alcohol use?
GABA, beta-endorphin, and serotonin
Higher heart rate
What are the psychological factors of alcohol use?
Behavioural disinhibition
Negative emotionality
Tension-reduction hypothesis
Alcohol expectancy theory
Behavioural tolerance effect
What is behavioural disinhibition?
Great difficulty inhibiting behavioural impulses
What is alcohol expectancy theory?
Reinforcement/effect individual expects from drinking alcohol
What is behavioural tolerance effect?
Environment influences substance use and how much can be taken
What are socio-cultural factors of alcohol use?
Drinking culture
Modelling
What is the Minnesota model of treatment?
12 step alcoholics anonymous philosophy viewing alcohol as disease
Education about consequences with goal of abstinence
What are the 3 medications for alcohol use treatment?
Naltrexone, acamprosate, antabuse
What is naltrexone?
Blocks pleasurable effects of alcohol
What is acamprosate?
Facilitates inhibitory action of GABA @ receptors
What is antabuse?
Makes alcohol use unpleasant by blocking ability to metabolize alcohol
What was the foundation of the support group Alcoholics Anonymous?
Christian, complete abstinence and disease model
What are the behavioural treatments of alcohol use?
Aversion therapy
Contingency management
Community reinforcement approach
Behavioural self-management
What is aversion therapy?
Pair alcohol with unpleasant stimulus
What is contingency management?
Rewards and punishments on small steps towards sobriety
What is the community reinforcement approach?
Peer/relative recruited to participate in program, learn coping skills and antecedents to drinking
What is the community reinforcement approach?
Peer/relative recruited to participate in program, learn coping skills and antecedents to drinking
Relapse prevention treatment aims to avoid…
Relapse, and manage when it occurs
Relapses in the relapse prevention treatment are seen as…
Failure of coping skills and temporary occurrences due to specific situations
What is motivational interviewing?
Freely discuss pros and cons of alcohol use to bring awareness to problem, client-centered and semi-directive
What do depressants do?
Inhibit NT activity in the CNS
Barbituric acid was one of the first drugs developed to treat…
Anxiety, tension and sleep issues
Why is barbituric acid no longer widely prescribed?
Addictive potential
Why are benzodiazepines more frequently prescribed?
Safer alternative, but can still be addictive
What do the different doses of barbiturates and benzodiazepines do?
Small: mild euphoria
Large: impaired functioning
Very large: cardiovascular dysfunction, coma
Tolerance to barbiturates develops ________ while tolerance to benzodiazepines develops ________.
Rapidly; more slowly
What is abstinence syndrome?
Insomnia, aching, anxiety, depression from not using substance lasting for months
What are stimulants?
Stimulate/arouse CNS by influencing rate of uptake of dopamine, norepinephrine, and serotonin
Stimulants are the ______ used and abused drugs
Most commonly
What is nicotine?
Stimulant that stimulates release of DA
What are the long term health risks of tobacco?
Cancer, respiratory illness, heart disease
What are the types of treatment for tobacco?
Psychological and pharmacological
What is the psychological treatment for tobacco?
Counselling, self-help material
What is the pharmacological treatment for tobacco?
Replacements
What is bupropion hydrochloride?
Reduces cravings and withdrawal symptoms
What is varenicline tartrate?
Reduce cravings and decrease pleasurable effects
Amphetamines have similar effects to _______.
Adrenaline
What are the two most abused forms of amphetamines?
Methamphetamine and dextroamphetamine
Methamphetamine is also known as…
Speed, ice, crystal
Methylene-dioxymethamphetamine (ecstasy) is a ________ with _________ properties.
Stimulant; hallucinogenic
Low doses of amphetamines cause…
Increased alertness, improved attention and cognitive performance, suppressed appetite
Higher doses of amphetamines cause…
Feelings of exhilaration, extroversion, confidence
Very high doses of amphetamines cause…
Restlessness and anxiety
Repeated high doses of amphetamines can cause…
Hallucinations, delirium, paranoia
What are the 2 long term effects of ecstasy?
Permanent depletion of serotonin, neuropsychiatric problems
What are the short term effects of cocaine?
Euphoria, confidence, increased dopamine
High doses of cocaine can cause…
Overstimulation of CNS
What are the physical symptoms of cocaine?
Increased blood pressure, irregular heartbeat, blurred vision, fever, convulsions, coma
What are the psychological treatments for amphetamines and cocaine?
12-step programs, CBT, management programs
What are the biological treatments for amphetamines and cocaine?
Antidepressants, methylphenidate
What are the MAIN effects of opioids?
Reduction of pain and sleep inducement
The most commonly abused opioid is ________.
Heroin
What are the effects of heroin?
Immediate pleasure, dulled senses, sedation
Higher doses of heroin can cause _______ and even _______.
Comas; death
Withdrawal symptoms for opioid are ___________ and begin __________ after last dose.
Extremely severe; 8 hours
What does naltrexone do?
Alleviates initial withdrawal symptoms
What does methadone do?
Heroin replacement, used to reduce cravings
Two types of cannabis are…
Marijuana and hashish
Marijuana is made of…
Dried and crushed leaves/flowers from hemp plant
Hashish is made of…
Resin produced by plant, much stronger form
Cannabis generally has _______ effects, but can increase___________ and produce _________.
Depressive; heart rate; hallucinations
What is the prevalence of cannabis use?
37.5%
What are the effects of cannabis?
Deficits in motor skills, short term memory, reaction time, attention, increased blood pressure, appetite
Small doses of cannabis cause _______ and ________ while high doses cause _________.
Euphoria; relaxation; hallucinations
What are 3 effects long-term users of cannabis may face?
Lung problems, cancer, fertility problems
What is amotivational syndrome?
Continuing pattern of apathy, profound self-absorption, detachment from others, abandonment of goals
Cannabis is used as a treatment for…
Cancer, AIDS, glaucoma
What is the lifetime prevalence of cannabis?
6.8%
What are the treatments for cannabis?
Treatment programs, CBT and motivational enhancement, pharmacological therapy
What do hallucinogens do?
Change person’s mental state by inducing perceptual and sensory distortions
What are 3 hallucinogens?
LSD
Mescaline
Psilocybin (magic mushrooms)
What is the prevalence of hallucinogens?
13.1%
What are the effects of hallucinogens?
Sensory experiences, euphoria, distortion of senses, flashbacks
What are characteristics of gambling disorder?
Short-term pleasure, relief from negative feelings, cravings, alters mood and perception
What is the prevalence of gambling disorder?
80%
DSM-5 criteria for gambling disorder patterned after those for __________.
Substance dependence
What are the treatments for gambling disorder?
Evidence-based treatments, family interventions, prevention models
What are the evidence-based treatments for gambling disorder?
CBT, motivational interviewing, acceptance and commitment therapy, online/app=based models
