Chapter 11 - Substance-Related Disorders Flashcards
substance use disorders
alcohol and drug addiction - recurrent use of one of specific substance that leads to consequences
10 different classes of substance use disorders
1) alcohol
2) caffeine
3) cannibis
4) hallucinogens
5) inhalants
6) opiods
7) sedatives
8) hypnotics and anxiolytics
9) stimulants
10) tobacco
4 general groupings of indicators
social impairment, impairment of control over use, risky use and pharmacological criteria
impairment of control
taking substance in greater amounts or for longer than intended, desire to cut down or quit, lots of time spent trying to obtain or recover from the substance, craving
social impairment
failure to fulfill major role obligations at work, home or school - continued despite clear negative consequences on relationships
risky use
use when it is physically dangerous, continued use despite having a problem that is made worse by the substance
pharmacological dependence
tolerance and withdrawal
tolerance
increased amounts of substance to achieve same effect
withdrawal
experience unpleasant and sometimes dangerous symptoms when substance is removed from body
which two methods of ingesting substance are the quickest to reach the brain
inhaling and injection (IV)
substance-induced disorders
associated with each of the 10 drug classes, including intoxication, withdrawal, and other substances
polysubstance abuse
simultaneous misuse or dependence upon two or more substances
low-risk drinking guidelines
indication of upper limits on drinking so that drinking is not likely to lead to physical impairment
ethyl alcohol
effective chemical compound in alcoholic beverages - reduces anxiety, produces euphoria, and creates a sense of well-being
Blood alcohol level
0.08% - usual
alcohol dehydrogenase
breaks down alcohol - women have less of this
what does alcohol do to your cycle of sleep
supresses REM phase of sleep, so first part of night is good then will rebound
Korsakoff’s psychosis
chronic disease characterized by impaired memory and a loss of contact with reality
fetal alcohol syndrome
patter of facial dysmorphology, growth retardation and CNS dysfunction caused by mother’s drinking habits
twins studies for alcohol
male monozygotic twins are more similar in their tendencies to develop problems with alcohol abuse and dependence
behavioral disinhibition
people with alcohol problems tend to have a relative inability to inhibit behavioural impulses
negative emotionality
tendency to experience psychological distress, anxiety, and depression
tension-reduction
hypothesis that drinking is reinforced by its ability to reduce tension, anxiety, anger, depression and other unpleasant emotions
alcohol expectancy theory
drinking behaviour is largely determined by the reinforcement that an individual expects to receive from it
behavioural tolerance
need for a greater amount for the same effect - greatest when conditioned environmental cues are present
acetaldehyde
breaks down alcohol - then it is further broken down by the enzyme aldehyde hydrogenase
short-term consequences of alcohol
cognitive, driving, health
long-term consequences of alcohol
related to genetic vulnerability, frequency/duration of alcohol use, severity of and frequency of binge drinking
Minnesota Model
popular treatment for people who show signs of withdrawal, treatment begins in a hospital or detoxification clinic under medical supervision - abstinence is the goal
Pharmacotherapy
assist in detoxification to reduce the pleasurable effects associated with drinking and to produce nausea when alcohol is consumed
antagonist drug
targets the neurotransmitters that mediate alcohol’s effects on the rain and “blocks” the pleasurable effects of alcohol
agonist drug
facilitates the inhibitory action of the neurotransmitter GABA at its receptors
antabuse
block the action of the metabolizing enzyme acetaldehyde dehydrogenase, resulting in a buildup of it in the body
advantage of antabuse
helping family member regain trust in the individual’s resolve to not drink
success of agonist drug
depends on the compliance of the individual
success of antagonist drug
reduces sensation of craving
alcoholics anonymous
goal is complete abstinence - believe there is no cure for alcoholism - believe in “higher power” to help them
success of alcoholics anonymous
effective treatment for some - others find a hard time with the spirituality aspect
behavioral treatment
based on operant conditioning principles - treats problem drinking as a learned behavior
contingency management
used to manipulate reinforcement contingencies for alcohol use
community reinforcement approach
a spouse, friend or relative who is not a substance user is recruited to participate in the program - both learn behavioural coping skills and how to develop contingency contracts
behavioural self-management
teaches people with alcohol use disorder to manage their own drinking through behavioural contracting, restructuring of thoughts about drinking and have individuals recognize patters of their drinking
brief interventions
1-3 sessions in length offering time-limited and specific advice regarding the need to reduce or eliminate alcohol consumption
motivational interviewing
approach that can be used with clients who present with varying levels of readiness to change their behaviour
depressants
inhibit neurotransmitter activity in CNS
benzodiazepines
more frequently prescribed for sleep and anxiety problems
long acting forms of benzodiazepines and barbiturates
prolonged sedation
short acting forms of benzodiazepines and barbiturates
used to treat insomnia
large doses of benzodiazepines and barbiturates
slurred speech, poor motor coordination, impaired judgement and concentration, induce sleep
small dose of benzodiazepines and barbiturates
euphoria
long term use of benzodiazepines and barbiturates
causes depression, chronic fatigue, mood swings, and paranoia
dependency of benzodiazepines and barbiturates
tolerance develops rapidly, dangerous if withdrawal occurs
abstinence syndrome
characterized by insomnia, headaches, aching all over the body, anxiety, and depression
stimulants
class of drugs that have a stimulating/arousing effect on the CNS and create their effects by influencing the rate of uptake of the neurotransmitters at receptor sites in the brain ex. cocaine
tobacco
stimulant drug
short term consequences of tobacco
minimal effects
long term consequences of tobacco
extensive effects
nicotine
CNS stimulant related to the amphetamines
dependency on tobacco
develops quickly
treatment of tobacco
psychological/pharmacological treatments
psychological treatments for tobacco
formal face-to-face counselling, online support groups for quitting, provision of self-help materials for quitting - goal setting, self-monitoring, reinforcement
pharmacological treatments
over the counter nicotine replacements and medications, block reinforcing properties, help with detoxification, reduce cravings, aversion therapy
amphetamines
effects on the body similar to those of adrenalin
low doses of amphetamines
increase alertness and allow the user to focus attention effectively
high doses of amphetamines
induce feelings of exhilaration, extroversion, confidence and at very high doses, restlessness and anxiety can occur
toxic psychosis
repeated high doses can cause hallucinations, delirium and paranoia
physical effects of amphetamines
increased or irregular heartbeat, fluctuations in blood pressure, hot or cold flashes, nausea, weakness, and dilation of pupils
caffeine
most popular stimulant drug
opioids
class of CNS depressants - main effects are the reduction of pain and sleep inducement ex.heroin
endogenous opiates
body’s natural painkillers
exogenous opiates
narcotics affect receptor sites located throughout the body including the CNS and bloodstream
dependency on opioids
withdrawal is dangerous
methadone
heroin replacement
treatment for opioids
medications, individual/group psychological programs, peer supports
therapeutic effects of cannabis
cancer, AIDS, glaucoma, terminal illness, chronic pain, anxiety
amotivational syndrome
continuing pattern of apathy, profound self-absorption, detachment from friends and family and abandonment of goals
dependency on marijuana
can become tolerant and dependent
hallucinogens
drugs that change a person’s mental state by inducing perceptual and sensory distortion or hallucinations
effects of hallucinogens
psychotic-like epsiodes
factors affecting experience of hallucinogens
personality, setting, expectations
dependence on hallucinogens
do not tend to cause dependence
sex differences in addiction
affects more men than women
what kind of experience do women have with addictions
“telescoping effect” - more progressive
what are women more sensitive to in addictions
more sensitive to rewarding effects, less sensitive to negative effects of drugs
risk factors - biological
family history, low sensitivity to alcohol
risk factors - psychosocial
impulsivity, negative/positive urgency, problematic coping strategies, positive expectations
risk factors - social
family acceptance of substance use, cultural permissive attitudes, availability, abuse, low SES, academic failure
harm reduction model
propose reducing consequences/dangerous behaviours but not necessarily quitting
self-help
step-by-step instructions to an individual, enabling them to carry out an established treatment protocol either independently or with minimal expert support
mutual help groups
support group for addictions
self-help - personalized feedback
assessment of current use and comparison with normative and for your age and gender
self-help - structured interventions
generally include numerous strategies - self-assessment, goal setting, self-monitoring, coping strategies, online forums
effectiveness of structured interventions
good for alcohol, questionable for cocaine
effectiveness of personalized feedback
questionable on it own with alcohol and gambling, effective if combined with self-help book about alcohol use
12-Step group
involves meetings, completing the 12 steps, obtaining a sponsor, doing service ex. AA, NA
SMART recovery
focus on building and maintaining motivation, coping with urges, managing thoughts, feelings and behaviours, and living a balanced life - goal is abstinence
modern management
goal is moderation, not abstinence
cognitive behavioral program
self-monitoring, goal setting, learning behavioural management skills, managing triggers, finding non-drinking activities, relapse prevention
residential treatment
many different programs, high variability, usually based on 12-step principles