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Psych 405 > Chapter 11 - Substance Use Disorders > Flashcards

Chapter 11 - Substance Use Disorders Flashcards

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1
Q

What percent of people have a substance use disorder in a given year?

A

16.5%

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2
Q

What percent of people have alcohol use disorder in a given year?

A

10.6%

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3
Q

What percent of Americans abstain from alcohol?

A

35%

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4
Q

What percent of people binge drink monthly?

A

21.5%

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5
Q

How many overdose deaths are there annually?

A

107,000

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6
Q

What percent of overdose deaths are opioid related?

A

75%

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7
Q

How many US deaths from smoking-related diseases annually?

A

Over 480,000

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8
Q

What percent of people have cannabis use disorder annually?

A

6%

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9
Q

What is the lifetime prevalence of cannabis use?

A

45%

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10
Q

What is the percent of people who use caffeine daily?

A

90%

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11
Q

What is a substance?

A
  • any natural or synthesized product that has psychoactive effects
  • changes perceptions, thoughts, emotions, and behaviors
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12
Q

What is addictive behavior?

A

behavior based on the pathological need for substance or activity

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13
Q

What classifies substance abuse?

A
  • the pathological use of a substance resulting in potentially hazardous behavior and continued use despite a persistent social, psychological, occupational, or health problem
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14
Q

What is the DSM-5 criteria for substance use disorder?

A
  • Two or more of the following occurs during 12 months, leading to significant impairment or distress:
  • Failure to fulfill important obligations at work, home, or school as a result of substance abuse
  • Repeated use of the substance in situations which it is physically hazardous to do so
  • Repeated relationship problems
  • Continued use of the substance despite repeated social or legal problems as a result of use
  • Tolerance, as defined by either: the need for markedly increased amounts of the substance to achieve intoxication or desired effect; markedly diminished effect with continued use of the same amount
  • Withdrawal, as manifested by either: the characteristic withdrawal syndrome; the same or closely related substance is taken to relieve or avoid withdrawal symptoms
  • The substance is often taken in larger amounts or over a longer period than was intended
  • There is a persistent desire or unsuccessful efforts to cut back
  • A great deal of time is spent in activities necessary to obtain the substance, use the substance, or recover from its effects
  • Important social, occupational, or recreational activities are given up or reduced because of substance use
  • The substance use is continued
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15
Q

What are the factors that influence the development of dependence?

A
  • route of administration (the quicker, the most addictive)
  • rate of action
  • length of action (longer lasting, less addictive)
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16
Q

What are the methods of taking substances and time to reach the brain?

A

Fastest to slowest, faster = more addictive:
Inhaling - snorting - injection - oral ingestion - other routes

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17
Q

What are depressants?

A
  • slow the activity of the central nervous system (CNS)
  • reduce tension and inhibitions
  • may interfere with judgment, motor activity, and concentration
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18
Q

What are the most used depressants?

A

Alcohol, sedative-hypnotic drugs, opioids

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19
Q

How many people in the world drink alcohol?

A

2 billion

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20
Q

How many Americans drink alcohol?

A

Over half

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21
Q

What is a binge-drinking episode?

A

Consuming 5 or more drinks on a single occasion

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22
Q

What is ethyl alcohol?

A
  • in all alcoholic beverages
  • absorbed into the blood through the stomach lining
  • takes effect in bloodstream and CNS
  • effect of ethyl alcohol and level of impairment is determined by its concentration in the blood
  • intoxication = 0.09 percent (.08 legally)
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23
Q

When do the effects of alcohol go away?

A

After it is metabolized by the liver

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24
Q

What does alcohol do in the brain?

A
  • increases the activity of the neurotransmitter GABA at key sites in the brain to shut down neurons
  • decreases activity in glutamate system
  • increases dopamine activity
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25
Q

What do women have less of that means they get more intoxicated than men easier?

A

the stomach enzyme called alcohol dehydrogenase

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26
Q

What are the personal and social impacts of alcoholism?

A
  • plays a role in suicides, homicides, assaults, rapes, and accidents
  • long-term excessive drinking can seriously damage physical health and major nutritional problems (Korsakoff’s syndrome)
  • the 30 million children of alcoholics are likely to experience a wide range of social and psychological struggles, fetal alcohol syndrome (FAS) and miscarriage risk
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27
Q

What is the clinical picture of alcohol use disorder?

A
  • regular consumption and reliance affect cognition, social life, and work behaviors
  • individual alcoholism patterns vary
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28
Q

What are tolerance and withdrawals like in alcoholics?

A
  • tolerance increases consumption levels
  • variety of negative withdrawal symptoms like delirium tremens (DTs)
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29
Q

How does alcohol damage the brain?

A
  • complex and often contradictory effects on the brain
  • alcohol abuse kills brain cells
  • associations between alcohol consumption and gray and white matter volumes (Daviet et al.)
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30
Q

What are sedative-hypnotic (anxiolytic) drugs?

A

Drugs that produce feelings of relaxation and drowsiness

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31
Q

What are sedative-hypnotic drugs like at low doses?

A

calming or sedative effect

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32
Q

What are sedative-hypnotic drugs like at high doses?

A

sleep inducers or hypnotics

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33
Q

What are some sedative-hypnotic drugs?

A
  • barbituates (widely prescribed for the first half of the twentieth century)
  • benzodiazepines (safer and less likely to lead to intoxication, tolerance effects, and withdrawal reactions, increase GABA activity)
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34
Q

What are the opioids?

A

Include natural (opium, heroin, morphine, codeine) and synthetic (methadone) compounds, known collectively as narcotics

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35
Q

When were opium-derived drugs deemed addictive and illegal?

A

By 1917

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36
Q

How do opioids cause CNS depression?

A

they attach to endorphin-related brain receptors

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37
Q

What are the dangers of opioid use?

A

Overdose, ignorance of tolerance, getting impure drugs, infection from dirty needles and other equipment

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38
Q

What are the medical opioids?

A

Morphine, codeine, and oxycodone

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39
Q

How are opioids injested?

A

Smoked, inhaled, snorted, injected, or swallowed

40
Q

What is skin-popping?

A

Injecting opioid just beneath the skin

41
Q

What is mainlining?

A

Injecting opioid deep into a muscle or vein

42
Q

What is a rush?

A

Right after injection, spasm of warmth and ecstasy sometimes compared with an orgasm followed by several hours of a high/nod

43
Q

What is tolerance and withdrawal like for heroin use?

A
  • tolerance for the drug quickly builds
  • withdrawal occurs when drug ingestion stops
  • increased doses required to avoid withdrawal
44
Q

What are the withdrawal symptoms for heroin?

A
  • early withdrawal symptoms include anxiety and restlessness
  • later symptoms include twitching, aches, fever, vomiting, diarrhea, and weight loss from dehydration
45
Q

What are stimulants?

A
  • substances that increase the activity of the central nervous system
  • cause increases in blood pressure, heart rate, and alertness
  • cause rapid behavior and thinking
46
Q

What are the most common stimulants?

A

cocaine, amphetamines, caffeine

47
Q

What is stimulant use disorder?

A
  • when stimulant dominates individual’s life
  • leads to poor functioning in social relationships and at work
  • tolerance and withdrawal reactions tied to increased doses
48
Q

What is the most powerful known natural stimulant?

A

Cocaine

49
Q

What does cocaine feel like?

A

a euphoric rush of well-being, orgasmic

50
Q

What does cocaine do in the brain?

A

increases the supply of dopamine at key neurons throughout brain as well as norepinephrine and serotonin levels

51
Q

What are the effects of high doses of cocaine?

A

cocaine intoxication, cocaine-induced psychotic disorder, depression-like letdown (crashing)

52
Q

What are the more powerful and cheaper versions of coke?

A

Crack and freebasing

53
Q

What are the physical dangers of cocaine?

A

overdose (greatest risk), excessive doses depress the brain’s respiratory function and stop breathing, heart failure, increased likelihood of miscarriage and of having children with abnormalities

54
Q

What are the symptoms of cocaine intoxication?

A

poor muscle coordination, grandiosity, bad judgment, anger, aggression, compulsive behavior, anxiety, and confusion

55
Q

What are amphetamines?

A
  • Lab-manufactured stimulants like amphetamine, dextroamphetamine, methamphetamine
  • Most often taken in pill or capsule form
56
Q

What are the effects of amphetamines?

A
  • Small doses: increased energy and alertness and reduced appetite
  • High doses: produce a rush, intoxication, psychosis
  • Cause emotional letdown as they leave body
57
Q

What amphetamine has become more popular recently?

A

Methamphetamine

58
Q

What are the dangers of meth?

A

serious negative effects on physical, mental, and social life; linked to increased ER visits; may cause neurotoxicity

59
Q

What are hallucinogens?

A

substances that produce delusions, hallucinations, and other sensory perception changes, cause trips

60
Q

What are the natural hallucinogens?

A

lysergic acid diethylamide (LSD), mescaline (peyote), psilocybin, MDMA (ecstasy)

61
Q

What is LSD (lysergic acid diethylamide)?

A
  • one of the most powerful hallucinogens derived from ergot alkaloids
  • brings on a state of hallucinogen intoxication (hallucinosis)
62
Q

What are the effects of taking LSD?

A
  • increased and altered sensory perception
  • psychological changes
  • physical symptoms
  • hallucinations and/or synesthesia
  • wear off in about 6 hours
63
Q

What does LSD do in brain?

A
  • binds to serotonin receptors
  • these neurons help control visual information and emotions, thereby causing the various effects
64
Q

What are LSD tolerance and withdrawals like?

A

These are rare

65
Q

What are the dangers of LSD?

A

self-injury, bad trips, flashbacks

66
Q

What is MDMA? (ecstasy/molly)

A
  • a stimulant and hallucinogen
  • provides an energy boost and strong feelings of connectedness
67
Q

What are the dangers of MDMA?

A

immediate psychological problems, cognitive impairment, unpleasant and potentially dangerous physical symptoms

68
Q

What does MDMA do in the brain?

A
  • causes neurotransmitters serotonin and dopamine to be released all at once throughout the brain
  • interferes with brain’s ability to produce new serotonin
69
Q

What is cannabis sativa?

A

A hemp plant

70
Q

What is hashish?

A

solidified resin of the cannabis plant

71
Q

What is marijuana?

A

mixture of buds, crushed leaves, and flowering tops

72
Q

What is the major active ingredient in marijuana?

A

tetrahydrocannbinol (THC)

73
Q

What are the effects of cannabis intoxication?

A
  • a mixture of hallucinogenic, depressant, and stimulant effects
  • lasting 2-6 hours (12 when eaten)
74
Q

what are the dangers of cannabis?

A

tolerance and withdrawal symptoms, occasional panic reactions, automobile accidents, and decreased memory while high, long-term health problems, reproduction problems, motivational syndrome, depression, increased risk of psychosis and risk of addiction to other substances

75
Q

what is cannabis use disorder influenced by?

A

regular use

76
Q

what is marijuana’s role in history?

A
  • historically, replaced by more effective drugs in the medical field and then outlawed
  • THC-related research opened cannabis use for new medical applications and legalization
  • medical use now allowed in 29 states & recreational in 8
77
Q

What is polysubstance use?

A

taking more than one drug at a time

77
Q

what is a synergistic effect?

A

the effects of taking multiple drugs at once when they multiply each other’s effects

78
Q

is it more dangerous to mix drugs with similar or opposite actions?

A

mixing drugs with similar actions can be deadly

79
Q

what are antagonistic effects in drugs?

A

combining drugs with opposite actions

80
Q

According to sociocultural views, what causes substance use disorders?

A
  • living in stressful socioeconomic conditions
  • having families that value or tolerate drug use
  • being confronted regularly by other kinds of stress
81
Q

According to psychodynamic views, what causes substance use disorders?

A
  • having powerful early-year dependency needs
  • displaying substance abuse personality
82
Q

According to cognitive-behavioral views, what causes substance use disorders?

A
  • operant conditioned by tension-reduction
  • rewarding effects of drugs (self-medication)
  • have rewards-produced expectancy that substances will be rewarding
  • influenced by classical conditioning when cues or objects are present during drug use
83
Q

According to biological views, what causes substance use disorders?

A
  • genetic predisposition
    • similarity of alcohol preferences
      among alcohol-preferring animals
      and their offspring
    • abnormal form of dopamine-2
      receptor gene in people with
      substance abuse disorders
  • neurotransmitters
    • drug tolerance and withdrawal
      symptoms are caused by cutbacks
      in the brain’s production of
      particular neurotransmitters
      during excessive and chronic drug
      use
    • lower GABA production (alcohol
      & benzos)
    • lower endorphin production
      (cocaine & amphetamines)
    • reduced anandamide production
      (marijuana)
    • dopamine is key NT
  • brain circuits
    • reward circuit (reward center)
    • pleasure pathway
    • drugs stimulate structures directly
      and indirectly
  • the dopamine reward system
    • incentive-sensitization theory
    • when substances repeatedly
      stimulate the reward center, the
      center develops a hypersensitivity
      to the substance
  • reward-deficiency syndrome (inability to derive reward from ordinary, everyday activities)
84
Q

According to the developmental psychopathology view, what causes substance use disorders?

A
  • externalizing or internalizing temperament
  • numerous stressors throughout childhood
  • inadequate parenting
  • rewarding substance use experiences
  • relationships with peers who use drugs
85
Q

What are psychodynamic therapies used to treat substance use disorders?

A

Clients are helped to become aware of and correct underlying needs and conflicts related to drug use

86
Q

What are cognitive-behavioral therapies used to treat substance use disorders?

A
  • aversion therapy
  • contingency management
  • relapse-prevention training
  • acceptance and commitment therapy
87
Q

What are biological therapies used to treat substance use disorders?

A
  • help people withdraw, abstain, or maintain level of use without further increases
  • detoxification
  • Antagonist drugs
  • Drug maintenance therapy
    (methadone/peyote maintenance programs are designed to provide a safe, legal, and medically supervised substitute for heroin)
88
Q

What is detoxification?

A
  • systematic and medically supervised withdrawal from a drug
  • outpatient or inpatient
  • gradual withdrawal or induced withdrawal
89
Q

What are antagonist drugs?

A

intended to help the person resist falling back into a pattern of substance abuse or dependence
- opioid antagonist drugs (naloxone)
- partial antagonists
- rapid detoxification

90
Q

what is aversion therapy?

A

repeat pairing an unwanted behavior with discomfort (ex: electric shock)

91
Q

what is contingency management?

A

when individuals are ‘reinforced’, or rewarded, for evidence of positive behavioral change)

92
Q

what are the sociocultural therapies used for substance use disorders?

A
  • believe psychological problems emerge in a social setting and are best treated in a social context
  • self-help and residential treatment programs
  • culture and gender sensitive programs
  • community prevention programs
93
Q

what are other addictive disorders (not drug-related)?

A
  • gambling disorder
  • internet gaming disorder is under possible inclusion in future DSM edition
94
Q

what are the causes of gambling disorder?

A
  • genetic predisposition
  • heightened dopamine activity and dysfunction when gambling
  • impulsive, novelty-seeking personality style
  • repeated and cognitive mistakes
95
Q

what are the treatments for gambling disorder?

A
  • cognitive-behavioral approaches (relapse-prevention training)
  • biological approaches (opioid antagonists)
  • self-help programs (Gamblers Anonymous)

Psych 405 (7 decks)

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