Chapter 12 Flashcards
What are psychoactive substances?
Substances that alter mood, behavior, or both.
What are the levels of involvement with psychoactive substances?
- Substance use – Moderate amounts with no major interference in life.
- Substance intoxication – Physiological reaction (e.g., impaired judgment, mood changes, lowered motor ability).
- Substance use disorder – Addiction with dependence on the drug.
What are the two types of dependence in Substance Use Disorder?
- Physiological dependence: tolerance + withdrawal
EX. one beer a day, eventually you won’t feel it so need two beers to have same effects
- Psychological dependence: Emotional/behavioral reliance on a substance (e.g., cravings).
What is the difference between tolerance and withdrawal?
Tolerance: Needing greater amounts of a substance to achieve the same effect.
Withdrawal: Negative physical response when the substance is no longer ingested.
What are the severity levels of Substance Use Disorder?
At least 2 symptoms in the 12-month period
Mild: 2-3 symptoms.
Moderate: 4-5 symptoms.
Severe: 6+ symptoms
What are the five categories of psychoactive substances?
◦ Depressants
◦ Opioids
◦ Stimulants
◦ Hallucinogens
◦ Other drugs
What are the three most common psychoactive substances?
Alcohol, nicotine, and caffeine.
What is Reverse Tolerance in alcohol use?
An increased sensitivity to alcohol’s effects after repeated use.
How can alcohol contribute to polysubstance use risks?
Alcohol can have synergistic effects with other drugs, lowering the dose needed for a fatal overdose.
How does alcohol affect the brain at different doses?
Depressant, inhibitory centers in the brain are depressed, or slowed
Low dose: Reduces inhibitions.
High dose: Acts as a potent sedative.
What are the physical effects of alcohol consumption?
Impaired coordination
Slowed reaction time
Memory blackouts
Confused judgment
Vision and hearing impairment
Which neurotransmitter systems are affected by alcohol?
GABA – Inhibitory control
Glutamate – Memory blackouts
Dopamine (DA) – Pleasure and reward
Serotonin – Alcohol cravings
What are some long-term effects of alcohol abuse?
- Chronic drinking causes severe biological damage and psychological deterioration
- Almost every tissue and organ is adversely affected:
What is Wernicke-Korsakoff syndrome?
A condition caused by severe Vitamin B1 deficiency, marked by confusion, loss of coordination, speech issues, and memory loss.
What is Fetal Alcohol Syndrome (FAS)?
A condition affecting children whose mothers drank during pregnancy, leading to developmental issues.
What are common withdrawal symptoms from alcohol?
Hand tremors
Nausea or vomiting
Anxiety
Hallucinations
Insomnia
What are Delirium Tremens (DTs)?
Severe withdrawal symptoms including frightening hallucinations and body tremors.
What is the prevalence of alcohol use disorder in Canada (2022)?
2.2% 12-month prevalence.
Who is most likely to engage in heavy drinking in Canada?
Men drink more than women.
Single males are the most likely heavy drinkers.
Why are women more affected by alcohol than men?
Women have less of the enzyme that metabolizes alcohol in the stomach.
How does early alcohol consumption impact future behavior?
Early consumption can predict dependence/abuse in later years.
How is alcohol linked to violent behavior?
Alcohol may reduce the fear of punishment, increasing aggression.
What are Sedative-, Hypnotic-, and Anxiolytic-Related Disorders?
Disorders involving substances that are:
Sedative – Calming
Hypnotic – Sleep-inducing
Anxiolytic – Anxiety-reducing
What drugs are included in Sedative-, Hypnotic-, and Anxiolytic-Related Disorders?
Barbiturates and Benzodiazepines (e.g., Valium, Xanax)
Work on the GABA neurotransmitter system.
What are the effects of barbiturates?
->(downers) - relax muscles, induce sleep
- Low doses produce mild feeling of well-being
- Large doses- effects similar to heaving drinking
- Overdosing is common means of suicide (diaphragm muscles relaxed = no breathing)
What are the effects of benzodiazepines?
- calming, induce sleep
- Tolerance and dependence with repeated use
What percentage of Canadians reported using sedatives in 2019?
12% (9% men, 14% women).
What are opiates and opioids?
Opiates: Natural chemicals from the opium poppy with narcotic effects.
Opioids: Natural, semi-synthetic, or synthetic drugs like codeine, morphine, heroin, oxycodone, and fentanyl.
What are the effects of opioids?
- Temporarily lessen pain and anxiety;
-high doses → overwhelming sense of euphoria: a “who cares” quality;
-Produce a feeling of pleasure that is almost like floating on a cloud or being in a dream like state
- Slow breathing, and cause lethargy
What risks are associated with opioid injection?
Increased risk of HIV and other infections.
What are common withdrawal symptoms from opioids and how quickly do they appear?
Symptoms appear within 6-12 hours and include:
Nausea
Vomiting
Chills
Muscle aches
Diarrhea
Insomnia
This often leads to further use
What are Stimulant-Related Disorders?
Disorders involving substances that increase alertness, energy, and euphoria.
What is cocaine derived from?
leaves of the coca plant
What are the effects of cocaine?
- Produces a quick rush of euphoria, indifference to pain and sense of well-being
- A crash of agitated depression occurs within 15 to 30 minutes after DA levels drop
What are the effects of amphetamines (Uppers)?
- Reduce appetite, weight, soldiers used to stay awake and alert
- Initially used to control mild depression and appetite
- Today used to treat children with hyperactivity
- Enhance the activity of NE and DA
- The high produced by these drugs is less intense but generally lasts longer (a few hours)
What is methamphetamine (crystal meth)?
The most abused form of amphetamine
- Intense exhilaration → followed by euphoria that can lasts for 6-12 hours
- Powerfully addictive
- Tolerance builds quickly; Withdrawal - prolonged periods of sleep, irritability, depression.
What are the effects of nicotine in tobacco?
Single most preventable cause of premature death (1 in every 5 deaths)
- is a psychoactive substance
- Produces dependance, tolerance, with-drawl
-Increases dopamine, promoting feelings of pleasure and reward.
What percentage of Canadians smoked in 2022?
12%
How does nicotine improve cognitive function at low doses?
It stimulates acetylcholine and glutamate, improving attention and memory.
What are the effects of caffeine?
Boosts mood and energy.
Excessive use can cause insomnia.
Withdrawal symptoms include headaches and irritability.
What is MDMA (Ecstasy)?
A synthetic stimulant and mild hallucinogen that increases NE, SE, and DA. Produces euphoria, hallucinations, and delusions.
What are hallucinogens?
Substances that alter perception, mood, and cognition, often causing visual or auditory hallucinations.
What are the effects of LSD (acid)?
- Type of mold that grows on grains
- Perceptual changes: subjective intensification of perceptions, depersonalization, and hallucinations
- Physical symptoms: pupillary dilation, rapid heartbeat, sweating, blurred vision
What are the two long-term effects of LSD use?
- Persistent psychosis – a long-lasting psychotic-like state after the trip has ended.
- Hallucinogen persisting perception disorder (HPPD) or Flashbacks– Recurring flashbacks of past LSD experiences.
What is cannabis?
Dried and crushed leaves of the Cannabis sativa plant. Contains THC as its active chemical.
What are the psychological effects of marijuana?
- Feel more relaxed and sociable
- Can dull attention, fragment thoughts, and impair memory
- Extremely heavy doses can induce hallucinations; psychotic reaction
What are the therapeutic effects of cannabis?
Relieves pain.
Reduces nausea and appetite loss (especially for chemotherapy patients).
What is Inhalant Use Disorder?
A disorder involving recurrent use and constant craving of inhalants like spray paint or paint thinner.
What are the symptoms of inhalant intoxication?
Similar to alcohol intoxication with symptoms like dizziness, slurred speech, and impaired judgment.
What are the long-term effects of inhalant use?
Damage to the bone marrow, kidneys, liver, and brain.
What are anabolic-androgenic steroids?
Drugs derived from or synthesized from testosterone to increase body mass and muscle growth.
What are the two common patterns of steroid use?
Cycling – Use for several weeks or months followed by a break.
Stacking – Combining various types of steroids for enhanced effect.
How do genetics influence substance use disorders?
OPRM1 receptor gene linked to early-onset drinking in adolescents.
Genes on chromosomes 1, 2, 7, & 11 linked to alcohol use.
A gene on chromosome 4 may protect against dependence.
How does the dopaminergic system influence substance use?
Psychoactive drugs activate the brain’s reward and pleasure center by increasing dopamine release in the Nucleus Accumbens (NAc).
Which brain regions are involved in the reward system?
Ventral Tegmental Area (VTA)
Nucleus Accumbens (NAc)
Ventral Pallidum
Prefrontal Cortex
What is dopamine sensitization?
Repeated exposure to stimulant drugs leads to increased dopamine release when taking the drug.
What is positive reinforcement in substance use?
Drugs provide a pleasurable experience, which increases the likelihood of repeated use.
What is negative reinforcement in substance use?
Drugs are used to escape from physical pain, stress, or anxiety
e.g., self-medication theory - drinking is done with the goal of removing an aversive state
What is the opponent-process theory?
an increase in positive feelings will be followed by an increase in negative feelings a short time later.
- an increase in negative feelings will be followed by a period of positive feelings.
→every high followed by low and every low followed by a high
What is the expectancy effect?
What people expect to experience when they use drugs influences their reaction to them.
How does alcohol myopia influence behavior?
A cognitive distortion that narrows focus, making immediate cues more influential while ignoring long-term consequences.
What is the Conditioning Theory of Tolerance?
->Based on notion that tolerance is a learned response
->environmental cues signal that a drug’s effect is coming, these cues come to be associated with substance use (classical conditioning)
What are conditioned compensatory responses?
Learned bodily responses that are opposite to the drug’s effects in preparation for the substance.
What are feed-forward-mechanisms?
regulatory responses made in anticipation of a drug
How can social factors influence substance use?
Exposure through friends, media, and family environments can increase risk.
How does parental monitoring affect substance use risk?
Parents with substance use disorders may monitor their children less, increasing their risk.
What are the two views of substance-related disorders?
- Moral weakness view
a. Attributes SUD to a lack of discipline - Disease model of physiological dependence
a. SUD is a chronic physical condition influenced by biological and genetic factors which impacts someone’s ability to control their behavior
→Both fail to see psychological and biological aspects to SUD
Why is patient awareness important in treatment?
The patient must admit they have a problem (contemplation stage) for treatment to be effective.
What is agonist substitution treatment?
A treatment that uses a drug with a similar chemical structure to the addictive drug.
EX’s:
Methadone – opioid agonist; may lead to dependence.
Buprenorphine – less risk of dependence.
Nicotine replacement – gum, patch, inhaler, or nasal spray.
What are antagonist treatments?
Drugs that block or counteract the effects of psychoactive substances.
EX’s:
Naltrexone – opioid antagonist; Produces immediate withdrawal symptoms; More effective if part of a treatment package; Also given for alcohol dependence – inhibits DA release in the Nucleus Accumbens
Naloxone – (internasal spry or injection) used in opioid overdose emergencies - fentanyl/opioid overdose
How are sedatives used in withdrawal treatment?
Used to minimize discomfort for people withdrawing from other drugs; must be tapered off gradually to avoid dependence.
What is Desipramine used for?
Increases abstinence rates for people recovering from cocaine addiction.
What is the purpose of inpatient facilities in substance use treatment?
To provide detoxification support during the initial withdrawal period.
Tranquilizers may be given to ease anxiety and discomfort.
What are the downsides of inpatient facilities?
They can be expensive and are typically used only for the initial withdrawal period.
What is Alcoholics Anonymous (AA)?
A 12-step program that encourages abstinence and is effective for motivated individuals.
What is a common challenge with AA programs?
High dropout rates, often due to the demanding commitment.
What is aversion therapy?
->Prescribed drugs make ingesting abused substances extremely unpleasant
EX:
Disulfiram (Antabuse) used for alcohol disorder
For smoking aversion: silver nitrate in gum, spray (makes it taste bad)
What is covert sensitization?
A technique where individuals imagine unpleasant scenes associated with substance use to reduce cravings.
What is contingency management?
The clinician and client work together to:
- select the behaviors that the client needs to change
- decide on the reinforcers that will reward reaching certain goals (behaviors inconsistent with the problem)
What is Behavioral Self-Control Training (BSCT)?
Emphasizes client’s control over behavior
Includes one or more of the following:
◦ Stimulus control - identifying and avoiding situations where tempted to drink
◦ Modification of the topography of drinking - change way alcohol consumed
◦ Reinforcing Abstinence
What is the community reinforcement approach?
Focuses on building social skills, employment support, and new recreational activities to replace substance use.
What is Motivational Enhancement Therapy (MET)?
increase motivation to change behavior by:
→ Building Trust: supportive and non-judgmental environment
→ Exploring Ambivalence: Clients weigh the benefits and drawbacks
of their substance use; understand how it affects their goals.
→ Setting Goals: Clients set achievable goals for reducing or quitting
substance use.
→ Developing a Plan: Therapists work with clients to create a
specific, step-by-step plan to reach those goals
What is the focus of relapse prevention?
Marlatt and Gordon - Relapse seen as failure of cognitive and behavioral coping skills
- Helping people remove any ambivalence about stopping their drug
◦ Examining their beliefs about the positive aspects of the drug
What is the harm reduction approach?
alternative to an approach that focuses on complete abstinence e.g. AA
→Controlled use
→Controlled use of a substance instead of abstinence e.g., controlled drinking
◦ May be an alternative, is not a cure
◦ Not very effective over the long term
→Safe injection sites (SISs)
What are key elements of prevention programs for substance use?
Education-based messages (harm reduction vs. “no drugs” messages)
Skills training to resist social pressures
Community-based interventions like enforcing drinking and driving laws.
What is gambling disorder?
A condition marked by persistent and problematic gambling that causes distress or impairment.
What are some risks of gambling disorder?
Job loss, bankruptcy, arrests, and family strain.
What treatments are effective for gambling disorder?
Gambler’s Anonymous
Cognitive Behavioral Therapy (CBT)
What is Intermittent Explosive Disorder?
- Aggressive impulses resulting in serious assaults, destruction of property◦ Lifetime prevalence is 7%◦ SE, NE, and testosterone levels◦ Dysfunction of orbitofrontal cortex in inhibiting amygdala activation
What is kleptomania?
A condition marked by the inability to resist stealing, often to relieve unpleasant emotions.
- Typically starts in adolescence
- High comorbidity with mood disorders
- Often referred to as “Antidepressant behavior”- relieving unpleasant feelings with stealing behavior
What is pyromania?
A disorder involving a compulsive urge to set fires and fascination with fire-related objects.
What is the main treatment for impulse-control disorders?
Cognitive-behavioral therapy (CBT), which helps individuals identify triggers and develop coping strategies.
