Chapter 12 - Substance Use and Impulse Control Flashcards
Define substance/psychoactive substance. What are some examples of psychoactive substances? (2)
-chemical compounds ingested to alter mood or behavior
-nicotine, alcohol
Define polysubstance use
-using multiple substances
What are the levels of involvement in substance use?
-use and intoxication
What is “use” as a level of involvement?
-morning coffee, drink with a friend
What is substance intoxication?
-drunkenness
Define tolerance
-greater amount of drug needed to experience the same effect
Define withdrawal
-negative physical response when the substance is no longer ingested
What are two key signs of physiological dependence?
-tolerance and withdrawal
What is psychological dependence in substance use disorder?
-Behavioral reactions to substance dependence, such as cravings or habits tied to substance use.
Can substance dependence exist without misuse?
-Yes
How can substance use and mental health disorders interact diagnostically?
-Substance use may occur alongside other mental health disorders, and mental health issues can lead to substance use disorder.
What is a potential effect of drug intoxication and withdrawal in terms of risk-taking behaviour?
-They can increase risk-taking behavior.
What are the five general categories of substances?
-Depressants, stimulants, opioids, hallucinogens, and other drugs.
Alcohol acts as a depressant. What changes can this cause in someone?
-impaired motor coordination, slower reaction times, and poor judgment.
Which neurotransmitter does alcohol primarily influence, and what effects can this cause? (2)
-GABA (an inhibitory neurotransmitter)
-blackouts and release of analgesics.
What are some medical effects of alcohol-related disorders? (2)
-Delirium tremens, which include frightening hallucinations and body tremors
-fetal alcohol syndrome, which affects children of mothers who drank during pregnancy.
What percentage of Canadians exceed low-risk guidelines for alcohol consumption?
-21% of Canadians.
What are key patterns in alcohol use and abuse, especially in either gender?
-Binge drinking is frequent among college students, men drink more than women, and single males are the most likely to be heavy drinkers.
What is the typical progression of alcohol-related disorders?
-Fluctuations between heavy drinking and abstinence, worsening over time if untreated, and early drinking predicting future dependence.
What do each do: sedative-, hypnotic-, and anxiolytic?
-Sedatives (calming), hypnotics (sleep-inducing), and anxiolytics (anxiety-reducing).
What do barbiturates do, and what risks do they carry?
-Relax muscles, pleasant mood, overdose risk is high.
What are benzodiazepines and what risk do they carry?
-Calm and induce sleep, but repeated use leads to tolerance and dependence.
What are some statistics on benzodiazepine use in Canada?
-Use declined by 6% between 2016–2017, and 12% of Canadians reported using sedatives in 2019
What are the main effects of amphetamines?
-“uppers,” reduce appetite and fatigue but lead to a “crash” after use.
Which neurotransmitters does MDMA (“ecstasy”) enhance?
-enhances norepinephrine and dopamine activity, potentially causing hallucinations and delusions.
What is cocaine derived from, and what are its effects?
-Cocaine comes from coca plant leaves and increases alertness, blood pressure, and insomnia.
What percentage of Canadians smoked in 2017, and how does nicotine affect the body? (2)
-15% of Canadians smoked
-nicotine stimulates pleasure pathways, produces dependence, and can link to depression.
What are the effects of caffeine, and what does caffeine use disorder involve?
-elevates mood, decreases fatigue, and can cause insomnia; caffeine use disorder involves problematic use causing significant impairment and distress.
What are opiates, and what effects do they have?
-natural chemicals from the opium poppy with narcotic effects, inducing sleep and relieving pain (analgesic).
What is the current situation regarding opioid use in Canada?
-Canada is facing an opioid crisis, worsened by the COVID-19 pandemic, with high impact among First Nations adults.
What are some risks associated with opioid use?
-Unpleasant withdrawal symptoms, risks of HIV with intravenous use, and high mortality rates.
What are some examples of hallucinogens?
-LSD, psilocybin (mushrooms), lysergic acid amide, dimethyltryptamine (DMT), mescaline (peyote), and PCP.
What perceptual and physical changes are included in the DSM-5-TR criteria for hallucinogen use?
-Perceptual changes: intensification of perceptions, depersonalization, and hallucinations.
-Physical symptoms: pupillary dilation, rapid heartbeat, sweating, and blurred vision.
What are some effects of cannabis use?
-Altered perceptions, mood swings, and impairments in memory, concentration, motivation, self-esteem, and relationships.
What is “reverse tolerance” in cannabis use?
-enhanced sensitivity to cannabis effects with repeated use.
What are some examples of inhalants?
-Spray paint, paint thinner, and amyl nitrate.
What are anabolic-androgenic steroids used for, and why are they classified as drugs?
-They are synthetic substances used to enhance muscle growth but can have harmful side effects and lead to misuse.
What are designer drugs?
-Synthetic substances created to mimic the effects of existing drugs, often with unpredictable and harmful outcomes.
What familial and genetic factors influence substance use disorders?
-Genetic vulnerability, the absence of alcohol dehydrogenase (ADH) in some people, and genes like DRD2 and one on chromosome 4 linked to alcohol dependence.
How do psychoactive drugs affect the brain’s reward system? What does this lead to? (2)
-activate dopaminergic system and opioid-releasing neurons
-leading to dopamine release and sensitization with repeated exposure.
What is the role of positive reinforcement in substance use?
-Psychoactive drugs provide pleasurable experiences, increasing use and tolerance.
What is the opponent-process theory in negative reinforcement?
-After experiencing a high, users may face an unpleasant crash, encouraging further use to avoid the negative feelings.
What is the expectancy effect in substance use?
-People’s expectations about a drug’s effects influence their reactions, and these expectancies evolve with more drug experiences.
How do social factors influence substance use?
-Exposure through friends and media, lack of parental monitoring in drug-addicted households, and social pressures contribute to use and abuse.
How do cultural norms affect substance use?
-Cultural norms dictate patterns of use, such as drinking heavily on social occasions, with biological factors sometimes interacting with these norms.
What does the integrative model of substance use disorders suggest?
-Substance use is influenced by access, exposure, psychological stressors, biological vulnerabilities, and social and cultural expectations.
What is Motivational Enhancement Therapy (MET)?
-A treatment aimed at increasing an individual’s motivation to change substance use behavior, effective for those at different readiness stages.
What is agonist substitution in biological treatments?
-Replacing an addictive drug with a safer drug of similar chemical makeup, such as methadone or buprenorphine, often combined with psychotherapy.
Define antagonist treatments. Describe the effect. Give an example (3)
Definition: substances that block or counteract the effects of certain drugs.
Example: Naltrexone is an antagonist for opioids and alcohol.
Effect: These treatments can produce immediate withdrawal symptoms because they stop the drug’s effects suddenly, which the body has become dependent on.
What is aversive treatment, and what are its challenges? (2)
-Using drugs like Antabuse to make substance use unpleasant.
-Noncompliance is a significant challenge.
What biological treatments address withdrawal symptoms?
-Sedatives to reduce alcohol withdrawal discomfort, and clonidine for opioid withdrawal
y
y
What is the philosophy of Alcoholics Anonymous (AA)?
-A 12-step program focusing on abstinence, independence from medical establishments, and mutual support, effective for motivated individuals.
What is controlled use in psychosocial treatments?
-Allowing regulated substance use as an alternative to abstinence. It is not a cure and is less effective long-term.
What techniques are included in component treatments, which are strategies used in therapy to address specific client needs or behaviors? (4)
-Covert sensitization
-contingency management
-community reinforcement approaches
-tailoring treatments to client needs.
What is the goal of relapse prevention in substance use treatment?
-Addressing cognitive and behavioral coping skills, removing ambivalence about stopping use, and challenging beliefs about drug benefits.
What is harm reduction in substance use treatment?
-Strategies like controlled drinking, safe injection sites (SISs), and prevention through education
What is the lifetime prevalence of gambling disorder in the U.S.?
-Approximately 2% of Americans.
What are some serious consequences of gambling disorder?
-Job loss, bankruptcy, and arrests.
How is gambling disorder similar to substance use disorders?
- It involves tolerance, withdrawal, and urges similar to those seen in substance-related disorders.
What are common characteristics of individuals with gambling disorder?
-Denial, impulsivity, and continual optimism.
What is Internet gambling disorder?
- A subtype of gambling disorder related to excessive gambling via online platforms.
What is intermittent explosive disorder?
-A condition involving aggressive impulses that result in serious assaults or destruction of property.
What is the lifetime prevalence of intermittent explosive disorder?
-7%
What is kleptomania?
-A recurrent failure to resist urges to steal things, often leading to stigma and legal consequences.
What is pyromania?
-An irresistible urge to set fires.
What is a common treatment approach for impulse control disorders?
-Cognitive-behavioral therapy (CBT).
