Chapter 5: Substance Use and Addictive Disorders Flashcards
Substance Abuse?
how many symptoms needed?
- failure to fulfill major obligations at one’s job, at school or to one’s family, recurrent problems with the legal issues, and persistent social or personal problems..
- any one of these= diagnoses
What is Substance Dependence?
symptoms?
duration before diagnoses?
how many symptoms needed?
- increased doses of the drug, withdrawal symptoms, unsuccessful attempts to cut down on drug use and continued use in spite of the drug’s harmful effects.
- 12 months
- 3+
What has DSM-5 switched out Substance Dependence and abuse for?
- 2 to 3 symptoms?Diagnoses?
- four or more ?
-Substance Use Disorder
L> moderate or severe.
-moderate
-severe
The varying definitions of addiction have the following four elements in common:
- addicted person has impaired control over the use of the drug(crucial question is can they stop?)
- the drug use has harmful consequences
- tolerance has developed
- Withdrawal occurs upon cessation of drug use.
Craving refers to what?
subjective term meaning a strong desire to use the drug…
The criterion for addiction?
- loss of control
- harm
- craving
- tolerance
- withdrawal symptoms
Addiction is often considered a _______ disorder with a high probability of _____.Which varies from person to person in intensity.
- chronic, relapse.
When an addiction has been “beaten” or they have been free of the addictive symptoms for a prolonged period of time that individual is considered to have been in what?
remission
Sustained remission means?
early or late remission
By 1870 addiction to alcohol was labeled as a ______ rather than a sin, it came to be considered a _________ via humanitarian proposal.
- disease
- medical issue
What association called addiction to alcohol Inebriety disease in 1870?
American Association for the Cure of Inebriates.
The disease model after being established by the antiopium and temperance social movements faded away and was re-established during the 1950s by who?
Jellinek
Two major approaches based on the disease model came to be. What were they?
- Predisposition Theories
2. Exposure theories
Predisposition theories?
- people are born with the disease or acquire it at some time before they begin abusing the drug.
- jellinek believed there to be no cure for alcoholism
- one drink=one drunk
- genetic variations/damage, exposure to certain enviro conditions in childhood or later in life…
Exposure Theories?
- oops phenomenon
- developed by?
addiction is caused by exposure to the drug alone
- harmful outcome is in no way intentional
- virtually inevitable that prolonged drug use will lead to addiction.
- Alan Leshner
Why is disorder better than disease when referring to a term for substance addiction.
- Disorder can include both diseases and injuries
- something is wrong without it being a pathogen or genetic malfunction. (brain functioning? )
The disease concept became popular for particular reasons in the USA which was??
Insurance would pay for treatment
In the twentieth century research was geared at the use/stop of opium/morphine. Autotoxin meant what?
-a metabolite of opium that stayed in the body after the drug was gone. This had effects opposite to the drug and when left in the body caused sickness.
Autotoxin was disproved and later coined ?
-withdrawal or abstinence syndrome
Physical dependence became to be widely recognized because of?
the ability of a drug to cause dependence and consequently withdrawal.
Dependence model (physical dependence ) two components ? addicts crave the drug because...
-avoidance of withdrawal
2. compulsive self administration
it will prevent withdrawal….media version of addiction**
In the DSM-5 the word dependence is restricted to mean?
- a condition in which withdrawal syndrome occurs, in part b/c withdrawal can occur with/out compulsive use.
aka only to refer to physical dependence not addiction! due to people in the medical world prescribing drugs that make people physically dependent on meds because their body needs them…not addicted though.
Tatum and Seevers suggested what in the discovery that ppl could be addicted to substances that did not cause severe physiological withdrawal?
-psychic addiction/ psychological dependence
Originally it was thought that only humans exhibited addictive behaviour because? (5)
aka Conditioned Taste aversion ?
- animals generally avoid taking drugs orally due to bitterness
- animals formed
a conditioned taste aversion to the drug - there is a delay between the taking of an oral drug and its positive effects.
- tech required for IV self administration by animals had not been developed yet.
- Scientists believed that animals could not make the connection btwn drug injection and relief from withdrawal.
Mello and Mendelson in the 1970’s studied human volunteers with a history of drug abuse in the lab. Subjects were required to do some work to obtain a dose of a drug via
operant tasks
Lab observation of drug abusers is better than observing them in their natural environment because of?
3
- can measure diff drug doses and types and compare their effects to that of placebo
- manipulate administration and work required.
- check effects of other drugs administered at the same time and carefully measure the changes in behaviour that might be via test drug
There is what kind of a dilemma with lab work?
ethical
cannot give drugs that could give addictions to people that other wise would not have one !
In non lab experiments subjects are given a drug one day and a placebo the next. Then given the choice between them. This choice of drug indicates what?
-if they choose the drug it is a reinforcer