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PSYCH 239 > Chapter 7: Substance Related and Addictive Disorder > Flashcards

Chapter 7: Substance Related and Addictive Disorder Flashcards

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1
Q

Substance Use Disorders

A

patterns of maladaptive behavior involving the use of a psychoactive substance

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2
Q

Substance-Induced Disorders

A

disorders induced by the use of psychoactive substances, including intoxication, withdrawal symptoms, mood disorders, delirium, and amnesia

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3
Q

Psychoactive

A

describing chemical substances or drugs that have psychological effects

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4
Q

Intoxication

A

substance-induced disorder characterized by clinically significant problematic behavioral or psychological changes caused by the recent ingestion of a substance (state of drunkenness or “being high”)

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5
Q

Withdrawal Syndrome

A

characteristic cluster of withdrawal symptoms following the sudden reduction or abrupt cessation of use of a psychoactive substance after psychological dependence has developed

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6
Q

Tachycardia

A

abnormally rapid heartbeat

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7
Q

Delirium Tremens (DT)

A

withdrawal symptom that often occurs following a sudden decrease or cessation of drinking in chronic alcoholics that is characterized by extreme restlessness, sweating, dissociation, and hallucinations

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8
Q

Delirium

A

(1) a state of mental confusion, disorientation, and extreme difficulty in focusing attention

(2) a syndrome occurring among the elderly that typically involves confusion, problems with concentration, and cognitive dysfunction

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9
Q

Disorientation

A

state of mental confusion or lack of awareness with respect to time, place, or the identity of oneself or others

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10
Q

Addicition

A

impaired control over the use of a chemical substance accompanied by physiological dependence

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11
Q

Physiological Dependence

A

state of physical dependence on a drug in which the user’s body comes to depend on a steady supply

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12
Q

Psychological Dependence

A

reliance, as on a substance, although one may not be physiologically dependent

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13
Q

Depressant

A

drug that lowers the level of activity of the central nervous system

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14
Q

Korsakoff’s Syndrome

A

form of brain damage associated with chronic thiamine deficiency

the syndrome is associated with chronic alcoholism and characterized by memory loss, disorientation, and the tendency to invent memories to replace lost ones (confabulation)

also called alcohol-induced persisting amnestic disorder

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15
Q

Barbiturates

A

types of depressant drugs that are sometimes used to relieve anxiety or induce sleep but that are highly addictive

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16
Q

Sedatives

A

types of depressant drugs that reduce states of tension and restlessness and induce sleep

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17
Q

Opiates

A

types of depressant drugs with strong addictive properties that are derived from the opium poppy

provide feelings of euphoria and relief from pain

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18
Q

Narcotics

A

drugs, such as opiates, that are used for pain relief and treatment of insomnia, but have strong addictive potential

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19
Q

Analgesia

A

state of relief from pain without loss of consciousness

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20
Q

Endorphins

A

natural substances that function as neurotransmitters in the brain and are similar in their effects to morphine

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21
Q

Amphetamines

A

types of synthetic stimulants such as Dexedrine and Benzedrine

abuse can trigger an amphetamine psychosis that mimics acute episodes of schizophrenia

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22
Q

Amphetamine Psychosis

A

psychotic state induced by ingestion of amphetamines

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23
Q

Cocaine

A

stimulant derived from coca leaves

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24
Q

Crack

A

hardened, smokable form of cocaine

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25
Q

Freebasing

A

method of ingesting cocaine by means of heating the drug with ether to separate its most potent component (“free base”) and then smoking the extract

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26
Q

Hallucinogens

A

substances that give rise to sensory distortions or hallucinations

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27
Q

Psychedelics

A

class of drugs that induce sensory distortions or hallucinations

also called hallucinogens

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28
Q

Lysergic Acid Diethylamide (LSD)

A

a powerful hallucinogenic drug

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29
Q

Flashbacks

A

(1) vivid re-experiencing of a past event, which may be difficult to distinguish from current reality

(2) experiences of sensory distortions or hallucinations occurring days or weeks after use of LSD or another hallucinogenic drug that mimic the drugs effects

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30
Q

Marijuana

A

a mild or minor hallucinogen derived from the Cannabis sativa plant

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31
Q

Delta-9-tetrahydrocannabinoid (THC)

A

major active ingredient in marijuana

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32
Q

Hashish

A

drug derived from the resin of the marijuana plant, Cannabis sativa

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33
Q

Inhalents

A

substances that produce chemical vapors that are inhaled for their psychoactive effect

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34
Q

Detoxification

A

process of ridding the system of alcohol or drugs under supervised conditions in which withdrawal symptoms can be monitored and controlled

35
Q

Methadone

A

artificial narcotic that lacks the rush associated with heroin and is used to help people addicted to heroin abstain without incurring and abstinence disorder

36
Q

Naloxone

A

drug that prevents users from becoming high if they subsequently take heroin

some people are placed on naloxone after being withdrawn from heroin to prevent return to heroin

37
Q

Naltrexone

A

chemical cousin of naloxone that blocks the high from alcohol as well as opiates and is now approved for the use in treating alcoholism

38
Q

Al-Anon

A

organization sponsoring support groups of family members of people with alcoholism

39
Q

Cue-Exposure Training

A

treatment used for people with substance-related disorders

it involves exposure to cues associated with ingestion of drugs or alcoholic beverages in a controlled situation in which the person is prevented from using the drug

40
Q

Relapse

A

recurrence of a problem behavior or disorder

41
Q

Relapse-Prevention Training

A

cognitive-behavioral technique used in the treatment of addictive behaviors that involves the use of behavioral and cognitive strategies to resist temptations and prevent lapses from becoming relapses

42
Q

Abstinence-Violation Effect (AVE)

A

tendency in people trying to maintain abstinence from a substance, such as alcohol or cigarettes, to overreact to a lapse with feelings of guilt and a sense of resignation that may then trigger a full-blown relapse

43
Q

Controlled Social Drinking

A

controversial approach to treating problem drinkers in which the goal of treatment is the maintenance of controlled social drinking in moderate amounts, rather than total abstinence

44
Q

What are substance use disorders?

A

patterns of maladaptive behavior involving the use of a psychoactive substances

substance-use disorders include substance-abuse disorders and substance dependence disorders

deals with the use itself

45
Q

What are substance-induced disorders?

A

disorders induced by the use of psychoactive substances, including intoxication, withdrawal syndromes, mood disorders, delirium, and amnesia

46
Q

What is gambling disorder?

A

problem gambling behavior was considered an impulse control disorder in former editions of the DSM

in DSM-5, gambling disorder is classified with other substance use disorders

gambling disorder has commonalities in expression, causes, comorbidity, and treatment with substance use disorders

the broader category, though not formally mentioned in DSM is process addictions, partial exception is Internet Gambling Disorder

legal problems: person being sued by credit card, “the reason I couldn’t pay is a diagnostic disease”, can be used as legal arguments

47
Q

What are the hallmarks of disordered substance use?

A

tachycardia

delirium tremens (shaking, sweating, hypertension, hallucinations, give benzos as treatment)

delirium (alcohol poisoning)

disorientation

physiological dependence (addiction): tolerance, withdrawal

psychological dependence

“wet-brain”: intoxicated even though no recent alcohol consumption

48
Q

What are the characteristics of substance use disorder (specifically alcohol) that are outlined in the DSM-5?

A

alcohol is often taken in larger amounts than intended

unsuccessful efforts to cut down or control use

a great deal of time is spent on activities related to alcohol

cravings

failure to fulfill major role obligations

persistent or recurrent social or interpersonal problems

activities are given up or reduced

physically hazardous

use is continued despite knowledge that it is harmful

tolerance

withdrawal

49
Q

What is tolerance?

A

a need for markedly increased amounts of alcohol to achieve intoxication or desired effect

a markedly diminished effect with continued use of the same amount of alcohol

50
Q

What is withdrawal?

A

the characteristic withdrawal syndrome for alcohol

alcohol (or a closely related substance, such as benzodiazepine) is taken to relieve or avoid withdrawal symptoms

51
Q

What are the specifiers of substance use disorder?

A

mild: presence of 2-3 symptoms
moderate: presence of 4-5 symptoms
severe: presence of 6 or more symptoms

in early remission (3 to 12 months)
in a sustained remission (12 months or longer)
in a controlled environment (if they were in rehab we don’t know that they will keep sober in the real world)

52
Q

What are the top three commonly used drugs in North America?

A

tobacco (about 25% of population)

alcohol (about 15% of population)

marijuana (about 5% of population)

53
Q

What are the pathways to drug dependence?

A

experimentation: most often in a social context, no loss of control

routine use: alterations to lifestyle and personal values, borrowing, pawning, theft, lying, and manipulation, may still believe they have control

addiction or dependence: efforts center on avoiding withdrawal symptoms, life is centered on getting the drug

54
Q

What are depessants?

A

“depress” CNS activity

alcohol

barbiturates

opiates

55
Q

What are stimulants?

A

heighten CNS activity

amphetamines

cocaine

nicotine

56
Q

What are hallucinogens?

A

distort sensory perceptions (e.g. synesthesia, colors, sounds, textures)

LSD

Phencyclidine (PCP)

marijuana

57
Q

What are inhalants?

A

GABA effects

inhibitory, relaxation

58
Q

What are the risk factors of alcoholism?

A

gender: rates about equal, but women start later and progress faster

age (starting before 40)

antisocial personality disorder

family history: both heritable and modeling effects

sociodemographic factors: lower SES and education, aboriginal > non-aboriginal, the damaging effects of alcohol abuse vary across ethnic groups in Canada, likely because of different cultural constraints and biological tolerance of alcohol

59
Q

What is alcohol-induced persisting amnestic disorder (Korsakoff’s syndrome)?

A

“wet-brain”

confusion, disorientation, recent memory loss

malnutrition (inflammation of digestive tract)

FASD (fetal alcohol spectrum disorder)

60
Q

Is there a health benefit to moderate drinking?

A

increases HDL

decreases clotting risk

</= 14 per week for men

</= 9 per week for women

now they are saying no more than 2/day either gender

61
Q

What kinds of deaths are related to alcohol use?

A

snowmobile accidents: about 77% of cases

homicides: over 50% of cases

traffic accidents: over 40% of cases

boating accidents: about 40% of cases

suicides: over 20% of cases

62
Q

What are barbiturates?

A

sedatives

mostly among middle ages adults

synergistic effect with alcohol (4x, two shots = eight shots)

requires medically supervised withdrawal, lethal withdrawal effects, high probability of relapse

63
Q

What are opiates?

A

intense rush

narcotics

analgesics

endorphins

64
Q

What are stimulants?

A

cocaine

amphetamines

65
Q

What is cocaine?

A

snorted or injected

often consumed in binges

crack: for smoking, fast, concentrated rush

freebasing: heated with ether

66
Q

What are the effects of cocaine?

A

birth defects: child will be addicted and have withdrawals

auditory information processing

sexual dysfunction (mostly males)

increased body temperature, respiratory distress, appetite suppression

67
Q

What are the mechanisms of overdose?

A

effective vs toxic doses (primarily physiological)

compensatory conditioning (primarily psychological)

68
Q

How do effective and toxic doses cause overdoses?

A

tolerance to intoxicating effects to a drug and the lethal dose

tolerance builds more quickly

over time, the amount of drug necessary to produce the high gets closer and closer to the lethal dose level

neuroadaption: brain changes that take place over time to compensate for presence of foreign chemicals, don’t react the same to the same dose

more you use, less likely to get high, but the lethal dose remains the same

69
Q

How does compensatory conditioning cause overdoses?

A

over the course of conditioning, a CS may elicit physiological CRs that oppose the US (compensatory CRs)

these CSs may include contextual cues present during conditioning

e.g. cytochrome P450, the body wants to speed up metabolism to get rid of toxic materials

this contributed to withdrawal symptoms as well as tolerance, the body will produce enzymes in the area of regular drug use

compensatory conditioning: organism will compensate for something coming their way

70
Q

How did the Siegel et al. (1982) study suggest that a failure to elicit such responses might play a part in drug overdose?

A

Phase 1 (conditioning trails): two groups of rats were heroin addicted over 30 days, conditions: same room, different rooms, same and different room groups got heroin every second day, and a saline infusion on odd days, saline and heroin were given in different rooms

Phase 2 (test day): same room group got a double dose of heroin in the room were heroin was usually delivered, different where they usually got saline, control group: never had heroin before but got a double dose

same room: 32% mortality
different room: 64% mortality
controls: 100% mortality

71
Q

What are factors that play a role in cigarette smoking in Canada?

A

the prevalence of smoking among adults is higher among Aboriginal than non-Aboriginal people, regardless of whether they live in rural or urban environments

smoking is becoming increasingly concentrated among the poorer and less well-educated segments of the population

72
Q

What are hallucinogens?

A

phencyclidine (PCP): angel dust, can become dangerous

marijuana: delta-9-terahydrocannabinol (THC), hashish, is more powerful in modern times because of selective breeding

inhalants: DA and GABA effects, sense of relaxation, solvents, gasoline, glue

73
Q

What are the biological perspectives on substance use disorder?

A

neurotransmitters: dopamine, brain’s reward centers (mesolimbic pathway, nucleus), pleasure associated with the surroundings and behaviors that took place

genetic factors: addictions tend to run in families, addictive personality types

alcohol dehydrogenase: ability to metabolize alcohol, flushing, nausea, intoxication at lower doses

74
Q

What are the learning perspectives on substance use disorder?

A

operant conditioning: alcohol and tension reduction, negative reinforcement and withdrawal, drinking alcohol takes away withdrawal symptoms which leads to negative reinforcement

the conditioning model of cravings, cues for substance use

observational learning: children pretend to drink after observing parents drink

75
Q

What are the cognitive perspectives on substance use disorder?

A

outcome experiences, decision making and substance

self-efficacy expectancies

does one slip cause people with substance abuse or dependence to go on binges

abstinence violation effect: attribution to stable internal factors

what you believe is what you get: amount consumed is influenced by expectation of alcohol, actual alcohol content didn’t matter

76
Q

What are the psychodynamic perspectives on substance use disorder?

A

oral fixation

77
Q

What are the sociocultural perspectives on substance use disorder?

A

both cultural and subcultural (e.g. religion)

some religions ban alcohol

North American cultures glamorize alcohol

78
Q

What are the states of change associated with recovery from substance abuse?

A
  1. pre-contemplation: no intention in changing behavior, don’t understand there is a problem
  2. contemplation: aware a problem exists but with no commitment to action
  3. preparation: intent on taking action to address the problem, know they need help, gather info on what to do
  4. action: active modification of behavior, therapy, meeting
  5. maintenance: sustained change, new behavior replaces old
  6. relapse: fall back into old patterns of behavior, not all or nothing
79
Q

What are the biological approaches to the treatment of substance use disorder?

A

detoxification: medically supervised, need to be sober before other treatment can occur

disulfiram (Antabuse): take this, if they drink alcohol they get violently sick, get around the treatment by not taking the pills

antidepressants: SSRIs reduce impulsivity

nicotine replacement therapy: gum, inhalable, patches

methadone maintenance programs: safer, lesser of two evils

naloxone and naltrexone: block the high from opiates, poor long-term compliance

80
Q

What are some general treatment approaches for substance use disorder?

A

nonprofessional support groups: Al-Anon, accountability, sometimes get a sponsor

residential approaches: lack generalization

psychodynamic approaches: don’t do anything

81
Q

What are some behavioral approaches for the treatment of substance use disorder?

A

self-control strategies: control-breaking, learn to drink small amounts

aversive conditioning: don’t go to places associated with use

social skills training: electric shocks, noxious odor therapy, aversive conditioning, punishment, resisting peer pressure

82
Q

What is relapse-prevention training?

A

involves dissecting behavior patterns and coming up with coping strategies (avoidance or escape strategies)

pattern/high risk factor recognition

predictability: build behavior chains into our life

weekly “bring-backs”

SUDs: seemingly unimportant decisions

abstinence violation effect

83
Q

Is controlled drinking a viable treatment option?

A

can people with alcoholism be taught to engage in controlled social drinking?

original research done in the 70’s: not encouraging, improper control procedures were used

the contention that people with alcoholism can learn to drink moderately remains controversial, self-fulfilling prophecies

controlled drinking programs may represent one pathway to abstinence for people who would not otherwise enter abstinence-only treatment programs

84
Q

What is the harm reduction model of treatment?

A

accept that there will be people who use, need to help reduce harmful effects to others

whereas most interventions aim to reduce or eliminate substance use entirely, the Harm Reduction approach attempts to mitigate the harmful consequences

needle exchange programs

methadone programs

designated drivers

restrict use to weekends or other non-workdays

PSYCH 239 (12 decks)

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