CP: Lecture 9 Substance Use Disorders Flashcards
what is too much? medical approach
women > 7 units,
men > 14 units
+ physical consequences
sociological approach
problems or personal consequences
psychiatric approach
substance use disorder
typical addiction symptoms
loss of control
pre-occupation
craving
tolerance
withdrawal
in welke 3 domeinen kunnen deze symptomen opkomen
behaviour
cognition
physical
(ze kunnen allemaal in alle 3 de domeinen komen!)
dsm 5 substance abuse disorder
at least 2, during 12 months:
- 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 down or control use of the substance.
- A great deal of time is spent in activities necessary to obtain the substance, use the substance, or recover from its effects.
- Craving, or a strong desire or urge to use the substance.
- Recurrent use of the substance resulting in a failure to fulfill major role obligations at work, school, or home.
- Continued use of the substance despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of its use.
- Important social, occupational, or recreational activities are given up or reduced because of use of the substance.
- Recurrent use of the substance in situations in which it is physically hazardous.
- Use of the substance is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance.
- Tolerance, as defined by either of the following:
a. A need for markedly increased amounts of the substance to achieve intoxication or desired effect.
b. A markedly diminished effect with continued use of the same amount of the substance. - Withdrawal, as manifested by either of the following:
a. The characteristic withdrawal syndrome for other (or unknown) substance (refer to Criteria A and B of the criteria sets for other [or unknown] substance withdrawal).
dus dsm 5 kort SUD
at least 2, during 12 months:
larger amounts or longer period of time than intended
persistent desire or unsucessful effort to quit
spent a lot of time in activities related to
craving
problems at work/school/home
continued use even after social/interpersonal problems
social/work/recreational activities are reduced due to substance
recurrent use in situations where it is not safe
use is continued even though there is a physical/psychological problem
tolerance: more needed or less effect of dosis
withdrawal: withdrawal syndrome or substance is taken to relief symptoms of withdrawal
dsm 5 gradaties van sud
2-3 symptoms: mild sud
4-5 symptoms: moderate sud
6+ symptoms: severe sud
12 month prevalence of alcohol addiction in usa vs china
usa = 7,7
china = 2,3
nl was heel laag, onder de 1
waardoor differences across countries in alcohol gebruik?
cultural differences: rituals, popularity, early vs late onset, definition of problems/function/distress
genetic differences: tolerance, dopamine reward
sad often comorbidity with…
anxiety and depression
voorbeeld ritual
carnaval
the earlier ppl drink…
the later on they will kep on drinking. dus earlier is meer in later life (maar niet altijd! denk aan usa vs nl)
vrouwen alcohol leeftijd in nl
hoe ouder, hoe meer drinken
door pensioen? meer geld? meer tijd?
history’s models of addiction
1850: moral
1920: pharmacological
1940: symptomatic
1950: illness
1975: learning (behaviouristic)
Late 70’s: social
1980: biopsychosocial
1990: brain disease
