Drug abuse and dependence

Question 1

What impact does addiction have on the EU and the UK?

Answer 1

• Billions of euros spent in a year to treat it because it has affects on multiple aspects of life
• 14.4% of the UK population use nicotine
• Smoking costs the gov £14 billion

Question 2

What is drug addiction and what is it characterised by?

Answer 2

A chronic relapsing disorder characterised by:

1. Compulsion to seek and take the drug
2. Loss of control in limiting intake
3. Emergence of a negative emotional state (dysphoria, anxiety, irritability)

Question 3

What is a way of diagnosing drug addiction?

Answer 3

A maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by two (or more) of the DSM-5 criteria with a 12-month period

Question 4

What are some of the DSM-5 diagnostic criteria?

Answer 4

• Craving
• Tolerance effects
• Taking in larger amounts than intended
• Withdrawal reactions

Question 5

What are the vulnerability factors involved in developing drug addiction?

Answer 5

• Stress – also a factor for relapse
• Genetic – very big factor
• Environment
• Drug induced effects – drugs cause certain changes in the brain

These factors interact with each other as well

Question 6

What is a comorbidity of drug addiction?

Answer 6

Mental Health disorders

• Prevalence in drug/alcohol services: 60-80%
• Emotional disorders key predictor of alcohol use
• Social anxiety disorders are severe in 60% of drug abusers seeking help
• 40% co morbidity between opioid addiction and anxiety, depression

Question 7

What are the stages in an addiction cycle?

Answer 7

• Rewarding effects/positive reinforcing effects - causes repeated drug intake
• Tolerance: causes an increase in the amount of drug taken – because they want to experience the same effects as they did consuming it for the first time
• Dependence: someone who experiences physical and emotional withdrawals (cravings) when not taking the drug
• Emotional withdrawal symptoms are much more long-lasting – usually people relapse because of the withdrawal system (negative reinforcement)

Question 8

What is the biggest hurdle in addiction treatment?

Answer 8

Maintenance of drug-free state as 70% of patients relapse

Question 9

What is tolerance?

Answer 9

when a person’s reaction to a drug decrease such that larger doses are needed to achieve the same effect

Question 10

What is dependence?

Answer 10

an adaptive state that develops from repeated drug administration, and which results in the emergence of physical and emotional withdrawal symptoms upon cessation of drug use.

Question 11

What are the different types of withdrawal symptoms?

Answer 11

• Physical, characterised by abstinence syndrome (LC): Sweating, gooseflesh (cold turkey), irritability, aggression
• Psychological, craving to avoid withdrawal effects

Question 12

What may a person experience during positive reinforcement?

Answer 12

Impulse control disorders:

1. tension/arousal
2. impulsive acts
3. pleasure/relief/gratification
4. retreat/guilt/self-reproach

then it starts all over again

Question 13

What may a person experience during negative reinforcement?

Answer 13

Compulsive disorders:

1. anxiety/stress
2. repetitive behaviour
3. relief of anxiety/relief of stress
4. obsessions

then it all starts over again