drug use and addiction Flashcards
pathological pursuit of pleasure or relief by substance use and other behaviors
addiction
addiction involves disruption of brains system related to
reward, motivation and memory
addictive behaviors are any activities or uses of substances that are
pursued compulsively for physical or psychological reward, despite unwanted consequences
experts agree that addiction is more fully defined by
behavioral characteristics and changes in the brain may underline addiction
body adapts to a drug so that the initial dosage no longer produces the original emotional or psychological effects
tolerance
behavioral addiction examples
gambling, gaming, eating, compulsive exercise, work addiction, sex and pornography, shopping, internet
when the activity becomes _______ its an indication of a problem
the focus of life at the expense of other needs
addiction most associated with
psychoactive drugs
psychoactive drugs
those that alter a person’s perception, mood, behavior, consciousness
in short term, psychoactive drugs can cause
intoxication
substance misuse
use of a substance that is not consistent with medical or legal guidelines
substance use disorder has a cluster of symptoms involving
cognitive, bodily, social impairment related to the continued use of a substance
the DSM-5 has 11 criteria for diagnosis of an addiction:
____= mild
___=moderate
____=severe
2-3
4-5
6+
addiction often starts when
a person does something to bring pleasure or avoid pain
increased dependence
reinforcement
increased usage
tolerancep
pleasure gone, use to avoid withdrawal
withdrawal
Diverse factors must come together to SUD to develop
personality, lifestyle, heredity, the social and physical environment, and the nature of the substance or behavior in question
allure of drugs: initial use
availability and peer influence
reasons for using drugs
To alter one’s mood
To feel a euphoric high
In pursuit of a spiritual experience
To escape boredom, anxiety, depression, feelings of worthlessness, other distressing symptoms
Cope with difficulties of life
factors associated with drug experimentation
males
troubled childhood
thrill-seeker
dysfunctional family
trouble at school
poverty
adolescents engaged in risky sexual behavior
characteristics associate with not using drugs
o Perceiving drug use as risky, and disapproving of it
o Positive self-esteem and self-concept
o Assertive, independent thinkers able to resist peer pressure
o Self-control
o Social competence
o Optimism
o Academic achievement
o Religiosity
o Open communication with parents
how drugs affect brain chemistry:fast acting drugs increase
dependency
how drugs affect brain chemistry: impacts ___ action
neurotransmitter
how drugs affect physical factors
body mass, health, genetics
how drugs affect psychological factors
response affected by user expectations
how drugs affect social factors
trusted environment
friends vs strangers
treatment for addiction should assess
other mental disorders as well as infectious disease
medication-assisted treatment
methadone
harm reduction strategies
syringe exchange programs
safe injection facilities
provision of easy to use forms of naloxone
free testing of street drugs
naloxone
drug that rapidly reverses opioid OD
any chemical other than food intended to affect the structure or function of the body
drug
a drug that can alter a persons consciousness or experience
psychoactive drug
the state of being mentally affected by a chemical
intoxication
chronic disease that disrupts the brains system of motivation and reward, characterized by a compulsive desire and increasing need for a substance or behavior and by harm to the individual ans/or society
addiction
compulsive behavior that is both rewarding and reinforcing and is often pursued to the marginalization or exclusion of other activities and responsibilities
addictive behavior
lower sensitivity to a drug or substance so that a given dose no longer exerts the usual effect and larger doses are needed
tolerance
the subjectively pleasing effects of a drug, usually feel quite soon after drug is taken
high
the use of any substance in a manner inconsistent with legal or medical guidelines
substance misuse or abuse
cluster of symptom involving cognitive, bodily, and social impairment related to the continued use of a substance; a single disorder measured on a continuum from mild to severe
substance use disorder
physical and psychological symptoms that follow the interrupted use of a drug on which a user is physically dependent; symptoms may be mild or life-threatening
withdrawal
frequent or consistent use of a drug or behavior that makes it difficult for the person to get along without it
dependence
the result of physiological and/or psychological adaptation that occurs in response to the substance or behavior
dependence
opioids
natural or synthetic drugs that relieve pain, cause drowsiness, and induce euphoria
intoxicating ingredient in fermented or distilled beverages
alcohol
beer ABV
3-6%
ales and malt liquor ABV
6-8%
wine ABV
9-14%
fortified wine ABV
20%
hard liquor ABV
35-50%
proof value
two times the percentage concentration
a 100-proof beverage contains ___% ABV
50
one drink refers to the amount of a beverage that typically contains
.6 oz of alcohol
calculare pure oz of alcohol in serving
12 oz beer 10 proof
10 proof= 5%
.05x12=.6 oz
calories in alcohol
7cal/g
standard drink is about ___g of ethanol
14
alcohol in one “standard drink” supplies ___ calorie
100-120
“light” in beer refers to
calories
rate of alcohol absorption is affected by
Food in the stomach slows the absorption
Carbonation and artificial sweeteners increase the rate
High alcohol concentration slow absorption
Biological sex, race, and ethnicity also affect the rate of absorption
where alcohol absorption takes place
small amount in oral mucosa
20% in stomach
75% in small intestine
remainder enters bloodstream
alcohol transported by the
circulatory system
main site for alcohol metabolism
liver
2-10% alcohol excreted by
lungs, kidneys, sweat glands
rate of metabolism varies among individuals
Genetic factors (ALDH)
Drinking behavior
Not affected by exercise, breathing deeply, eating, drinking coffee, taking other drugs, sleep
alcohol enters the brain and affects
neurotransmitters
with heavy alcohol use, loss of
brain function and changes in brain structure
BAC
ratio of alcohol in the blood by weight
BAC affected by
body weight, percentage of body fat, sex
in general, body can rid alcohol at a rate of
.1 oz/hr/50 lb
calculate how long it takes to rid alcohol
12 oz beer, 10-proof, drinker is 150 lb
2.5x10x12/150
2 hours
formula for rid alcohol rate
2.5 x proof x volume in oz / body weight
immediate affect of alcohol depend on
person, circumstances, and amount of alcohol consumed
primary factor for alcohol immediate effect
amount in blood
.02-.05% effects
reduced sensory and motor functioning; many people become sleepy, vision, smell, taste, hearing becomes less acute. depression of the CNS, muscles, and other body systems occurs
concentrations of .35% and higher
coma, fatality
alcohol hangover
headache, shakiness, nausea, diarrhea, fatigue, impaired mental functioning
large amounts of alcohol in short time can rapidly raise the BAC into the lethal range
alcohol poisoning
using alcohol with other drugs
alcohol-drug combinations are a leading cause of drug-related deaths
alcohol related injuries and violence
alcohol use is linked to homicide, suicide, automobile crashes, other traumatic incidents
alcohol and aggression
many arrests happen for drug and alcohol related offenses
over ___% of all murders, assaults, and rapes are related to alcohol
40
alcohol and sexual decision making
unplanned and unprotected sex becomes more likely
pattern of rapid, periodic drinking that brings a persons BAC up to .08% or higher
binge drinking
binge drinking: within two hours
5 for men, 4 for women
binge drinking associated with increased rates of ___, risk for ___
STD, rape, SA
how many people killed in alcohol related accidents in 2019
10,142
higher doses of alcohol are associated with a much greater probability of a crash and serious legal consequences
dose-response function
long term effects of alcohol misuse: digestive system
functioning of the liver altered
fatty liver
cirrhosis
pancreatitis
fatty liver
alcohol-associated hepatitis, cirrhosis
cirrhosis
disease in which the liver is severely damaged by alcohol other toxins, or infections
long term effects of alcohol misuse: cardiovascular system
higher doses elevate BP
may weaken the heart muscle
holiday heart
holiday heart
abnormal heart rhythm within 24 hours of a binge episode
long term effects of alcohol misuse: cancer
increased risk of cancer in the mouth, throat, larynx, esophagus, breast
colorectal, liver cancer
5-6 drinks per day combined with smoking increase risk of cancer by
factor of 50 or more
___ drink per day increases risk for breast cancer
1
long term effects of alcohol misuse: brain damage and mortality
brain shrinkage, cognitive impairments
life expectancy of people with AUD
15 years less than those who do not have the disorder
alcohol use during pregnancy
crosses the placenta, harms fetus
early in pregnancy, heavy drinking can cause
spontaneous abortion or miscarriage
FAS
lifelong disability for unborn child
alcohol-related neurodevelopment disorder
significant learning and behavioral disorders
the risk of HD increases starting with an average of
7 drinks per week
WHO statement on alcohol
there is no safe amount of alcohol to consume
world cancer research statement on alcohol
drinking alcohol increases the risk of cancer, and there is no threshold at which the risk decreases
meeting ___ of the DSM-5 criteria indicates AUD
2
AUD commonalities
o Alcohol often consumed in large amounts over a long period
o Unsuccessful efforts to control alcohol use
o Excessive time spent using alcohol or recovering from its effects
o Strong desire or craving to use alcohol
o Persistent alcohol use causes a failure to fulfill obligations
o Continued alcohol use despite recurrent social or interpersonal problems caused by its effects
o Important social or recreational activities reduced
o Persist in using alcohol in situations that are physically risky
o Continued use despite knowing it may worsen a recurrent physical or psychological problem
o Need for increased amounts of alcohol (increased tolerance)
o Symptoms of withdrawal
AUD warning signs
o Drinking alone or secretively
o Using deliberately and repeatedly to get through difficult situations
o Using alcohol to “self-medicate”
o Feeling uncomfortable on certain occasions when alcohol is not available
o Escalating consumption
o Consuming alcohol in risky situations
o Getting drunk regularly or more frequently than in the past
o Drinking in the morning
most binge drinkers are not
alcohol dependent
binge drinking causes more than___ of the 90,000 deaths and ____ estimated economic cost of excessive drinking in 2010
half, 3/4
severe alcohol use disorder characterized by
tolerance and withdrawal
patterns and prevalence of severe AUD
regular intake of large amounts
regular heavy drinking limited to weekends
long periods of sobriety interspersed with binges of daily heavy drinking lasting for weeks or months
heavy drinking limited to periods of stress
health effects of severe AUD
severe withdrawal
nutritional deficiencies
blackouts
social and psychological effects
alcohol severe withdrawal
seizure, confusion, hallucinations, delirium tremens
prevalence of psychiatric conditions is ___ in people with AUD
higher
precise causes of severe AUD
unknown
AUD treatment
AA
groups
moderation management
AI-Anon
lateen
employee assistant and school based programs
inpatient
pharmacotherapy
pharmacotherapy treatments for AUD
disulfriam, naltrexone, acamprosate
disulfiram
inhibits metabolic breakdown
naltrexone
reduces the craving for alcohol and decreases its pleasant effects
injectable naltrexone
single monthly shot
Acamprosate
acts on brain pathways related to alcohol craving
men or women more likely to drink, misuse, develop AUD
men
men: excessive drinking usually beings
teens, twenties
men or women account or majority of alcohol-related deaths
men
men or women tend to develop AUD at later ages
women
develop medical complications more often
women
ethnicity hs higher rates of AUD
native Americans
ethnicity use less alcohol than average for American adults
black Americans
black americans have disproportionately high levels of
alcohol-related medical problems and violence
hispanic Americans drinking pattern depend on
cultural background
rate of tobacco use vary based on
gender, age, race, ethnicity, educational level
adults with education of ____ or less are more likely to smoke cigarette
12 grade
tobacco
leaves of cultivated tobacco plants prepares for smoking, chewing, or use as snuff
primary reason for using tobacco
nicotine addiction
considered by many to be the most physically addicting the psychoactive drugs
nicotine
loss of control
users may plan their schedule around opportunities to satisfy their nicotine cravings
____combine with physiological addiction to maintain tobacco habit
social and psychological
stimuli that are not necessarily pleasurable in themselves but are associated with other stimuli that are pleasurable
secondary reinforcers
___% of adult smoker started before age 18
90
the average age for starting smokers and smokeless tobacco users is around
15
17 for ecig
most often young people start smoking because
peers are already doing it
tobacco users often rationalize the dangers
sense of invincibility also contributes
tobacco smoke is a toxic mix that
adversely affects nearly every part of the body
unfiltered cigaretts: __ particles per cubic mm
5 billion
unfiltered cigarettes have ____ times more particles than smoggy urban air
50,000
condensed particles in the cigarette produce
brown, sticky mass: cigarette tar
___ chemicals in a burned cigarette are linked to cancer
69
carcinogens either directly cause cancer or
combine with other chemicals to cause cancer
tobacco contains acutely poisonous substances
arsenic, hydrogen cyanide, nicotine
smoking and carbon monoxide
displace oxygen in RBC depleting body supply of oxygen needed for extra work
additives account for roughly ___% of a cigarette
10
additives in cigarettes
added sugars
bronchodilators and ammonia
added sugar in cigarette
mask bitter tase and enhance the additive effect
bronchodilators and ammonia in cigarettes
boost nicotine delivery
side stream smoke
un inhaled smoke from burning cigarette
toxic chemicals in vaping
formaldehyde, acreolein, acetaldehyde
beginning smoker often has symptoms of mild nicotine poisoning
dizziness, rapid pulse, cold clammy hands, nausea, vomiting, diarrhea
depending on the dosage, nicotine can ___ or __ the NS
excite, tranquilize
nicotine stimulus the
cerebral cortex, discharge of adrenaline
outer region of the brain which controls complex behavior and mental ability
cerebral cortex
long term effects of smoking: CVD
CHD
atherosclerosis
angina pectoris
myocardial infarction
stroke, aortic aneurysm, pulmonary HD
hardening of arteries
CHD
deposit of fatty substances called plaques in arterial walls
atherosclerosis
chest pain due to CHD
angina pectoris
heart attack
myocardial infarction
primary cause of lung cancer
smoking
long term effects of smoking: COPD
emphysema, chronic bronchitis
long term effects of smoking: additional health, cosmetic, economic concerns
Severe covid
Ulcers
Thinning of brain cortex
Erectile dysfunction
Reduced fertility
Dental disease
Diminished senses of taste and smell
Injuries
Cosmetic concerns
Economic costs
pack-a-day habit can exceed $____ per year
3600
women are at greater risk for smoking related
blood clots, stroke, cancer
in addition to nicotine, carcinogens and other toxic chemicals, e-cog also produce
nanoparticles which have been linked to inflammation leading to asthma, stroke, HD
smoking and pregnancy linked to
miscarriage, ectopic pregnancy, low birth weight
behavioral problems, lower intelligence test scores, memory
what can be done to combat smoking
state anti-tobacco and anti-vaping laws
FDA regulation
individual action
options for quitting tobacco
behavior change
national toll free number
smoking cessation products
opioid drug names
morphine
heroin
codeine
oxycodone
hydrocodone
fentanyl
morphine street names
M, miss Emma, white stuff
street names heroine
dope, H, junk, brown sugar
street names codeine, oxycodone, hydrocodone
oxy, killer, captain Cody, OC
fetanyl street names
goodfellas, murder 8, tango and cash
mechanism of actions opioids
binding to opioid receptors
pan relief
euphoria and reward system activation
respiratory depression
short term effects of opioids
relief of anxiety and pain
drowsiness
nausea
respiratory depression
persistent use of opioids creates dysregulation of ___ and co-occuring impairment in
dopamine transmission, frontal brain regions impacts cognition and function
opioid endocrine effects are probably dose related and can lead to
amenorrhea in women
reduced libido
erectile dysfunction
infertility
depression, fatigue
OD
according to AMA, ___% of people who take prescription pain meds develop addiction
3-19
people misusing opioids may try to switch from prescription pain killers to
heroine
opioid OD death rates have ____ in the past decade
almost tripled
CDC indicates____ in drug OD deaths
decrease
in 2022 heroin was involved in___% of opioid-related ED visits
44%
covid pandemic saw a ___ in opioid-related ED visits
rise
opioid treatment options
rehab
OUD
pharma
therapy, support group
CNS depressants drug names
benzodiazepines, barbiturates, GHB, alcohol
CNS depressant street names
xanax, blues, sleepers
benzodiazepines affect neurotransmitter
GABA
GABA is main ___ neurotransmitter
inhibitory
the inhibition of neuronal activity results in
calming effects, reducing anxiety, promoting sleep, produce muscle relaxation
barbiturates enhance effects of
GABA
barbiturates bind to GABA-A receptor and increase
duration og chloride channel opening, leading to more prolongs inhibitory effect
GHB acts on ___ receptor a
GABA-B
when GHB binds to these receptors it
enhances effects of GABA and produces CNS depressions
alcohol enhances GABA activity by
increasing opening frequency of GABA-A channels
inhibits glutamine
short term effects of benzodiazepines
Relaxation, drowsiness, impaired coordination, memory impairment, and reduced anxiety
short term effects of barbiturates
Sedation, euphoria, respiratory depression, and altered perception
short term effects of GHB
Euphoria, sedation, dizziness, and muscle relaxation
short term effects of alcohol
lowered inhibitions, slurred speech, impaired judgment, and motor skills.
long term effects benzodiazepines
Tolerance, dependence, cognitive impairment, memory issues, and potential for overdose
long term effects barbiturates
Tolerance, dependence, liver damage, respiratory issues, and overdose risk.
long term effects GHB
Memory loss, dependence, withdrawal symptoms, and potential for overdose.
long term effects alcohol
Liver damage, neurological damage, heart problems, cognitive decline, and gastrointestinal issues
potential for abuse/addiction: benzodiazepines
high potential for abuse and dependence. tolerance builds quickly leading to increased doses
potential for abuse/addiction: barbiturates
high potential for abuse, addiction, and fatal OD due to respiratory depression
potential for abuse/addiction: GHB
high abuse potential and can lead to dependence and dangerous withdrawal
potential for abuse/addiction: alcohol
extremely high potential for abuse and addiction, leading to AUD
estimated ED visits and death: benzodiazepines
thousands annually
estimated ED visits and death: barbiturates
less common now
estimated ED visits and death: GHB
ER visits and OD, death uncommon
estimated ED visits and death: alcohol
tens of thousands
treatment options for CNS depressants
CBT, support group, detox, therapy, rehab, counseling
CNS stimulant drug names
cocaine, caffeine, nicotine, ecstasy, methamphetamine, adderall
CNS stimulant street names
blow, Nic, Molly, bennies, speed, black, adds
mechanism of action for CNS stimulants
increase activity of neurotransmitters and block reuptake which stimulates their release or directly activate receptors
increase alertness
increase attention
increase energy
raise BP, HR, breathing rate
caffeine blocks
adenosine receptors
short term effects of CNS stimulants
increase, irregular HR, BP
nervousness
insomnia
heightened sense of well being
excitement, euphoria
reduced appetite
long term effects if CNS stimulants
paranoia/psychosis
hostility
brain damage
damage neuron receptors
depression, anxiety, irritability
lower impulse control
potential for abuse/addiction CNS stimulants
rewarding, makes you feel alert, ready
meth related ED visits
406 per 100,000 in 25-44 year old
males 250/100,000
cocaine ED visits
223/100,000 males 178/100,000
in 2010 ___% of OD involved stimulants, in 2021 ___%
1, 21
CNS stimulant treatment options
crisis lifeline
inpatient/outpatient rehab
group therapy
detox
counseling
drug names cannabis
weed, marijuana
cannabis is the
plant
cannabis native to
central or South Asia
active ingredients in cannabis
THC, CBD
street name for cannabis
aunt Mary, BC, bud, grass, doobie, blunt/joint, boom, chronic, sticky icky, ganja, Mary Jane, reefer, gas, trees, devils lettuce, wacky tabacky, hash, dope, pot, week
weed mechanisms of action
active ingredient THC cannabinoid receptors in the brain and other organs, affecting nerve cell activity
weed short term effects
means of ingestion, increased or slowed HR, lessened balance and coordination, dreamy state of mind
weed long term effects
gain a high tolerance/tolerance breaks, poor mental aptitude, poorer memories, lung damage
highest % of drug related ED visits are ___% for cannabis
11.9
weed treatment options
behavioral therapy
hallucinogens drug names
ecstacy, ketamine, LSD, PCP
hallucinogens street names
angel dust, acid, vitamin K, speed, candy, jet, special K
mechanisms of action: classical hallucinogens
LSD binds to seretonin receptors in the prefrontal cortex which results in visual distortions, altered sense of time, change in self-awareness
mechanism of action: dissociative hallucinogens
ketamine and PCP bind to NMDA receptors
hallucinogen short term effects
tachycardia, anxiety, nausea, sweating, hypertension, paranoia, hallucinations
hallucinogen long term effects
psychosis, hallucinogen persisting perception disorder, cognitive impairments
ketamine is more addictive because of
euphoric effects
treatment options for hallucinogens
therapy, rehab
inhalants drug names
solvents, aerosols, gases, nitrates
huffing
inhaling chemical vapors
term for the euphoric feeling produced by inhalants
rush
refers specifically to nitrous oxide
whippets
refers to amyl nitrate or other nitrates
poppers
another term for nitrous oxide or certain gas-based inhalants
snappers
nitrous oxide, often used for its euphoric effects l
laughing gas
refers to inhaling glue fumes
glue sniffing
refers to inhaling spray paint or other paint-based solvents
paint
refers to inhaling substances like gasoline or lighter fluid
solvent abuse
inhaling substances like computer cleaning dusters
air blast
mechanisms of action for inhalants
paint cans
glue
sharpies
paint thinner
lighter fluid
amyl nitrate
shoe polish
short term effects inhalants
head high (euphoria)
dizziness
hallucinations
slurred or distorted speech
lack of body control
vapes contain chemicals that cause long term damage to
lungs, brain, overall body
formaldehyde
changes lung function
breathing problems
acrolein
respiratory disrress
delayed pulmonary edema
acetaldehyde
cancer causing
irreversible damage to DNA
nicotine can alter brain development including
memory, learning, how you process info
metal particles in vape
chromium, nickel, lead, tin, aluminum
increased risk of cancer
inhalant long term effects
bone development
liver injury
hearing loss
asphyxia-related brain damage
bone marrow disease
occasionally, first time uses can be fatal
treatment options inhalants
medical intervention, therapy, rehab
synthetic drugs
new psychoactive substances, made to mmic effects of existing illicit drugs
synthetic drug names
opioids, cannabinoids, cathinones, ecstasy, phenethlyamines
opioid street names
perc, captain Cody, miss Emma, juice, oxygen 80
street names cannabinoids
spice, k2, skunk, blaze, blis
street names cathinones
bath salts, flakka, gravel
street names ecstasy
Molly
street names phenethylamines
smiles, blue mystic, n-bomb
drugs made to mimic natural drugs
THC, CBD, opium, cahinone, amphetamine, cocainr
THC and CBD interact with ___ receptors
cannabinoid
short term effects of synthetic drugs
relaxation, hallucinations, confusion, anxiety, rapid HR, vomitting, GI problems, dizziness, feelings of wellbeing
long term effects synthetic cannabinoids
kidney damage, seizures, breathing pain, chest pain, heart attack
long term effects cathinones
kidney damage, muscle breakdown, heart problems, convulsions
synthetic drug treatment options
PCP, inpatient programs, therapy