Exam 1 Flashcards
How are substance use and addiction portrayed in the media?
-Glamorization versus Criminalization
-People associating the cartel with Mexicans, but not white young college students who use drugs
-Prescription drugs are marketed directly towards the consumer in the U.S.
-Tobacco and alcohol are very commonly shown in movies; Other substances like ecstasy and cocaine are more commonly used in songs.
-Prescription drugs are marketed as an immediate “fix” to one’s life and provides medical warnings of side or long term health effects.
-Alcohol and other drugs are marketed in a more sexual way to people of all income levels.
Substance
Any natural or synthesized chemical product that has psychoactive effects (changes perceptions, thoughts, emotions, behaviors, etc.)
What term should be used in place of the word “addiction”?
Substance Use Disorder
Craving
The urge/desire to use a substance
Heavy Use
Drug use that is beyond “acceptable” limits.
How is language important when it comes to discussing substance use disorders?
The word choice we use can change depending on the setting we are in and certain terms can create unwanted stigma and discrimination towards those who struggle with substance use and are in recovery.
Ex: Use a “person with a substance use disorder” instead of calling them an “addict”
What are the implications of direct-to consumer advertising of pharmaceuticals in the U.S?
It has increased the price of pharmaceutical drugs, but also provides more awareness to people of certain drugs that could benefit their health and well-being.
Why is substance use a concern in modern society?
- It is viewed as a threat to public health and safety (spread of infectious diseases, substance-related fatalities like overdose, traffic accidents, suicide, and violent crime).
- It is burdensome on health care systems because of frequent ER and mental health visits which we do not have the structure to support.
- It is viewed as being a major cause of criminal activities, especially when it comes to black and brown individuals, reinforcing racial biases.
What are the 4 basic principles of psychoactive drugs?
- Drugs are neither good nor bad
- Every drug has multiple effects
- Both the size and quality of a drug’s effects depend on the amount taken and potency
- The subjective effects of a drug depends on the user’s history and expectations
Culture
The belief systems and value orientations that influence customs, norms, practices, and social institutions, including psychological processes.
How are social identities talked about in research?
- They are not discussed at all
- They are used as independent variables (Ex: a certain race has increased depressive symptoms when taking a drug)
- They are used as moderators (Ex: comparing different races results for the same independent variable)
What information do we get from social identities being discussed in research? What information do we miss?
We only get information about a numerical trend/relationship and a relation between different groups. We miss the “why?” and context which contributes to stereotypes, biases, prejudice, and discrimination.
How have the diagnostic criteria for substance use disorders evolved over time?
Normative Substance Use
Substance use that is not affecting one’s day-to-day life, has minimal long lasting negative effects, and is used only occasionally and/or in “socially acceptable” ways.
Problematic Substance Use
Substance use that is starting to affect one’s everyday responsibilities such as work, school, and relationships, but not a complete physical dependency on the drug. Substance use is taking up more time or financial resources, there are noticeable cravings and relief when using, and they are using despite known negative consequences.
Substance Use Disorder
A complete physical dependence on a drug including a high tolerance and withdrawal symptoms if not taken. Negative consequences are pervasive and persistent and the user has lost the power of choice.
How do we evaluate substance use patterns?
- Quantity– How much of the substance is used?
- Frequency
- Methods of administration
- Age of onset and progression
What are some typical metrics used to describe the quantity of drug use?
-Weight per occasion (ex: grams, ounces)
-Number of pills (or mg if known)
-Hits used per occasion
-Drug-specific metrics (joints, blunts)
-Amount of money spent per occasion
-Standard drinks for alcohol (0.6 oz per 1 standard drink
What is a standard drink?
-0.6 ounces of pure alcohol
-1 mixed drink with 1.5 fl oz of liquor
-5 fl oz of wine
-12 fl oz of beer or wine cooler
What are the “safe” drinking limits of men and women according to the NIH?
No more than 4 drinks on any single day for men and 3 drinks for women. No more than 14 drinks per week for men and 7 for women.
How have the diagnostic criteria for substance use disorders evolved over time?
- DSM-I: Alcoholism was written as a subcategory of sociopathic personality disorder
- DSM-II: Alcoholism was a separate category under “Personality Disorders and center other Non-Psychotic Mental Disorders”– Alcohol abuse vs Alcohol dependence.
- DSM-III: A new “Substance Use Disorders” section which separated substance use (impairment of social or occupational functioning) and substance dependence (pathological use/impairment, and evidence of tolerance or withdrawal).
- DSM-IV: Separated substance abuse (a maladaptive pattern leading to clinically significant impairment or distress with one or more symptoms) and substance dependence (with 3 or more symptoms).
- DSM-V: Removed legal problems as a criteria for alcohol use disorder; integrates abuse and dependence into “Substance Use Disorder” with mild, moderate, and severe subclassifications for each drug type.
What are the DSM-5 diagnostic criteria for Substance Use Disorders?
- Impaired control– unsuccessful attempts to quit usage, spending a great deal of time obtaining the substance or recovering from its effects , and repeated cravings.
- Social impairment– difficulty in fulfilling major role obligations, continued use despite having social or interpersonal problems.
- Risky use– Use of substances where it is physically hazardous.
- Pharmacological criteria– Tolerance and withdrawal.
SAMHSA
Substance Abuse and Mental Health Services Administration
NIDA
National Institution on Drug Abuse
NIAAA
National Institute on Alcohol Abuse and Alcoholism
DSM-5
The Diagnostic and Statistical Manual of Mental Health Disorders
How is alcohol use defined by SAMHSA studies?
In 2015, SAMHSA redefined binge drinking as five or more drinks for men and four or more drinks for women on the same occasion on at least one day in the past 30 days. Heavy alcohol use = binge drinking on five or more days in the past 30 days.
Prescription drug misuse
The use of a prescription drug in any way that Doctor did not direct you to use them (use without a prescription, use in greater amounts, more often, or longer than prescribed)
Epidemiology
The study of the patterns, causes, and effects of health and disease conditions in defined populations.
What are some of the challenges to research on substance use trends?
-Recruitment
-Types of questions
-Variability in standardized measures
-Emergence of new drugs
-Difficulty in having accurate and complete information (lack of honesty, misrepresentative sampling, black market hides imports and amount sold)
What are some of the benefits and negatives of surveying in measuring drug use
Benefits: Easy to administer, inexpensive, and efficient
Negatives: Biases in populations represented and an inaccurate portrayal because of self-reporting
What trends are of interest when it comes to research on substance use?
Prevalence (rate of all cases) and incidence (rate of new cases) of substance use and SUD
Geographic, sociodemographic, changes in patterns over time, patterns of treatment access
Monitoring the Future Project (MTF)
Gathers data from students (8th-12th grade and college); conducted annually for over 30 years on prevalence of drug use and the perceived risk/availability of various drugs.
National Survey on Drug Use and Health (NSDUH)
Gathers data from U.S. households (not just students) through face-to-face interviews. All people ages 12 and above are included and they collect data on prevalence and frequency of drug use.
How has drug use levels changed over time globally?
The extent of global illicit drug use has remained stable. The illicit market for opiates and cocaine has decreased in the last century.
Name the common data distortions:
-Manipulating scales to distort the apparent size of the difference or the change over time
-Cherry-picking data points
-Using the wrong type of graph (pie graph when it isn’t the whole population)
-Ignoring error estimates to imply differences
-Examining data points in isolation/ignoring third variables (SES, employment limitations)
When did international drug control efforts begin?
At the International Opium Convention signed at the Hague, 1912. This was where each government was urged to “take measures for the gradual suppression of the practice of opium smoking in its own territories”.
What are the 3 main methods of drug control?
Regulation, Prevention and Treatment
Prohibition
A general policy orientation that defines cultivation, production, distribution, and possession of substances as criminal.
Decriminalization
A general policy orientation that removes criminal sanctions related to personal use and/or possession, but does not legalize the production or sale of it.
Legalization
A general policy orientation that involves the lifting of all criminal and civil prescriptions and sanctions.
Food and Drug Act of 1906
Passed by the U.S department of agriculture. The goal was to make sure that drugs were pure and honestly labeled.
Harrison Narcotics Act of 1914
Passed by the U.S. Department of the Treasury. The goal was to restrict the sale and manufacturing of drugs to only authorized agents.
What are drug policies driven by?
Emotional, political, and financial power, as well as several high-impact public health and safety issues that are related to the drug trade.
Laissez Faire Model
No restrictions on the sale of drugs except for minors.
Limited Distribution Model
Generally, state will closely regulate and tax the sale of drugs.
Medical Model
Makes drugs legal only for recognized medical purposes or “certified addicts” who need it to overcome withdrawals.
Harm Reduciton
Services aimed at current drug users with the goal of preventing some of the negative consequences of drug use. (Clean needle programs, supervised consumption sites. drug batch testing)
“War on Drugs”
Nixon’s process of dramatically increasing the size and presence of federal drug control agencies, and pushing through measures such as mandatory sentencing and no-knock warrants. This is when drug policy started deviating from scientific evidence.
What are the unintended consequences of the War on Drugs?
-Emergence of the black market
-Narco-terrorism
-Criminalizing poverty and creating barriers to social integration
-Creating a permanent underclass
-Mistrust between citizens and law enforcement
-Corruption in politics and law enforcement
-Reinforced biases surrounding drug users and racial prejudice
-Increased levels of incarceration
How are other countries working towards a more progressive drug policy?
Countries like Portugal have regulated markets similar to alcohol for other substances, allocate tax revenue to prevention, treatment, education, healthcare, and remove felony questions from job applications to promote reintegration.
Vienna Declaration
The Vienna Declaration (2010) was a call for evidence-based drug policies prompted by the failure of traditional drug policies in the HIV/AIDS pandemic.
Name an example of Human Rights Violations in the War on Drugs:
A war in the Philippines in which the President killed 3900 “drug personalities” in a state-sanctioned campaign of mass murder.
Discuss how SEU Alcohol/Drug Policy is related to similar to the War on Drugs
Every community has their own values, just how our campus has a set of mission markers. So, if a drug policy does not match those community values, it may cause unintended consequences.
Crop substitution
Crop substitution programs identify legal crops that replace the income. from illegal narcotic-producing crops; they also provide farmers with. materials and technical assistance for growing the legal crops.
