EXAM #2 Flashcards
1
Q
What is the name for plant alkaloids derived from the opium poppy?
A
Opiate
2
Q
What is the name for a compound resembling opium in addictive properties or physiological effects?
A
opioid
3
Q
What is the name for dried latex obtained from the seed capsules of the opium poppy?
A
opium
4
Q
What are narcotics?
A
drugs that relieve pain and dull the senses,
and the use of the word is most commonly associated with opioids
5
Q
what is Heroin?
A
an opiate! It can be a white or brown powder or a black sticky substance (black tar).
6
Q
Other common names for heroin include…
A
big H, horse, hell dust, and smack.
7
Q
How do people use heroin?
A
People inject, sniff,
snort, or smoke heroin.
8
Q
What is speedballing?
A
mix heroin with crack cocaine together.
9
Q
what is fentanyl?
A
a synthetic opioid similar to morphine but 50-100 times more potent.
10
Q
Street names for illegally used/made fentanyl are…
A
Apache, China Girl, China White, Dance Fever, Friend, Goodfellas, Jackpot, Murder 8, and
Tango & Cash.
11
Q
When prescribed, how is fentanyl taken?
A
When prescribed, it can be given as a shot, a patch, or as lozenges.
12
Q
When illegally used, how is fentanyl taken?
A
The illegally used synthetic fentanyl is sold as a powder, dropped onto blotter paper, put in eye droppers
and nasal sprays, or made into pills that look like other prescription opioids.
13
Q
What do these sentences represent?
-Prescribed by doctors creates a false user-belief that they are safe, but tolerance causes many to seek other coping substances.
-The majority of abuse started from legitimate prescription use, while public gaze sees
Moral Model judgments and “junkies”
A
Gateway drug
14
Q
Which country (4.6% of the world’s population), consumes ~80% of the world’s opioid supply and
99% of the world’s supply of hydrocodone (the opioid in Vicodin)
A
The United States!
15
Q
Enormous growth of prescription opioid abuse =
A
Iatrogenic Epidemic
16
Q
What is Doctor Shopping?
A
The assumption is that opioid prescription abusers “shop around” and use multiple
doctors in order to obtain high quantities of opioids.
in 2015, 1.7% of people 12 and over reported getting drugs from more than 1 doctor
17
Q
Opioids act by binding to opioid receptors on neurons distributed throughout the nervous
system and immune system.
A
REMEMBER
18
Q
endogenous peptides what are they?
A
naturally occuring in the body
19
Q
endogenous peptides regulate and modulate several important functions, including the
following:
A
- Pain
- Stress
- Temperature
- Respiration
- Endocrine activity
- Gastrointestinal activity
- Mood
- Motivation
20
Q
Does your brain change even with short term use of opioids?
A
YES!
21
Q
What are some examples of opioids?
A
morphine, heroin, codeine, oxycodone, hydrocodone and fentanyl.
22
Q
What is it called: the decrease of the receptors’ effectiveness?
A
Downregulation
GRISEL: “The romance is no longer hot when your lover is present,
but when your lover is absent your body and mind are
overcome with suffering.” (p. 75)
23
Q
Imagine that satiated and dream-like state amplified hundreds of times ……what is this?
A
opioids!
24
Q
Mental effects of opiods include:
A
- Euphoria
- Sedation
- Decreased anxiety
- Tranquility
- Indifference to pain
- Delirium and Coma (severe intoxication)
25
Chronic use of opioids creates...
tolerance and physical dependence
26
Remember !
Opioids with rapid onset of action and short half-lives have the greatest potential for
destructive addictive behaviours, as addicted individuals get immediate reward followed by
noticeable withdrawal symptoms. (IV injected heroin for example is a good example of this).
27
In recent animal studies, 3 conditions reliably induce opioid addiction
relapse:
1. Stress
2. Exposure to conditioned cues related to past drug use
3. A dose of the previously administered drug or a drug with similar properties
28
Opioid use can cause:
1. significant physical and psychological morbidities
2. social, family, work, and legal difficulties.
3. IV use of opioids increases risk of blood-borne infections like Hepatitis B and C and HIV.
4. Abscesses
and collapsed veins are also common experiences from intravenous use.
5.
29
remember
Tolerance is so thorough that small-sized pupils may be the only observable sign of opioid
addiction. Inflamed nasal passages may be seen if heroin is snorted and “track marks” if injected.
30
Evidence ______suggest long term opiate use helps with chronic pain
does NOT
31
Evidence ______ suggest significant harm from long term opiate use
does
32
Pain and addiction are ________ mutually exclusive
NOT
33
Over ______ of people who take opioid therapy for 6 months will still be taking opioids years later
50%
34
WTF?? WHY? remember!
Pain management: A recent systematic review found that patients with chronic pain
(noncancer) who had comorbid substance use disorders are more likely to be prescribed
opioids and higher doses of opioid medications compared with patients who do not have a
history of substance use disorders despite similar pain outcomes.
35
People regualrly using opioids are ____ more liekly to attemept _______
People regualrly using opioids are 2X more likely to attempt suicide.
36
People who take __________ amounts of opioids for pain are at an increased risk of accidntal overdose death.
higher quantities
37
Even when someone is
very motivated to cut
down/quit opioid
(ab)use, it is extremely
difficult because.....
the
withdrawal symptoms
can be excruciating.
38
What are some INITIAL (some of the first) withdraw/detox synptoms when someone stops using opioids?
- muscle aches and spasms
-trouble sleeping
-racing heart
-anxiety
-sweating
-yawning
-hypertension
-fever
-agitation
39
When do withdrawal symptoms begin for short acting and long acting opiates?
Short: 6-12hrs
Long: 30 hrs
40
At 72 hours, what happens?
Symptoms peak! (The worst symptoms)
41
What are the peak symptoms of opitate withdrawl?
-nausea
-vomitting
-cramps
-diarrhea
-goosebumps
-depression
-drug cravings
42
Overall name some of the withdrawal symptoms that are associated with opiates?
* Irritability
* Extreme Agitation
* Restlessness
* Severe depression
* Untreatable insomnia
* Suicidal thoughts
* Anxiety and panic attacks
* Diarrhea
* Nausea
* Vomiting
* Stomach cramps
* Sweating
* Extreme joint pain
* Extreme muscle aches
* Spasms
* Runny nose
* Watery eyes
* Headaches
* High blood pressure
* Irregular / racing heartbeat
* Goose bumps
* Hot and cold chills
* Dilated pupils
* Yawning
* Intense cravings
43
Withdrawal from opioids always involves.....
significant pain - especially where old injuries or
surgeries occurred. This can make it hard to fight the thought that the medication was
preventing that pain, even if it is only withdrawal-induced pain
44
What are these things related to?
* can happen weeks or months later
* is associated with insomnia, anxiety, and severe depression
* often includes suicidal thoughts
* these symptoms can lead to relapse, which is a high risk for overdose due to lowered
tolerance since last use
Post-Acute Withdrawal
45
The half-life of a drug is the time it takes for the amount of a drug's active substance in your body to reduce by half.
The half-life of a drug
46
what are some opiate detox factors?
-liver health
-kidney health
-age
-body fat/mass
-metabloism
-drug strength
-drug half life
-water intake
and others!
47
For treatment, current guidelines advocate for comprehensive treatment using _______________ in conjunction with ________________.
pharmacological
interventions (methadone, buprenorphine, or buprenorphine with naloxone) in
conjunction with psychosocial therapy.
48
No 2 people will EVER go thru the exact same ________
withdrawal expereince.
49
What is methadone?
-eliminates the rollercoaster of highs and lows you usually experience with opioids.
-Methadone is an opioid taken once/day as a liquid mixed with juice.
-It lasts 1-3 days in the body, whereas most opiates only last 1-3 hours.
-methadone can allow people with opioid dependency to stop chasing a “fix” and live relatively normal lives again.
-Methadone also blocks any high you would get using other opioids and therefore prevents cravings with regular use.
50
what can methadone cause?
* Drowsiness, sleepiness, nausea, reduced energy
* Reduced cough reflex and slower, shallower breathing
* Reduction of any physical pain
* Small pupils, constipation, dry mouth, lower blood pressure, and difficulty passing urine
* Reduced menstrual periods, reduced testosterone levels in men, reduced
sex drive and sugar cravings.
51
pharmacology is just one of the tools used to help someone get off of opiates. Medication is typically used in conjunction with _______________.
addictions counselling and attending AA/NA or SMART Recovery meetings.
52
Besides therapy, what are the pharmalogical treatments for opioid?
METHADONE
SUBOXONE
SUBLOCADE
NALOXONE
53
______________ is not approved for use in pregnancy, but ___________ is.
Suboxone is not approved for use in pregnancy, but methadone is!
54
more people die from opioid overdoses than car crashes T or F
True!
55
Remember
Opioids can cause severe, and sometimes fatal, depression of the respiratory system when
taken in large doses, when mixed with other depressants or when a user’s usual tolerance
has been compromised.
56
Naloxone, or Narcan®, is a ....
pure opioid antagonist
57
what is narcan?
It is an injectable medication that can reverse opioid overdose to regain normal breathing
and consciousness, usually in 2-5 minutes
58
In 2016, the Government of Canada replaced the National Anti-Drug Strategy with
the new Canadian Drugs and Substances Strategy – an evidence-based public
health approach to addiction and problematic substance use. Its four pillars are:
* Prevention
* Treatment
* Harm Reduction
* Enforcement
REMEMBER!!!!!! it WILL be on the exam!
59
What does this represent? Less than 50% of people who went to their doctor because of alcohol-related issues were asked about the problem
Point-of-Care Ignorance
60
Alcohol is a sledgehammer because it....
Alcohol is a sledgehammer because it affects virtually every organ system in the body.
61
In the brain, alcohol affects several neurotransmitter systems including:
* Opiates
* GABA
* Glutamate
* Serotonin
* Dopamine
62
Brain excitability* caused by long-term alcohol ingestion can lead to brain effects such
as:
* cell death
* cerebellar degeneration
* Wernicke-Korsakoff syndrome (degenerative brain or neurological disorder)
* tremors
* alcoholic hallucinosis
* delirium tremens (severe withdrawal – sudden/severe mental/nervous system changes)
* withdrawal seizures
63
remember
*long term use of alcohol increases opiate receptors in the brain so when alcohol is removed, brain excitability happens
64
T or F: Intent of the drinking has influence over the experience
T!
65
Emotional Effects of Alcohol:
* manipulate emotions (serotonin and dopamine – happiness and rewards)
* from being on top of the world to feeling unloved and useless
* sad people happy, happy people sad, quiet people animated, and nervous people relaxed
66
t or f: Beer, wine, and liquor each affect the body differently
T
67
Regular drinking affects the hormone levels of the brain =
Mood swings!
68
Alcohol is a depressant, which causes:
* lower inhibitions - increased risky behaviours
* dormant emotions to surface
* increased anxiety (often exhibited as anger)
69
if you are drinking because you are sad...
it often enhances the sadness!
70
In the study by Schuckit and smith, if you are a son with a alcoholic dependant father...
you are 26% more likely to become an alcoholic yourself!
71
What are the three models that explain alcohol abuse?
* Behavioural models
* Cognitive models
-Psychoanalytic models
72
what model is this? - explain alcohol abuse in terms of learning theory - operant conditioning reinforces alcohol use to become habitual
behaviroal
73
what model is this? explain alcohol abuse in terms of “automatic thoughts” - which precede the person’s feelings about alcohol - “I deserve a drink because I’ve had a rough day"
Cognitive
74
What model is this? explain alcohol abuse in terms of ego defenses and intrapsychic conflicts - an escape from the uncomfortable internal conflict
Psychoanalytic
75
what is is the leading known cause of
developmental delays (1 in 1000 births)?
Fetal alcohol spectrum disorder (FASD)
*Alcohol-related birth defects and neurodevelopmental problems are
estimated at 3X that
76
More than ___________ babies are born with FASD annually in North America
2000
77
A 2001 study by Sood et al: children aged 6-7 whose mothers consumed alcohol (even in small amounts) exhibited more _______________.
behavioural problems
78
A 2003 study by Baer et al: moderate alcohol consumption while pregnant
produces an increased rate of children with problem drinking at the age of
21, after controlling for environmental and genetic factors... REMEMBER
Remember
79
Alcoholism can be categorized into 2 types:
* early-onset (biological predisposition to the disease)
* late-onset (brought on by environmental or
psychosocial triggers)
80
expect __________ of issues. during alcohol detox/withdrawal.
a week.
81
withdrawal/detox symptoms of alcoholism
* Anxiety / Agitation / Irritability
* Nausea / Vomiting
* Rapid heart rate
* Sweating
* Headache
* Tremors
* Diaphoresis
* Visual and Auditory Hallucinations
Signs of delirium tremens (DTs) - alcohol withdrawal delirium:
* Disorientation (critical)
* Hallucinations
* High body temperature
* Illusions / Delirium
* Paranoia
* Seizures
* Tachycardia
* Hypertension
82
T or F If a person experiences withdrawal symptoms
from alcohol, then they have taken enough of
the drug to cause damage to other organs.
T!
83
what is the downer class?
tranqulizers!
84
what are considered downers?
* Muscle Relaxants
* Alcohol
* Opioids
* Tranquilizers
85
What are considered tranqulizers?
* Sedatives – barbiturates (anesthetic)
* Anxiolytics – benzodiazepines (anti-anxiety, anti-epileptic)
* Hypnotics – non-benzo sleep meds
* Dissociative Anesthetics – Ketamine, PCP, and Dextromethorphan
86
Tranquilizers are often called
sedatives
87
what is ketamine?
fast-acting anesthetic used in medical or
veterinary surgery.
88
What is GHB (Gamma hydroxybutyrate)?
naturally occurs in the body (in small doses) and produces a depressant effect, slowing the
nervous system. It was originally manufactured as a surgical anesthetic.
*GHB is a central nervous system depressant that causes drowsiness and reduces heart rate. It is used to treat sleep disorders but can be dangerous if misused.
89
what are some names for GHB?
* Liquid E GHB
* Georgia home boy
* Fantasy
* Liquid X
* Liquid ecstasy
* Organic Quaalude
* Everclear
* Easy lay
* Salty water
* Cherry meth
* Grievous bodily harm
90
What drug is known as the date rape drug?
GHB
91
What is the simialrity between GHB and Ketamine?
Both are tranquilizers, colourless & odourless, and been used as “date rape” drugs
92
Effects of GHB include:
* Feeling relaxed
* Dizziness
* Inebriation (like alcohol)
* Happy, with a sense of well-being (euphoria)
* Uninhibited
* Loss of short-term memory.
Incapacitated.
93
GHB physical symptoms:
* Slowed breathing
* Nausea and vomiting
* Drowsiness, loss of consciousness
* Decreased blood pressure and heart rate
* Jerky muscle movements and loss of
coordination
All of these help predators take advantage of you when they use GHB as a date rape drug at parties for example.
94
What are Other risks of GHB:
* Coma or death
* Very easy to overdose
* Significant risk when taken with other
depressants.
* Risk of death from asphyxiation by
choking on vomit if unconscious.
95
street names for ketamine
* Special K
* K
* Super C
* Cat Valium
* Jet
* Super acid
* Green
96
Effects of Ketamine include:
* Dissociation, sense of mind and body separation (K-hole)
* Blocks nerve messages about pain (dentist example from Erin).
* Alters experience of sight and sound
* Inability to speak
* Drunken, dizzy feeling
* Loss of short-term memory
* Sleepiness, confusion, loss of coordination, inability to move
* Sensations of weightlessness
* Vivid dreams or hallucinations
97
What is the ketamine The “K Hole”?
* Paralyzing. Introspective. Detached. Peaceful. Frightening. Euphoric.
Transformative. Near-death.
* A dream or a nightmare.
*A total dissassociation!
* Feel paralyzed and as if you’ve left your body and are watching it from afar.
* “‘K-hole’ refers to ‘how profoundly scary and aversive the experience can be’ because, for some, it can feel like dying. But it’s not a negative experience for
everyone.”
98
What is PCP known as on the street?
Angel dust
99
What is PCP?
Phencyclidine is a synthetic drug used to anesthetize and
tranquilize large animals and has not been used medically
for humans since the 1950s
100
What drug is: Illicitly sold as tablets, capsules, and coloured powders,
and called “Angel Dust”
PCP
101
What drug is commonly taken by swallowing or snorting or dissolving and
injecting, and is often mixed into other tablets and
powders such as methamphetamine, and is also smoked
with parsley, oregano, tobacco, or marijuana
PCP!
102
What are the examples of stimulants?
* What are Stimulants
* Nicotine
* MDMA (“Ecstasy”)
* Methamphetamine (“Crystal Meth”)
* Cocaine and Crack
* Bath Salts
103
What are stimulants?
Central nervous system stimulants - increase the amounts of the
dopamine and norepinephrine, which improves concentration
104
class of drugs that increase the activity of the brain. They are used for various purposes, such as enhancing alertness, attention, motivation, cognition, mood, and physical performance.
Stimulants
105
Stimulants are a broad class of drugs, including:
* Prescribed medications
* Drugs manufactured for illicit substance abuse
* Substances in over-the-counter (OTC) decongestants, herbal
extracts, caffeinated beverages, and cigarettes
106
Interesting..I mean I drink a shit ton of energy drinks to help so i guess i am victim to stimulants too...
Many people abuse prescription stimulants to enhance performance
rather than to get high. In fact, athletes and students have a long history of abusing prescription stimulants to outperform their peers.
107
The APA guidelines propose using these psychosocial interventions:
* group and family counselling
- psychodynamic/interpersonal therapy (IPT)
-cognitive-behavioural therapy
108
_____________ and _________are the only approved
opioids used medicinally for the treatment of opioid
addiction.
Methadone and Buprenorphine
109
The standard of care has been ______________ for more than four decades.
Methadone maintenance
therapy (MMT)
110
What are some treatments for opiod withdrawl?
-Naloxone
-methadone
-buprenorphine
-Suboxone
-Sublocade (same as suboxone but without naloxone)
111
what symptoms do stimulants cause?
* Euphoria
* Decreased appetite, anorexia
* Wakefulness, difficulty sleeping, insomnia
* Talkativeness
* Energy and increased concentration
* Nervousness
* Increased pulse and blood pressure
* Alertness with increased vigilance
* Psychotic symptoms
112
Long-term effects of stimulant abuse:
* Addiction
* Aggression
* Anxiety
* Psychotic behaviour
* Malnutrition
* Damage to blood vessels
* Kidney damage
* Lung damage
* Stroke
* High blood pressure
113
Common withdrawal symptoms of stimulants
* Insomnia
* Depression
* Irritability
* Difficulty concentrating
* Struggling to think clearly
* Apathy and mood swings
114
What is nicotine?
Nicotine acts as both a stimulant and a depressant, it’s
naturally produced in tobacco leaves
115
T or F: You can crave nicotine for months or
years, even once the other withdrawal
symptoms are gone.
T
116
T or F: The desire to smoke can be especially
strong when you are under stress,
drinking alcohol, out with friends, or
when feeling extremely bored.
T
117
What drug is possibly the most difficult drug of abuse to stop using once dependant?
Nicotine is possibly the most difficult drug of
abuse to stop using once dependent.
118
Withdrawal symptoms of nicotine may include:
* dizziness and shakiness
* headaches
* anxiety and irritability
* nervousness and restlessness
* difficulty concentrating and sleeping
* increased appetite
* slight depression or feeling down
* cravings for a smoke
119
Smoking is also a _________behaviour, causing you to form habits that are tough to break.
Smoking is also a LEARNED behaviour, causing you to form habits that are tough to break.
You learn to associate things
with smoking, like:
* the pleasant feelings that it brings you
* the temporary relief of worry, tension, boredom or fatigue
* drinking coffee or alcohol
* eating a good meal
* having a good time with friends
120
It can take as little as ____________ for nicotine to reach
the brain after being inhaled
10 seconds
121
Initial experiences of smoking can include:
coughing,
dizziness, dry/irritated throat, nausea, weakness, stomach
cramps, headache
122
Tolerance __________the initial negative experiences
lessens
123
Nicotine causes:
* heart rate and blood pressure increase (stimulant)
* blood vessels constrict, causing a temperature drop in
your hands and feet
* brain waves are altered and muscles relax (depressant)
124
Stands for 3,4-
methylenedioxymethamphetamine,
commonly called __________ and _____________.
Ecstasy or Molly
125
Which drug am I talking about? A stimulant that can also cause
hallucinations and comes as tablets of
various size, shape, colour, potency,
“official looking stamps”
MDMA (ectasy or molly)
126
What drug is this? Effects begin within about an hour and last 3-6 hours (some
unpleasant effects can last a week or longer)
MDMA
127
___________ is being studied as a
possible therapeutic
treatment for anxiety and
PTSD, but it is not yet at the
point of approval – currently
Phase 3 Clinical Trials
MDMA
128
A powerful, highly addictive, and very
dangerous stimulant.....
Meth!
129
What are some other names for meth?
ice, meth, chalk, crank, crystal meth, speed
130
__________is when the effects of
meth are wearing off
Tweaking
131
Symptoms of tweaking:
* Drug craving and poor concentration
* Anxiety and sleeplessness
* Irritability and aggression
* Paranoia and hallucinations
* Intense, negative, psychological effects
can cause self-mutilation, attempted suicide, violent attacks on others for no reason.
132
Powder made from the leaves of the
South American coca bush....What are these drugs?
Cocaine and crack
133
How is cocaine taken?
snorted or dissolved in water and injected
134
cocaine and crack are __________.
Powerful and highly addictive stimulants
135
What exactly is crack?
Crack is cocaine mixed with baking soda, compressed into
rocks, and smoked. (Dirty grampa; I just smoked crack!)
136
_____________produces stronger and
faster effects, making it even more addictive than ____________.
Crack produces stronger and
faster effects, making it even
more addictive than cocaine
137
Can crack also be injected?
Yes!; Crack can also be injected by first
dissolving the rocks in vinegar or lemon juice
138
Effects of crack and cocaine begin within a few seconds and include:
Mental and physical symptoms.
139
What are some of the mental effects of cocaine/crack?
* Sense of well-being (euphoria)
* Panic
* Anxiety
* Feeling happy and mentally alert
* More energy and self-confidence
* Paranoid thinking (people want to
hurt you)
140
What are some of the physical effects of cocaine/crack?
* Dry mouth
* Becoming talkative
* Restlessness and irritability
* Dilated pupils
* Quicker startle reflexes and muscle
twitches
* Heightened sense of sight, sound,
and touch
* Temporary decrease in need for
sleep and food
141
What are some other symptoms of crack and cocaine?
* Tremors
* Dizziness
* Violent behaviour
* Nausea and vomiting
* Rapid breathing, difficulty breathing, respiratory
failure
* Seizures or convulsions
* Stroke
* Irregular heartbeat, heart attack, or heart failure
142
What are the withdrawl symptoms of cocaine and crack?
* Fatigue, loss of physical and mental energy
* Irritability and violent behaviour
* Depression
* Feeling hungry all the time
* Difficulty sleeping or disturbed sleep
143
What are the Long-term mental effects of crack/cocaine?
* Depression
* Sleeping problems
* Extreme changes in mood
* Erratic or violent behaviour
* Feelings of jealousy and paranoia
* Losing touch with reality (hallucinations, delusions, psychosis)
144
What are some long term physical effects of crack/cocaine?
Lung, nose, breathing problems:
-severe chest pain
-low blood oxygen
-difficulty breathing.
Heart problems:
-high blood pressure
-fast and irregular heartbeat.
Stomach problems:
-abdominal pain
-nausea & vomiting
145
