General Concepts, Definitions, & Epidemiology Flashcards
What are the “general conditions” required for DSM-IV Drug Dependence?
Maladaptive substance use leading to clinically significant impairment or distress as manifested by 3 (or more) of the 7 criteria occurring any time during the same 12 month period
The 7 criteria for Drug Dependence: 1), 2): TW
3) LA/LP; 4) PD/US to CD/CU; 5) T OUR; 6) I SORa GU/R; 7) SU C D PoPp caused or exacerbated by the substance
1) Tolerance; 2) Withdrawal
3) The substance is taken in Larger Amounts or Longer Period than was intended;
4) Persistent Desire or Unsuccessful Efforts to Cut Down or Control Use of the substance;
5) a great deal of Time is spent in activities necessary to Obtain, or Use the substance or Recover from its effects
6) Important Social, Occupational, or Recreational Activities are Given Up or Reduced because of substance use;
7) Substance Use Continues despite Physical or Psychological Problems caused or exacerbated by the substance
What are the “general conditions” required for DSM-IV Drug Abuse? I/D 1 or more of 4 in someone who has never met criteria for DD.
Maladaptive substance use leading to clinically significant impairment or distress, as manifested by 1 (or more) of 4 criteria in someone who has never met the criteria of Dependence.
What are the 4 criteria for DSM-IV Drug Abuse?
1) RSU LF TM WSH O
2) RSU in a S P H
3) RS-R LP
4) SU DP/R S/IP caused by use.
1) Recurrent Substance Use Leading to Failure To Meet Work, School, or Home Obligations.
2) Recurrent Substance Use in a Situation that is Physically Hazardous
3) Recurrent Substance-Related Legal Problems
4) Substance Use continues Despite Persistent or Recurrent Social or Interpersonal Problems caused by use.
Continuum of Use
Social
(Recreational Use)
⇓
Abuse
(Experiences Problems) ==> Spontaneous
⇓ Remission
Dependence ==> Spontaneous
(Impulse Dyscontrol) Remission
According to Koob (2008) (Txtbk of Substance Abuse Treatment
Addiction or Dependence is:
1) C, 2) LoC in LI, 3) eNES when AD
1) a Compulsion to take a substance
2) Loss of Control in Limiting Intake
3) Emergence of a Negative Emotional State when Access Denied
Behavioral Constructs of SUD Progression according to Koob
Abuse Impulse Control Positive
Disorder Reinforcement
(Reward)
⇓ ⇓ ⇓
Dependence Compulsive Negative
Disorder Reinforcement
(Avoidance)
Recent ASAM Definition:
Addiction is characterized by:
A,B,C,D,E
a. Inability to consistently Abstain
b. Impairment in Behavioral control
c. Craving
d. Diminished recognition of significant problems
e. A dysfunctional Emotional response
The 3 C’s that characterize addiction
Craving/Compulsion
Continued Use
Loss of Control
Key National Prevalence/Incidence Surveys
-look up NSUDH annually in SAMSHA
NSDUH NESARC
Survey Annual 2001-2002
2004-2005
Sample
Size 67,870 43,093
Response
Rate 74% 81%
Age 12 & up 18 & up
Top 3?
NIcotine deaths/year
Nicotine apx 23% Alcohol apx 15% Arthritis apx 13% HTN APX 12% Asthma apx 10% COPD apx 10% Heart Disease apx 8% Illicit Drugs apx 8% Diabetes apx 4%
NIcotine deaths/year 440,000
Who smokes?
1.3 Billion Adult Smokers,
Between 1990-2010, the biggest increase in use was
pain relievers
At any given time, about ______ % or _______ million americans has had an alcohol use disorder in the previous year.
Alcohol Abuse ____ million (____%)
Alcohol Dependence ____ million (____%)
8.5 % or 17.6 million
Alcohol Abuse 9.7 million (4.7%)
Alcohol Dependence 7.9 million (3.8%)
At any given time, about ______ % or _______ million americans has had an alcohol use disorder in the previous year.
Alcohol Abuse ____ million (____%)
Alcohol Dependence ____ million (____%)
8.5 % or 17.6 million
Alcohol Abuse 9.7 million (4.7%)
Alcohol Dependence 7.9 million (3.8%)
