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Block 8 Week 5 Colt > Intro to Addiction Medicine - Zelan > Flashcards

Intro to Addiction Medicine - Zelan Flashcards

1
Q

what are the comorbid issues associated with SUD?

A

Depression
Anxiety (esp. PTSD)
Personality disorder (esp. borderline personality disorder – BPD)
Bipolar disorder

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2
Q

25-60% of pts with (blank) also have SUD

A

BPD

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3
Q

What is the lifetime prevlaence of alcohol use disorder/

A

30%
high risk drinking 30%
prevalence higher in younger age group

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4
Q

What are the medical complications of SUD?

A

Neuro: dementia, psychosis, seizure, depression

Liver, CV, pancreas

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5
Q

Alocohol use correlates to violence from the standpoint of…

A

both perpetrator and victim

MORE THAN OTHER DRUGS

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6
Q

T/F: SUD leads to increased morbidity and mortality from all causes

A

true

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7
Q

what is the top two drugs prescribed in the US?

A

Vicodin

simvastatin

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8
Q

Addiction correlates to physical signs of….

A

dependence and tolerance

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9
Q

T/F: addiction can be suspected on a basis of behavioral signs of compulsive use

A

true

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10
Q

What are signs of compulsive use?

A

: use despite harmful consequences, use that is escalating, pervasive urges to use, high risk behaviors, failed attempts to stop or reduce use.

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11
Q

what are the DSM5 criteria for SUD?

A 
Taken in larger amounts than intended.
Failed attempts to control or stop.
Excessive time given to use or recovery.
Strong urges to use.
Functional impairment.
Ignoring harmful consequences. 
High risk behaviors. 
Withdrawal or efforts to avoid withdrawal. 
Tolerance: escalating use/ diminishing effects.
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12
Q

mild SUD has how many Sx?

A

2-3 symptoms

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13
Q

moderate SUD has how many Sx?

A

4-5

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14
Q

severe SUD has how many Sx?

A

6 or more

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15
Q

What is the CAGE quesitionnaire?

A

Cut down?
Annoyed?
Guilty?
Eye-opener?

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16
Q

What is sensitivity?

A

proportion of cases that return true positives

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17
Q

what is specificity?

A

proportion of non-cses that return true negatives

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18
Q

screening tests are designed for high…

A

sensitivity

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19
Q

confirmatory tests are designed for high…

A

specificity

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20
Q

What is PPV?

A

proportion of test positives that are true positives

21
Q

What is NPV?

A

proportions of test negatives that are true negatives

22
Q

SUD is a behavioral illness that correlates to both (blank and blank) variables

A

heritable and acquired

23
Q

T/f: SUD is highly heritable

A

true

24
Q

1st degree relatives have a (blank) fold risk of developing SUD

A

8x

25
Q

T/F: environmental triggers are clinically relevant

A

true

26
Q

Does motivation have a relationship to willpower?

A

nope

27
Q

how do you define motivation?

A

defined as a history of being reinforced for a behavior

28
Q

Is motivation a binary variable?

A

no

29
Q

Motivation is relative to (blank) and must be measured on a continuous spectrum

A

environment

30
Q

T/F: mental health tx must pass through specific stages of treatment like attachmment, pattern search, working through, and termination

A

false!

31
Q

T/F: the expertise of the mental health professional is more important than the type of treatment

A

false

32
Q

what is the best way to decrease behaviors you want to see less of?

A

validation!

33
Q

what are the factors that go into the formation of motivation?

A

Rewards that occur quickly are more rewarding.
Rewards that you have to wait for are less rewarding.
Rewards that you have to work hard for are less rewarding.
Rewards that you don’t have to work hard for are more rewarding.

34
Q

many addictive behaviors are reinforced through (positive/negative) reward

A

negative reward

35
Q

what is emotional vulnerability?

A

an emotion that lasts a long time, has a high intensity, and takes a long time to resolve

36
Q

what is the effect of stress on emotional vulnerability

A

increases it

37
Q

what is the goal of Tx in addiciton medicine/

A

reduce the effects of emotional vulnerability

38
Q

Negative reward schedules also teach…

A

avoidance; if you get a reward for stopping something unpleasant, you learn to avoid the unpleasant thing in the first place

39
Q

As SUD progresses, the reward of use (increases/decreases) and the reward of Tx and abstince is punished (more/less)

A

reward of use increases and punishment for abstinence or treatment increases

40
Q

Dopamine is released by what drugs?

A

EtOH
Cocaine
Opiates
THC

41
Q

abused amphetamines are potent releasers and reuptake inhibitors of….

A

ALL the monoamines

42
Q

T/F: amphetamines may function as MAOIs

A

true

43
Q

ecstasy enhances prosocial behaviors through (blank) pathways

A

oxytocin; seen especially in teens

44
Q

how does choice play into addiction?

A

not a factor in acquisition, but a factor in treatment

45
Q

T/F: therapy interfering behavior is part of the illness

A

true

46
Q

T/f: doctors may exhibit therapy interfering behaviors

A

yes, normally in response to one from the patient

47
Q

What are the component of accpetance that are important to SUD treatment/

A

No one intervention is going to be curative.
Recovery is slow and painful.
As a part of the illness, motivation waxes and wanes (for both patient and doctor!).
Doctors have a duty to learn how to amplify motivation (in themselves and others!)
Doctors have a duty to not give up, or if they can’t avoid giving up, refer the patient to someone who hasn’t yet given up.

48
Q

T/f: lack of motivation is part of the illness

A

true; seen in both doc and pt

49
Q

T/F: drug addiction is a social, interpersonal illness more than any other disorder

A

true

Block 8 Week 5 Colt (12 decks)

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