Kap 4 Substance dependence Flashcards
What are negative consequences of alcohol consumption?
(Bodily)
Liver damage (140 people die because of that yearly in NO)
nerve cells
risk for inflammation
risk for esophagus cancer
risk for pancreas cancer
risk for high blood pressure
risk for inflammation of the stomach
risk for Polyneuropathy (nerve damage in hands and feet)
Do you have any statistics on dependence?
People in treatment for these dependences:
Opioids: 50%
Alcohol: 4%
Medication: 1%
Which types of medication can make dependent?
Sleep medication (hypnotics/sedatives)
Anxiety medication (Anxiolytica)
Pain medication (various opioids)
What is the problem of withdrawal of addictive medication and how can it be confusing for the patient?
They can lead to the same symptoms that the medication was intended to treat. This makes it difficult to distinguish between them two.
What are substances that commonly lead to (deadly) overdoses?
Heroin
GHB (gamma-Hydroxybutyric acid)
Which pathway is central in substance disorders?
And which other brain areas are also part of it?
The Mesolimbic pathway which is a dopaminergic system.
The prefrontal cortex and the Amygdala.
What are the four types of issues/damages that substance abuse can have on a person, with some examples?
Direct acute issues
- Overdose
- Poisoning
Direct chronic issues
- Organ damage/failure
- Cancer
Indirect acute issues
- Suicide
- Injuries under the influence
- Violence (and abusing)
Indirect chronic issues
- Loss of social circle
- Loss of job
What are the highest comorbid psychological disorders to substance abuse?
Anxiety
Depression
Serious personality disorders
What are the types of substance related diagnoses?
Harmful use:
12 months - 1 month with daily use
Use leads to psychological or physical issues, but NOT social issues (incarceration, break up)
No diagnosis if dependence is there
At least one:
1. Use leads to direct health issues
2. Use leads to indirect health issues
3. Health issues pga administration
Dependence:
12 months - 3 month with daily use
two of these:
1. Loss of control over substance use
2. Substance use has priority over other areas
3. Physiological symptoms:
- Withdrawal effects
- Tolerance effects
- Substance use to help withdrawal
What is the usual course of substance dependence
- The person sees the substance as something positive
(maybe others are concerned) - The person develops a ambivalent relationship to the substance
(some issues appear) - The need increases
enjoyment decreases
withdrawal symptoms appear
tolerance increases
chronic issues happen
What are tests used to find out about substance abuse?
AUDIT/DUDIT:
Alcohol/Drug Use Disorder Identification Test
Alcohol-E
DUDIT-E
DTCQ - How likely use is (subjective)
Which therapies are used with substance dependence?
Motivational Interviewing
CBT
MBT
Family Therapy
Mindfulness
Group Therapy
How much of the variance in substance dependence can be explained by genetic vulnerabilities?
Around 40-70% of the variance can be explained by genes.
Which psychological disorders are connected to substance dependence?
And how many people with a psychological disorder will develop a substance dependence at least once in their lifetime?
(unipolar) Depression
Anxieties
(serious) Personality disorders
untreated ADHD
Around 40% of people with a psychological disorder
Which qualities are important in a therapist treating someone with substance dependence?
Patience (because a lifestyle change takes time)
Empathy
Accepting relapse (will happen)
Support all small steps in the right direction
