L8- Substance misuse Flashcards
definition of substance misuse
refers to the harmful or hazardous use of psychoactive substances, including alcohol and illicit drugs. Psychoactive substance use can lead to dependence syndrome- a cluster of behavioural, cognitive and physiological phenomena that develop after repeated substance use and that typically include a strong desire to take the drug, difficulties in controlling its use, persisting in its use despite harmful consequences, a high priority given to drug use than other activities and obligations, increased tolerance, and sometimes a physical withdrawal state
types of substances
stimulants
hallucinogens
depressants
stimulants make you feel
feel more alert and like you have more energy and confidence.
example of stimulants
tobacco, cocaine, amphetamine (speed) and mephedrone
hallucinogens are described as
as ‘mind- altering’ as they can change/impact your perceptions, mood and your senses.
examples of hallucinogens
include LSD and magic mushrooms (note that sometimes drugs have mixed effects – ecstasy for example is sometimes described as a stimulant hallucinogen).
depressants make you feel
relaxes
depressants incude
Examples include alcohol, heroin, tranquillisers and cannabis.
drinking highest in those who earn
> 40,000/year
the cheaper the alcohol
the more people drink
how many adults aged between 16-59 having used drugs in the last year
1 in 12 (8.5%)
how many young people ages 16-24 report use in the last year and last month
- 1 in 5 (19.2%) of and 1 in 11 (9%) in the last month
how many adults report having used drugs in their lifetime
34.2%
how many adults have alcohol dependency
595,131
dependence can be
physical or posychological
physical dependence relates to
experiencing symptoms associated with withdrawal
psychological dependence relates to having
impaired control
how can dependence be described (2)
1) ICD-10
2) DSM
ICD-10
a diagnostic guidline
A cluster of physiological, behavioural, and cognitive phenomena in which the use of a substance or a class of substances takes on a much higher priority for a given individual than other behaviours that once had greater value. A central descriptive characteristic of the dependence syndrome is the desire (often strong, sometimes overpowering) to take psychoactive drugs (which may or may not have been medically prescribed), alcohol, or tobacco. There may be evidence that return to substance use after a period of abstinence leads to a more rapid reappearance of other features of the syndrome than occurs with nondependent individual.
DSM
overlaps with ICD-10 (quite similar)
Audit- C
screens for at risk populations
risk factors for drug use
- family life (neglects, drug use and abuse)
- mental health
- employment and educational attainment
- social group
- previous drug use
- biology
use of drugs one early life
been shown to increase likelihood of going on to have problematic use
adverse childhood experiences ACE
Massive risk factor for drug and alcohol abuse
14% of pop will have some ACEs
ACE exapmples
Maltreatment
Childhood household including specific factors
maltreatment
1) verbal abuse
2) physical abuse
3) sepal abuse
Childhood household including specific factors
- parental separation
- domestic violence
- mental illness
- alcohol abuse
- drug abuse
- incarceration
theories of dependence
1) Learning theory
2) imitation theory
3) rational choice theory
learning theory and dependence
Learned associations between positive and negative reinforcement
learning theory: classical conditioning models
Drug dependence arises from environmental effects paired with a drug effect.
- unconditional stimulus
- conditional stimulus
unconditional stimulus
stimulus such as falling blood alcohol levels leads to an unconditional response such as having withdrawal symptoms
conditional stimulus
- e.g. sight of a needle or the smell of fav drinks- paired with an unconditional stimulus like falling blood alcohol levels
dependence enad imitation theories
A social learning theory (Bandura): learning through observation and listening to others- our behaviours and decision making is developed through what we observe in peers and in our role models.
- modeling
- expectation
- self-efficacy
modleing
Risk of developing drug use issues is increased if you see others around you participating in this behaviour.
expectation
: A positive reward makes drug use more likely. This can include early connections between behaviours and perceived rewards – for example we might see a parent come home from work stressed and then use alcohol to relax. Conversely a negative experience will promote avoidance
self-efficacy
How you view your ability to abstain or deal with situations impacts on behaviour.
imitation theories and CBT
reduces expectation of a positive reward and develops self-efficacy
imitation theories and twelve step programme
positive role models and promotes coping skills
rational choice theories and dependence
Dependency involves making rational choices that favours the benefits of dependence over the costs. Individuals are motivated by their ‘preferences’ which are their wants or gaols.
theory of rational addictions
- An economic model that applies economic concepts to addiction/dependence
- Makes a distinction between harmful and beneficial addictions – a harmful addiction or dependence has a negative impact on an individuals resources
- People who are dependent/addicted make ‘utility maximising decisions’ about whether or not to take a substance and they take into account how their current use impacts on the future
- People who ‘discount’ the future more are more likely to become addicted
- People with dependence are seen as rational consumers, they behave in away that aims to maximise their preferences
- Making drugs more costly (in all ways, not just financial) would lead to reduced drug use
