Lecture 10: Substance Abuse and Addictive Disorders Flashcards
drug
any substance other than food affecting the body or mind, including alcohol, tobacco, and caffeine
substance intoxication
cluster of changes in behavior, emotions, or thought caused by substances
substance use disorder
maladaptive behaviour patterns and reactions caused by repeated substance use
diagnosis of substance use disorder
diagnosis requires the presence of at least two of the following symptoms within a 1-year period:
- substance is often taken in large amounts or over a longer period than intended
- unsuccessful efforts or persistent desire to reduce or control substance use
- much time spent trying to obtain, use, or recover from the effects or substance use
- failure to fulfill major role obligations at work, school, or home as a result of repeated substance use
- cessation or reduction of important social, occupational, or recreational activity because of substance use
- continued use of substance despite persistent social or interpersonal problems caused by it
- continued use in dangerous situations
- continued to use substance despite awareness that it’s causing or worsening physical or psychological problem
- craving for substance
- tolerance effects
- withdrawal effects
tolerance
need for increasing doses of substance to produce desired effect
withdrawal
unpleasant and sometimes dangerous symptoms occurring with drug stopping or cutting back
depressants
drugs that slow activity of the CNS, by reducing tensions and inhibitions and may interfere with judgment, motor activity and concentration. include:
- alcohol
- sedative-hypnotic (anxiolytic) drugs
- opioids/narcotics
alcohol
a type of drug in alcoholic beverages
- women typically become more intoxicated than men on equal doses of alcohol
- 0.09% of alcohol in the blood is the threshold for intoxication. 0.55% is likely fatal
- the effects of alcohol subside when concentration is lowered: alcohol is broken down by the liver into carbon dioxide and water, and expelled
binge drinking episode
five or more drinks on a single occasion
alcohol use disorder/alcoholism
characterized by regular intake of large amounts of alcohol, which eventually interfered with daily life
delirium tremens (DTs)
extreme withdrawal reaction that includes visual hallucinations and clouded mind
korsakoff’s syndrome
vitamin B deficiency due to long-term excessive alcohol use, marked by memory loss and other problems with nervous system
fetal alcohol syndrome
abnormalities in the fetus due to alcohol use by the pregnant mother, characterized by face deformities, intellectual disability, heart defects, slow growth and hyperactivity
cirrhosis
irreversibly scarred and dysfunctional liver, can be caused by excessive drinking
social impacts of alcoholism
play a role in suicides, assaults, rapes, and accidents. can destroy families, social relationships, and careers
college binge drinking
has impacts on mood, memory, and brain/heart functioning and is related to academic problems and dropping out of college
sedative-hypnotic (anxiolytic) drugs
produce feelings of relaxation and drowsiness. 2 types:
- low doses: calming or sedative effect
- high doses: sleep inducers or hypnotics
barbiturates
addictive and dangerous drugs, which were prescribed by some physicinas in the first half of the 20th century
benzodiazepines
anti-anxiety drugs that are not commonly prescribed by physicians, increase GABA activity
opioids/narcotics
all drugs derived from opium, such as morphine and heroine. cause CNS depression: pleasurable and calming feelings, nausea, narrowing of the pupils, and constipation. can be smoked, inhaled, snorted, injected, or swallowed.
endorphines
opioids attach to receptors that normally receive endorphins, which are neurotransmitters that help relieve pain and reduce emotional tension
use of opium
- in the past, opium was used as a painkiller, but it is very addictive. later, opium was converted into morphine.
- morphine was used because it is stronger than opium, but it also turned out to be addictive
- from morphine, another painkiller can be made: heroin. this was used for several years as a cough medicine and for other medical purposes, however it was discovered that heroin is even more addictive than morphine
opioid use disorder
excessive use of opioids, which interferes with daily functioning
dangers of opioid use
overdose, ignorance to tolerance, getting impure drugs, and infection from dirty needles
stimulants
substances that increase activity in the CNS, resulting in increased blood pressure, heart rate, alertness, and rapid behavior and thinking
cocaine (stimulant)
central active ingredient coca plant, most powerful stimulant, increases dopamine, norepinephrine, and serotonin activity, which overstimulates the nervous system, resulting in a euphoric, wakeful, and aroused state. snorted and sometimes injected or smoked
cocaine intoxication
when high doses are taken, symptoms include poor muscle coordination, aggression, anger, grandiosity, compulsive behavior, confusion, anxiety, and bad judgement
cocaine-induced psychosis
when high doses are taken, experiencing delusions and hallucinations
crashing
depression-like letdown after taking high doses, experiencing depressive feelings, headaches, dizziness, and fainting
freebasing
technique in which pure cocaine basic alkaloid is chemically separated from processed cocaine, vaporized by heat from a flame and inhaled with a pipe
crack
ready to smoke free-base cocaine
dangers of cocaine use
overdose: excessive doses at first stimulate and then depress the brain’s respiratory function, so breathing may stop. cocaine can also lead to brain seizures and fatal heart failure. use of cocaine during pregnancy increases likelihood of miscarriage and of having children with abnormalities
amphetamines (stimulant)
stimulants created in laboratory, initially to treat asthma. became popular for weight loss, providing extra energy, helping to stay awake. because they are dangerous, they are now prescribed less frequently
use of amphetamines
- increase dopamine, norepinephrine and serotonin activity in CNS and can cause emotional letdown as they leave the body
- small dose: increases energy and alertness and reduce appetite
- high dose: produces a rush, intoxication and psychosis
methamphetamine
type of amphetamine, which is available in crystal form (crystal meth), smoked by users to lower inhibitions and increase arousal
- danger: negative effects on physical mental and social life, increased ER visits; and neurotoxicity (damage to nerve endings)
stimulant use disorder
being dependent on the use of stimulants, which interferes with daily life
caffeine (stimulant)
most used stimulant, stimulates CNS by releasing dopamine, serotonin and norepinephrine, which results in increased motor activity and arousal levels and lower fatigue
hallucinogens (psychedelic drugs)
substances that produce powerful changes in sensory perceptions (=trips)
LSD (lysergic acid diethylamide) (hallucinogens)
increases and alters sensory perceptions, causing hallucinogen intoxication by binding to serotonin receptors. LSD tolerance and withdrawals are rare
dangers of LSD use
- self injury, bad trips, and flashbacks after the LSD has left the body
- long-term use of LSD can result in mood and anxiety disorders or in psychosis
cannabis
types of drugs produced from hemp plants. main active chemical is THC, which produces depressants, stimulants and hallucinogenic effects
Hashish (cannabis)
solidified resin of cannabis plant. most powerful
marijuana (cannabis)
mixture of buds, crushed leaves, and flowering tops. can be used for medical purposes, to treat diseases and relieve pain
dangers of marijuana use
- tolerance and withdrawal symptoms
- panic reactions, interferes with motor task, memory, and cognitive functioning
- long-term health problems: reproduction problems
cannabis intoxication (high)
feelings of joy and relaxation, time seems to slow down, distances seem greater than they really are. physical symptoms include eye reddening, dry mouth, dizziness, and increased heartbeat, blood pressure, and appetite.
cannabis use disorder
exercise use of cannabis, which interferes with daily life. current varieties of marijuana are more powerful than those available in the past
dangers of cannabis use
- tolerance and withdrawal problems - if tolerance is built, one may feel restless, irritable, and have fluke symptoms when not smoking
- occasional panic reactions, automobile accidents, decreased memory while high
- long-term health problems, reproduction problems
polysubstance use
taking more than one drug at a time
cross-tolerance
being tolerant to a drug you have never taken before because you have developed a tolerance for another drug that is very similar to it
synergistic effect
multiple substances strengthen each other’s effect when taken at the same time
sociocultural view of causes of substance use disorders
people who are most likely to develop these disorders:
- living in stressful SES conditions
- have families that value or tolerate drug use
- are confronted regularly by other kinds of stress
psychodynamic view of causes of substance use disorders
people who are most likely to have these disorders:
- result of childhood dependency needs: when a child grows up with insufficient nurturing, they seek comfort and nurture in other things
- the child develops a substance abuse personality that makes them vulnerable to substance abuse
cognitive-behavioral view of causes of substance use disorders
people who are most likely to develop these disorders:
- operant conditioned by tension-reduction, rewarding effects of drugs
- have rewards-produced expectancy that substances will be rewarding
- influenced by classical conditioning when cues or objects are present during drug use. these cues can produce similar effects to drug use. similarly, cues present during withdrawal can produce withdrawal-like symptoms
biological view of causes of substance use disorders
people who are most likely to develop these disorders:
- have genetic predispositions to be prone to drug addiction
- their brain reduces its natural production of neurotransmitters because it gets used to the drug increasing the levels
incentive-sensitization theory
when substances repeatedly stimulate reward center, the center develops a hypersensitivity to substances (wanting can grow independent of liking)
reward deficiency syndrome
reward center is not readily activated by “normal” life events so the person turns to drugs to simulate the pleasure pathway
developmental psychopathology view of causes of substance use disorders
- genetically inherited predispositions, numerous stressors throughout childhood, inadequate parenting, rewarding substance use experiences, and relationships with peers who use drugs
psychodynamic view of treatments of substance use disorders
clients are helped to become aware and correct underlying needs and conflicts related to drug use
aversion therapy (cognitive-behavioral view)
linking an unpleasant stimulus to use of substances, so client becomes conditioned to react negatively to substances. only effective when motivation to continue is high
contingency management (cognitive-behavioral view)
rewarding clients when they abstain from using drugs. only effective when motivation to continue is high
relapse-prevention training (cognitive-behavioral view)
keeping track of substance use, learning new coping strategies, and planning of time in order to be prepared for risky situations. helpful to reduce intoxication and binge drinking
acceptance and commitment training (cognitive-behavioral view)
accepting thoughts related to substance use and realizing they are part of something normal
detoxification (biological view)
systematic and medically supervised withdrawal from a drug
- outpatient/inpatient, gradual or induced withdrawal
antagonistic drugs (biological view)
intended to help people resist falling back into a pattern of substance abuse or dependence by giving drugs that block or change the effect of addictive drugs
- naloxone: opioid antagonist drug that attaches to endorphin receptor sites and makes it impossible for opioids to act
drug maintenance therapy (biological view)
clients are given a substitute drug with the same effects under medical supervision so that they do not have to use drugs in their daily environment
- methadone maintenance programs: heroin substitute (agonist), produces a moderate high, can be taken orally
self-help and residential treatment programs (sociocultural view)
organizations or programs that help support people in overcoming their addiction
culture and gender sensitive programs (sociocultural view)
programs that give special attention to potentially problematic sociocultural pressures
- alcoholic anonymous (AA): provides support for people with alcohol use disorder
- residential treatment centers; places where former drug addicts can work and live in a drug-free environment
community prevention programs (sociocultural view)
preventing substance use disorder on a large scale instead of treating it
gambling disorder
recurrent gambling from which people cannot walk away. leads to financial, social, occupational, educational, and health problems. people with gambling disorder need to increase amounts of money (tolerance) and feel restless or irritable when they try to reduce or stop gambling (withdrawal)
causes of gambling disorder
genetic predisposition, heightened dopamine activity and dysfunction when gambling, impulsive, novelty-seeking personality style, and repeated and cognitive mistakes
treatment of gambling disorder
relapse prevention training, opioid antagonists, and self-help programs
internet use disorder
uncontrollable need to be online, which interferes with daily life
- not included in the DSM-5, but version of it (internet gaming disorder) is being investigated for a future DSM edition
