Lecture 5a - Substance Use Disorders Flashcards
Which are the two categories of Substance use disorders?
- Substance abuse
2. Substance dependence
What are the main substance use disorders?
Alcohol Amphetamine Cannabis Cocaine Gambling (new to DSM Hallucinogen Inhalant Opioid Phencyclidine Sedative/hypnotic/ Tobacco
Criteria for substance use disorder
+Problematic pattern of use that impairs functioning. Two or more symptoms within a 1 year period:
• Failure to meet obligations
• Repeated use in situations where it is physically dangerous
• Repeated relationship problems
• Continued use despite problems caused by the substance
• Tolerance
• Withdrawal
• Substance taken for a longer time or in greater amounts than intended
• Efforts to reduce or control use do not work
• Much time spent trying to obtain the substance
• Social, hobbies, or work activities given up or reduced
• Continued use despite knowing problems caused by substance • Craving to use the substance is strong
Severe ratings for substance use disorders
Mild - 2-3 criteria
Moderate - 4-5 criteria
Severe - 6 or more
What is Addiction?
\+Severe substance use disorder Having 6 or more severe symptoms such as: \+tolerance \+Withdrawal \+Using more than intended amounts \+Trying unsuccessfully to stop \+Having physical or psychological problems made worse by drug \+Experience problematic relationships
+With physiological dependence:
Presence of either tolerance or withdrawal
+Without physiological dependence:
Absence of either tolerance or withdrawal
What is alcohol use disorder?
When somebody is physiologically dependent in alcohol
What is delirium tremens (DTs)
+Can occur when blood alcohol levels drop suddenly Results in:
+Deliriousness Tremulousness Hallucinations
+Primarily visual; may be tactile
What is Polydrug abuse?
When somebody abuse multiple substances
Cigarette, cocaine, marijuana, alcohol
Prevalence of alcohol abuse
+Lifetime prevalence
+ Binge drinking - 5 drinks in one hour
+Heavy use of drinking - 5 drinks, 5 or more times in a period of 30 days
+Higher prevalence in men
+White and Hispanic adolescents and adults more likely to binge drinking
+ Binge and heavy use drinking lowest among Asian Americans and African Americans
+ Alcohol dependence highest among Native Americans and Hispanics
+Comorbidity with other disorders: personality disorders, mood disorders, schizophrenia, and anxiety disorders
Short term effects of alcohol
\+Interacts with several neural systems \+Stimulates GABA receptors \+Reduces tension \+Increases dopamine and serotonin \+Produces pleasurable effects \+Inhibits glutamate receptors \+Produces cognitive difficulties
Short term effects of alcohol
1. Interacts with several neural systems \+Stimulates GABA receptors \+Reduces tension \+Increases dopamine and serotonin \+Produces pleasurable effects \+Inhibits glutamate receptors \+Produces cognitive difficulties
- Effects of ingesting large amounts
Significant motor impairment
Poor decision making
Poor awareness of errors made
Long term effects of alcohol
Malnutrition
• Calories from alcohol lack
nutrients
• Alcohol interferes with digestion and absorption of vitamins from food
Damage to endocrine glands and pancreas
Heart failure
Erectile dysfunction
Hypertension
Stroke
Capillary hemorrhages
• Facial swelling and redness, especially in nose
Destruction of brain cells
• Especially areas important to memory
• Deficiency of B
causes Amnestic syndrome
-
Severe loss of memory for both
complex vitamins
+ Malnutrition
Calories from alcohol lack nutrients
Alcohol interferes with digestion and absorption of vitamins from food
Deficiency of b-complex vitamins causes Amnestic syndrome.
Severe loss of memory for both long and short term information.
+Cirrhosis of the liver
• Liver cells engorged with fat and protein, impeding functioning
• Cells die, triggering scar tissue which obstructs blood flow
• Liver disease and cirrhosis rank 12 in the U.S causes of death
\+Damage to endocrine glands and pancreas
\+Heart failure
\+ Erectile dysfunction
\+Hypertension
\+Stroke
\+Capillary hemorrhages
Facial swelling and redness, especially in nose.
\+Destruction of brain cells
Especially areas important to memory
-
and
-
short
-
term information
What is Fetal alcohol syndrome?
\+Heavy alcohol intake during pregnancy A leading cause of mental retardation Fetal growth slowed Cranial facial and limb anomalies occur \+Total abstinence by pregnant women recommended
Tobacco use disorder
+Nicotine
Addicting agent of tobacco
Stimulates dopamine neurons in mesolimbic area
Involved in reinforcing effect
Prevalence and Health consequences of tobacco
+18% prevalence
+Smoking is the single most preventable cause of premature death in the U.S
+Cigarettes kill 1000 people every day
+Lung cancer is most common cancer
+Cigarettes also cause or exacerbate: emphysema, cancers of larynx, esophagus, pancreas, bladder, cervix, stomach, cardiovascular disease
Sudden infant death syndrome and pregnancy complications
Prevalence and Health consequences of tobacco
+More prevalent among white and Hispanic youth than African Americans
+More prevalent among men than women
+Second hand smoke
What is Marijuana?
Drug derived from dried and ground leaves and stems of the female hemp plant.
What is Hashish?
+ Stronger than marijuana
+ Produced by drying the resin exudate of the tops of plants
+ In DSM-5 called Cannabis use disorder
Marijuana prevalence
+Most frequently used illicit drug in U.S
+Greater use by men than women
+Rates of daily use are on the rise
+ May be related to varying degrees of legal status by state
Effects of Marijuana
- Psychological
Major active ingredient - tetrahydrocannabinol
Feelings of relaxation and sociability
Rapid shifts of emotion
Interferes with attention, memory and thinking
Decline in IQ over time
• Heavy doses can induce hallucinations and panic
• Difficult to regulate dosage
Effects take 30 minutes to appear
Smoke more than intended waiting for effects
• Interfere with cognitive functioning
2. Physiological
• Bloodshot and itchy eyes
• Dry mouth and throat
• Increased appetite
• Reduced pressure within the eye
• Increased BP
• Damage to lung structure
and function in long users
Marijuana and the Brain
Two cannabinoid brain receptors CB1 and CB2 High concentration in hippocampus Increased blood flow to emotion regions Amygdala and anterior cingulate Habitual use leads to tolerance Withdrawal symptoms also observed
Therapeutic effects of Marijuana
+reduces nausea and loss of appetite caused by chemotherapy
+relieves discomfort of AIDS, chronic pain
Supreme court rulings:
+federal law prohibits dispensing marijuana for medicinal purposes
+Medical use can be prohibited by federal government even if states approve
