Lecture 9: Substance Abuse Part 1 COPY Flashcards
What are the two types of substance uses?
Substance use, which is just sporadic consumption with NO MAJOR ADVERSE COMPLICATIONS.
At-Risk Substance use, which is consumption that risks MAJOR ADVERSE COMPLICATIONS.
Define codependency.
A condition characterized by an individual who is significantly affected by another person’s substance use or addiction.
What qualifies as substance abuse?
At least ONE of these occurring over a 12-month period:
Failure to fulfill major role obligations
Use of drugs in hazardous situations
Recurrent legal problems due to substance use.
Continued drug use despite persistent social or interpersonal problems because of use
Define dependence.
State of adaptation manifested by a SUBSTANCE CLASS SPECIFIC WITHDRAWAL SYNDROME.
What 3 things can cause withdrawal syndromes?
Rapid dose reduction or cessation of a substance. (EX: You try to quit alcohol cold turkey and you get the DTs)
Administration of an antagonist (EX: you get narcan and start withdrawal symptoms instantly.)
Tolerance to the substance (EX: you keep upping your dose to get the same high)
What are the two types of dependence?
Psychological
Physiological
Define addiction.
Primary, chronic, neurobiologic disease with genetic, psychosocial, and environmental factors influencing its development and manifestations.
What 4 things characterize addiction?
Impaired control over substance use
Compulsive substance use
Continued substance use DESPITE HARM
Craving for substance
What is the key difference between substance use and dependence or addiction?
Pts have control of their use in substance use.
Once they start having changes that affect their dopamine levels in the mesolimbic system, it becomes much harder to control their desires consciously.
How many criteria do you need to meet to have a substance use disorder according to the DSM V TR?
2+
How common is illicit drug use?
12+ have used an illicit drug at least once in the past month. AKA 1 in 10 (14%)
49% of people use illicit drugs at least once in their life.
How common is marijuana use?
Almost identical to illicit drug use stats.
12+ in past month are 1 in 10 or 13%.
45% of people have used marijuana in their lifetime.
How unaware are people of their substance abuse problem?
95% ):
When are people most at risk of become addicted?
Late teens and early 20s.
The lower the age of their first use, the higher the risk of a later addiction.
What is the second most common illicit drug use after marijuana?
Opioids.
How has drinking prevalence changed since 2021?
Decreased in current and binge drinking
What is the lifetime prevalence of ETOH use?
4 out of 5, 78% of pts 12+.
How common is ETOH use in the past year? In the past year for ages 12-20?
2 out of 3 overall (62%)
1 in 10 for underage drinking. (15%
What demographic is more susceptible to binge drinking and heavy drinking?
Males.
2x binge drinking likelihood.
3x heavy drinking likelihood.
How common is lifetime cigarette/vaping use?
1 out of 2 pts (58%)
How common is cigarette/vaping use in the past yr for 12+?
1 out of 5 (26%)
What is the #1 substance for dependence and abuse in the US?
Alcohol.
What is the leading preventable cause of death in the US?
Tobacco.
How much does substance abuse cost us annually?
800b
What are the 3 risk factors for substance use that are substance factors?
Early onset tobacco use
Early experimentation with substances
Type of substance tried.
What associated psychiatric disorders are risk factors for substance use?
Conduct disorder
MDD or bipolar disorder
ADHD
Antisocial personality disorder
What NT does THC mimic?
Anandamide
What are the 5 NTs that drugs affect?
Dopamine
Serotonin
Glutamate
Endorphins
GABA
What does dopamine do?
Movement, motivation, REWARD, ADDICTION, well-being
What does serotonin do?
Mood, memory, sleep, cognition
What does glutamate do?
Learning, memory
What do endorphins do?
Lessened PAIN, euphoria
What does GABA do?
Relaxation, anxiolytic
What do nearly all drugs of abuse affect NT-wise?
Increase dopamine levels.
Affect serotonin and glutamate levels.
What happens to dopamine receptors as drugs of abuse are used?
Decreased availability.
What are the 3 C’s of addiction?
Control
Compulsion
Chronicity