M2s1 Substance Use Disorder Flashcards
Opioid crisis
-brought light to the impact and prevalence of substance use disorders (SUD)
-from Jan 2016 to sept 2020, 19,355 Canadians died of apparent opioid overdose (so every 2 hours Canadian life lost, 94% of these deaths accidental)
What is SUD criteria
-defined and diagnosed by number of criteria
-once individual meet a minimum of 2 criterias = mild SUD
-more criteria an individual meets, the more severe the SUD
-various criteria can be generalized into subgroups
Social Impairments
-the individual fails to fulfill major roles (e.g. in work, school, home) and/or has persistent social or interpersonal problems. Additionally, social, occupational, or recreational activities may be given up or reduced
Risky Use
-individual may use the substance in physically hazardous situations or use the substance despite physiological or psychological problem caused by them
Impaired control
-the individual may have persistent craving for the substance ( I.e. addiction)
Withdrawal
-the individual may Experince a withdrawal syndrome after stopping use of the substance
Tolerance
-the individual may develop tolerance to the substance
Syndrome definition
A group of signs and symptoms occurring together that characterize a particular abnormality or condition
Addition
-one component of a complex disorder
-emotional and mental preoccupation with the drug’s effects and by a persistent craving for the drug, regardless of the consequences
-state in which stopping or abruptly reducing the dose of a given drug produces non-physical symptoms
-can occur not only to drugs, but other stimuli as well (e.g. gambling, shopping, video games, etc.)
The Dopamine Hypothesis
Predominant hypothesis to explain addition is called the dopamine hypothesis. 2 main components
Effects on reward systems
-this hypothesis suggests commonly misused drugs increase dopamine in the reward systems of the brain (I.e. the limbic system)
-other neurotransmitter systems are involved in substance misuse, but the increase in dopamine appears to be a key component of the brain’s reward system
Dopamine increase
-these dopaminergic systems are also responsible for natural rewards such as food and sex as well as for stimulus-related rewards such as video games and gambling
-drugs associated with addiction (such as cocaine) caused an exaggerated increase in dopamine, altering communication in the brain
*look at good notes for photos
Characteristics of Addictive Drugs
-categorized based off effect produce
Increase Dopamine - some substances lead to increase in dopamine in brain reward systems
Ex. Central nervous system (CNS) stimulates - cocaine, amphetamines, nicotine, caffeine
Opioids - morphine, heroin, oxycodone
And other drugs like alcohol and cannabis
Produce novelty - have novel feeling in person taking drug
Exs, lysergic acid diethylamide (LSD) and ecstasy also known as MDMA (3,4-Methylenodioxymethamphetamine)
Reduce anxiety - addictive as reduce anxiety in person taking them
Ex. CHS depressants like benzodiazepines and barbiturates
Drug withdrawal
-abnormal physiological state produced by repeated administration of drugs which leads to appearance of a withdrawal syndrome when drug administration is discontinued or dose is decreased
-severity of withdrawal syndrome increases with speed of drug withdrawal as biological processes that accommodated to the presence of drug do not have time to reverse themselves
-fear of withdrawal is one factor that contributes to the continuing of the drug- taking behaviour
Withdrawal symptoms
-usually opposite it the effects of the drugs ‘
Stimulants
Ex. Cocaine and amphetamines
-sleepiness
-muscle pain
-anxiety
-tremors
-low mood
-suicidal ideations (in some cases)
-cardiovascular problems ( in some cases)
Opioids
Ex. Heroin, morphine, and prescription medication like oxycodone
-sweating
-muscle aches
-agitation
-diarrhea
-abdominal cramping
-vomiting
Drug tolerance definition
-repeated administration of a given dose of a drug has progressively less pharmacological effect OR a state in which the dose of a drug must be increased to obtain the same magnitude of pharmacological effect as was produced by original drug dose
How would dose-response curve change after drug tolerance has developed
The graph would Experince a right word shift (more stretched that way) in order to receive as high of a percent response the drug dose must be increased
Drug tolerance and dose-response curve
- check goodnotes for image of graph
-usually expressed as a shortened duration of action and a decrease magnitude of effect
-extent and rate of development of tolerance is specific for each drug
Ex. Tolerance develops to the euphoria caused by morphine, but not to consitpating eggects caused by morphine
Note that tolerance does not develop to all drugs or all aspects of a drugs action
Drug tolerance is reversible upon drug discontinuation
Cross tolerance
- refer to goodnotes for graph
-can occur between pharmacologically similar drugs
-defined as resistance or tolerance to one drug because of the resistance or tolerance to a pharmacologically similar drug
Ex. If person tolerant to the CNS depressant alcohol, they would also be tolerant to the CHS depressant benzodiazepines, even if they have never taken a benzodiazepine before in their life
SUD
Substance use disorder
Factors influencing SUD
Genetic factors
-can predispose an individual to SUD
-ex. Genetic mutations in dopaminergic pathways in the brain, which are associated with addiction confer an increased risk of SUD
Pre-existing disorders
-individuals with major affective disorder (ex. Depression or bipolar disorder), anxiety disorder or schizophrenia are at higher risk for SUD than general population
Environmental factors
-exposures to environments that promote drug use, family dynamics, trauma, engaging in specific social/work groups all alter risk of SUD
-even when considering genetic factors, spouses and siblings of those with SUD are higher risk of developing SUD
Developmental factors
-individuals more vulnerable during certain developmental timeframes
-ex. Adolescence and early adulthood are at age groups primarily associated with initiation of SUD
-smoking usually begins before age 18, 80% of those with alcohol disorder being problematic use alcohol before age 30, illicit drug use often begins between 15 and 18 years of age
Stigma of SUD
-by society and medical professionals
-can lead to isolation and low self esteem
-consequence of this is individuals not receiving the medical or social help they need
-can help reduce stigma by changing language use ( instead of abuser, addict, druggie, or junkies -> use person with SUD, instead if abuse -> use use/misuse, instead of clean -> use in recovery/not currently using)