Module 8 - Substance related and addictive disorders Flashcards
Substances of abuse are defined into 10 classes
alcohol
caffience
cannabis
opiods
sedatives, hypnotics, anxiolytics (depressant drugs)
inhalants
halluncinogens
stimulants
tobacco
other or unknown substances
Criteria by which we define problem use
Impairment of control over use
Social impairment
Risky Beh.
Pharmacological dependence; withdrawal and tolerance
SUDS
Substance INDUCED disorders.
Mental disorders that resemble indepedent disorders in the DSM-5-TR such as depression, psychosis or anxiety that are produced by the use of, or withdrawal from, a substance
What are the characteristics of Nicotine
-CNS Stimulant related to amphetamines .
-INcreases the availability of NT’s (DA, NE, 5-HT) and affects nucleus accumbens (primary reward centre).
-Dependence develops quickly, beh. effects severe enough to have a substance use disorder in DSM-5
What are the characteristics of Amphetamine
-Has similar effects on the body as adrenalin.
-Increased heart rate or irregular heartbeat, fluctuations in blood pressure, hot/cold flashes, nausea, weakness, dilation of pupils.
-At low doses it increase alertness, offering improved performance on cognitive tasks. Suppress appetite
-At high doses - feelings of exhiliaration, extraversion, and confidence
-Repeated high doses can cause halluncinations, delerium, and paranoia (toxic psychosis)
-At very high doses - restlessness and anxiety. Seizures, confusion, comas
-Chronic use is associated with fatigue and sadness as well as periods of social withdrawal and anger.
-Prolonged use leads to weight loss
Most common versions are methamphetamine (speed when injected, ice/crystal when smoked) and dextroamphetamine (prescription drug). Ritalin (ADHD med) is a methamphetamine.
Methylated amphetamines(designer drugs):
-Both stimulants and halluncinogenics
- Ex: MDMA, E
Moderate or greater use can lead to permanent serotonin loss.
Tolerance and dependance develops very quickly
What is the most used and abused group of drugs
stimulants
Characteristics of Cocaine
-Increased blood pressure and body temperature, irregular heartbeat
Users become more alert, talkative, reduced appetite, increased excitment and energy
-High dose- CNS is overstimulated, leading to poor muscle control, confusion, anxiety, anger and aggression.
-Continuous use - mood swings, loss of interest in sex, weight loss and insomnia, Can also lead to toxic psychosis.
-Death can occur because of its effect on the brain centres that control respiration
Produces intense psychological dependence and results in severe withdrawal symptoms (craving, depression, paranoia and fatigue). Withdrawal symptoms can take a month to dissapear completely.
Characteristics of opiods
CNS depressant
Main effects are reduction of pain and sleep inducement
Heroin - Euphoria and dream-like sedation. user may appear drunk. Supresses appetite and even small doses can cause restlessness, nausea, vomiting
Chronic users may develop chronic respiratory and pulmonary problems
Characteristics of cannabis
-Generally depressant effects but increases heart rate like a stimulant.
-Involves mild changes in perception with enhancement of physical experiences.
-Under influence users show deficits in complex motor skills, short term memory, reaction time and attention
Small doses - mildly euphoric and sociable.
Some long term users develop amotivational syndrome
Regular use has been connected to increased onset of psychosis and withdrawal and tolerance symptoms
amotivational syndrome
A continuing pattern of apathy, profound self-absorption, detatchment from friends and family, and abandonment of career and educational goals evident in some long term use of cannabis.
Depression and Cannabis
About 30% of regular cannabis users have depression symptoms
Characteristics of halluncinogens
-Change a persons mental state by producing perceptual and sensory distortions
-Excitatory effect on CNS and mimic effects of serotonin
-Effects depend on personality of user and amount of product consumed, the setting the user is in when taking.
-Small number of individuals are left with prolonged psychotic disorder long after the drug has worn off
What factors make individuals vulnerable to substance use disorders?
Neurobiological:
- Changes in dopamine NT system and brain regions involved in rewars
-HT such as GABA, beta-endorphin and serotonin
Psychological:
- Negative emotionality
- Neuroticism
- Behavioural disinhibition
- Self medication hypothesis (use to relieve other mental health symptoms)
Socio-Cultural:
- Social learning theory
- Acculturation
- Cultural attitudes about gender roles (more acceptable for men to drink/drugs/gamble, therefore women protected against addiction)
Effective treatments for substance abuse
Pharmacology:
-to assist in detoxification, to reduce the pleasant effects of substance or produce adverse effects
Ex:
-Benzo’s or naltrexone for alcoholism
-antidepressants for cocaine and amphetamine
-naltrexone, clonidone and methadone for opiods
-Smaller doses of benzo and barbiturates
Mutual support Groups:
-AA
-SMART
-Moderation management
Psychological:
-Behavioural treatment
-CBT
-relapse prevention
-marital and family therapy
-brief interventions
Motivational interviewing (a brief intervention approach)
client centered and helps engage intrinsic motivation for changing beh. by creating discrepancy and exploring and resolving ambivalence within in a client
