SM_123b: Substance Use Disorders Flashcards
Substance disorders consist of ____, ____, ____, and ____
Substance disorders consist of risk harmful use, social impairment, impaired control, and physical dependence
____ represent 50% of the risk for substance abuse disorders
Genetics represent 50% of the risk for substance abuse disorders
- Impaired breakdown of alcohol: decrease risk
- Low level sensitivity to alcohol: increase risk
- Some psychiatric disorders: increase risk
- Some personality traits: increase risk
____ and ____ are traits that increase risk for substance abuse disorders
Negative emotionality and poor executive function are traits that increase risk for substance abuse disorders
Environmental risk factors for substance abuse include ____, ____, ____, ____, ____, and ____
Environmental risk factors for substance abuse include family, peers, social / cultural, adverse effects, current status, and current situation
Psychosocial risk factors include ____, ____, ____, and ____
Psychosocial risk factors include social control, social learning, behavioral choice, and stress & coping
Motivations have two dimensions ____ and ____
Motivations have two dimensions valence (direction of mood change) and source (change mood by altering)
- Valence: positive mood, negative mood
- Source: internal state, external situation
Motives for substance abuse include ____, ____, and ____
Motives for substance abuse include social, enhancement, and coping
- Social: be sociable
- Enhancement: get high, fun
- Coping: forget problems, cheer up
Motives link ____ traits to influence substance abuse
Motives link personality traits to influence substance abuse
____ is main neurotransmitter implicated in substance abuse
Dopamine is main neurotransmitter implicated in substance abuse
(mediates reward)
(there are others)
Drugs ____ dopamine D2 receptors
Drugs decrease dopamine D2 receptors
Neural systems for ____, ____, ____, and ____ are involved in substance abuse
Neural systems for inhibitory control, motivation / drive, learning / memory, and reward / salience are involved in substance abuse
Substance use disorders are characterized by ____, ____, ____, and ____
Substance use disorders are characterized by loss of control, compulsive behavior, continued use despite negative consequences, and changes in brain structure and function
Treatment for substance abuse should match ____
Treatment for substance abuse should match severity
Psychosocial treatment for substance abuse involves ____, ____, ____, ____, and ____
Psychosocial treatment for substance abuse involves motivational interviewing, 12-step facilitation, cognitive behavioral therapy, contingency management, and couples / family therapy
Psychosocial treatment for substance use targets ____, ____, ____, and ____
Psychosocial treatment for substance use targets social control, social learning, behavioral choice, and stress and coping
Alcohol has ____ and ____ effects
Alcohol has direct and indirect effects
Advers effects of alcohol include ____, ____, and ____
Advers effects of alcohol include depression, mild-moderate cognitive deficits, and Wernicke’s encephalopathy / Wernicke-Karsakoff syndrome
____ is a mu opioid antagonist used to treat alcohol abuse by decreasing positive reinforcement
Naltrexone is a mu opioid antagonist used to treat alcohol abuse by decreasing positive reinforcement
____ is glutamate antagonist used to treat alcohol abuse by reducing craving, dysphoria, and anxiety
Acamprosate is glutamate antagonist used to treat alcohol abuse by reducing craving, dysphoria, and anxiety
Disulfiram is used to treat alcohol abuse and acts by ____
Disulfiram is used to treat alcohol abuse and acts by preventing conversion of acetaldehyde to acetate by irreversible inhibiting acetaldehyde dehydrogenase, causing accumulation of acetaldehyde
(flushing, nausea, vomiting)
____ are used to treat alcohol abuse but have side effects of motor and cognitive impairment
Benzodiazepines are used to treat alcohol abuse but have side effects of motor and cognitive impairment
Cannabinoids have psychoactive component which is ____ (agonist) and non-psychoactive component which is ____ (antagonist)
Cannabinoids have psychoactive component which is THC (agonist) and non-psychoactive component which is cannabidiol (antagonist)
Endocannabinoids act on the CB1 receptor to cause ____
Endocannabinoids act on the CB1 receptor to cause psychoactive effects
(CNS)
Endocannabinoids act on the CB2 receptor to cause ____
Endocannabinoids act on the CB2 receptor to cause immune upregulation / inflammation
(immune cells)
Describe adverse effects of marijuana
Marijuana adverse effects
- Cannabis use disorder: high
- Motor vehicle accidents: high
- Symptoms of chronic bronchitis: high
- Diminished lifetime achievement: high
- Progression to toher drug use: medium
- Schizophrenia: medium
- Depression / anxiety: medium
- Abnormal brain development: medium
- Lung cancer: low
Synthetic cannibinoids have ____ than THC because they are ____ at the CB1 receptor
Synthetic cannibinoids have greater potency than THC because they are full agonists at the CB1 receptor
____ are not detected in urine toxicology
Synthetic cannibinoids are not detected in urine toxicology
Cocaine ____ dopamine reuptake, metabolizes ____, and has effects lasting ____
Cocaine decreases dopamine reuptake, metabolizes rapidly, and has effects lasting 1-2 hours
Amphetamine ____ dopamine reuptake and ____ dopamine release, metabolizes ____, and has effects lasting ____
Amphetamine decreases dopamine reuptake and increases dopamine release, metabolizes slowly, and has effects lasting 10-20 hours
Adverse effects of stimulants are ____, ____, ____, ____, and ____
Adverse effects of stimulants are myocardial infarction, stroke, persistent psychosis, decreased inhibitory control, and altered risk-reward decision making
____, ____, and ____ are serotonergic hallucinogens
LSD, psilocybin, and mescaline are serotonergic hallucinogens
PCP and ketamine are dissociative anesthetics that are ____
PCP and ketamine are dissociative anesthetics that are NMDA glutamate receptor antagonists
Opioids include ____, ____, and ____
Opioids include opiates, semi-synthetics, and synthetics
- Opiates: detected on urine toxicology screen
- Semi-synthetics: sometimes detected on urine toxicology screen
- Synthetics: NOT detected on urine toxicology screen
Endogenous opioid receptors include ____, ____, and ____
Endogenous opioid receptors include mu, delta, kappa
- Mu: euphoria, analgesia, decreased breathing / muscle tone
- Delta: decreased breathing, euphoria
- Kappa: analgesia, sedation, and miosis
B-endorphins act on ____ opioid receptors
B-endorphins act on mu opioid receptors
(also delta)
Enkephalins act on ____ opioid receptors
Enkephalins act on delta opioid receptors
Dynorphins act on ____ opioid receptors
Dynorphins act on kappa opioid receptors
Adverse effects of opioids include ____, ____, ____, ____, and ____
Adverse effects of opioids include nausea / vomiting, constipation, itching, cognitive slowing / fatigue / drowsiness, and overdose
____ is a mu opioid receptor agonist used to treat opioid abuse
Methadone is a mu opioid receptor agonist used to treat opioid abuse
____ is a mu opioid receptor partial agonist used to treat opioid abuse
Buprenorphine is a mu opioid receptor partial agonist used to treat opioid abuse
(combined with naloxone to decrease diversion)
____ is a mu opioid receptor antagonist used to treat opioid abuse in select populations
Naltrexone is a mu opioid receptor antagonist used to treat opioid abuse in select populations
Mechanisms of action of drugs of abuse include ____, ____, and ____
Mechanisms of action of drugs of abuse include blocking dopamine / 5 HT / NE receptors, modulating ion channels, and modulating receptors
