SM_123b: Substance Use Disorders

Question 1

Substance disorders consist of ____, ____, ____, and ____

Answer 1

Substance disorders consist of risk harmful use, social impairment, impaired control, and physical dependence

Question 2

____ represent 50% of the risk for substance abuse disorders

Answer 2

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

Question 3

____ and ____ are traits that increase risk for substance abuse disorders

Answer 3

Negative emotionality and poor executive function are traits that increase risk for substance abuse disorders

Question 4

Environmental risk factors for substance abuse include ____, ____, ____, ____, ____, and ____

Answer 4

Environmental risk factors for substance abuse include family, peers, social / cultural, adverse effects, current status, and current situation

Question 5

Psychosocial risk factors include ____, ____, ____, and ____

Answer 5

Psychosocial risk factors include social control, social learning, behavioral choice, and stress & coping

Question 6

Motivations have two dimensions ____ and ____

Answer 6

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

Question 7

Motives for substance abuse include ____, ____, and ____

Answer 7

Motives for substance abuse include social, enhancement, and coping

• Social: be sociable
• Enhancement: get high, fun
• Coping: forget problems, cheer up

Question 8

Motives link ____ traits to influence substance abuse

Answer 8

Motives link personality traits to influence substance abuse

Question 9

____ is main neurotransmitter implicated in substance abuse

Answer 9

Dopamine is main neurotransmitter implicated in substance abuse

(mediates reward)

(there are others)

Question 10

Drugs ____ dopamine D2 receptors

Answer 10

Drugs decrease dopamine D2 receptors

Question 11

Neural systems for ____, ____, ____, and ____ are involved in substance abuse

Answer 11

Neural systems for inhibitory control, motivation / drive, learning / memory, and reward / salience are involved in substance abuse

Question 12

Substance use disorders are characterized by ____, ____, ____, and ____

Answer 12

Substance use disorders are characterized by loss of control, compulsive behavior, continued use despite negative consequences, and changes in brain structure and function

Question 13

Treatment for substance abuse should match ____

Answer 13

Treatment for substance abuse should match severity

Question 14

Psychosocial treatment for substance abuse involves ____, ____, ____, ____, and ____

Answer 14

Psychosocial treatment for substance abuse involves motivational interviewing, 12-step facilitation, cognitive behavioral therapy, contingency management, and couples / family therapy

Question 15

Psychosocial treatment for substance use targets ____, ____, ____, and ____

Answer 15

Psychosocial treatment for substance use targets social control, social learning, behavioral choice, and stress and coping

Question 17

Alcohol has ____ and ____ effects

Answer 17

Alcohol has direct and indirect effects

Question 18

Advers effects of alcohol include ____, ____, and ____

Answer 18

Advers effects of alcohol include depression, mild-moderate cognitive deficits, and Wernicke’s encephalopathy / Wernicke-Karsakoff syndrome

Question 19

____ is a mu opioid antagonist used to treat alcohol abuse by decreasing positive reinforcement

Answer 19

Naltrexone is a mu opioid antagonist used to treat alcohol abuse by decreasing positive reinforcement

Question 20

____ is glutamate antagonist used to treat alcohol abuse by reducing craving, dysphoria, and anxiety

Answer 20

Acamprosate is glutamate antagonist used to treat alcohol abuse by reducing craving, dysphoria, and anxiety

Question 21

Disulfiram is used to treat alcohol abuse and acts by ____

Answer 21

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)

Question 22

____ are used to treat alcohol abuse but have side effects of motor and cognitive impairment

Answer 22

Benzodiazepines are used to treat alcohol abuse but have side effects of motor and cognitive impairment

Question 23

Cannabinoids have psychoactive component which is ____ (agonist) and non-psychoactive component which is ____ (antagonist)

Answer 23

Cannabinoids have psychoactive component which is THC (agonist) and non-psychoactive component which is cannabidiol (antagonist)

Question 24

Endocannabinoids act on the CB1 receptor to cause ____

Answer 24

Endocannabinoids act on the CB1 receptor to cause psychoactive effects

(CNS)

Question 25

Endocannabinoids act on the CB2 receptor to cause \_\_\_\_

Answer 25

Endocannabinoids act on the CB2 receptor to cause immune upregulation / inflammation (immune cells)

Question 26

Describe adverse effects of marijuana

Answer 26

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

Question 27

Synthetic cannibinoids have ____ than THC because they are ____ at the CB1 receptor

Answer 27

Synthetic cannibinoids have greater potency than THC because they are full agonists at the CB1 receptor

Question 28

\_\_\_\_ are not detected in urine toxicology

Answer 28

Synthetic cannibinoids are not detected in urine toxicology

Question 29

Cocaine ____ dopamine reuptake, metabolizes \_\_\_\_, and has effects lasting \_\_\_\_

Answer 29

Cocaine decreases dopamine reuptake, metabolizes rapidly, and has effects lasting 1-2 hours

Question 30

Amphetamine ____ dopamine reuptake and ____ dopamine release, metabolizes \_\_\_\_, and has effects lasting \_\_\_\_

Answer 30

Amphetamine decreases dopamine reuptake and increases dopamine release, metabolizes slowly, and has effects lasting 10-20 hours

Question 31

Adverse effects of stimulants are \_\_\_\_, \_\_\_\_, \_\_\_\_, \_\_\_\_, and \_\_\_\_

Answer 31

Adverse effects of stimulants are myocardial infarction, stroke, persistent psychosis, decreased inhibitory control, and altered risk-reward decision making

Question 32

\_\_\_\_, \_\_\_\_, and ____ are serotonergic hallucinogens

Answer 32

LSD, psilocybin, and mescaline are serotonergic hallucinogens

Question 33

PCP and ketamine are dissociative anesthetics that are \_\_\_\_

Answer 33

PCP and ketamine are dissociative anesthetics that are NMDA glutamate receptor antagonists

Question 34

Opioids include \_\_\_\_, \_\_\_\_, and \_\_\_\_

Answer 34

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

Question 35

Endogenous opioid receptors include \_\_\_\_, \_\_\_\_, and \_\_\_\_

Answer 35

Endogenous opioid receptors include mu, delta, kappa * Mu: euphoria, analgesia, decreased breathing / muscle tone * Delta: decreased breathing, euphoria * Kappa: analgesia, sedation, and miosis

Question 36

B-endorphins act on ____ opioid receptors

Answer 36

B-endorphins act on mu opioid receptors (also delta)

Question 37

Enkephalins act on ____ opioid receptors

Answer 37

Enkephalins act on delta opioid receptors

Question 38

Dynorphins act on ____ opioid receptors

Answer 38

Dynorphins act on kappa opioid receptors

Question 39

Adverse effects of opioids include \_\_\_\_, \_\_\_\_, \_\_\_\_, \_\_\_\_, and \_\_\_\_

Answer 39

Adverse effects of opioids include nausea / vomiting, constipation, itching, cognitive slowing / fatigue / drowsiness, and overdose

Question 40

\_\_\_\_ is a mu opioid receptor agonist used to treat opioid abuse

Answer 40

Methadone is a mu opioid receptor agonist used to treat opioid abuse

Question 41

\_\_\_\_ is a mu opioid receptor partial agonist used to treat opioid abuse

Answer 41

Buprenorphine is a mu opioid receptor partial agonist used to treat opioid abuse (combined with naloxone to decrease diversion)

Question 42

\_\_\_\_ is a mu opioid receptor antagonist used to treat opioid abuse in select populations

Answer 42

Naltrexone is a mu opioid receptor antagonist used to treat opioid abuse in select populations

Question 43

Mechanisms of action of drugs of abuse include \_\_\_\_, \_\_\_\_, and \_\_\_\_

Answer 43

Mechanisms of action of drugs of abuse include blocking dopamine / 5 HT / NE receptors, modulating ion channels, and modulating receptors