substance abuse Flashcards
alcohol, tobacco, illicit drugs or improperly used medication are considered what?
substances
sporadic consumption with no major adverse consequences is called ?
substance use
consumption that risks major adverse consequences is called ?
At-Risk Substance Use
condition characterized by an individual who is significantly affected by another person’s substance use or addiction
codependency
_____: maladaptive use causing impairment or distress over a 12-month period where 1+ has occurred:
substance abuse
1. Failure to fulfill major role obligations
2. Use of drugs in hazardous situations
3. Recurrent legal problems due to substance use
4. Continued drug use despite persistent social or interpersonal problems because of use
state of adaptation manifested by a substance class-specific withdrawal syndrome
dependence
dependence can be produced by?
- Rapid dose reduction or cessation of a substance
- Administration of an antagonist
- Tolerance to the substance
2 types of dependence that patients may manifest
- psychological dependence
- physiologic dependence
Primary, chronic, neurobiologic disease with genetic, psychosocial, and environmental factors influencing its development and manifestations
addiction
addiction can be characterized by behaviors including:
- Impaired control over substance use
- Compulsive substance use
- Continued substance use despite harm
- Craving for substance
difference between substance use and dependence/addiction
- Substance use - pts retain control of their use
- Control can be affected by poor judgement, social factors, environment - Dependence and Addiction - No longer have full control
- Brain is “hijacked” by substance - need as powerful as thirst or hunger
- Users may still have some degree of conscious control
___: often predate the initial substance use, thought to be genetically predisposed
Measurable brain abnormalities
- Substance use → changes that affect dopamine level in mesolimbic system
- Changes are often permanent - account for relapses
Patients 12 yrs and up with any illicit drug use in the past 1 month: ?%
14% - 1 in 10
About half (49%) of people over their entire lifetime
Almost ___% are unaware that they have a substance abuse problem
Often goes unrecognized in clinical practice!
95%
who is the highest age of risk of substance abuse
late teens and early 20s
↓ age at first use = ?
↑ risk of later addiction
- Lifetime prevalence of ETOH - __% of pts 12+
- ETOH within past 12 months - __%
- ETOH within past 12 months, ages 12-20 - __%
4/5 (78%)
2/3 (62%)
1/10 (15%)
who is nearly twice as likely to engage in binge drinking
Almost three times as likely to engage in heavy drinking
males
Cigarettes or Vaping:
__% - Lifetime, pts 12 and up
__% - Past 1 yr, pts 12 and up
1/2 (58%)
1/5 (26%)
who are are more likely to use vaporized cigarettes (vapes)
young adults
what is the #1 substance for dependence and abuse in US (17.3 million)
alcohol
substance abuse costs over ? annually in costs related to crime, work productivity and healthcare
$800 billion
1. tobacco
2. alcohol
3. illicit drugs
4. Rx opiates
what is the leading preventable cause of death in the US
tobacco
what is involved in up to 50% motor vehicle fatalities?
illicit drugs or alcohol
substance use has an effect on social, physical, mental and public health problems, including:
- Medical Conditions
- Hepatitis
- Cirrhosis
- HIV/AIDS
- STIs
- Motor vehicle crashes/fatalities - Social Conditions
- Teenage pregnancy
- Domestic violence
- Child abuse
- Physical fights
- Overall crime
- Homicide/Suicide
what are the risk factors for substance use?
- Substance Factors
- Early onset tobacco use
- Early experimentation with substances
- Type of substance tried - Societal Influence
- Family
- Peer groups
- Religious groups
- Cultural and societal norms - Patient Personality Traits
- Risk-takers, thrill-seekers, novelty seekers
- Poor impulse control or emotional control
- Difficulty relating to others - Associated Psychiatric Disorders
- Conduct disorder
- MDD or Bipolar disorder
- ADHD
- Antisocial personality disorder - static patient demographics
- male
- black, AI/AN or NHOPI ethnicity
- gay or lesbian
- genetic predisposition - modifiable patient demographics
- low socioeconomic status
- single or divorced
- low educational level
- violent or high-crime neighborhood
- personal history of abuse
why do ppl use substances?
- feel good
- feel better
- fit in
Chemical structure of many drugs is similar to ?
neurotransmitters
allows them to be recognized by neurons and alter brain messages
Neurotransmitter involved in regulation of pain, appetite, memory, mood
Anandamide
active ingredient in marijuana
THC
NT that involves movement, motivation, reward,
addiction, well-being
dopamine
NT involved with mood, memory, sleep, cognition
serotonin
NT involved with learning, memory
glutamate
NT involved with lessening pain/euphoria
endorphins
NT involved with relaxation, anxiolytic
GABA
what are the three C’s of addiction?
- Control
- Early social & recreational use
- Eventual loss of emotional & behavioral control
- Cognitive distortions (denial and minimization)
- Tolerance and withdrawal - Compulsion
- Drug-seeking activities and craving → addiction
- Continued use despite adverse consequences - Chronicity
- Natural history of multiple relapses preceding stable recovery
- Possible relapse after years of sobriety
the attempt to alleviate symptoms of mental illness
self-medication
May increase vulnerability to mental illness are called ?
casual effects
Same/similar risk factors for substance use and mental illness are called ?
correlated causes
Up to what percent of substance abuse pts also have a mental disorder?
50%
Up to 40% have comorbid substance abuse disorder aka what disorder?
mood disorder