Substance Abuse Flashcards
DSM 5 Added and took away what of the Substance Use Disorder
took away dependence since is = addiction
added craving to drug
and took away legal consequences
who has the highest rate of etoh use
caucasians, M>F but heavy drinking is = among races . higher in cities than rural
drinkers are more likely to be educated
no socioeconomic status
How much is too much
men - 12 drinks per week or 4 drinks per day
women- 7 drinks per week or 3 drinks per day
CAGE
Cut - even felt you should cut down
Annoyed- have ppl annoyed you by criticizing
Guilt- ever felt guilty
Eye Opener- to steady nerves in am
Early or later onset better or worse>
early onset (<25) has a poorer prognosis
cloningers type 1 and type 2
Type 1 -influenced from childhood experiences, inherited from mother, onset >25 , M and F, ability to abstain from drinking, desire to avoid harm.
Type 2 - uninfluenced by childhood experiences , inherited from father onset <25, inability to abstain, no desire to avoid harm
Babor Type A and type B
A- later onset , few childhood risk factors, less symptoms, less psychopath, less streess, less everything
B- earlier onset, more childhood risks, family alcholism, more everything
ETOH and women
- drink alone
- higher etoh bc of less gastric alcohol dehydrogenase and less volume distribution and less total body water
- faster progression from first drink to problems
6 teps of alcohol intoxications
euphoria - difficulty concentration, talkative
excitement - senses dulle. impaired judgment
confusion - exaggerated emotions
stupor - cant stand or walk, vomiting
coma - low body temp, unconscious
death - respiratory arrest
Delirium Tremens
medical emergency
withing 72 hrs of etoh withdrawal
high mortality
Treatment of ETOH
detox : benzos
Opioids - who and what age
M:F - 3:1
peak use in 20;s - mature out by 30’s
- more in lower socioeconomic classes
Primary effects on opioid receptors
u (Mu)- analgesia, respiratory depression, dependence
k - kappa - analgesia, sedation
Tx for opioid- overdose, non opi detox , detox and maintenance
overdose- naltrexone
non opioid detox - clonidine
detox and maintenance - methadone
buprenorphine , ssris
how does cocaine work
binds to dopamine transporter and inhibits the reuptake of synaptic dopamine, - admin of cocaine results in increases in extracelluar levels of dopamine
