Substance Abuse Flashcards
Define: Intoxication
Tolerance, Dependence, Withdrawal
Intoxication – induced by substance
Tolerance – Decreased responsiveness after repeated administration
Dependence – physiologic adaptation that occurs after prolonged exposure
Withdrawal – Adverse physiological or psychological reaction to reduced use of a substance. opposite of the state of intoxication
Know the many define of substance abuse.
“A cluster of cognitive, behavioral and physiologic symptoms indicating that the individual continues using the substance despite significant substance related problems”
“An important characteristic of substance use disorders is an underlying change in brain circuitry that may persist beyond detoxification”
Substance Use in the DSM:
Substance Induced Disorders
“Includes intoxication, withdrawal and other substance / medication induced mental disorders”
- developed within 1 month of substance intoxication or withdrawal
- contribute to mental disorders. Mental disorders can contribute to substance use disorders
What are some causes of Substance Use Disorder?
Genetic susceptibility Runs in families Adoption studies Psychiatric factors Depression Anxiety Psychosis Social factors Poverty, etc Environment
Risk Factors for Alcohol and Drug Use
Psychiatric Environment Family Genetic Behavioral Social
Psychiatric Depression, loneliness, hopelessness Anxiety Low self-esteem Low tolerance for stress mental health disorders loss of control over life
Environment
Male
Inner city
low socioeconomic status; lack of employment and/or opportunities
Family
drugs and alcohol in FH
poor parenting skills
Family trauma
Genetic
abnormal brain cortisol reactions to stress
Behavioral Aggressive behavior in childhood Conduct disorder; antisocial personality disorder Impulsivity and risk-taking illegal activities Poor interpersonal relationships
Social peers Social or cultural norms approving use Expectations positive effects of drugs and alcohol Availability
Which NT has affect with alcohol?
Dopamine -mesolimbic reward system
GABA The universal inhibitor
Alcohol
Sedatives
How do long-term drug exposure impairs brain functioning?
- Substances release 2 to 10X more dopamine than natural rewards (eating, sex and social activities)
- motivates people to take drugs again .
- The brain adjusts - producing less dopamine and reducing the number of receptors that can receive signals
- ANY pleasure is reduced.
What are w/in the DSM5
Substance Use Disorder Substance Intoxication Substance Withdrawal Substance Induced Disorders Substance Induced Mood Disorders Unspecified
In early Remission
In sustained Remission
In a controlled Environment
Mild, Moderate, Severe
Example: Alcohol
Alcohol Use Disorder
A great deal of time to obtain alcohol
failure to fulfill major role obligations
Use where it is physically hazardous
(aggressive behavior, mood lability, impaired judgement)
slurred speech nystagmus, incoordination, impairment memory, stupor or coma
W/D
hyperactivity, tremor, insomnia, nausea, Hallucinations, psychomotor agitation, anxiety, seizures
Alcohol and genetics
Alcohol Dehydrogenase
Aldehyde Dehydrogenase
Cannabis
THC Delta-9-tetrahydrocannabinol
stimulant and sedative properties
Interact brains own cannabinoid receptors triggering, dopamine release
panic, delirium and psychosis
Amotivational syndrome in frequent users
Use in youth: increased schizophrenia
Cannabis Intoxication
(impaired motor coordination, euphoria, anxiety, impaired judgement, social withdrawal)
S/S -conjunctival injection, increased appetite, dry mouth, tachycardia, perceptual disturbances (hallucinations)
W/D Irritability, anger, aggression Anxiety Insomnia Decreased appetite Restlessness Depressed mood Physical symptoms: abdominal pain, tremor, sweating, fever, chills, headache
Opioids
euphoria followed by apathy, dysphoria, impaired judgement, psychomotor agitation or retardation
Drowsiness or coma
slurred speech,
impaired attention, pupillary constriction
Opioids
Opioid Withdrawal
Dysphoric mood, nausea or vomiting, muscle aches, lacrimation or rhinorrhea, pupillary dilation
DMS5 doesn’t quite paint in the colors…but this is extremely unpleasant for the sufferer!!!
What is the role of opioid epidemic?
medical establishment
pharmaceutical Industry
economic / employment / social factors
Pain as a vital sign
Opioid refugees
Prescriptions to Heroin
What is the ASAM criteria?
Deminsion
Acute intoxication or WD- Current ROS
Biomedical Conditions- PMH
EMotional, Behavior, Cognitive- thoughts
Readiness to Change
Relapses, Cont. Use
Recovery/Living Environment
