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PSYC 100 - clinical > Substance Abuse > Flashcards

Substance Abuse Flashcards

1
Q

substance related and addictive disorders

A

abuse of drugs and other substances people take to alter the way they think, feel and behave

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2
Q

psychoactive substances

A

chemical compunds that alter mood, behaviour or both

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3
Q

substance use

A

ingestion of psychoactive substances in moderate amounts that does not significantly interfere with social, educational or occupationa fucntioning

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4
Q

substance intoxication

A

physiological reaction to ingested substances (drunkeness or getting high)

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5
Q

substance abuse

A

pattern of psychoactive substance use leading to significant distress or impairment in social and occupational roles in hazardous situations

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6
Q

substance dependence (aka addiction)

A

a maladaptive pattern of sibstance use characterized by:
-the need for increased amounts to achieve the desired effect (tolerance)
-negative physical effects when the substance is withdrawn (withdrawal)
-unsuccesful efforts to control its use
-substantial efforts expended to see it or recover from it
it is possible to be physically dependent on a drug but not abuse or be addicted to it

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7
Q

depressants

A

result in relaxation and sleepiness

alcohol, barbituates, benzo

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8
Q

stimulants

A

increase altertness and elevate moss

amphetamines, cocaine, nicotine, caffeine

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9
Q

opiods

A

produce pain relieve (analgesia) and euphoria

heroin, opium, morphine, codeine, methadone, oxycodone, hydrocodone

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10
Q

hallucinogens

A

alter sensory perception, can produce delusions, paranoia and hallucinations
LSD, psilocybin, DMT, mescaline, ketamine, PCP, MDMA

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11
Q

cannabis

A

marijuana

results in silliness or dreamlike state, possibly heightened sensory experiences

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12
Q

other drugs of abuse

A

inhalents, anabolic steriods, medication etc

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13
Q

what is the leading cause of preventable death and disease

A

smoking

1 in every 5 deaths

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14
Q

opiod dependency impact stats

A

rapid growth over the last 10 years
majority of drug overdoses invole an opiod
since 1999, rate of prescription opiod related deaths has quadrupled
12.3% of high school senior reported using opiods for nonmedical reasons

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15
Q

consequences of substance use

A

• Child and spousal abuse
• STDs including HIV
• Teen pregnancy and fetal health problems
• Problems at school and work – low productivity
• Family and social problems
• Health problems – cardiovascular, liver, brain,
immune system, gastrointestinal, pancreas,
kidneys, lungs…
• Motor vehicle crashes, homicides, suicides,
accidental death

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16
Q

what did DSM5 do in changing its definitions of substance abuse

A

substance use disorders (SUD)
no longer distinguishes substance abuse from substance dependence
combined the two with a couople of changes

17
Q

features of dsm5 substance use disorders

A

At least two of:

  1. Doesn’t meet obligations
  2. Use in hazardous situations
  3. Use despite social or interpersonal problems
  4. Tolerance
  5. Withdrawal
  6. Use larger amounts or for more time than intended
  7. Can’t cut down or control use
  8. Much time spent getting, using, or recovering
  9. Important activities given up or reduced
  10. Use despite physical or psychological problems
  11. Craving or a strong desire or urge to use
18
Q

overview 6 reasons people become addicted

A 
bio
learning
cognitive factors
social factors
comorbid disorders
personality features
19
Q

biological mechanisms of addiction

A

reward pathway
-mesolimbic dopamine system
-ventral tegmental area (VTA) -> nucleus accumbens
amygdala, hippocampus and PFC also involved

20
Q

explain dopamine cells in the nucleus accumbens

A

see textbook to fill in

21
Q

vulnerabilities of bio to substance abuse

A

level of response
-low response = vulnerable, runs in families
genetic factors
-vulnerability
-also protective
eg alcohol metabolism
alcohol ->ADH to acetaldehyde ->ALDH2 acetic acid
asians = no ALDH2 so poisoning = red blotches etc so less alcoholic asians

22
Q

classical conditioning model of addiction

A 
drug cue (neutral)
drug (unconditioned stimuli)
brain changes (unconditioned response)
over time turns to
drug cue (conditioned stimulus)
brain changes (conditioned response)
23
Q

evidence for classical conditioning in alcohol drinkers

A

alcohol use disordered teens showed more brain response to alcohol pictures than nondrinkers
visual cortex and nucleus accumbens lit up

24
Q

what is operant conditioning and how does it relate to substance abuse

A

positive reinforcement - pleasure of intoxication

negative reinforcement - avoiding withdrawal, stress relief, self-medication

25
Q

cognitive factors to addiction

A

expectancy effect

26
Q

social factors to addication

A

perceived norms

parental supervisions

27
Q

cultural factors to addiction

A

norms/ expectations

28
Q

comorbid disorders

A

high rates of comorbidity between SUD and other psychiatric disorders
mood
anxiety
psychotic dis
antisocial personality dis
but chicken and egg problem which came first
high rates of poyubstance use among those with SUD

29
Q

personality features

A 
behavioural disinhibition
-umpusivity
-sensation seeking
extraversion
neuroticism
30
Q

treatment of sud overview

A 
75-80% relapse in first year
average 5-7 quit attempts before final success
treatments
-biological
-psychosocial
31
Q

biological treatments of sud

A 
agonist subsitution
-methadone maintaenance for opiods
-nictonie patch/ gum
antagonist treatments
-naltrexone for opiates and alcohol
-acamprosate for alcohol
aversive treatment
-antabuse for alcohol, blocks ALDH2 enzyme = asian reaction to alcohol
32
Q

psychosocial treatment of sud

A 
inpatient or outpatient
alcoholics anonymous
CBT
-contingency management
-community reinforcement
-skills training, particularly important for comorbidity with other psych problems
33
Q

explain how depressants like alcohol work

A 
GABA agonist
-relaxation and sleepiness
-frontal lobe = dishinibition
-cerebellum = motor impairment
glutamate antagonist
-hippocampus = impairs memory
tolerance = yes
-brain adaptation
-metabolic change
withdrawal = yes
- after 8-12 hours
-agitation, insomnia, tremors, increased heart rate, seizures
-"delerium tremens" confusion, delusions, hallucinations
-37% mortality without treatment
--detox with benzodiaxepines (GABA)
34
Q

alcohol and brain damage

A

wernicke-korsakoff syndrome
thiamine deficieny
early = reversible - confusion, visual problems, stupor, coma, hypothermia, hypotension
late = irreversible - anteretrograde amnesia
10-20% mortality

35
Q

stimulants effects

A

acute
-euphoria
-psychostimulant effect = increased positivity, improved performance
-sympathetic arousal = decreased appetite, increased heart rate
-psychotic symptoms = hallucinations and delusions, paranoia
tolerance
-euphoria and appetite supresion
-no tolerance to physical stimulation
sensitisation - increased effect with increased use
-stimulant effects
-psychosis and paranoia
withdrawal
-depression
-irritability
-fatigue

36
Q

opiates effects

A

morphine, heroin, codein, oxycontin, vicodin
endogenous opiod agonists
-3 receptor systems
-many endogenous chemicals
tolerance
-euphoria > analgesia > respiratory depression > consitpation
-situation tolerance
withdrawal
-starts in 6-12 hours, lasts 5-10 days
-flu-like state
-methadone - slow acting opiate used for detox
-naltrexone - antagonist used for detox
-naloxene - antagonist = immediate withdrawal used for overdose

37
Q

hallucinogens

A

LSD, mushrooms, peyote
ecstasy
marijuana
alter sensory perceptions

38
Q

marijuana

A

tolerance
-modest in heavy users
withdrawal
-starts in approx 12 hours, lasts 3-4 days
-relatively mild
-tired, weak, anxious, irritable, trouble concentrating

39
Q

ecstasy

A 
tolerance - mechanism unclear
withdrawal
-depression
-anxiety and panic
-insomnia
-paranoia

PSYC 100 - clinical (13 decks)

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