Substance Abuse Disorders Flashcards
A state of chronic or recurrent intoxication characterized by psychological dependence
Addiction
The person is emotionally dependent on a drug, is able to obtain a desired effect from the specific dosage, and experiences withdrawal symptoms after he stops taking the drug
Addiction
It is the inability to stop drinking that seriously alters a normal living pattern.
Alcoholism
Cessation of drinking or a reduction in intake results in
withdrawal symptoms
Behaviors exhibited by significant others of a substance-abusing individual that serve to enable and protect the abuse at the exclusion or personal fulfillment and self development
Codependence
Strong, overpowering urge for drugs felt by an individual who abuses or is dependent on drugs
Craving
Condition occurring when individuals exhibit a set of behaviors associated with inability to control use of a drug
Drug dependence
Maladaptive pattern of use of a drug in situations of real or potential harm
Substance Abuse
It is an acquired resistance to the effects of a drug
Tolerance
Defined in DSM IV as either needing to increase drug dosage to achieve a given effect or finding decreasing effect from a continued, fixed dosage
Tolerance
It is a condition occurring when cessation of drug use results in a drug-specific set of symptoms that would be relieved by additional doses of the drug
Withdrawal
Behaviors associated with drug dependence
*Develop tolerance to drug effects
*Manifest withdrawal from a drug
*Use more drug than intended
*Try persistently or unsuccessfully to cut down the use
*Spend significant amount of time using or trying to obtain the drug
*Give up important activities because of the drug
*Continue to use a drug despite knowing it is causing physical or psychological problems
Causes of addiction
Biologic and genetic theories
Learning Theories
Social Theories
All drugs of abuse have one thing in common
stimulation of dopamine secretion
blocks the mechanism of which dopamine is reabsorbed into the cells that release dopamine
Cocaine
provoke the release of dopamine
Amphetamines
acts on a receptor for the neurotransmitter acetylcholine and may prevent the enzyme monoamine oxidase from breaking up the dopamine molecule.
Nicotine
act as receptor sites for the brain’s own morphine-like substances
Opiates
Genetic predisposition
Biologic and genetic theories
Examples of sedatives
Hypnotics, alcohol and barbiturates, and benzodiazepines
act in various parts of the brain on neurons that release GABA, which direct neurons to quit firing
Sedatives
Some are predisposed to addiction because of
High level of stress hormones
Behavioral theorists believe that addiction is the result of the positive effect or mood alterations that one experiences using drugs or alcohol
Learning theory
The potential for addiction is affected by
Economic conditions
Formal and informal control
Cultural traditions
Companionship
Approval of other drug users
Peers and their values are particularly strong influences.
Social theories
Experimentation, curiosity, rebellion, and boredom
Social theories
Many theories believed that substance abusers are fixed in — and —- level of development
Oral and infantile
Abusers tend to seek ——- of needs
Immediate gratification
Characteristics of addictive personality
Low self-esteem
Feelings of dependency
Low tolerance to frustration & anxiety
Antisocial behavior
Fear
can cause an individual to become dependent on alcohol or drugs to cope with increasing anxiety, depression, social and sexual inadequacy, increased social pressure, a desire to lower one’s inhibition.
Early childhood reject
Over protection
Undue responsibility
Age of first drink
12-14
Age first intoxicated
14-18
Age of first minor alcohol problem
18-25
Usual age of first major problem
28-30
Usual age entering treatment..
40
Usual age of death (leading causes: heart disease, cancer, accidents, suicide)
55
Year abstinence alternates with active drinking……any “Spontaneous remission” rate or response to nonspecific interventions
10%-30%
Phase: Drinks because of social motivations
Phase 1: Pre alcoholic
Phase: Finds that alcohol relieves stress
Phase 1: Pre alcoholic
Phase: Over time, needs to increase the amount of alcohol needed for relief
Phase 1: Pre alcoholic
May be told by others that his drinking is too heavy or too frequent
Phase 1: Pre alcoholic
Can be described as the “non -addicted heavy drinker”
Phase 1: Pre alcoholic
Phase: Begins to drink alone
Phase 2: Early Alcoholic
Phase: Becomes preoccupied with the supply with drinks
Phase 2: Early Alcoholic
Phase: Hides bottles of alcohol at work, home or car
Phase 2: Early Alcoholic
Phase: Wakes up in the morning and needs a drink to control tremors (the eye opener)
Phase 2: Early Alcoholic
Phase: Uses denial s a defense mechanism and does not admit to being dependent on alcohol.
Phase 2: Early Alcoholic
Phase: Completely loses control over ability to choose whether or not to drink
Phase 3: true alcoholic
Phase: goes out on binge-drinking episodes; stops drinking only when too sick to take another drink
Phase 3: true alcoholic
Phase: Experiences the following: isolation from others, aggression, loss of interest in any activity that once brought pleasure, impotence, frigidity, nutritional impairment
Phase 3: true alcoholic
In this phase, most who were gainfully employed have lost their jobs, many have lost their families, and all have lost their self-esteem
Phase 3: true alcoholic
Phase: Over time, the individual’s continuous use of alcohol leads to extensive emotional disorganization.
Phase 4: Chronic alcoholic
Phase: May exhibit impairment of reality testing; regression; and/or loss of a sense of ethics
Phase 4: Chronic alcoholic
Phase: Physically the individuals exhibits disorders of the CNS (bilateral, progressive neuritis of the lower extremities; temporary nerve palsies, liver and vascular disease
Phase 4: Chronic alcoholic
Alcohol dependence Dx
3 or more in 12 mos
Alcohol abuse dx
One or more in 12 mos
Alcohol-induced disorders
Alcohol intoxication
Alcohol withdrawal
Alcohol withdrawal delirium
Occurs after the ingestion of alcohol and is evidenced by behavioral changes such as impaired social and occupational functioning, fighting, or impaired judgment
Alcohol intoxication
characterized by: mood changes, increased verbalization, impaired attention span and irritability
Alcohol intoxication
Slurred speech, lack of coordination, unsteady gait, nystagmus, impaired memory stupor and coma
Alcohol intoxication
Happens within several hours or days after the cessation or reduction of heavy and prolonged alcohol consumption
Alcohol withdrawal
Alcohol withdrawal delirium other name
Delirium tremens
occurs 24-72 hours after the client’s last drink
Delirium tremens
Characterized by: increased vital signs, restlessness, tremulousness, agitation and hyper alertness. Speech is incoherent, sensory misinterpretation and others
Delirium tremens
Chronic alcoholism can develop
Alcohol dementia
severe loss of intellectual ability, impaired memory, judgment and abstract thinking. Permanent brain damage may occur
Alcohol dementia
Dementia with profound loss of recent memory
Korsakoff psychosis
Treatment for Korsakoff psychosis
Supportive care
Prognosis for Korsakoff psychosis
Poor for cognitive recovery
Delirium with cranial nerve dysfunction
Wernicke’s encephalopathy
Cause of Wernicke’s encephalopathy
Thiamin deficiency
Treatment for Wernicke’s encephalopathy
Thiamin administration
Prognosis for Wernicke’s encephalopathy
excellent with early thiamin administration
