Substance and Addictive Disorders

Question 1

Alcohol-Related Disorders (three types)

Answer 1

• Sedatives: calming (e.g. barbiturates)
• Hypnotic: sleep-inducing e.g. Ambien
• Anxiolytic: anxiety-reducing (benzodiazepines)
• Generally tranquilizing effects: slowed cognitive system & motor functions
• act on GABA receptros
• More likely to be female abusers
• Similar effects to large doses of alcohol
  
  • combining w alcohol synergistic
  • tolerance and withdrawal

Question 2

Chronic Use Alcohol

Answer 2

• Cihhrosis: inflamation and scarring of liver
• Withdrawal: delirium tremens – hallucinations and tremors
• Wernicke Korsakoff: thiamine deficiency results in memory impairment, lack of coordination, speech impairment
• Psychosocial problems (domestic violence, loss of employment)

Question 3

Statistics Use and Abuse alcohol

Answer 3

• most adults are light drinkers or abstainers (half americans currently drink)
• Higher among whites
• Males more abuse
• Binge drinking: 24% of americans, most common in college
• 1/3 adults will meet criteria for alcohol use disorder

Question 4

Stimulants overview

Answer 4

• Stimulate CNS by
  
  • Enhancing NE and DA release
  • Reuptake is blocked
    *

Question 5

Opiates vs opioids

Answer 5

• opiate: natural chemical in opium poppy with euphoric and analgesic effects
• opioid: natural and synthetic substances with euphoric and analgesic effects

Question 6

Effects of Opioids

Answer 6

• Activates bodies endorphins
• Low doses = euphoria, pain relief, drowsiness and slowed breathing
• High doses = medulla inhibition, respiratory depression and death
• Relapse and mortality rate is high
  
  • many die from additives “cut” with heroin
  • HIV infections
  • Naloxone = lifesaving drug for OD

Question 7

Cannabis-related Disorder

Answer 7

Marijuana

• considered mild hallucinogen
• Different reactions
  
  • Can include euphoria, mood swings, paranoia, hallucinations, less concentration, panic
  • Used medically for pain, nausea, anxiety, appetite suppressant
• Dependence and withdrawal common
• Increased societal acceptance
• Most frequently used illicit drug

Question 8

Inhalants

Answer 8

• mostly used in early adolescence (easy access)
• Found in spray paint, hair spray, glue, paint thinners, gasoline
• Breathed into lungs for rapid absorption
• Similar effects to alcohol intoxication
• Can lead to organ damage & cognitive impairment

Question 9

Gambling Disorder

Answer 9

• Recurrent gambling leading to clinically sig distress or impairment
• Similar biological origins to substance use
• 4+ symptoms in a year:
  
  • Difficulty stopping/reducing gambling
  • restlessness/irritability when trying to cut back
  • need to gamble w increasing amounts of money
  • attempting to “win it back” after a loss
  • Lying about gambling
  • relying on others for financial support
  • Jeopordizing significant job/relationship/opportunity

Question 10

Gambling addiction Treatment

Answer 10

• Motivation to get better is critical: dropout is high
• Similar treatment to substance use
• Multipart CBT interventions seem to help
  
  • Scheduling alternative activities, setting financial limits,

Question 11

Psychological dimensions

Answer 11

• operant conditioning
  
  • Positive reinforcement initially
  • Turns to negative reinforcement
  • self-medication
  • Opponent process theory, taking drug way to deal with withdrawal
• classical conditioning (behavioral tolerance)
• cogntive factors
  
  • Expectancies of positive effects
• Cravings
  
  • Dangerous classical conditioning

Question 12

Cultural dimensions

Answer 12

• 1/3 college students meet DSM criteria for alcoholism
• Models for substance use – parents, media, peers exposure is prerequisite for use
• Culture
  
  • Influence how people react to a substance
  • if culture believes alcohol increases aggression it will increase aggression

Question 13

Biological treatments

Answer 13

• Agonists
  
  • methadone, nicotine patch etc
• Antagonists: block mechanism of action of drug
  
  • naltrexone for opioid
• Aversive treatment: Make substance unpleasant to use
  
  • Antibuse for alcohol

Question 14

Harm Reduction vs complete abstinence (other psych treatments)

Answer 14

• Harm reduction: making it safer to user substance e.g. provide clean needles for injection
• Complete abstinence: don’t use it at all
• Covert sensitization: imagining negative outcomes while consuming substance (suprisingly works)

Question 15

relapse prevention

Answer 15

• Address cognitive distortions (I’ll never be able to get clean)
• Increase motivation to change
  
  • Empathy
  • roll with resistance: if a person does not want to get better don’t force them to
  • Hope
• Identify high-risk situations
• Reframe relapse: failure of coping skills not person