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Substance Disorders Flashcards

1
Q

theme

A
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2
Q

what is dependence?

A
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3
Q

What is Substance Abuse?

A

Excessive use of substance leads to:

  • Dangerous behaviour (e.g., DWI) - ex: driving while drunk
  • Continued use despite persistent problem:
  • Social
  • Psychological
  • Occupational
  • Health
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4
Q

Tolerance

A

Physiological need for more substance for same effects

This results from biochemical changes affecting:
* Rate of metabolism
* Elimination of substance from body

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5
Q

Withdrawa

A

Physical symptoms that result from stopping use(or decrease the drug quantity)

Examples:
* Nausea
* Sweating
* Tension
* Headaches
* Tremors

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6
Q

Stages of Substance Abuse

A
  1. Positive attitude
  2. Experimentation
  3. Regular use
  4. Heavy use
  5. Physical dependence/abuse
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7
Q

DSM-5: Alcohol Use Disorder

A
  • Problematic pattern of ETOH use > impairment
  • 2+ symptoms within 12 months:
  1. More ETOH than planned
  2. Desire to control use
  3. Time spent in ETOH pursuits
  4. Craving
  5. Use > interpersonal problems
  6. Use despite above
  7. Activities given up because of use
  8. Use in physically dangerous situations
  9. Use despite physical/psychological problems due to ETOH
  10. Tolerance
  11. Withdrawal
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8
Q

Heavy episodic drinking:

A
  • ≥ 6 drinks(at least)
  • ≥ 1x/month(at least)
    “Alcoholic” no longer used
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9
Q

Prevalence

A

Harmful drinking patterns

30% Canadian undergraduates
vs.
17% population

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10
Q

Quantity-Specific Effects

A

High levels
* Brain functioning depressed

Low levels
* Brain areas associated with pleasure
activated

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11
Q

Blood Alcohol Concentration (BAC)

will depend on:

A

Amount ingested in a particular period of time

Food in the stomach (vs. absorption in small intestine)

Body size and composition (muscle vs. water)

Efficiency of metabolism (but performance often unchanged)

Sex (weight, water concentration, elimination from system)

Age(older people more effected)

Medications

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12
Q

BAC & Hangover Severity

A

BAC goes down, alchol hangover severity increses

why people drink more so they wont get as bad of a hangover

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13
Q

Short-Term Effects of alchool

A
  • Stimulating, then depressant action (sleep/death)
  • Interference with complex thought and motor coordination
  • Interacts with several neural systems
    -Stimulates GABA receptors (tension & motor coordination)
    -Increases 5-HT & DA (motivation for
    pleasure/craving/addictive)
    -Inhibits glutamate receptors (cognitive effects)
  • Effects strongly tied to expectations
    (esp aggression and sexual drive)
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14
Q

Long-Term Effects for alchool

A
  • Malnutrition
    -B vitamin deficiency = memory loss
  • Cognitive impairment(delirium and dementia)
  • Cirrhosis of the liver
  • Cardiovascular problems: heart failure, hypertension, stroke, capillary hemorrhages
  • Reduced immune functioning (increse breast cancer risk)
  • Fetal alcohol syndrome(harm to babies)
  • Psychosis
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15
Q

Etiology: Bio

A

Genes

What is inherited?

  • Alcohol risk personality(ex:sensation seeking)
  • Ability to tolerate / metabolize alcohol
  • ** Motivation for substance use**
    less for tension vs. more for pleasure (pleasure motivation is more heritable)

Reinforcing effects of the substance

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16
Q

Neurobiology of Addiction

A

MCLP center of psychoactive drug activation (mesolimbic )

it is central in the relese of dopamine and mediating the properties of drugs (craving and plesure) are relatd in this

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17
Q

Etiology:Psycho

A
  • Stress, tension reduction, reinforcement
  • Expectations of social success
  • Perceived benefits outweigh costs
  • Sensation (or novelty) seeking
  • Drinking motives (enhancement,coping,social,conformity)
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18
Q

Etiology: Sociocultural

A

Culture
* Attitudes/use patterns
* Tradition of aggression
* Religion
* Geographic location

Family
* Parent use/guidance
* Family/marital problems
* Older siblings

Exposure and learning
Availability of substance
Peer/social influences(even percived)
Media

19
Q

Treatment: Bio

A

Medications:

-Block desire to drink
* Antabuse
* Naltrexone

-Lower side effects of withdrawal
* Valium

20
Q

Treatment: Psycho

A

CBT and Behavioural
* Aversion conditioning
* Skills training
* Self-control
* Motivational enhancement
(incresing motivation for person to do the treatment) (very effective!)

Controlled drinking vs. abstinence (highly debated - which one should be the goal)

21
Q

Treatment: Social

A

Group therapy
* Forced to confront problem

Alcoholics Anonymous (AA)

Environmental intervention
* Halfway houses

22
Q

Treatment Efficacy

A

Wide range

Depends on:
* Severity of substance abuse
* Type of treatment

23
Q

Comparing Treatment Efficacy

A

However…
1 Study compared:
* 12-step program
* CBT
* Motivational enhancement therapy

Results: All equally effective

24
Q

DSM-5: Substance Use Disorders

A

Criteria specific by substance

In general, same as alcohol use disorder

25
Drugs Associated with Addiction
Most common: * Narcotics * Sedatives * Stimulants * Anti-anxiety drugs * Pain medication * Hallucinogens
26
**Narcotics**
**Opium** Derivatives: * **Morphine** * **Heroin** * **Coedine**
27
Synthetic Opioids
**Fentanyl** 50-100x as potent as morphine (easy to overdose on) Often mixed with heroin, cocaine (without user knowing) Responsible for 72% of 2017 overdose deaths in Canada (84% in BC)
28
Biological Effects: Short-Term
* reduces physical pain * Relaxation * reduces anxiety * Euphoria
29
Biological Effects: Long-Term
* Physiological craving * Withdrawal symptoms * Physical deterioration * Immune system => organ damage * Consequences of poor health, dangerous behaviour - if passing through withdrawl there tolarance decreses if they take the drug agian with the same dosage as before there is a big chance for overdose
30
Etiology
* Pleasure(social,psycho,biology) * Curiosity * Peer pressure(social) * Stress relief * Personal maladjustment(social) * Sociocultural conditions(social)
31
Neural Basis for Addiction
Binds to opiate receptors => replaces natural endorphins -pleaseure is due to opinote receptord **DA theory of addiction** * Addiction = dysfunction of DA reward pathway * All addiction comes from motivation for pleasure **Reward deficiency syndrome** * Addiction = genetic deviation in reward pathway * **Folks with genetic deficiency causing less satisfaction from natural rewards (food, sex, etc) more likely to become addicted once exposed**
32
Comorbidity
* 70% other psychological disorders * 50% other substance abuse * 36% history of trauma * Depression * Anxiety * Antisocial personality disorder
33
Treatment
**Bio:** * Methadone * Buprenorphine **Psychosocial:** Similar to alcohol abuse Narcotics Anonymous (NA)
34
Stimulants
Cocaine Amphetamines (including methamphetamine) Caffeine Nicotine **Effects:** ↑ alertness ↓ fatigue
35
Amphetamines
**Abuse** * Intense fatigue * Psychologically & physically addictive * Brain damage, “amphetamine psychosis” * Suicide, homicide, violence **Treatment** * Withdrawal from drug * Depression (peaks in days, can last months) * GI symptoms
36
Methamphetamine
Highly addictive **↑ DA in brain** Structural changes in brain Treatment resistance (relapse common) **Long-term cognitive effects ** * Psychosis, paranoia * Learning and memory problems
37
Synthetic Cathinones
**“Bath salts”** **Mimicscocaine/amphetamines** Long-term effects severe (psychosis, agitation, heart problems)
38
**Hallucinogens**
LSD Mescaline Psilocybin MDMA (Ecstasy, Molly)
39
**MDMA**
Hallucinogen & stimulant Chemically similar to methamphetamine Popular party drug
40
MDMA
**Short-term effects** * Rush of pleasure * Sense of wellbeing * Depressed mood (for days after use) **Occasional negative effects** * Death * Psychosis * Anxiety disorders **Long-term (all negative) effects** * Brain damage (frontal & temporal lobes) * Memory deficits * Hallucinations
41
**Marijuana**
**Active ingredient:** THC **Short-term effects** * Relaxation, sense of wellbeing * Hallucinations * ↑ perceptual acuity * Euphoria **Long-term effects** * **Psychosis/schizophrenia** (if have diathesis) * Memory loss
42
**Synthetic Cannabinoids**
Spice, Blaze, K2 **Mimics THC** (similar short-term effects) **Long-term effects severe** (anxiety, seizures, heart problems)
43
**Gambling Disorder**
Addictive behaviour **Similar to substance addiction:** * Personality type (sensation seeking) * Maladaptive behaviour: -Relationships -Financial -Responsibilities * **Treatment** * high rates of Relapse (similar to substance abuse)

psyc 300 (15 decks)

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