Substance related and addictive disorders Flashcards

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1
Q

Substances

A
  • Alcohol,
  • Caffeine,
  • Cannabis,
  • Hallucinogens (ex. LSD)
  • Inhalants (ex. glue)
  • Opioids (ex. morphine)
  • Sedatives ( depressants )
  • Hypnotics and anxiolytics (induce drowsiness and decrease emotional tension)
  • Stimulants (ex. cocaine)
  • Tobacco, and other (or unknown) substances)
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2
Q

DSM DIAGNOSTIC CRITERIA for Substance Abuse

A

1 Substance is often taken in larger amounts or over a longer period than was intended *

  1. There is a persistent desire or unsuccessful efforts to cut down or control alcohol use *
  2. A great deal of time is spent in activities necessary to obtain, use, or recover from it’s effects
  3. Craving, or a strong desire or urge to use. (New) *
  4. Recurrent use resulting in a failure to fulfill major role obligations at work, school, or home
  5. Continued use despite having persistent or recurrent social or interpersonal problems caused
    or exacerbated by the effects of alcohol *
  6. Important social, occupational, or recreational activities are given up or reduced because of
    the substance *
  7. Recurrent use in situations in which it is physically hazardous *
  8. Use is continued despite knowledge of having a persistent or recurrent physical problem that
    is likely to have been caused or exacerbated by (drug)
  9. Tolerance- increased or decreased need *
  10. Withdrawal- syndrome- or taken to relieve or avoid withdrawal symptoms

2-3 criteria are met - mild
4-5 criteria are met - moderate
6 or more are met - severe

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3
Q

Intoxication

A

Reversible symptoms occurring after exposure to
a drug

Can occur in those w/o substance use disorder

Not attributable to another medical disorder or
mental condition

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4
Q

Withdrawal

A

Behavioural, physical, and cognitive symptoms
occurring after reduction or discontinuation of
heavy and prolonged substance use

Not attributable to another medical disorder or
mental condition

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5
Q

Other substance/medication
induced mental disorders

A

Psychotic, bipolar, depressive, anxiety, OCD,
sleep, sexual disorders; delirium; neurocognitive
disorders

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6
Q

Genetic Factors of Substance Use Disorders

A

Genes involved in sensitivity of the reward
system

Genes related to neurotransmitter systems
- Gabaergic, dopaminergic,
glutamatergic, serotonergic, opioid, and cholinergic systems implicated in the
vulnerability to alcohol dependence

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7
Q

Neurobiological Factors of Substance Use Disorders

A

Changes in dopamine transmission and reward
system

Changes in serotonin system

Evidence for some neurobiological
vulnerabilities: reduced dopamine transmission;
brain activity measured using EEG (p300; beta waves)

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8
Q

Jacobs General Theory of Addictions

A
  • Self-medication and tension reduction
  • Positive reinforcement - learned behaviours
  • Continued use despite harms
  • Substance abuse as a means to cope with negative affect
  • Expectancies influence use and relapse
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9
Q

Vicious Addiction Cycle

A

Drink - feels good - passed out - wake up hungerover - anxiety increase - willpower fails - drink again - feels good …

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10
Q

Tolerance Dependency Model

A

Anxiety causes Alcohol which lowers anxiety + alcohol tolerance goes up. Withdrawal, anxiety goes up + tolerance goes up.

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11
Q

Agonist Substitution

A

Safe drug with a similar chemical composition as the abused drug

Examples include methadone for heroin addiction, and
nicotine gum or patch

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12
Q

Antagonistic treatment

A

Drugs that block or counteract the positive effects of
substances

Examples include naltrexone for opiate and alcohol
problems

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13
Q

Aversive treatment

A

Drugs that make the injection of abused substances
extremely unpleasant

Examples include antabuse (disulfiram) for alcoholism

Inhibits metabolism of alcohol causing immediate hangover
effects

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13
Q

MODELS OF ADDICTION: Sin

A

Lack of will; moral ineptitude

Treatment: Punishment; shame; retribution

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14
Q

MODELS OF ADDICTION: Medical/Disease
Model/Syndrome
model

A

Faulty brain function; genetic
liability; controlled use never
possible

Treatment: AA, inpatient treatment; medications to modulate response to reward

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15
Q

MODELS OF ADDICTION: learning model

A

Addiction is a developmental
process; societal factors like
isolation; adverse events shape
learning and reward processing;
brain learns from use

Treatment: Developmental growth; psychological intervention

16
Q

Is Addiction a Brain Disease

A

YES
Many people use, not all get addicted; Genetic risk is important

NO
*Brain change is learning, not necessarily disease
*Natural process corrupted by substances
* Neural networks are formed by drug use by plasticity
(learning through use of addictive substances) rather
than causing a disease state à drug addiction
* Most people with addiction recover without treatment

17
Q

Opioids

A

refers to a class of natural and synthetic substances
with narcotic effects

18
Q

Opiate

A

natural chemical in the opium poppy with narcotic
effects (i.e., pain relief)

19
Q

Cannabis

A

*Previously considered a hallucinogen
* Depending on individual, could be stimulant,
depressant, hallucinogen (and depending on type of
cannabis)
* Active psychoactive chemical is tetrahydrocannabinol
(THC)
* May produce several symptoms (e.g., Mood swings,
paranoia, hallucinations)
* Impairment in motivation is not uncommon (i.e.,
Amotivational syndrome)
* Major signs of withdrawal and dependence do not
typically occur

20
Q

THC

A

euphoria, anti-inflammatory,
psychosis

21
Q

CBD

A

non-psychoactive, anti-anxiety,
antipsychotic?

Perhaps CBD or other cannabinoids
may ultimately play a role in ongoing
treatment of psychosis

22
Q

Short-Term Problems with Cannabis

A

decision-making, driving, psychotic-like experiences

23
Q

Long-Term Problems with Cannabis

A

Poorer cognition, increased anxiety, increased depression, increased risk for psychosis