Substance Related (and other) Addictive Disorders

Question 1

Substance use disorders involve:

Answer 1

An extensive variety of psychoactive substances; Wide-ranging physiological and psychological effects (effects mind and body on some level); Significant impairment and costs to the individual, relevant others (e.g., family, friends), and society in general

Question 2

So many terrible things happen to people that get caught up in Substance Use such as…

Answer 2

Cause many people to lose everything they have (kids, money, home); Death is at top of the list; Also may cause accidents, suicide, homicide, overdose

Question 3

Substance abuse effects on society are…

Answer 3

Tax money is spent on jail or prison because of dealing and possession

Question 4

Family and friends are effected by those with substance use disorder because…

Answer 4

They have to watch them suffer and lose everything

Question 5

Many students wonder: How much does a person have to drink or use drugs to have a “problem?”

Answer 5

The answer is that, generally speaking, AMOUNT IS NOT THE ISSUE! Two people could drink/use the same amount, and one may have a disorder while the other does not; What matters is: HOW DOES THE USAGE AFFECT THE PERSON’S HEALTH AND LIFE IN GENERAL? (Many ppl who drink/smoke daily do not meet criteria)

Question 6

How does the usage affect the persons health and life in general?

Answer 6

Social/ family functioning, Relationships, Work, School, Multiple DWI

Question 7

Use

Answer 7

Any ingestion/injection of a substance

Question 8

Intoxication

Answer 8

Use has resulted in noticeable or impairing effects that can be physical or psychological

Question 9

Abuse

Answer 9

A pattern of use that results (or could easily result) in personal, social, legal, or other problems in functioning

Question 10

Dependence

Answer 10

A state in which one’s body or mind has adapted to the effects of a substance, resulting in cravings, tolerance, and withdrawal

Question 11

Addiction

Answer 11

Often equated with “dependence”…compulsive seeking and use of the substance; loss of control over usage and obvious danger/impairment

Question 12

The primary disorder in this realm is called…

Answer 12

(Insert Substance) Use Disorder:

Question 13

Substance Use Disorders: Diagnoses

Answer 13

Symptoms need to co-occur within a period of 12 months; But only two symptoms need to co-occur within that period; Labeled as mild, moderate, or severe…depending on number of criteria met

Question 14

A variety of other diagnoses for Substance Use Disorders pertain to:

Answer 14

Intoxication; Withdrawal (e.g., nicotine withdrawal is new to DSM-5); or “Persistent Effects”

Question 15

“Persistent Effects” (Diagnosis of SUD)

Answer 15

(e.g., hallucinogen persisting perception disorder) where brain chemistry/ connections and sensory perceptions may be turned off

Question 16

Five Main Categories of Substances

Answer 16

Depressants; Stimulants

Hallucinogens and Dissociative Anesthetics; Substances with mixed properties (*read in text)

Question 17

Common examples of Substances with mixed properties (*read in text)

Answer 17

Nicotine, Marijuana, and Ecstasy

Question 18

Depressants Effects

Answer 18

Have the effect of slowing down CNS functions, causing relaxation, mild euphoria or “buzz,” disinhibition, and drowsiness. (Also pain reduction)

Question 19

Common examples of Depressants

Answer 19

Alcohol, Opiates (opioids or “narcotics”), Anxiolytics/Sedatives

Question 20

Opiates (opioids or “narcotics”) (Category of Depressants)

Answer 20

Target pain reduction; Examples: heroin, morphine, hydro/oxycodone

Question 21

Anxiolytics/Sedatives (Category of Depressants)

Answer 21

Calm anxiety or induce sleep; Examples: benzos (Xanax, Valium); sleeping pills (Ambien)

Question 22

Stimulants Effects

Answer 22

Have the effect of enhancing or stimulating CNS functions, causing increased energy and focus, alertness, and more intense euphoria

Question 23

Common examples of Stimulants

Answer 23

Caffeine, Amphetamines, Cocaine

Question 24

Caffeine (Category of Stimulants)

Answer 24

the most widely used “substance”

Question 25

Amphetamines (Category of Stimulants)

Answer 25

Examples: methamphetamine; Rx drugs like Adderall, Ritalin, Vyvanse, Dexedrine

Question 26

Hallucinogens Effect

Answer 26

Largely affect sensory perception and conscious awareness, although the effects range widely (Distort experiences)

Question 27

Examples of Hallucinogens

Answer 27

LSD (acid), psilocybin (mushrooms)

Question 28

Dissociative Anesthetics Effect

Answer 28

Produce a “dream-like” detachment (and considered by many to be a specific class of hallucinogens)

Question 29

Dissociative Anesthetics Examples

Answer 29

PCP (phencyclidine), ketamine

Question 30

Biological Dimension of SUD

Answer 30

Hereditary influences; Dopamine reward/stress pathways; Brain chemistry alterations; Physiological Dependency

Question 31

Psychological Dimension of SUD

Answer 31

Self-medicating of mental illness; Stressful emotions; Behavioral under control; Coping with life transitions

Question 32

Social Dimension of SUD

Answer 32

Parental and peer models; Social pressures; Childhood maltreatment

Question 33

Sociocultural Dimension of SUD

Answer 33

Cultural norms and values; Media influence; Societal stresses, Coping with discrimination

Question 34

Pleasure Centers of the brain

Answer 34

Prefrontal Cortex, Nucleus Accumbens, Ventral Tegmental AreA (VTA)

Question 35

Another part of the psychological risk for substance use problems has to do with…

Answer 35

A person’s learning history (Positive and negative reinforcement)

Question 36

Positive and negative reinforcement in SUD

Answer 36

for obvious reasons, can translate into continued substance use that becomes problematic or diagnosable over time

Question 37

Treating Substance Use Disorders: General Issues

Answer 37

Can be inpatient, outpatient, or community-based; Is often quite difficult; requires high motivation and willingness to make significant life changes; A first step may involve detoxification (depending on the substance and the severity); The focus of most programs is preventing relapse

Question 38

To prevent relapse of drug use for those with SUD must consider…

Answer 38

Abstinence vs. “harm reduction” (or moderated use) are highly debated as the “best approaches

Question 39

Treating Substance Use Disorders: Specific Strategies

Answer 39

Motivational Enhancement Therapy (or “Motivational Interviewing”) has strong research support for helping people with substance use problems; Involves resolving ambivalence (feeling torn) about quitting

Question 40

It is difficult for those with SUD to get motivated and make significant life changes because…

Answer 40

People normally have to remove themselves from their social group or certain settings

Question 41

Treatment of Alcohol Use Disorder Example

Answer 41

Medications (e.g., Antabuse) are available but their use/ prescription is fairly rare; AA is a common component (with mixed results); Therapy involving MI or CBT is the best bet

Question 42

Remember: this category encompasses “Substance-Related and Other Addictive Disorders,” Currently, the only other official diagnosis in this section is

Answer 42

Gambling Disorder (Which very much resembles the substance use disorder criteria, but applies to gambling behavior); A proposed diagnosis is “Internet Gaming Disorder” (But adding diagnoses to this group is a slippery slope – can’t people become addicted to anything, really?)