Substance Related (and other) Addictive Disorders Flashcards
Substance use disorders involve:
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
So many terrible things happen to people that get caught up in Substance Use such as…
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
Substance abuse effects on society are…
Tax money is spent on jail or prison because of dealing and possession
Family and friends are effected by those with substance use disorder because…
They have to watch them suffer and lose everything
Many students wonder: How much does a person have to drink or use drugs to have a “problem?”
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)
How does the usage affect the persons health and life in general?
Social/ family functioning, Relationships, Work, School, Multiple DWI
Use
Any ingestion/injection of a substance
Intoxication
Use has resulted in noticeable or impairing effects that can be physical or psychological
Abuse
A pattern of use that results (or could easily result) in personal, social, legal, or other problems in functioning
Dependence
A state in which one’s body or mind has adapted to the effects of a substance, resulting in cravings, tolerance, and withdrawal
Addiction
Often equated with “dependence”…compulsive seeking and use of the substance; loss of control over usage and obvious danger/impairment
The primary disorder in this realm is called…
(Insert Substance) Use Disorder:
Substance Use Disorders: Diagnoses
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
A variety of other diagnoses for Substance Use Disorders pertain to:
Intoxication; Withdrawal (e.g., nicotine withdrawal is new to DSM-5); or “Persistent Effects”
“Persistent Effects” (Diagnosis of SUD)
(e.g., hallucinogen persisting perception disorder) where brain chemistry/ connections and sensory perceptions may be turned off
Five Main Categories of Substances
Depressants; Stimulants
Hallucinogens and Dissociative Anesthetics; Substances with mixed properties (*read in text)
Common examples of Substances with mixed properties (*read in text)
Nicotine, Marijuana, and Ecstasy
Depressants Effects
Have the effect of slowing down CNS functions, causing relaxation, mild euphoria or “buzz,” disinhibition, and drowsiness. (Also pain reduction)
Common examples of Depressants
Alcohol, Opiates (opioids or “narcotics”), Anxiolytics/Sedatives
Opiates (opioids or “narcotics”) (Category of Depressants)
Target pain reduction; Examples: heroin, morphine, hydro/oxycodone
Anxiolytics/Sedatives (Category of Depressants)
Calm anxiety or induce sleep; Examples: benzos (Xanax, Valium); sleeping pills (Ambien)
Stimulants Effects
Have the effect of enhancing or stimulating CNS functions, causing increased energy and focus, alertness, and more intense euphoria
Common examples of Stimulants
Caffeine, Amphetamines, Cocaine
Caffeine (Category of Stimulants)
the most widely used “substance”
Amphetamines (Category of Stimulants)
Examples: methamphetamine; Rx drugs like Adderall, Ritalin, Vyvanse, Dexedrine
Hallucinogens Effect
Largely affect sensory perception and conscious awareness, although the effects range widely (Distort experiences)
Examples of Hallucinogens
LSD (acid), psilocybin (mushrooms)
Dissociative Anesthetics Effect
Produce a “dream-like” detachment (and considered by many to be a specific class of hallucinogens)
Dissociative Anesthetics Examples
PCP (phencyclidine), ketamine
Biological Dimension of SUD
Hereditary influences; Dopamine reward/stress pathways; Brain chemistry alterations; Physiological Dependency
Psychological Dimension of SUD
Self-medicating of mental illness; Stressful emotions; Behavioral under control; Coping with life transitions
Social Dimension of SUD
Parental and peer models; Social pressures; Childhood maltreatment
Sociocultural Dimension of SUD
Cultural norms and values; Media influence; Societal stresses, Coping with discrimination
Pleasure Centers of the brain
Prefrontal Cortex, Nucleus Accumbens, Ventral Tegmental AreA (VTA)
Another part of the psychological risk for substance use problems has to do with…
A person’s learning history (Positive and negative reinforcement)
Positive and negative reinforcement in SUD
for obvious reasons, can translate into continued substance use that becomes problematic or diagnosable over time
Treating Substance Use Disorders: General Issues
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
To prevent relapse of drug use for those with SUD must consider…
Abstinence vs. “harm reduction” (or moderated use) are highly debated as the “best approaches
Treating Substance Use Disorders: Specific Strategies
Motivational Enhancement Therapy (or “Motivational Interviewing”) has strong research support for helping people with substance use problems; Involves resolving ambivalence (feeling torn) about quitting
It is difficult for those with SUD to get motivated and make significant life changes because…
People normally have to remove themselves from their social group or certain settings
Treatment of Alcohol Use Disorder Example
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
Remember: this category encompasses “Substance-Related and Other Addictive Disorders,” Currently, the only other official diagnosis in this section is
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?)
