Substance-Related Disorders Flashcards
Definition of Addiction
- Biopsychosocial disorder manifested by compulsively seeking a desired effect (intoxication) despite harmful consequences
- Addiction= severe substance use disorder
Dopaminergic Brain Reward pathway
- Addictive substances tend to activate endogenous dopaminergic brain reward pathways
- Ventral Tegmental Area to Nucleus Accumbens (“pleasure center”)
First use of a substance is often voluntary
What does an alteration in the prefrontal lobe cause?
From addiction
- Impaired inhibition
- Reduced capacity for delayed gratification
- Impaired working memory
- Impaired decision-making and reasoning
- Impaired long-term planning
Can lead to physical withdrawal symptoms and discomfort
What is methadone used for and why?
- Opioid Addiction
- Replacement therapy-less addictive
Addiction Risk Factors
- Genetics (50%)
- Environment-peer pressure, availibility of substance
- Dual Diagnosis-mental/physical illness that requires pain meds leading to addiction
- Age of first use-prefrontal lobes still developiung
- Substance of choice
- Method of use-injecting vs swallowing
Substance Intoxication Definition and Symptoms (6)
Definition: reversible substance-specific syndrome-recent ingestion-maladaptive changes d/t CNS effects
Diagnosis: Significant maladaptive psychological/behavior change (impaired judgement) PLUS 1
1. Slurred speech
2. Incoordination
3. Unsteady gait
4. Nystagmus
5. Impaired attention/memory
6. Stupor or coma
Substance Withdrawal Definition and Diagnosis (8)
Definition: substance-specific syndrome occurring following cessation of a substance after heavy/prolonged use
Diagnosis: 2 of the following symptoms
1. ANS hyperactivity
2. Hand Tremor
3. Insomnia
4. Nausea/Vomiting
5. Hallucinations/Illusions
6. Psychomotor agitation
7. Anxiety
8. Generalized Seizures
Usually results 2-3 days after last use
Substance Use Disorder Definition and Diagnosis
Definition: maladaptive pattern of substance use-
Diagnosis: 12 months of 2+ symptoms
Substance Abuse Disorder Symptoms (4 Categories-11 Symptoms)
Symptoms:
A) Impaired control
1. Taken in a larger amt than intended
2. Persistent unsucessful attempts to cut back
3. Time consuming (obtaining, using, recovering)
4. Cravings or strong desire for the substance
B) Social Impairment:
5. Failure to fulfill major role obligations (work)
6. Social/interpersonal problems
7. Reduction of important activities
C) Risky use:
8. Use in physically hazardous situations
9. Use despite having a physical/psychological problem related to the substance
D) Pharmacological criteria (physical dependence)
10. Tolerance
11. Withdrawal syndrome unpon cessation
Severity of Substance Use Disorder
Number of symptoms
2-3=mild
4-5=moderate
6+=severe
Sedative Intoxication Symptoms
Alcohol, Benzodiazepines, Barbiturates (CNS depressants)
- Sedation
- Impaired judgement
- Slurred speech
- Stupor
- Respiratory depression
- Overdose potentially lethal
Sedative Intoxication Withdrawal Symptoms
- Anxiety, insomnia
- Hand tremor
- Extreme tachycardia/HTN
- Delirium
- Hallucinations (Formication-bugs on skin)
- Seizures
Bolded=potentially lethal
Major Stimulant Intoxication Symptoms: Psychological (3) /Physical (6)
Amphetamines, Cocaine (CNS activators)
Pyshological
1.Euphoria and grandiosity
2. Psychomotor acceleration & sterotypies
3. Paranoia & hallucations
Physical
1. Mydriasis (pupil dilation)
2. Elevated HR & BP
3. Appetite loss
4. Insomnia
5. Increased energy
6. Seizures
Bolded=similar to manic
Major Stimulant Withdrawal Symptoms (4)
- Dysphoric mood
- Hypersomnia
- Increased Appetite
Not usually life threatening
Symptoms like: MDD w/ atypical features
Minor Stimulant Intoxication Symptoms (7)
Caffeine, Nicotine (minor CNS activators)
- Increased Energy
- Restlessness
- Nervousness
- Racing thoughts
- Tachycardia
- Increased alertness
- Decreased appetite
All the symptoms=hypomania
