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Abnormal 3018 > Substance Use > Flashcards

Substance Use Flashcards

0
Q

What are some socioeconomic constraints on drug taking?

A
  • price
  • availability
  • social norms
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1
Q

What are the different criterions to be classed as substance use disorder

A

A impaired

Control, social impairment, risky use, pharmacological

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2
Q

What are some motivations to consume?

A
  • peer group
  • reinforcement
  • genetic predisposition
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3
Q

What are some factors leading to access to and patterns of drug taking?

A
  • socioeconomic constraints on drug taking

- motivation to consume

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4
Q

What are some consequences of chronic drug use?

A
  • drug dependency

- addiction

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5
Q

What are some acute consequences of drugs?

A
  • health related issues
  • violence
  • public intoxication
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6
Q

What are some principles of effective management?

A
  • no single tx is appropriate
  • needs to be readily available and accessible
  • attends to multiple psychological, medical and social interventions
  • dual diagnoses clients should have both disorders treated in an integrated fashion
  • tax does not need to be voluntary to effect change
  • can be long term process and frequently requires multiple episodes of tx
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7
Q

What are the learning based approaches to target in CBT for addiction?

A
  • maladaptive behaviour patterns
  • motivational and cognitive barriers to change
  • skills deficits
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8
Q

What are some cognitive/ motivational

strategies in CBT for addiction?

A
  • identify high risk situations (cues)
  • reduce likelihood events are encountered
  • rehearse non drug alternatives to - motivational interviewing (ie exploration of ambivalence)
  • enhance motivation for alternative activities
  • target cognitions that enhance likelihood of drug use
  • strategies to target cognitive distortion a specific to substance abuse including rationalisation and giving up
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9
Q

What is the aim and how do we shift contingencies in CBT for addiction?

A
  • eventual aim is to increase the reinforcing consequences of drug reduction thrpugb naturally occurring rewards (eg employment, improved relationships, social success)
  • artificial rewards may be used (monetary prizes, vouchers for goods eg take home methadone)
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10
Q

What are some skills training for CBT in drug addiction?

A
  • emotion regulation
  • non drug alternatives to coping with negative affect
  • rehearsal of socially acceptable responses to offers of drugs (with imaginal exposure or emotional induction)
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11
Q

What are some common barriers to overcoming addiction?

A
  • psychiatric co morbidity
  • acute or chronic cognitive deficits
  • medical problems
  • social stressors
  • lack of social resources
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12
Q

What is a drug/ substance?

A

Any substance that exerts an effect on the body or mind (prescription, legal and illicit)
Effect may be: neurophysiological, emotional, behavioural, cognitive

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13
Q

What is an eg

Of a depressant?

A
  • alcohol, barbiturates, benzodiazepines, sedatives, inhalants
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14
Q

What are some egs stimulants?

A
  • cocaine, caffeine, nicotine, MDA, amphetamines
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15
Q

What are some egs of hallucinogens?

A
  • altered perceptions- mescaline, LSD, psilocybin
16
Q

What are some egs of opioids/ narcotics?

A

Analgesias- oxycodone, morphine, heroin, codeine, methadone

17
Q

What are some egs of cannabinoids?

A

Marijuana, hash, ganja

18
Q

How do you define addiction?

A

Behaviours characterised by compulsion, loss of control and continued use despite perceived or negative consequences

19
Q

What is the difference btw physiological and psychological dependence?

A

Physiological is associated with physical symptoms of tolerance and withdrawal on cessation eg can lead to increased use when trying to withdraw
Psychological is cravings leading to repetitive use ie related to conditioning

20
Q

What does the choice theory of addiction suggest?

A
  • perceived benefits, urges are balanced against perceived costs and self control leading to addictive behaviour
21
Q

How is impaired control defined?

A
  • use of amounts for longer than intended
  • repeated unsuccessful attempts to cease
  • excessive time obtaining drug
  • craving
22
Q

How is social impairment defined?

A
  • failure to meet obligations: work, school, home
  • social and interpersonal problems
  • social, occupational or recreational activities reduced
23
Q

How is risky use defined?

A
  • continued use despite awareness of negative problems with use
  • used in physically hazardous situations
24
Q

How is pharmacological symptoms defined?

A
  • tolerance

- withdrawal eg manifested by hallucinations, tremors

25
Q

How come there are such high rates of comorbidities in substance use?

A
  • overlapping genetic vulnerabilities
  • overlapping environmental vulnerabilities
  • involvement of similar brain regions
26
Q

Why does substance abuse belong to the young?

A
  • younger ppl more exposed to peer related alcohol and drug use
  • mortality associated with substances abuse
27
Q

Why is neural sensitisation important in drug addiction?

A
  • Susceptibility to sensitization: individual differences

- some individuals sensitize readily and others not so readily

28
Q

How is susceptibility to sensitiSation determined?

A
  • host of factors including genes, sex hormones, stress hormones, past trauma etc
29
Q

What may individuals show once sensitized?

A

Cross sensitisation

30
Q

What do addictive drugs do to the brain?

A

Usurp neural pathways normally involved in pleasure, incentive motivation, learning
They change these pathways not just engaging these reward systems

31
Q

What and how do twin studies suggest about the heritability of addiction?

A
  • strong genetic component to substance disorders
  • monozygotic twins show higher concordance rates for: alcohol, cannabis, Tobacco, stimulants, hallucinogens, opioids, sedatives
  • likely non-specific rather than unique to specific substances (ie more likely related to vulnerability to response to reward and punishment
32
Q

Drugs of dependence work on which two brain systems?

A
  • dopaminergic

- endogenous opioid system

33
Q

How is dopamine hypothesised to be involved in drug addiction?

A
  • mediated by functional and structural changes in circuits modulated by dopamine including frontal cortex
34
Q

What parts of the Mesolimbic area are involved in dopamine activities?

A

Amygdala, nucleus accumbens, hippocampus

35
Q

What is the Mesolimbic area responsible for in drug addiction?

A

Excitement, acute reinforcing effects, memory and conditioning linked to craving and emotional and motivational changes during withdrawal

36
Q

What areas of the mesocortical area are involved in drug addiction?

A
  • prefrontal cortex, orbitofrontal cortex and anterior cingulate
37
Q

What is the mesocortical area responsible for in drug addiction?

A

Executive function: conscious experience of intoxication, salience, expectations, cravings and inhibitory control/ decision making

Abnormal 3018 (9 decks)

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