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BRS Y2 > Substance Use and Addiciton > Flashcards

Substance Use and Addiciton Flashcards

1
Q

What are the 2 main ways drugs work?

A

They can be stimulants or depressants

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2
Q

What is negative reinforcement

A

When people take drugs to overcome bad states

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3
Q

What is positive reinforcement

A

When people take drugs to gain positive states

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4
Q

How do we figure out wether there is positive or negative reinforcement or neither?

A

Ask why they are taking the drug

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5
Q

What qualifies as harmful substance use?

A

When actual damage has been caused to the mental or physical health of the user in the absence of diagnosis of dependence syndrome

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6
Q

What qualifies as hazardous substance use?

A

When harm is likely to be caused if the user continues at the current level

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7
Q

What are the criteria for dependence syndrome?

A

A strong desire or compulsion to take the substance, there is difficulty controlling usage, there is physiological withdrawal state when substance use stops, there is evidence of tolerance, persisting usage despite harmful consequences, progressive neglect of alternate interests

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8
Q

How many criteria must be met to qualify as dependant?

A

3 criteria for dependance

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9
Q

What are the criteria for addiction?

A

Compulsive drug use despite harmful consequences, inability to stop using the drug, failure to meet work/social/family obligations and sometimes tolerance and withdrawal

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10
Q

What is the difference between dependance and addiction?

A

Dependance refers to a physical adaptation to a substance, it is therefore possible to be dependant and not addicted

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11
Q

What makes a drug more addictive?

A

If it can reach the brain faster

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12
Q

What balance does alcohol disrupt? In which direct

A

Balance between the inhibitory and excitatory systems, it increases the effectiveness of the inhibitory system

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13
Q

What is the bodies inhibitory and excitatory system in reference to alcohol? Include the names of the neurotransmitters and receptors

A

Inhibitory: GABA-A system, GABA-A receptor
Excitatory: Glutamate system, NMDA receptor

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14
Q

What happens during alcohol withdrawal?

A

The alcohol is no longer making the inhibitory system more effective, so the excitatory system becomes unregulated in compensation

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15
Q

What medication is given to help alcohol withdrawal?

A

Acamprosate

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16
Q

How does acamprosate work?

A

It reduces NMDA function so there is redcued compensatory upregulation of the excitatory system and withdrawal is reduced

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17
Q

How are some ways addiction develops?

A

Due to positive reinforcement
Due to overcoming an adverse state (negative reinforcement)
Impulsivity

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18
Q

What neurotransmitter is highly involved with addiction?

A

Dopamine- drugs often increase levels of dopamine in the brain

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19
Q

How does dopamine work as addiction worsens?

A

It becomes more about motivation to get the drug rather than feelings of reward

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20
Q

What system is a key modulator of dopamine?

A

Mu opioid

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21
Q

How may drugs increase levels of dopamine?

A

Block reuptake, enhance release, indirectly by increasing firing dopamine neurons

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22
Q

Which drugs block dopamine reuptake?

A

Cocaine and amphetamine

23
Q

Which drug enhances dopamine release?

A

Amphetamine

24
Q

Which drugs work indirectly by increasing dopamine neurone firing?

A

Alcohol, opiates, nicotine

25
Q

What are dopamine receptors called?

A

D2 receptors

26
Q

What happens when someone has fewer D2 receptors?

A

They are likely to be more responsive to stimulants as they already have lower levels of dopamine functioning in their brain

27
Q

What brain region is associated with binge/intoxication?

A

Thalamus

28
Q

What brain region is associated with withdrawal/negative effect?

A

Hypothalamus, brainstem effectors, amygdala

29
Q

What brain region is associated with pre-occupation/anticipation/craving?

A

Hippocampus

30
Q

Which out of positive and negative reinforcement develops as addiction gets worse?

A

Goes from positive reinforcement to addiction developing and turns into negative reinforcement

31
Q

What happens to motivation as addiction develops and why?

A

Motivation increases because the addiction is present due to negative reinforcement so there is a lot of motivation/anxiety to acquire the drug

32
Q

Where is dysregulation most apparent during addiction?

A

Amygdala

33
Q

What system is the stress system?

A

Kappa opioid system

34
Q

What lights up the amygdala on an fMRI?

A

Showing a normal image then an aversive one

35
Q

How may units is a bottle of beer?

A

1.6 units

36
Q

How many units is a pint of beer?

A

2.3 units

37
Q

How many units is a pint of cider?

A

2.6 units

38
Q

How many units is a shot?

A

1 unit

39
Q

How many units is a medium glass of wine?

A

2.3 units

40
Q

How many units is a bottle of wine?

A

9.8 units

41
Q

How many units of alcohol is the limit for one week?

A

14 for both men and women

42
Q

What acronym is used to assess alcoholics and what does it stand for?

A

CAGE
Cut down- have you ever felt you need to cut down on your drinking?
Angry- has anyone annoyed you and made you angry by talking about your drinking?
Guilty- have you ever felt guilty about drinking?
Eye opener- have you ever felt you need a drink first thing in the morning?

43
Q

What are some symptoms of alcohol withdrawal?

A

Hot, sweaty, tremor of hands, retching/belching, abdominal pain

44
Q

What are some symptoms of opiate withdrawal?

A

Tachycardia, sweating, breathlessness, restlessness, dilated pupils, bone aches, runny nose, GI upset, tremor, yawning, anxiety, irritability, gooseflesh skin

45
Q

What terms are used when talking about conditions where people are addicted to alcohol or opiates? What terms used to be used?

A

Used to use abuse and dependence, we how use alcohol use disorder and opiate use disorder

46
Q

What is the name of the criteria used for opiate and alcohol use disorder?

A

DM5 criteria- the words alcohol and opiates can be used interchangeably depending on which youre assessing

47
Q

What does a history for someone who is addicted include?

A 
Presenting complaint
History of presenting complaint (onset, time frame etc)
Substance misuse history
Family history
Past psych history
Social and personal history
48
Q

In a history taking for addiction, what must be included in the substance misuse history?

A

Length of current use and when last used.
Current amount (units/grammes per day) and for how long at this level.
Total length of use, max use, and any periods of abstinence
Mode/method of use
Evidence of withdrawals and severity (e.g. seizures, admissions)
Any previous treatments - medication, psychotherapy, detox, rehab.
Any previous substance overdoses (accidental vs deliberate)

49
Q

Out of alcohol and opiate withdrawal, which is worse and why?

A

Alcohol withdrawal as it an cause seizures whereas opiate withdrawal doesn’t

50
Q

What should you examine for in alcohol use disorder?

A

Clubbing, anaemia, DVT, cyanosis, jaundice, collapsed veins, track marks

51
Q

What are the 2 ways opiates work?

A 
Reducing pain (analgesia)
Euphoric feelings
52
Q

What is the difference between opiates and opioids?

A

Opiates are natural (e.g. opium, morphine)

Opioids are all natural, semisynthetic, synthetic or natural

53
Q

What are signs of opiate overdose?

A 
Tiny pupils
Slow or no breathing
Choking/snorling/gurgling sounds
No moving, cant be woken
Clammy/cold skin
Cyanosis
54
Q

What do you do when you find someone who has overdosed?

A

Inject naloxone into upper arm or thigh, if no response repeat after 3 mins
Provide airway support and put them in the recovery position

BRS Y2 (85 decks)

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