substance use and related disorders Flashcards
2 DSM-5 diagnoses related to substance
- substance-induced disorders - caused by substance
- substance use disorders
list the substance-induced disorders
substance intoxication
substance withdrawal
substance intoxication
substance-INDUCED
person ingests substance then develops reversible syndrome
as substance leaves the body, the effects of the substance are reduced and eventually disappear
symptoms are specific to the substance used but are clinically significant
substance withdrawal
substance-INDUCED
pattern!!! of repeated episodes of intoxication leads to withdrawal syndrome
occurs when…
1. physiological dependence developed
2. sudden reduction or cessation of use
3. experience characteristic grouping of symptoms
substance-specific problematic behavior changes with psychological or physiological impairment
substance-use disorders
a pathological (maladaptive, causing personal harm) pattern of behaviors related to the use of a substance
underlying changes in brain circuitry even beyond detox
typically involves withdrawal symptoms
impaired control over use of substance
social impairment
risky use
physiological dependence
psychological dependence
addiction
tolerance and withdrawal = pharmacological criteria
pathways to drug dependence (weiss & mirin)
experimentation - routine use - dependence
major categories: drugs of abuse
depressants - slows activity of CNS
stimulants - increase activity of CNS
hallucinogens
alcohol (depressant)
most widely abused substance
more common in men
between 20-40 years old
genetic component
more common in those with anti-social personality disorder
higher in individuals of lower socioeconomic status
higher in individuals with less education
higher in people who live alone
physiological affects of alcohol
heighten activity of inhibitory neurotransmitter GABA (leads to feelings of relaxation)
psychological effects of alcohol
vary from person to person
interaction of the physiological effects and our interpretation of them
physical effects of heavy use of alcohol
liver disease (alcoholic hepatitis & cirrhosis)
increased risk of cancer
coronary heart disease
neurological: Korsakoff’s syndrome - severe vitamin B deficiency, impairment of body’s ability to absorb nutrients
significant memory loss - RARE b/c long term memories lost first
barbiturates (depressant)
sedative drugs: amorbarbital, phenobarbital, secobarbital
also sleep medications: hypnotics & anti-anxiety meds (anxiolytics)
high potential for addiction but highly controlled
opioids (depressant)
narcotic (pain relief)
highly addictive, very controlled
naturally occurring: morphine, heroin, codeine
synthetic: demerol, darvon
function like endorphins
morphine
narcotic drug, relieves pain and induces feelings of well-being
restricted drug
no stigma until in became restricted
highly addictive but necessary in some very painful surgeries
heroin
no stigma until it began to be restrictive
narcotic derived from morphine
highly addictive
very powerful depressant
most widely used opiate
stimulants
activate the central nervous system
types:
1. amphetamines
2. ecstasy
3. cocaine
4. nicotine
5. caffeine
amphetamines
stimulant - synthetic
causes hallucinations and delusions
can cause amphetamine psychosis
ecstasy (MDMA)
stimulant
known as a designer drug
high risk for negative psychological effects
cocaine
stimulant - natural
increases dopamine
rise in blood pressure can lead to fatal symptoms
nicotine
stimulant that releases epinephrine
hallucinogens (psychedelics)
LSD - synthetic
PCP - originally designed to be an anesthetic
marijuana - cannabis sativa plant
LSD
hallucinogen
causes sensory distortions
can cause relaxation and euphoria but also negative psychological symptoms and panic
biological theory: substance disorders
neurotransmitter changes, familial patterns suggest genetic influence
learning theory: substance disorders
substance use disorders result from learned behaviors and can be unlearned
- classical conditioning
- operant conditioning
- observational learning
- relapse = negative reinforcement for withdrawal symptoms
cognitive theory: substance disorders
role of expectancies - socially, physically
substance use may increase person’s self-esteem or self-efficacy
psychodynamic theory: substance disorders
oral fixation leads to dependent personality
applies to substances ingested orally, but oral fixation tends to be highly dependent people too
sociocultural theory: substance disorders
result from environment, norms, culture, and peer pressure
treatments for substance disorders (general)
detoxification
inpatient programs
relapse prevention
AA
naltrexone - blocks euphoric & sedative effects
treatment - alcohol use disorder
antabuse - didn’t work as hoped because people just stopped taking it
suboxone - used for opioids too
AA
treatment - cocaine
antidepressants - inconsistent though
treatment - opioids
methadone - synthetic substitute for heroin - doesn’t produce a high but still addictive
suboxone
naloxone (narcan) - knocks opioids out of receptors to prevent overdose
abuse of gambling disorder
persistent and recurrent maladaptive gambling behavior that disrupts personal, family, and/or vocational pursuits
clinically significant impairment and/or distress for the individual or others in their lives
3 criteria for something to be considered gambling
- wagering money on an object of value
- bet is irreversible
- outcome relies on chance
treatment of gambling disorder
harm reduction - don’t immediately cut out gambling right away
CBT - having the person modify their thoughts about gambling
medication depending on what may be co-occurring with the gambling disorder
inpatient, outpatient, and group modalities
