Substance Use Disorder Flashcards
What SES group has highest alcohol abuse?
Low SES groups
Is alcohol abuse higher in rural or urban settings?
Rural
Is non alcohol drug abuse higher in rural or urban settings?
Urban
What is substance abuse highly comorbid with?
Anxiety and depression
What are Substance Induced Disorders?
Symptoms result from acute and chronic effects of substances on CNS (intoxication and withdrawal biochemical impact)
What is Substance Use Disorder?
Specific patterns of maladaptive behaviour, cognitions and physiological symptoms from regular drug use
What are the DSM-V criteria for Substance Use Disorder?
A. Probematic pattern of substance use leading to significant impairment and stress with 2 of the following for 12 months:
- Impaired control - increased use, unsuccessful control and cravings
- Social impairment - use despite impacting relationships and work, abandoning social, occupational or recreational activities
- Risky use - continued use despite serious problems
- Pharmacological - tolerance and withdrawal
What substances are classified as Group A?
Alocohol, Opiods and sedatives
What impact do depressants have?
Slows activity in CNS leading to reduced tension, judgement, motor activity and concentration
What impact does Alcohol have?
- Delirium tremens, sympathetic overdrive, global confusion, seizures
- Alcohol hallucination
- Cirrhosis (liver damage), depressed heart functioning, nutritional problems (Vitamin B deficit), Wernicke’s encephalogy (delirium, double vision), Korsakoff’s syndrome (profound memory impairment)
What is Wernicke’s Encephalogy?
Delirium and double vision due to vitamin B deficits
What is Korsakoff’s Syndrome?
Profound memory impairment due to vitamin B deficit
What is the Genetics view of the aetiology of alcoholism?
- Heritiability risk of alcoholism 66%
- Adoption studies: environment predicts initial use but genetics predict progression to dependency
What is the Biological view of the aetiology of alcoholism?
- Psychoactive drugs stimulate rewards pathways
- Endorphin compensation hypothesis- - Alcohol increases the production of endorphins
- Serotonin Hypothesis - Alcohol increases serotonin to average levels
What is the Behavioural view of the aetiology of alcoholism?
- Tension reduction hypothesis
- Operant conditioning
- Modelling and vicarious reinforcement
What is the Cognitive view of the aetiology of alcoholism?
Attitudional/expectancy variables
What is the Social Contexts view of the aetiology of alcoholism?
- Peer pressure, availability and legal context
What are sedatives/hypnotic drugs?
- Anti anxiety drugs (benzodiazepines eg valium)
- Barbiturates
What are the effects of Barbituates?
- Respiratory failure
- Low blood pressure
- Accidental/deliberate overdose
- tolerance increases rapidly
- withdrawal symptoms similar to alcohol
What are Opioids (narcotics)?
Heroin, morphine, methodone/buprenorphine, painkillers (eg Oxycontin, panadeine)
What drugs make up Group B Stimulants?
Nicotine, caffine, cocaine, Amphetamines (speed)
What do stimulants do to the body?
Increase activity in the CNS - increase blood pressure, heart rate, intensified behavioural activity, thought processes and alertness
What drugs make up Group C Hallucinogens?
Psychedelic drugs (LSD, ecstasy), Cannabis
What do Hallucinogens do to the body?
Causes changes in sensory perception. May intensify emotions and create a sense of detachment
What is the active ingredient in cannabis?
Tetrahydrocannabinol
What is the strongest cannabis?
Hashish
What is the weakest cannabis?
Marijuana
What are the 3 types of cannabis
Hashish, Ganja, Marijuana
What happens to the body with the use of cannabis?
- Paranoia/Anxiousness - panic reactions
- Cannabis intoxication
- Cognitive changes
- Lung disease (contains tar and benzpyrene)
- Lower sperm count and abnormal ovulation
- Mild suppressive effect on immune system
What are common properties of addictive drugs?
- Initially pleasurable so reinforcing
- Tolerance develops with repeated use
- Discontinuation causes withdrawal symptoms
- Addictive behaviours are not just just but food and gambling too
What is metabolic tolerance?
Liver produces more enzymes
What is Pharmcodynamic tolerance?
Brain adapts to drug presence
What is Behavioural conditioning mechanism in regards to tolerance?
Environmental cues elicit a conditioned response
What is the Genetic view of the aetiology of Substance Use Disorders?
- Twin and adoption studies indicate predisposition to substance use disorders
- Flipped switch theory - controlled to addition due to genetics
What is the Biological view of the aetiology of Substance Use Disorders?
- Natural reward system in the brain as Dopaminergic system and relieving neurons, prefrontal cortex, nucleus accumbers, amygdala, ventral tegmentarea
- Amphetamines and cocaine act on dopamine
- Opiates inhibit GAMA release
What is the Behavioural view of the aetiology of Substance Use Disorders?
- Operant conditioning
- Classical conditioning - Conditioned appetitive motivational model: conditioned to stimuli eg people or lights
Describe the Brauer et al nicotine study
Cues are more important to smokers than nicotine
What is the Incentive Sensitisation Theory of the aetiology of Substance Use Disorders?
Wanting drugs does not mean liking drugs. Implicit desire not explicit due to neural circuits
What is the Cognitive view of the aetiology of Substance Use Disorders?
Expectancy effects
What is the Social view of the aetiology of Substance Use Disorders?
- Direct or indirect exposure to substances
- Moral weakness model
- Disease model
What is the Biological treatment of Substance Use Disorders?
- Detoxification
- Antagonist drugs (eg Antabuse, revial)
- Drug maintenance therapy - methadone, nicotine patches
What is the Psychological treatment of Substance Use Disorders?
- Psycheducation
- Motivational interviewing
What is the CBT treatment of Substance Use Disorders?
- Coping skills
- Relation training
- Drinking refusal self efficacy
- Expectancy modification
- Relapse prevention - self efficacy coping mechanisms, lapses are temporary
What is more effective in reducing substance abuse and increasing functioning?
12 steps and CBT equally effective
What is the Harm reduction treatment of Substance Use Disorders?
- Substitute prescribing
- Needle exchanging
- Safer sex
