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Psychopathology - 13 mins > Substance use disorder > Flashcards

Substance use disorder Flashcards

1
Q 
Depressants:
Alcohol use disorder
1) race
2) Effects on
3) Cognitive impact
4) Some symptoms
A
  • Asians < AA < Hisp < White (recent article in news about punjabi culture & problem drinking –> won’t come forward due to family pride) (under represented)
  • Reliance + leads to interference with work/social life
  • MRI scans have revealed damage in various regions of their brains and impairments in memory, speed of thinking, attention skills and balance
  • drinking more than intended, uncontrollable, activities directed @ alcohol, persistence even after problems occur
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2
Q

What are “DT’s”

A

only from withdrawal from alcohol

Delirium tremens - withdrawal reaction; terrifying visual hallucinations. Severe withdrawal reaction

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3
Q

Depressants:

- hypnotic drugs

A
  • produce feelings of relaxation and drowsiness at low doses
  • At higher doses they are sleep inducers or hypnotics
  • Xanax, Vallium
  • Bind to GABA receptors
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4
Q

Depressants:
Opioids
what?/binds to?

A
  • Opimum - taken from poppies; makes up heroin, codeine & morphine
  • Heroin was seen as the new wonder drug from morphine BUT was found to be more addictive; all opiates now illegal
  • Binds to endorphin sites; which help relieve pain and reduce emotional tension
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5
Q

Opioid use disorder

A
  • Heroin – after just a few week of use = opioid use disorder
  • peaks after just 3 days of using
  • Big problem in US
  • Hep c / AIDS/ bacterial infections –> some saying @ risk for a HIV outbreak.
  • Hep c is increasing with the increasing IV opioid use
  • fentanyl, drug overdoses claimed 64,000 lives in 2016 alone, more than the entire death toll during the Vietnam War.

**synthetic opioid = fentanyl

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6
Q

similar structure of symptoms for most substance use disorders

A
  • take more than intended
  • persistent desire/unseccessful to cut down
  • failure to fufill obligations
  • use even in harmful situations/where there’s a problem already
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7
Q

Stimulants
Cocaine
- affects where?
- dangers of cocaine?

A
  • largely increases the effects of dopamine & norepinphrine in the brain (reward)
  • Overdose; strong doses can have effects on respiratory areas of the brain; stimulating -> suppressing
  • Heart irregularities
  • Brain seizures that make heart/brain stop
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8
Q

Stimulants:

Amphetamines

A
  • Manufactured in the lab

- Dopamine, serotonin, norepinephrine action increased

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9
Q

Stimulant use disorder

A
  • regular use may lead to this disorder

- poor functioning socially + at work etcetc

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10
Q

Hallucinogens

  • cannabis
  • LSD
A

LSD:
- binds to serotonin
- tolerance + withdrawal effects aren’t present
- flashbacks + anxiety disorders may occur
Cannabis:
- Hallucinogenic, depressant and stimulant effects
- Lower doses = relaxation and joy
- Higher doses = odd visual experiences, hallucinations, confusion, impulsivity

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11
Q

Cannabis use disorder

A
  • Regularly getting high
  • Tolerance for it can build up + withdrawal symptoms (flulike symptoms + irritable)
    & the rest of common symptoms
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12
Q

Is marijuana dangerous?

A
  • It is becoming stronger; can cause panic reactions + some can feel as if theyre losing their minds
  • Memory can be affected
  • Long term problems: lung disease, reproduction
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13
Q

combination of substances (disorder & interaction)

A
  • Poly substance use
  • interactions of drugs –> when taken together they seem to heighten each others effects
  • *Synergistic effect - when the effect of the combo is greater than the sum of all the effects of the drugs alone
  • when they have opposing effects - severe intoxication/death
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14
Q

Aetiology of substance use disorders
- Sociocultural Views: evidence for
(5)

A
  • stressful socioeconomic conditions
    a) poorer people have a higher rate
    b) unemployed > employed
    c) more intense discrimination = more use
    d) family environments where substance use is normalised
    e) Problem drinking are more likely to occur when the family/peers problem drink + whose families are unsupportive
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15
Q

Aetiology of substance use disorders
- Sociocultural Views:
EVALUATION

A

Discrimination
- a powerful link exists between discrimination and mood and substance-use disorders among racial/ethnic minority populations in the United States (AA)
- dose response relationship found too; the higher the discrimination, the higher the intake of drugs
- Rate varies according to the discrimination experienced: across multiple domains (character based, disrespect, hostility etc) – higher rate than if just one form experienced (i.e. just discrimination) Isolated exp of discrimination = not
enough
- mediated by anxiety?

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16
Q

Aetiology of substance use disorders

- Cognitive Behavioural Views: WHAT?

A

Operant conditioning:

a) temporary reduction in tension = positive, rewarding effects
b) Leads also to the expectancy of postive effects + this leads to people to be motivated to take the drug to relieve tension

17
Q

Aetiology of substance use disorders

- Biological Views: what/support (4 factors)

A

GENETIC PREDISPOSITION
a) Identical twins have a higher concordance rate
BUT
* may simply be the same parenting that leads to it i.e. similar parenting may occur for identical twins rather than fraternal?*
b) Adoption studies - show higher rates of alcoholism when bio parent had alcohlism

BIOCHEMICAL FACTORS
- when drugs is taken, it alters the neurochems in the brain
- when people keep taking it permanently alters levels in brain
- withdrawal continues until back to normal
BUT
this theory explains why people who regularly take drugs, take them. But doesn’t explain why drugs are so rewarding + why do people turn to them in the first place?**
REWARD CENTRE
- Dopamine + other neurotransmitters
- When dopamine gets activated along those pathways a person feels pleasure
- when drugs repeatedly stimulate this area - it becomes hypersensitive to substances. i.e. fires more readily when stimulated by them
REWARD DEFICIENCY SYNDROME
- Reward centre not readily activated by usual events so they turn to drugs to stimulate it, particularly in times of stress (Garfield eta l. 2014)
- Abnormal genes (i.e. abnormal D2 receptor gene)

18
Q

Aetiology of substance use disorders

- Biological Views: what/support (4 factors)

A

GENETIC PREDISPOSITION
a) Identical twins have a higher concordance rate
BUT
* may simply be the same parenting that leads to it i.e. similar parenting may occur for identical twins rather than fraternal?*
b) Adoption studies - show higher rates of alcoholism when bio parent had alcohlism

BIOCHEMICAL FACTORS

  • when drugs is taken, it alters the neurochems in the brain
  • when people keep taking it permanently alters levels in brain
  • withdrawal continues until back to normal

REWARD CENTRE
- Dopamine + other neurotransmitters
- When dopamine gets activated along those pathways a person feels pleasure
- when drugs repeatedly stimulate this area - it becomes hypersensitive to substances. i.e. fires more readily when stimulated by them
REWARD DEFICIENCY SYNDROME
- Reward centre not readily activated by usual events so they turn to drugs to stimulate it, particularly in times of stress (Garfield eta l. 2014)
- Abnormal genes (i.e. abnormal D2 receptor gene)

19
Q

REWARD CENTRE

EVAL

A
  • mesolimbic dopamine pathway: VTA (dopamine producing) —> nucleus accumbens (reward & motivation)
  • mesocortical pathway: VTA –> cerebral cortex
  • DA release = wellbeing
  • extraversion has been found to have a protective role over this reward system –> linked with an increased D2 density & also higher OFC activity (decision making)
    NEED MORE???
  • meds that target this dopamine system = quite successful
20
Q

BIOCHEM FACTORS EVAL

A

this theory explains why people who regularly take drugs, take them. But doesn’t explain why drugs are so rewarding + why do people turn to them in the first place?**

21
Q

internet gaming disorder

A
  • Awaiting official status (?) —- not included in dsm5
  • All or most of waking hours on it (networking, buying, gaming, browsing, virtual worlds etctec)
    • symptoms are parallel to those with SUD***
22
Q

Biological treatments

A

1) DETOXIFICATION
- systematic + supervised withdrawal from drug
- outpatient or inpatient
- removal of drug or put on another one to reduce symptoms of withdrawal

EVAL

  • rarely work alone; need in combo
  • helps those who are motivated
  • Relapse rates are high for those who do not receive a follow-up form if treatment – psychological, biological, sociocultural – after detox

2) ANTAGONIST DRUGS
- block the effects of the drug
- Help resist temptation
Problem: only motivated people will take them as prescribed + need to be careful (EG heroin users may suffer severe withdrawal if not used precautiously)

3) DRUG MAINTENANCE THERAPY
- drug related lifestyle may be a bigger problem than the drugs direct effects (eg heroin & unclean needles)
- support for use comes from high HIV + hep c in drug users
- The research suggests= most effective when in combo with education, psychotherapy, family therapy, employment and counselling

23
Q

Sociocultural therapies

A

SELF HELP

  • alcoholics anonymous
  • Members available to help each other 24 hours a day

COMMUNITY PREVENTION PROGRAMS

  • PREVENTION
  • involve the parents, peer group, school, community
  • involving family seems to have an impact; but a problem is that some drug users don’t have a support network

Psychopathology - 13 mins (14 decks)

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