Substance Use Disorder Flashcards
What are the DSM-5 criteria for Substance Use Disorder (10 in total)? How many symptoms need to be present, and for how long?
Two or more symptoms within a 1-year period:
- Failure to meet obligations
- Repeated use of substance in situations where it is physically dangerous
- Repeated relationship problems
- Continued use despite problems caused by the substance
- Tolerance
- Withdrawal
- Substance taken for longer time or greater amounts than intended
- Efforts to reduce or control use do not work
- Much time is spent trying to obtain the substance
- Social, hobbies, or work activities given up or reduced
- Craving to use the substance is strong
What symptoms may accompany alcohol withdrawal?
- Muscle tremors
- Elevated pulse
- Blood pressure
- Temperature
- **Delirium tremens
What is Delirium tremens?
Rare withdrawal symptom when alcohol in blood drops suddenly. Intense symptoms: - Delirium (state of confusion) - Tremulous (shaking) - Visual hallucinations
What are two key features of Substance Use Disorders?
- Tolerance - Larger doses of drug needed to produce desired effect, effects of drug decrease if usual amount is taken.
- Withdrawal - Negative physical and psychological effects from stopping substance use, E.g., muscle pain, twitching, sweats, vomiting, diarrhea, insomnia.
What percentage of people with Alcohol Use Disorder smoke tobacco?
80-85%
How many criteria qualify for mild, moderate and severe Substance Use Disorder?
- Mild - 2-3
- Moderate - 4-5
- Severe - 6+
Which age population is alcohol use disorder common in?
College-age adults.
- 39.4% report binge drinking (5 drinks in a short period of time)
- 12.5% report heavy-use drinking (5 drinks on the same occasion 5 or more times a month)
Is there a gender rate difference between genders?
Yes, it is more common in men but the difference is shrinking.
In what marital status is it most common to have alcohol use disorder?
Rate higher for never married / divorced people.
What is substance use disorder comorbid with?
Borderline and antisocial personality disorders, mood disorders, anxiety disorders.
What neurotransmitter does alcohol interact with? What psychological effects does this cause?
- Stimulates GABA receptors, reducing tension
- Increases dopamine and serotonin, has a pleasurable effect
- Inhibits glutamate receptors, causing cognitive difficulties
What are the long-term effects of prolonged use of alcohol?
- Impaired digestion of food and absorption of vitamins, E.g., efficiency of B-complex vitamins – severe memory loss
- Cirrhosis of the liver
- Damage to the endocrine glands, brain, pancreas, heart failure, erectile dysfunction, hypertension, stroke, capillary hemorrhages
What are the effects of high dose of alcohol (.08 blood alcohol content)?
- Significant motor impairment
- Difficulty monitoring errors and making decisions
What is Fetal Alcohol Syndrome?
Heavy alcohol intake during pregnancy causing:
- A leading cause of intellectual disability among children
- Slowed fetal growth
- Cranial, facial, and limb anomalies
How does nicotine affect the brain?
It stimulates dopamine neurons in mesolimbic area (involved in reinforcing effect of most drugs).
What are some of the medical conditions that cigarettes can cause or worsen?
- Emphysema, cancers of larynx, esophagus, pancreas, bladder, cervix, and stomach, cardiovascular disease
- Sudden infant death syndrome and pregnancy complications
In what socio-economic groups is smoking most prevalent?
Lower socio-economic classes
What particular effects does cigarette smoking have on African Americans, compared to other groups?
- Less likely to quit
- More likely to get lung cancer
- Nicotine is metabolized more slowly
- More likely to smoke menthol cigarettes(direct advertisement to this community) - people tend to inhale more deeply and hold the smoke for longer
What particular effects does cigarette smoking have on Chinese Americans, compared to other groups?
- Metabolize less nicotine from cigarettes than European American or Latino smokers
- Lung cancer rates are lower
What are the effects of second hand smoke?
It contains higher concentrations of ammonia, carbon monoxide, nicotine, and tar than smokers. It’s also dangerous, can cause lung damage, possibly permanent.
Babies of women exposed to secondhand smoke during pregnancy are more likely to: be born prematurely, have lower birth weights, have birth defects.
What are some symptoms that children of smokers are likely to suffer from?
Upper respiratory infections, asthma, bronchitis, and inner-ear infections.
How do FDA regulations treat E-cigarettes and why?
FDA regulations treat E-cigarettes like other regulated tobacco products. because among young people, those who vape (E-cigarettes) are more likely to take up smoking cigarettes.
Is there a gender difference in the rates of Marijuana Use Disorder?
Yes, more common among men.
Is there a difference in rates of Marijuana Use Disorder between races and ethnic groups?
Hah! no.
What are the mental effects of marijuana? what are effects of large and heavy doses?
- Feelings of relaxation and sociability
Large doses:
- Rapid shifts of emotion
- Interferes with attention, memory, and thinking
Heavy doses:
- Hallucinations and panic
- Cognitive impairment
What are short-term physical effects of marijuana?
- Bloodshot and itchy eyes
- Dry mouth and throat
- Increased appetite
- Reduced pressure within the eye
- Increased blood pressure
What are long-term physical effects of marijuana?
- Damage to lung structure and function in long-term users
- Cognitive problems linked to the effects of marijuana on CB1 and CB2 receptors in the brain (e.g., hippocampus)
- Different patterns of connectivity between amygdala and frontal cortex among users compared to non-users
- Users can develop tolerance and withdrawal
What are therapeutic effects of marijuana?
- Reduce nausea and loss of appetite caused by chemo
- Can relieve discomfort associated with cancer, glaucoma, chronic pain, muscle spasms, seizures, AIDS
Name some opioids.
opium, morphine, heroin, codeine
How prevalent is opioids abuse?
Prescription pain medications are among the most abused of all drugs (Vicodin, Zydone, Lortab, Percodan, Tylox, OxyContin).
“Opioidic crisis” - 7% of US population misused opioids at least once.
Is there a gender difference in the rate of heroin use disorder?
Yes, more common among men.
Is there a gender difference in the rate of prescription pain medication abuse?
Yes, slightly higher in men.
Is there an (American) ethnic difference in the rate of prescription pain medication abuse?
Yes, higher among white Americans compared to other ethnic groups/
What are the psychological and physical effects of opioids?
- Produce euphoria, drowsiness, and lack of coordination - loss of inhibition, increased self-confidence. Severe letdown after about 4 to 6 hours
- Heroin and OxyContin - intense feelings of warmth and ecstasy following injection.
- Stimulate receptors of the body’s opioid system
- Exposure to infectious agents (e.g., HIV) through intravenous drug use