Substance Use Disorder And Addiction Disorder Flashcards
What are the effects of substance use?
Tolerance: High quantities of a substance need to be taken to achieve the same effects
Withdrawal: The symptoms experienced when a person stops using a drug
Work with existing neurotransmitters
Cocaine – Dopamine
Alcohol – GABA
Drugs can change the amount of neurotransmittersby blocking the reuptake or inhibit presynaptic release
Receptors in the brain will become less and less sensitive in – Desentsize
Downregulation: So accustomed to getting hit over and over by the drug, so as to enhance the chemical.. Reduced the number of neurotransmitters – experience tolerance —brain trying to autocorrect
Metabolic system will adapt: Drink a lot of alcohol – body will try to process more efficiently because blood alcohol level will try to regulate or die from alcohol poison
Liver will produce more enzymes and break it down more quickly (becomes more efficient) builds that tolerance
What are the positive, negative, and withdrawal effects of Alcohol?
Positive Effects (Sought out effects)
Relaxation – Natural sedative
Lower inhibition – Bolder, not overthinking in social context
Analgesia - Reduces pain – pain killer, sensation of pain less painfully)
Negative
Diminished muscle control
Slow reaction time
Increased rate of injuries
More drowsiness
Less attentive
Less alert
Nauseous
Impaired memory – More extreme levels of drinking, the brain can only handle so much alcohol
Death – Intoxication, poisoned, respiration, suffocation (nausea), liver failure, coma
Withdrawal
Hangovers: No longer intoxicated, substance left system, left with sweating, headache, extreme dehydration, etc
Delirium Tremens: 2-5 days after the last drink, very severe: Shaking, confusing, hallucinations, vomiting, fatal (body has adapted to high levels of alcohol)
What are the names of the types of Stimulants? What are the positive, negative, and withdrawal effects of stimulants?
E.g., Amphetamines, meth, cocaine, caffeine
Positive Effects
Elevated mood
Increased initiative
Increased productivity
Increase self-confidence
Increase of energy
Increase heightened sexual interest
Negative Effects
Increase Height rate and blood pressure (mimic anxiety)
Increase risk taking
Risk of psychosis (visual or auditory)
Increase aggressive behavior
Sexual dysfunction
Overdose
Withdrawal
Depression, anxiety
Sleep disturbances
Anhedonia
What are the names of the types of Opiates? What are the positive, negative, and withdrawal effects of opiates?
E.g., Heroin, morphine, opium, prescription opioids
Positive
Dream-like euphoria
Less stress/distress
Analgesia: pain killer
Negative
Nausea
Slow shallow breathing – lead risk to overdose
Constipation
Lethargic
Losing motivation
Tolerance develops really quickly
Withdrawal
Intense craving
Agitated
Sweating
Muscle cramps
Vomiting
Insomnia
List goes on
What are the names of the types of Cannabis? What are the positive, negative, and withdrawal effects of Cannabis?
AKA. weed, marijuana, pot
Positive
Experience a pleasant mood, laugh more, lower bar for sense of mood
Pain killer
Relaxation
Slow sense of time
Promote sleepiness
Negative
Well-high–difficulty with concentration
Hard time remembering/processing information
Slow reaction time
Ability to self-access is impaired (report they don’t feel slower, ex. Won’t realize reaction time is slower – increase risk of injury)
Increase anxiety and paranoia
Decrease in motivation (while high, and in between when high)
Genetic risk for bipolar, psychosis, family history of those disorders and smoking cannabis increases the likelihood of onset of those disorders
Lung disease
Withdrawal
Irritable, depressed, or anxious mood
Long-term sleep difficulties
What are the names of the types of Hallucinogens And Related Drugs? What are the positive, negative, and withdrawal effects of Hallucinogens + related drugs?
E.g., LSD, MDMA(ecstasy, CP, mushrooms, psychedelics
Positive
Elevated mood
Euphoria
Novel experiences of auditory or visual hallucinations
New epiphanies, cosmic, religious thought
Open to new experiences – experience emotions usually avoided
Social facilitator
Tingling sensation
Negative
Headaches
Extreme high doses of PCP – risk of coma or stupor?
Distinguishing reality becomes impaired
Paranoia
Psychedelics can put people at risk to abuses of power
Dependent on it for coping
Withdrawal
Depression (from some but not all drugs) – Molly: influx of serotonin (used up all the serotonin, decrease of serotonin)
DSM-5: Substance Use Disorder (Includes Alcohol, Cannabis, Opioid)
Persistence
Incorporated into symptom descriptions (e.g., “persistent desire”, great deal of time spent”)
Symptoms
11 symptoms related to dependence, risky use, resulting problems, and impaired control
Distress Or Impairment
Incorporated into symptom descriptions (e.g., social or interpersonal problems caused by use)
Severity
Based on the number of symptoms
Mild: 2-3 symptoms
Moderate: 4-5 symptoms
Severe: 6-11 Symptoms
DSM-5 - Symtpoms: Substance Use Disorder
- Related to lack of control Using larger amounts/for longer time than intended
- Goes out, and says they will have one drink, and drinks more than one - Persistent desire to cut down but cannot
- Persistent is baked in
Requires having tried to cut down
- “I drank a lot this week, I will compensate by not drinking the next week, but cannot do it” - Great deal of time spent obtaining, using or recovering
- Spending lots of time obtain substance
Ex. meeting drug dealer, having to go to the bank to get money
Losing time due to hangover - Craving
- Brain can’t stop thinking about it
- Brain naturally starts imagining use
- Physical sensation of craving – sense of restlessness
- So distracted by craving, cannot focus what is on hand - Failure meet work, home, or school demands due to substance use
- Impairment is baked in - Continuing use despite persistently exacerbated social/relational problems
- Starting to have strain relationships
- Show more of an addiction
- High in cocaine, get into yelling matches, loses friends - Reduced time on important social, occupational, or recreational activities
- Ex. Were into running and give up on it because spent so much time getting high or are out looking for drugs
- Cutting back on things they did/cared about - Using a physically hazardous way
- Ex. Drinks and drives intoxicated
- The fact that they use it in a hazardous way counts, regardless of accident or not - Continued use despite persistent physical/psychological health consequences
Ex. Told by their doctor of early signs of lung cancer has gone up exponentially, and continue using despite this information - Tolerance
Take more to feel the effects - Withdrawal
Withdrawals specific to the abuse
What is the prevalence environment for Substance Use Disorder?
All about access (financial means)
Heroin and cocaine are more expensive than meth
Higher prevalence for heroin?
Cocaine is used more frequently in certain counties (South America, USA compared to India)
Grown in Cocoa trees – North America
Higher opioid abuse in India than USA
Opium poppy is grown in middle-eastern countries
Will influence prevalence rate
Age
Below the legal age of alcohol/marijuana – the easiest thing to use is inhalants such as household cleaners, huff the fumes
Higher in teenagers than adults
Less prevalent substance abuse (illegal substances) with elderly people ??
Prevalence Rates
Both graphs serve high school seniors
Senior year: 17-18 years
Alcohol use is high, but once legal age is met is decreases a bit (although still can obtain)
Likewise for cigarettes
Marijuana has started to increase prevalence as in some states it is legalized and it has easier access
Cigarettes have decreased
What are the social norms in Substance Use Disorder
Religious norms (Islam, Latter Day Saints, Puritans)
Gender Norms
Substance use disorder not specific: age group 20-23 is higher in men than in women but for both higher drinking during that age group
Developmental Norms
Binge Use - is most common in the 20s
Binge use goes down but chronic development occurs
Between Opiods, Cocaine, and Heroin, which one causes more overdoses thoughout the year?
- Opiods
- Cocaine
- Heroin
What are the prevention programs for Substance Use Disorder?
DARE (Drug Abuse and Resistance Education)
- Initiated in 1983 in Los Angeles
- Joint effort between teachers and police
- Prevent drug and alcohol in teenagers
- Police officers show up in school and show the dangers of these (fear-tacts)
- Latrogenic effects (ineffective, no reduction in the likelihood in not doing alcohol/drugs), schools who had DARE programs, have actually increase in drug use due to the exposure
- Less effective — are trying to make changes to increase outcome (fear-tactics is not a motivation to change people behavior)
BASICS (Brief Alcohol Screening Intervention For College Students)
- Better approach
- Motivational interviewing, feedback, goal-setting
- Given to college students who start showing symptoms of this issue
- Two sessions with face-to-face intervention
- Combination of motivational interviewing
- Empathetic approach, no judgment
- Provides personalized feedback
- Research: 18 studies: 1.50 drinks / week – Reduce amount of drinks
What are the medications for Alcohol Abuse?
Goal: Reduce Craving
For abstinence purposes
1. Disulfiram (Antabuse)
When people take these pills, creates negative effects when they drink alcohol
Blocks the breakdown of alcohol → Become extremely sick after drinking → Happens immediately that the body starts associating that we will become sick and this reverse condition will lower the amount of drinks until they don’t
- Naltrexone (Revia)
Blocks positive effects of drinking
When taken, decrease endogenous opioid system
Blocks euphoria, analgesia
Cravings goes down because we get less positive effects - Acamprosate (Campral)
Direct effect on the brain by reducing the craving directly
Naturally fixation/craving goes down
Cravings really drive substance abuse
Goal: Manage Comorbid Depression
1. SSRIs
Can be self medicated
Can help alleviate depression, and may help give up alcohol
What is detoxification?
Setting: Hospital inpatient or residential treatment centers
Goal of treatment: manage withdrawal symptoms → prevent relapse
Intense withdrawal symptoms they will most likely use again to manage withdrawal
How it works
Medications (ones above)
Manage withdrawal symptoms (e.g., fluids (IV), pain killers, anti-nausea meds (high-intensity anti nausea medication can make it more bearable))
Prevent access (Ex. in hospital or facility should have zero access to reduce temptation when recovering
What is the 12-Step Group?
E.g., Alcoholics Anonymous, Narcotics Anonymous
Setting: Informal
Relevant Risk Factors: Environmental factors, social triggers, social networks
Goal of treatment: Abstinence
How it works
Focus on short-term progress → Ex. Stay sober for 24 hours
Recognize long-term progress → Ex. Chips given for periods of sobriety
People place things → Talk alot about cues regarding alcohol/drugs and recognize which cues makes them tempted to crave, use, cope with stressors and if encountered these triggers they should go to a meeting or sponsor.
Work through 12 steps → One of them is apologizing/making amends
If they quit, more chance of relapse
