Substance Use Disorders

Question 1

define SUD

Answer 1

medical illness caused by repeated misuse of substance or substances

Question 2

SUD is characterized by

Answer 2

clinically significant impairments in health, social function, and impared control over substance use

Question 3

what is the 3 stage cycle of substance use

Answer 3

Binge/ intoxication with a substance (reward of pleasurable effect)
Withdrawal/ negative effect (emotional state without substance
Preoccupation/ anticipation (seek substance in period of absence)

Question 4

the 3 stage cycle
1. decreases in severity with continued substance use
2. produces changes in brain function that revert when substance use is stopped
3. tend to cycle qwk
4. sees reduced ability to control substance use

Answer 4

4
1. increases
2. persist long after use stops
3. cycle depends on the individual and the substance

Question 5

what are the main areas of the brain that change with substance use?

Answer 5

basal ganglia
extended amygdala
prefrontal cortex

Question 6

which part of the brain is the pleasure and habit forming portion that causes + reinforcement with SU

Answer 6

basal ganglia

Question 7

which part of the brain is responsible for the stress and negative feelings associated with withdrawal, resulting in negative reinforcement

Answer 7

extended amygdala

Question 8

what portion of the brain is responsible for executive function exerting control over substance use

Answer 8

prefrontal cortex

Question 9

substance misuse disrupts ____ circuits in the brain, resulting in ____ D2 receptors and decrease in sensitivity of the brain’s _______

Answer 9

disrupts dopamine circuits
resulting in decrease in D2 receptors
decreased sensitivity of brain’s reward system

Question 10

what behaviour of the cycle leads to initial substance usage

Answer 10

impulsivity

Question 11

describe compulsivity in the SU cycle

Answer 11

when driver of use shifts from wanting pleasure to needing relief = addiction and loss of control
This is why people relapse, even if they’ve stopped for a while

Question 12

describe withdrawal

Answer 12

feeling worse in absence of the substance

Question 13

RF for SU

Answer 13

early like experiences and exposures during adolescence
genetics
psych comorbidity (2x)
differences in sex, race, ethnicity

Question 14

which of the following is false
1.early exposure to substances cause developmental changes in the brain
2. Those who have earlier substance exposure tend to have a higher risk of developing a SUD with lower intensity than those who start at a later age
3. SUD 2x as common in psyc comorb, psyc comorb 2x more common in SU population
4. psych comorb SUD is associated with worse treatment outcomes

Answer 14

2

Question 15

what are the 2 most common psyc comorbidities assoc with SUD

Answer 15

antisocial personality disorder (84%), schizophrenia (47%)

Question 16

psyc comorbidity and SU is associated with ________, _________, and ______-

Answer 16

worse tx outcomes
more severe illness
high healthcare/ service utilization in hospital and community

Question 17

the brain story emphasizes the importance of the first ____ years of life

Answer 17

0-6

Question 18

Inadequate experiences and negative environments = development of _________

Answer 18

toxic stress

Question 19

toxic stress from negative environment effects

Answer 19

affects gene expression responsible for regulating stress
long lasting changes in behaviour and health
Exaggerated neurological response to toxic stress never goes away = mental health concerns, behavioural issues, predisposition to addiction as coping mechanism

Question 20

T or F: exaggerated neuro response to toxic stress never goes away

Answer 20

T

Question 21

list 3 ACEs

Answer 21

Abuse: emotional, physical, sexual
Household of dysfunction: domestic violence, household substance use, mental or chronic physical illness in household, parental separation or divorce, emotional and physical neglect, incarceration of caregiver or parent

Question 22

list 3 things an increase in ACE increases the chances for

Answer 22

alcoholism and abuse, depression/ anxiety, suicide attempts, illicit drug use, STIs, multiple sexual partners, early sex, fetal death, unintended pregnancies, poor work performance, financial issues, poor health related QoL, ischemic heart disease, COPD, liver disease, intimate partner violence, sexual violence

Question 23

2+ ACEs significantly increased the risk of ________ and _______

Answer 23

depression/ anxiety and chronic fatigue/ fibromyalgia

Question 24

children exposed to _________ had highest risk for negative health outcomes in adulthood

Answer 24

abuse and dysfunction

Question 25

what are some changes needed to address SUD

Answer 25

address root cause
supports and resources needed early in life to prevent poor health outcomes later