Substance use disorders

Question 1

What is substance abuse?

Answer 1

excessive use of a substance that leads to dangerous behavior and continued use despite problems (social, psychological, occupational, and health)

Question 2

What is substance dependence?

Answer 2

when substance abuse leads to tolerance and withdrawal

Question 3

Tolerance

Answer 3

a physiological need to keep increasing the amount of a substance to experience the same effects

Question 4

What causes the development of tolerance?

Answer 4

biochemical changes affecting one’s metabolism rate and the elimination of the substance from the body

Question 5

Withdrawal

Answer 5

physical symptoms that result from stopping use (e.g. nausea, sweating, tension, headaches, tremors)

Question 6

5 stages of substance abuse

Answer 6

positive attitude, experimentation, regular use, heavy use, physical dependence/abuse

Question 7

Alcohol use disorder according to the DSM-5

Answer 7

a problematic pattern of drinking that leads to impairment when at least 2 symptoms are present within 12 months (applicable to substance use disorders too)

Question 8

Symptoms of alcohol use disorder in DSM-5

Answer 8

more use than intended; desire to control use; time spent in alcohol pursuit; craving; use leading to interpersonal problems; use despite interpersonal problems; activities given up because of use; use in physically dangerous situations; use despite physical/psychological problems due to alcohol; tolerance; withdrawal

Question 9

Harmful alcohol use according to WHO

Answer 9

heavy episodic drinking or having at least 6 drinks at least once a month

Question 10

Factors affecting blood alcohol concentration

Answer 10

amount ingested in a particular period of time, food in the stomach (vs absorption in the small intestine), sex, age, medications

Question 11

Short-term effects of alcohol

Answer 11

stimulation then depression; interference with complex thought and motor coordination; interaction with several neural systems; effects tied to expectations (especially aggression and sexual drive)

Question 12

How does alcohol affect neural systems?

Answer 12

stimulates GABA receptors (decreases tension and motor coordination); increases 5-HT and DA (motivation for pleasure, craving, addiction); inhibits glutamate receptors (lower cognitive functioning)

Question 13

Long-term effects of alcohol

Answer 13

malnutrition (e.g. memory loss due to vitamin B deficiency); cognitive impairment; cirrhosis; cardiovascular problems (e.g. heart failure, hypertension, stroke, capillary hemorrhages), reduced immune functioning (increased breast cancer risk); fetal alcohol syndrome; psychosis

Question 14

Biological factors of alcohol abuse

Answer 14

genes (e.g. alcohol risk personality, ability to tolerate/metabolize alcohol, motivation for substance use (to reduce tension or increase pleasure); reinforcement of substance effects

Question 15

Psychological factors of alcohol abuse

Answer 15

drinking motives like sensation/novelty-seeking, stress/tension reduction, expectations of social success; when perceived benefits outweigh costs

Question 16

Which drinking motives place a person at most risk?

Answer 16

enhancement (positive-internal) and coping (negative-internal)

Question 17

Sociocultural factors of alcohol abuse

Answer 17

culture (e.g. attitudes, use patterns, tradition of aggression, religion), family (e.g. parent use/guidance, family/marital problems, older siblings), exposure and learning, availability, peer/social influences, media

Question 18

Biological treatment for substance abuse

Answer 18

medications (e.g. antabuse and naltrexone to block the desire to drink; valium to lower side effects of withdrawal)

Question 19

Psychological treatment for alcohol abuse

Answer 19

transtheoretical or stages of changes model; CBT and behavioral therapy (e.g. aversion conditioning, skills training, self-control, motivational enhancement); controlled drinking vs. abstinence

Question 20

5 stages of TTM

Answer 20

precontemplation, contemplation, preparation, action, maintenance (may lead to relapse)

Question 21

Social treatment for alcohol abuse

Answer 21

group therapy, alcoholics anonymous, environmental intervention (e.g. halfway houses)

Question 22

Factors affecting treatment efficacy for alcohol abuse

Answer 22

severity of substance and type of treatment

Question 23

Most common drugs associated with addiction

Answer 23

narcotics, sedatives, stimulants, anti-anxiety drugs, pain medication, hallucinogens

Question 24

Derivatives of narcotics or opioids

Answer 24

morphine, heroin, codeine

Question 25

Synthetic opioids (e.g. fentanyl)

Answer 25

50-100x as potent as morphine; often unknowingly mixed with heroin and codeine; responsible for 72% of overdose deaths in Canada in 2017

Question 26

Short-term biological effects of addiction

Answer 26

decreased physical pain and anxiety; relaxation; euphoria

Question 27

Long-term biological effects of addiction

Answer 27

physiological craving, withdrawal symptoms, physical deterioration

Question 28

Factors of addiction

Answer 28

pleasure-seeking, curiosity, peer pressure, stress relief, personal maladjustment, sociocultural conditions

Question 29

Comorbidities of addiction

Answer 29

70% of other psychological disorders, 50% of other substance abuse, 36% with history of trauma, depression, anxiety, antisocial personality disorder

Question 30

Biological treatment for addiction

Answer 30

methadone and buprenorphine

Question 31

Psychosocial treatment for addiction

Answer 31

TTM, CBT, group therapy, environmental interventions, controlled intake vs. abstinence, narcotics anonymous

Question 32

Types of stimulants

Answer 32

cocaine, amphetamines (including methamphetamine), caffeine, nicotine

Question 33

Effects of stimulants

Answer 33

increased alertness and reduced fatigue

Question 34

Effects of amphetamine abuse

Answer 34

intense fatigue, psychologically and physically addictive, brain damage (e.g. psychosis), suicide, homicide, violence

Question 35

Treatment for amphetamine abuse

Answer 35

withdrawal from drug, depression (peaks in days and can last for months), gastrointestinal symptoms

Question 36

Effects of methamphetamine abuse

Answer 36

highly addictive, increased dopamine in brain, structural changes in brain, treatment resistance (usually ends in relapse), long-term cognitive effects (e.g. psychosis, paranoia, learning and memory problems)

Question 37

Types of hallucinogens

Answer 37

LSD/acid, mescaline, psilocybin/mushrooms, MDMA/ecstasy/molly

Question 38

What is MDMA?

Answer 38

both a hallucinogen and stimulant; chemically similar to methamphetamine; a popular party drug

Question 39

Short-term effects of MDMA

Answer 39

rush of pleasure, sense of well-being, depressed mood for days after use

Question 40

Occasional negative effects of MDMA

Answer 40

psychosis, anxiety disorders, death

Question 41

Long-term effects of MDMA

Answer 41

all negative: brain damage (frontal and temporal lobes), memory deficits, hallucinations

Question 42

Short-term effects of cannabis

Answer 42

relaxation, sense of well-being, euphoria, hallucinations, increased perpetual acuity

Question 43

Therapeutic effects of cannabis

Answer 43

reduced nausea and pain, increased appetite and sleep

Question 44

Long-term effects of cannabis

Answer 44

psychosis/schizophrenia (if the person has a diathesis), memory loss

Question 45

Factors of gambling disorder

Answer 45

sensation-seeking personality type, maladaptive behavior (e.g. due to problems in relationships, finances, responsibilities)

Question 46

Treatment for gambling disorder

Answer 46

relapse