substance use disorders

Question 1

substance use

Answer 1

ingestion with no negative side effects

Question 2

substance intoxication

Answer 2

experiencing intended physiological effects of substances

Question 3

substance abuse

Answer 3

when substance use causes distress and/or impairment

Question 4

physiological substance dependence

Answer 4

the body is dependent on drug for normal functioning and experiences withdrawal if it is not taken

Question 5

psychological substance dependence

Answer 5

emotional or mental components of substance use disorder

Question 6

substance use disorder

Answer 6

pattern of use that causes significant impairment and distress.

etiological factors: genetics, reward areas of brain (prefrontal cortex, amygdala, hippocampus), disease model, parental influence, positive and negative reinforcement, opponent process theory, conditioned place preference.

treatment: antagonist medication (valium, naloxone), methadone, medically supervised withdrawal, 12 step program, support groups, inpatient programs, CBT, motivational interviewing, harm reduction.

Question 7

disease model

Answer 7

describes addiction as a disease with biological, neurological, and environmental sources of origin. causes changes to brain pathways.

Question 8

opponent process theory

Answer 8

when you experience one emotion, the opposite emotion is inhibited. repeated exposure to conditioned stimuli decreases first emotion and opposing emotion intensifies in experience and suppresses the first. (in addiction, intoxication first, withdrawal second.)

Question 9

conditioned place preference

Answer 9

associations are formed with repeated drug use and become triggers. can be associated with emotional states, people, and environments. triggers cravings which contributes to relapse. drug usage in new environments can lead to overdose.

Question 10

alcohol use disorder

Answer 10

a problematic pattern of alcohol use leading to clinically significant impairment or distress, as manifested by at least 2/11 of the criteria, occurring within a 12-month period.

yearly prevalence: 12% men, 5% women.

etiological: genetics (men), family history, low glutamate, increased GABA, alcohol dehydrogenase, cultural differences, alcohol myopia, motivations for use.

treatment: antabuse (nausea), naltrexone (decrease euphoria), AA, CBT.

Question 11

alcohol dehydrogenase

Answer 11

enzyme that breaks down alcohol, not found in 30-50% of asian people.

Question 12

binge drinking

Answer 12

more than 5 drinks at once for men, more than 4 for women.

Question 13

opioid use disorder

Answer 13

etiological: enkephalin and endorphin systems, withdrawal symptoms prompting re-use, sensation seekers vs. emotional copers.

treatment: methadone and buprenorphine, naltrexone (prevent intoxication), NA, CBT, harm reduction.

Question 14

cannabis use disorder

Answer 14

12 month prevalence: 1-4%.

etiological factors: endocannabinoids, sensitization, motivations for use.

treatment: treat comorbid conditions, CBT (relapse prevention), harm reduction.

Question 15

hallucinogen addiction

Answer 15

12 month prevalence: 0.1%. rare, only used by 3% of the population overall.

etiological: serotonin and norepinephrine, motivations for use.

treatment: no bio treatment, CBT, harm reduction. rare, most people just stop.

Question 16

gambling disorder

Answer 16

persistent and recurrent problematic gambling behaviour, as indicated by 4/9 of the DSM criteria for a 12 month period.

12 month prevalence: 0.2-5%

etiological: impact dopamine and serotonin systems, decreased activity in impulse control areas of brain, positive and negative reinforcement, overestimate skill, lack of understanding of chance.

treatment: opioid antagonists, SSRI’s, lithium, CBT, harm reduction, gambler’s anonymous (rarely effective).

Question 17

3 subtypes of gambling disorder

Answer 17

1. behaviourally conditioned.
2. emotionally vulnerable (hide their distress).
3. antisocial-impulsive (looking for a rush. may steal to gamble.)