Substance Use Disorders Flashcards
addiction
A cluster of cognitive, behavioral, and physiological signs that indicate compulsive use of a substance and inability to control intake despite negative consequences (eg., medical illness, failure in life roles, interpersonal difficulties)
dependence
Upon cession of drug, an individual experiences pathological signs and symptoms (eg., tolerance and withdrawal)
tolerance
Requiring a markedly increased dose of the substance to achieve the desired effect, or a markedly reduced effect when the usual dose is consumed
withdrawal
A shrug specific syndrome that occurs when blood or tissue concentrations of a substance decline in someone who had maintained prolonged heavy use
most addictive drug?
Nicotine
Heroin is the next one
most used illicit drug?
marijuana
epidemiology
21 million people 12 years and over age in need of SUDS treatment (1 in 13, or 7% of US)
Greater use in adolescence translates into greater use as an adult (the earlier you start, the more likely it is to persist into later life)
- More use from multiracial, lgbtq+, transgender
- More use from small/large metropolitan areas
risk factors (family and peers)
- Chaotic home environment especially parent substance use and mental illness
- Lack of parental monitoring
- Use by siblings
- Peer substance use
- Affiliation with deviant peer group
risk factors (environmental/cultural)
- Perceptions of approval of drug using behaviors in school, peer, and community environments
- Drug availability
- Trafficking patterns
- Urban settings
- Homelessness
- Low socioeconomic status - poverty
risk factors (life events)
- School/academic failure
- Poor social coping skills
- Verbal, physical, or emotional abuse or neglect
- Early first use under 15
- Chronic pain or disability
besides nicotine, what is the most used drug
What is mostly available is mostly abused
influence of early drug/alcohol use
Used as kids, will use in teen years, etc
- early onset
- starting earlier is worse
the “gateway” concept
–> Most people try alcohol and tobacco before they try marijuana
–> But most people who use marijuana don’t regularly use other drugs
MEANING:
- Softer drugs, not lead to harder drugs
protective factors
- Strong bonds with family
- Parental monitoring
- Success in school performance
- Strong bonds with pro-social
- Exposure to use prevention programs
role of education in drug abuse/addiction
–> Illicit drug use is lower for college graduates (5.1%) than those who did not graduate from high school (9.3%), high school graduates (8.6%) nd those with some college (8.9%)
–> By contrast, college graduates are more likely to try illicit drugs in their lifetime than adults who have not completed high school (52% vs 36%)
MEANING:
If you are more educated, you are less likely to use alcohol and drugs
dopamine theory of addiction
D1 and D2 receptors
D1:
- turns on neurons and gives a “feel good” signal, teaching us about positive outcomes
- Pay attention; this thing really matters
D2:
- turns off neurons and gives us a “feel bad” signal, teaching us about negative outcomes
- Pay attention; stay away from this thing
MEANING:
People who habitually use drugs have lower levels of dopamine D2 receptors
- Indicates they get less of a feel bad message from the drug
negative health effects of alcohol
Dehydration
Addiction
Accidents and injury
Depression and psychosis
Ulcers
Cancer of mouth/throat/stomach
Cirrhosis
Brain damage
Pancreatic damage
Decreased fertility
Fetal alcohol syndrome
High blood pressure
Increase risk of breast cancer
warning signs of drug and alcohol abuse
CHANGES IN:
- school performance
- peer group
- activity level
- physical appearance
- eating habits
- sleeping habits
SUDS and mental health
substance use and mental health
Comorbid → call them co-occurring
Dual diagnoses
- Mental diagnosis and you have a substance abuse or addictive disorder diagnosis
Risk factors for the others
Mental illness will precede use of drugs
CRAFFT screening tool
public domain; administered verbally during routine visit
→ C: Have you ever gotten into a CAR driven by someone (including yourself) who was “high” or using EtOH or drugs?
→ R: Do you use EtOH or drugs to RELAX?
→ A: Do you ever use EtOH or drugs while you are by yourself, ALONE?
→ F: Has any FRIEND, FAMILY member, or other person ever thought you had a problem with EtOH or drugs?
→ F: Do you ever FORGET (or regret) things you did while using?
→ T: Have you ever gotten into TROUBLE while using EtOH or drugs, or done something you wouldn’t normally do?
results of CRAFFT screening tool
If two or more of those factors are registered for positive = high substance use
