Substance Use Disorders Flashcards
Addiction
cluster of cognitive, behavioral, and physiologic signs that indicate compulsive use of a substance and inability to control intake despite negative consequences.
Dependence
upon cessation of drug, an individual experiences pathological signs and symptoms
Tolerance
requiring a markedly increased dose of he substance to achieve the desired effect, or a markedly reduced effect when the usual dose is consumed.
Withdrawal
a drug specific symptom that occurs when blood or tissue concentrations of a substance decline in someone who has maintained a prolonged heavy use.
Epidemiology
9% of adolescent aged 12-17 are classified as needed treatment for alcohol and substance abuse.
Greater use in adolescence translates into greater use as an adult
Gay, lesbian, and bisexual youth report more SUDS use that heterosexual–females are more likely than males among GLB group. Males are more likely that females among heterosexual.
Frequency
10-20% of population at some point will have an addiction.
10% of individuals with SUDS commit suicide
- 4% will have a substance dependence or abuse.
- 2 million abuse alcohol and illicit drugs
- 9 abuse illicit drugs
- 9 abuse alcohol.
Most frequently abused drugs
8.9% are illicit drug users. Marijuana was the most commonly used illicit drug with a rate of 6.9%.
.6% used cocaine; 25% of whom used crack
Hallucinogens were used by .5%.
166,000 are current heroine users.
2.7% of population abused psychotherapeutic drugs.
Influence of early drug/alcohol use
Dramatic relationship between use of first drug and drug abuse dependence
Early first use ( 3 times the odds of dependence compared to >21
Early first use ( increases rate of alcohol abuse by 6 fold. Each year drinking onset is delayed, risk of alcohol dependence is reduced by 14%.
CONCLUSION: If risk factors discovered and treated early and drug initiation delayed–> adolescent SUDS can be prevented
Risk Factors
Family and peer Chaotic home environment Lack of parental monitoring Parental permisiveness Use by siblings Verbal, physical, and emotional abuse Peer substance use Affiliation with deviant peer group
Environmental/Cultural Perception of approval of drug using behavior in school, peer, and community environments. Drug availability Urban settings Homelessness Low SES Media Promotion
Life Events School/academic failure Poor social coping skills Abuse/neglect Exposure to violence
Protective Factors
Strong bonds with family Parental monitoring Clear rules of conduct Involvement of parents Success in school performance Strong bonds with pro-social institutions: family, school, and religious organizations Exposure to Use prevention programs
The role of education in drug abuse/addiction
College graduates 5.1%
Did not graduate HS 9.3%
High school graduation 8.6%
Some college 8.9%
Dopamine theory of Addiction
Want to increase DA in limbic circuit
DA is a neurotransmitter which helps to regulate motivation of behaviors necessary for survival. They turn our attention to what is salient (fun, sad, important for survival, aversive)
If D2 density is decreased in drug users, they will then experience less of a signal from the firing of DA neurons
Natural Reinforcers are less rewarding than they would otherwise bc because DA are not large enough to signal them as salient
Increases in DA in the synapse is 5-10x greater with drugs than natural reinforcers
Moreoever drugs, like cocaine, amphetamines, and methamphetamines block the reuptake transporter, so DA stays in the synapse longer than with natural reinforcers
Negative health effects of alcohol
Dehydration Addiction Pancreatic damage Brain damage Decreased fertility Ulcers Accidents and Injury Depression/psychosis FAS High BP
Warning signs of drug and alcohol abuse
Change in school performance Changes in peer group Breaking rules Affect changes (mood swings) Activity level Withdrawal from family Changes in physical appearance Eyes: red, watery, glassy Nose: runny Eating/sleeping habits Decreased motivation in pleasure teen activities Anti-social behavior Possession of drug paraphernalia Initiation of drug use before ages 12/13
CRAFFT Screening Tool
Verbally administered
C= Have you ever gotten into a Car with someone who was high or used EtoH or drugs R= Have you ever used drugs to Relax? A= Have you ever used drugs Alone? F= Have family members, friends, or others thought you had a problem? F= Have you ever forgotten things while using? T= Have you ever gotten into Trouble while using drugs, or done something you wouldn't normally do?
