Substance Use Disorders - 2.2

Question 1

What are the factors influencing substance use disorder?

Answer 1

1. Genetic factors
2. Co-existing disorders
3. Environmental risk factors
4. Developmental aspect

Question 2

Genetic factors

Answer 2

predispose an individual to substance use disorder

ex. sons of alcoholic parents are at higher risk to become alcoholics than sons of non-alcoholic parents

Question 3

Co-existing disorders

Answer 3

people with MAD (major affective disorder) ; depression, anxiety. schizophrenia, are at higher risk for substance use disorder.

Question 4

Environmental risk factors

Answer 4

• places/environments that promote the use of drugs.
• unstable family life
• social and work groups

Question 5

Developmental aspect

Answer 5

young adults and adolescence are the age groups primarily associated with starting a substance use disorder.

ex. smoking before 18 years, 80% alcoholics begin before 30 years.

Question 6

The Dopamine Hypothesis

Answer 6

suggests that drugs of abuse increase dopamine in the reward systems of brain (limbic system) which alter communication with brain.

• reward/dopaminergic systems responsible for:
  1. natural rewards (food and sex)
  2. stimulus-related rewards (video games, gambling, fire starting

Question 7

Addictive drugs can ________ (characteristics)

Answer 7

1. Increase dopamine
2. Produce novelty
3. Reduce anxiety

Question 8

Substances that increase dopamine

Answer 8

1. CNS stimulants (cocaine, amphetamines, nicotine, caffeine)
2. Opiates (morphine, heroin, oxycontin)
3. Alcohol
4. Cannabis

Question 9

Substances that produce novelty

Answer 9

1. LSD

2. Ecstacy

Question 10

Substances that reduce anxiety

Answer 10

1. Benzodiazepines

2. Barbiturates

Question 11

Substance abuse

Answer 11

• A pattern of substance use manifested be recurrent and significant adverse consequences.
  ex. repeated failure to fulfil obligations, repeated use in situations in which it is physically hazardous, legal problems, social and personal problems
• use of any drug in a manner that deviates from approved medical and social patterns
• social disapproval

Question 12

Criteria for substance abuse

Answer 12

1. use of any prohibited drugs
2. use of therapeutic drugs for other than intended use
3. intentional digestion of amounts greater than prescribed, taking drug by routes not medically approved
4. drug combination for greater effect
5. excessive use of legal social drugs
6. use of non-therapeutic substances

Question 13

Abuse potential of a drug

Answer 13

1. Dependence liability
   a) nature of drug
   b) route by admin
   c) amount and frequency of use
2. Availability
3. Inherent harmfulness

Question 14

Explain dependence liability and its 3 factors

Answer 14

Tendency of drug to cause dependence and addiction

Nature of drug - pleasurable effects produced by drug increase probability of drug being taken again.

Route of admin - routes that give rapid absorption/effects have greater potential for abuse (ex. sniffing, inhalation, intravenous injection)

Amount and frequency - greater dose and frequency of use has greater potential for dependence development.

Question 15

Explain availability

Answer 15

Widespread drugs are more likely to be abused.

Question 16

Explain inherent harmfulness

Answer 16

The potential of a drug to cause harm. If a drug is a serious risk to life and health, it will not be widely available.

Question 17

Substance dependence and its 3 aspects

Answer 17

Complex disease process of CNS through repeated consumption and/or chronic use

1. drug tolerance
2. drug dependence and withdrawal
3. drug addiction

Question 18

Drug tolerance

Answer 18

State in which repeated admin of a dose has progressively less pharmacological effect. State in which dose of drug must be increased to obtain same magnitude of pharmacological effect as original dose

Question 19

Drug dependence and withdrawal

Answer 19

Abnormal physiological state produced by repeated admin of drug leading to appearance of withdrawal syndrome when drug is discontinued or dose decreased

• Severity of withdrawal symptoms increase with speed of withdrawal
• Symptoms usually opposite of drug effects.

Question 20

Drug addiction

Answer 20

State in which stopping or abruptly reducing dose of drug produces non-physical symptoms.

• emotional and mental preoccupation with drug’s effects and persistent craving for drug
• universal characteristic of chronic substance abuse and more difficult to treat than dependence.