Substance use disorders Flashcards
Influencing factors of addiction
- neurobiology
- social context and norms
- cultural values
What is tolerance
- Larger doses of a substance are needed to produce the desired effect
- Effects on the drug become markedly less if the usual amount is taken
What is withdrawal
- Negative physical/ psychological effects that develop when a person stops/ reduces the amount of drug taken
- Each drug has unique pattern of withdrawal .
Substance use disorder (SUD): Diagnostic Critera
Problematic pattern of use that impairs functioning. 2 or more symptoms within a yr period
- tolerance - withdrawal - Strong Craving - substance taken for a longer time or in greater amounts than intended - efforts to reduce or control use do not work - Spend time to trying to obtain substance - continued use despite knowing problems caused - repeated use in situations that are physically dang - failure to meet obligations - social, hobbies, or work activities are given up or reduced
SUD’s: ten classes
- alcohol
- tobacco
- cannabis
- stimulants
- opioids
- sedatives, hypnotics, anxiolytics
- inhalants
- other/ unknown
- caffeine (only intoxication and withdrawal)
SUD’s cont
for ea drug, a person can be diagnosed with:
- intoxication (recent ingestion)
- Withdrawal
- Addiction- typically refers to a severe form of SUD (greater tolerance, physical dependence, withdrawal, and impairment) - severe SUD= 4 or more symptoms
- Intoxication also unique
Alcohol Use Disorder
- people who are physiologically dependant on alcohol
- increased tolerance
- increased withdrawal symptoms
- anxious, depressed, weak, restless, sleep problems
- Delirium Tremens (DT’s)- severe withdrawal that
includes hallucinations
- Often part of what is called “polydrug Abuse” =abusing more than one drug at a time
Short term effect- felt effects are based on tolerance, not metabolism
- alcohol acts with brain:
- stimulate GABA receptors
- increase dopamine/serotonin levels
- blocks glutamate receptors
Alcohol cont
Short term effect
- felt effects are based on tolerance, not metabolism
- alcohol acts with brain:
- stimulate GABA receptors
- increase dopamine/serotonin levels
- blocks glutamate receptors
Long term effects
- Malnutrition
- korsakoff’s syndrome - vit B deficiency
- severe memory deficits
- anterograde and retrograde amnesia confabulatio
- Brain tissue Damage
- Loss of gray matter from temporal lobes
- Liver cirrhosis
Tobacco Use Disorder
- Nicotine- addicting agent of tobacco
- stimulates release of DA in mesolimbic area
- initial pleasurable effects, then tolerance
- withdrawal symptoms; craving,restless, anxiety
- stimulates release of DA in mesolimbic area
Cannabis Use Disorders
Pot
- dried/ crushed leaves of hemp plant
Hashish
- dry resin from tops of plants
- Effects depend on expectancy factors
Actions of pot
- THC (active ingredient)
- Binds to cannabinoid receptors
- Psychological effects- relaxed, social. cog- impairmen
- physiological eff- munches, dry mouth, increase BP
long term- damage to lung and functions
- Therapeutic Eff- reduces nausea, loss of app, pain
- tolerance is used habitually
Opioid Use Disorder
- Group of addictive sedatives that in moderate doses relieve pain and induce sleep
- Opium
- Morphine- separated from raw opium, bitter tasting powder, powerful sedative and pain reliever
- Heroin-was used as a cure from morphine, more additive and powerful than morphine
- morphine, heroin, codeine
- prescription opiates include: vicodin, Oxy
- effects:
Euphoria, drowsiness, impaired coordin, analgesia - stimulates opioid system
- Tolerance;withdrawal within 8 hrs (flu like)
Stimulant use disorders
- amphetamines
- historical use in WWII to ward off fatigue
- depression and weight loss
- Low dose effects include: alert, euphoric, increase self confidence
- High dose: paranoia
- Tolerance developes quickly (6 Days)
Stimulant use cont (methamphetamine)
- amphetamine derivative
- used and manufactured in small towns and urban cities
- High cravings
- euphoria — shoulder— tweaking
- DA and 5- HT
- Chronic use: reduction in hippocampus (important for memory
stimulant use cont (cocaine)
- Freud “magical and marvelous” and yrs later “third scourge of humanity”
- results in: euphoria, increased self confidence
- blocks the uptake of DA
- Overdose: chills, nausea, hallucinations
- Long term use- irritable, paranoia, relationships
- Highly addictive w/ withdrawal symptoms
- some tolerance
Hallucinogen use disorder
- alter sensory perceptions and create sensory experiences
- LSD, Mescaline, PCP
- General effects of LSD: synesthesia (blending of sensory info, sense of time is slowed, mood swings,
- effects can depend on setting (good vs Bad trips)
- flashbacks
hallucinogen use cont
- MSMA/ ecstacy
- stimulant but can have hallucinogenic properties
- psychological effects- euphoria, altered sensory perceptions
- physiological effects - increased temp
Developmental process of substance use disorders
- positive attitude=experimentation=regular use= heavy use=dependence or abuse
etiology of substance use disorders
- Biological factors
- twin studies -sensitivity toward addiction, no matter the drug
- ability to metabolize substances varies by ethnicity
- avoiding withdrawal—dependence
- –nicotine, meth, alcohol, heroin
- Psychological factors
- effects mood: used to enhance positive or decrease negative mood
- expectancies
- personality traits
- Socialcultural factors
- acceptance of use
- availability of drug
- social/family influences
- media
- Incentive-sensitization model
- distinguishes between liking (pleasure) and wanting(craving)
- initial “sensitization” of liking (both drug effects and Cues)
- leads to wanting
- then “liking decreases” and wanting maintains
Treatment for substance use dis Biological Treat
- Biological treatments
- agonist substitution
- replacing one drug with similar drug that is safer
- methadone- heroin substitute
- replacing one drug with similar drug that is safer
- Antagonist substitution
- Blocking ones drug effect with another drug
- Naltrexone - alcohol, heroin - relieving withdrawal symptoms
- w/drawal symptoms become medical issue
- benzodiazepines (eg valium, ativan) =alcohol
- clonidine - opiate w/drawal
- w/drawal symptoms become medical issue
- Aversive treatments
- drugs that make taking substances very unpleasant
- antabuse
- drugs that make taking substances very unpleasant
- agonist substitution
Psychological treatment for substance use dis
- Combination therapy often more effective than monotherapy
- Group therapy, AA, Motivational interviewing
Prevention of Substance use dis
- peer pressure resistance training
- correction of beliefs/ expectations
- peer leadership
- inoculation against mass media messages
What is Korsakoff’s syndrome
- An alcohol related disorder marked by extreme confusion, memory impairment, and other neurological symptoms
Cross tolerance
- Tolerance for a substance that one has not taken before as a result from from use of a similar substance
Synergistic effect
- an increase of effects that occurs when more than one substance is acting on the body at the same time
Anatagonist drugs
- drugs that block or change the effects of an addictive drug
