Substance Use Disorders

Question 1

Two examples of sedative hypnotics

Answer 1

Benzodiazepines, Barbituates

Question 2

Examples of stimulants

Answer 2

Cocaine, amphetamines, methylphenidate

Ephedrine, Caffeine

Question 3

Examples of hallucingens

Answer 3

LSD, Mescaline, Peyote, DMT

Question 4

Examples of dissociative anesthetics

Answer 4

PCP, Ketamine

Question 5

Preferred opioid for abuse

Answer 5

Prescriptions

Heroin

Question 6

Describe the neurobiology of addiction

Answer 6

The nucleus accumbens controls dopmine secretion and used this activity to control activity in the forebrain. Pre and post drug use, wiring changes can be seen.

Question 7

Self-administration of ________ is very similar to stimular self administration

Answer 7

electrical stimulation reward areas

Question 8

Describe the mechanism of action of Alcohol

Answer 8

Does not have a specific receptor or neurotransmitter

Stimulates domaine release in the NA, stimulates GABA-a receptor, and inhibits NMDA receptor

Question 9

Describe the mechanism of cocaine action

Answer 9

Blocks reuptake of dopamine in the mesolimbic system
Stimulates NA release peripherally
Blocks Na channels

Question 10

Describe the mechanism of amphetamine action

Answer 10

Directly stimulates the release of dopamine in the meso-limbic

Question 11

Describe the mechanism of opiates

Answer 11

Binds to the mu, sigma, and kappa receptors centrally and peripheral
Indirectly stimulate the release of VTA dopamine release

Question 12

What drug has the strongest withdrawl symptoms

Answer 12

Opiates

Question 13

What is a substance use disorder

Answer 13

A maladaptive pattern of substance use leading to clinically significnt impairment or distress

Question 14

Criteria for AUD

Answer 14

• Taken in larger amounts/over a longer period than intended
• Persistent unsuccessful effort to cut down alcohol use
• A great deal of time is spent obtaining alcohol
• Craving or a desire to use a specific substance
• Failure to fulfill major role obligations
• Continued use despite persistent social/problem from OH
• Tolerance
• Withdrawal

Question 15

Tolerance is defined by what two things…

Answer 15

• A need for markedly increased amounts of the substance to achieve intoxication or desired effect
• Markedly diminished effect with continued use of the same amount of the substance

Question 16

Withdrawl is defined by…

Answer 16

• The characteristic withdrawl syndrome for the substance

- A closely related substance is taken to relieve or avoid withdrawl symptoms

Question 17

Difference between early and sustained remission

Answer 17

Early – 3-12 months without use

Sustained – 12 months without use

Question 18

What does CAGE stand for?

Answer 18

C – Have you ever cut down your drinking?
A – Have you ever been annoyed by criticism of your drinking?
G – Have you ever felt guilty about things you have done while drinking?
E – Do you ever have an eye opener?

Question 19

GGT is a test for…

Answer 19

Especially sensitive to alcohol

Question 20

1 beer raises BAC by

Answer 20

0.25

Question 21

BAL above ____ with no signs of intoxication indicate tolerance

Answer 21

0.8

Question 22

In liver damage, who is higher, AST or ALT

Answer 22

AST

Question 23

Five stages of quitting

Answer 23

Precontemplation
Contemplation
Action
Maintenence
Relapse

Question 24

Components of addiction treatment

Answer 24

Management of withdrawl
Behavioral Approaches
Treatment of co-existing mental health issues
Pharmacologic

Question 25

Three sets of drugs that require detox

Answer 25

Alcohol
Sedative hypnotics
Opiates

Question 26

Symptoms of alcohol withdrawl

Answer 26

Tremors, diaphoresis, elevated BP
Seizures
Delirium tremens

Question 27

Treatment for aversion

Answer 27

Disulfram

Question 28

Treatment for anticraving

Answer 28

Naltrexone, Wellbutrin, Acamprosate

Question 29

Treatment for replacement

Answer 29

Methadone, Nicotine

Question 30

How does disulfram work?

Answer 30

Inhibits aldehyde dehydrogenase leading to accumulation of aldehyde

Causes flushing, nausea, and hypotension

Question 31

So….tell me about naltrexone

Answer 31

Blocks u receptor to decrease OH reinforcing properties

Question 32

What is Methadone and Buprenorphine?

Answer 32

Replaces heroin and other opiates that the patient is addicted to. Administered in a controlled setting

Question 33

Antidepressants are related to alcohol.

Answer 33

I’m tired and don’t want to write a question.