Substance Use Disorders Flashcards
Substance intoxication
Temporary condition, the body becomes cleared and person goes back to baseline
May lead to :
- Decrease attention / visual-motor skills / perceptual-organizational / flexibility / problem-solving - Structural brain changes and shrinkage - Short term memory issues
Substance Use Disorder
Substance use disorders occur when the recurrent use of alcohol and/or drugs causes clinically and functionally significant impairment, such as health problems, disability, and failure to meet major responsibilities at work, school, or home. According to the DSM-5, a diagnosis of substance use disorder is based on evidence of impaired control, social impairment, risky use, and pharmacological criteria.
Possible indicators of substance abuse disorder
- ranges from mild to severe
with 2-3 = mild
with 4-5 = moderate
with 6+ = severe - wanting to cut down, but being unable to do so.
- continued use despite relationship problems
- giving up social, recreational, occupational activities
-significant time procuring , using, or recovering from effects
-cravings - time/money spent on substance behaviors
- not managing life stuff
-relationship problems - giving up other important activities
- danger
- health problem that substance abuse exacerbates
- tolerance
-withdrawal
Binge-drinking
- drinking 5 or more alcoholic drinks on the same occasion on at least 1 day in the past 30 days.
Heavy drinking
-drinking 5 or more drinks on the same occasion on each of 5 or more days in the past 30 days.
Metabolism of Alcohol
- most ethanol goes straight to brain, heart and liver
- when at the liver it is broken down to Acetaldehyde
- unmetabolized alcohol can be measured by BAC
- GABA increases= involved in emotional regulation
- GABA suppresses inhibitory senses, which activates behaviors
- GABA suppresses the cortex….
some demographics/prevalence of alcoholism
- 3% of deaths in the US are due to alcohol (assuming this is a year?)
- individuals of Asian descent oxidize alcohol more rapidly (nobody knows why)
- kids of alcoholic biological parents show high levels of propensity to alcoholism even when they are adopting by non-alcoholic parents.
- there is a genetic component of alcoholism
- sensitive dopamine receptors–> may explain why some drink more than others
Alcohol induced disorders
- alcohol induced psychotic disorder
- alcohol delirium - heightened morbidity /mortality
- inability to attend to the environment
- delirium tremens (major withdrawal disorder from alcohol use)
- muscle tremors, profuse sweating, seizures–> death
-Wernicke Korsakoff’s
2 phases:- Wernicke= thiamine deficiency, reversible, confusion, loss of coordination of muscle movements
- korsakoffs= memory loss- remembering only up to a certain time and difficulty filling the blanks
- muscle tremors, profuse sweating, seizures–> death
Biological markers for Alcoholism
- abnormal beta waves
- less EEG changes when provided with alcohol
- low MAO activity= greater sensation seekers, monotony avoidance, impulsiveness, vulnerability
- study with monkeys with low MAO showed less intoxication and voluntarily consumed more alcohol
Theories of Alcohol use (4)
- Tension reduction hypothesis : alcohol releases tension in the body which is also extended to anxiety in the body, such as social avoidance and muscle rigidity
- Social Learning theory : observations of other people engaging in addictive behavior can lead to development of addiction. We see that alcohol may be an appropriate way to deal with stress. ( perhaps this is why AA works?)
- children with parents who drink are more likely to abuse substance - cognitive expectancy theory : addictive behaviors are chosen over healthy behaviors due to our expectations of them
- if we expect to reduce tension, we will drink. those who drink to escape/avoid rather than engage in prosocial drinking are likely to develop drinking problems. - Parenting styles: authoritarian (strict) and permissive (not strict enough) parents are more likely to have substance abusing children.
- children of parents who drink are more likely to abuse substances are more likely to abuse as well.
biggest predictor of alcoholism?
Availability!
drinking differs from country to country
- England/north america = heavy drinking, loss of control, binge drinking
- France= steady drinkers who never overconsume they just sip on it throughout the day
Treatments for alcoholism
- CBT (prevention model/training)
- Alcohol Anonymous
- Motivational Enhancement Therapy (MET)
CBT- prevention model for alcoholism
- teaching /providing skills to prevent episodes of abuse
- habitual behaviors that should be stopped (short term over long term gain)
- teaching proper coping in crisis situations
- teaching that relapse does not always mean everything is undone
Alcohol Anonymous
Self help network (social learning theory may explain why this works)
Philosophy: looks at alcohol as a progressive disease that cannot be controlled without the help from a higher power and support of fellow members
Pushes for complete abstinence
Its a 12 step program about giving yourself to god “a higher power”
Education is provided, testimonials of individuals are shared
There are no clinical trials on this treatment…they don’t see the benefits of submitting their program to this scrutiny.
