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Disciplines 3 Shea > Substance Use Disorders > Flashcards

Substance Use Disorders Flashcards

1
Q

According to American Society of Addiction medicince (ASAM), the definition of addiction is:

Addiction is a _______, chronic disease of brain reward, motivation and related circuitry

A

Primary

(meaning addiction is the disease process)

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2
Q

ASAM Addiction definition:

  • Dysfunction in these circuits (i.e. reward, motivation, memory) leads to to what 4 characteristic manifestations?
  • How is this reflected in an individual?
A
  • leads to characteristic biological, psychological, social and spiritual manifestations.
    • This is reflected in an individual pathologically pursuing reward/relief by substance use and other behaviors.
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3
Q

ASAM addiction definition:

Addiction is characterized by what 5 things?

A
  1. inability to consistently abstain
  2. impairment in behavioral control
  3. craving
  4. diminished recognition of significant problems with one’s behaviors and interpersonal relationships
  5. a dysfunctional emotional response
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4
Q

Like other chronic diseases, addiction often involves cycles of what 2 things?

A

relapse and remission

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5
Q

W/o tx or engagement in recovery activities, addiction is _______ and can result in disability or premature ______.

A

progressive

DEATH

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6
Q

Drug addiction causes persistent changes in the brains ____ and ____

A

structure and function

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7
Q

T/F:

Addiction is preventable and treatable

A

True

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8
Q

T/F” Addiction changes biology and if it is left untreated it can last a lifetime

A

true

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9
Q

Addiction is a ______ disease that starts when?

A

A developmental disease

Starts in adolescence and childhood

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10
Q

What age range has a high level of first time dependence for alcohol, tobacco and cannabis?

Why is this?

A

10-25 y/o

This is because the brain is still developing during this time

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11
Q

Why do people take drugs in the first place? (2 main reasons)

A
  1. To feel good (to have novel feelings, sensations, experiences and to share them)
  2. To feel better (to lessen, anxiety, fears, depression, etc)
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12
Q

The following are examples of things that increase what?

  1. Addiction/drug abuse
  2. movement
  3. motivation (doing things that are enjoyable)
  4. Reward and well being- socializing, eating/drinking
A

dopamine

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13
Q

What are 5 functions of the dopamine pathway?

A
  1. Reward (motivation)
  2. Pleasure, euphoria
  3. motor function (fine-tuning)
  4. Controlling compulsion
  5. Perseveration
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14
Q

What are 4 functions of the serotonin pathways?

(not sure if we need to know this)

A
  1. Mood
  2. Memory processing
  3. Sleep
  4. Cognition
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15
Q

What three parts of the brain are part of the reward pathway?

A
  1. Ventral tegmental area (VTA)
  2. Nucleus accumbens
  3. Prefrontal cortex
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16
Q
A
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17
Q

What is the reward pathway (VTA, nucleus accumbens, prefrontal cortex) activated by?

A

reward stimulus (food, water, sex)

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18
Q

Reward pathway- dopamine

What is the normal process? (4 steps)

A
  1. Dopamine released into synapse
  2. binds to receptors
  3. sends signal to post synaptic neuron
  4. Dopamine is then transported back to te presynaptic neuron
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19
Q

How is the reward pathway altered by drugs (ex: cocaine)?

A
  1. Cocaine blocks removal of dopamine
  2. Results in Dopamine buildup in synapse
  3. leads to continuous stimulation of post synaptic neurons leading to euphoria
  4. over time receptors become overloaded (so body starts to decrease dopamine receptors
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20
Q

T/F: natural rewards such as food or sex decrease dopamine levels

A

False, these natural rewards Elevate dopamine levels

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21
Q

What is the effect of drugs on Dopamine release over time?

A

Over time, drugs that are apart of the reward pathway must be taken in a larger amount to have the same effect. This also affects other functions of the reward pathway (emotions, etc)

This is due to the body decreasing dopamine receptors

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22
Q

Why is drug use at a younger age especially bad?

A

Because after using drugs for an extended period of time, dopamine receptors decrease.

This also affects the differnet areas that are controlled by the reward pathway (emotions, behavioral learning, early learning and memory processing, etc)

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23
Q

What are 4 areas of the reward pathway (areas that drugs can affect)

A
  1. Emotional and behavioral learning
  2. Control of body movement
  3. Early learning and memory processing
  4. Attention states and automatic function
24
Q

when there is ________ drug use, A “molecular switch” is thrown in the brain

  • Sensitization, Craving and Relapse
  • Loss of control over drug use
  • Compulsive drug seeking behavior
A

continued

25
Q

Loss of dopamine transporters in methamphetamine abusers may result in what 2 things?

A
  1. slowing of motor reactions
  2. memory impairment
26
Q

Drugs release ___ to ____ times more dopamine than natural rewards (eating, sex and social activities)

A

2-10x

27
Q

How does the brain adjust to long-term drug exposure? (2 things)

What is the result of this?

A
  1. Produces less dopamine
  2. Reducing # of receptors that can receive signals

Result= ability to experience ANY pleasure is reduced

28
Q

______ _________ is a type of motivation created in the brain because it has developed an association between a certain stimuli and reward.

“I want and I want it now!!”

A

Incentive Salience

29
Q

T/F: Incentive salience is a much smaller incentive than just liking something.

A

FALSE

Incentive salience is a far greater incentive than merely liking something.

30
Q

Incentive Salience- Wants/cravings:

The following are examples of what?

  • Smelling cigarette smoke can trigger a craving for nicotine
  • Drug paraphernalia now trigger drug craving.
  • Driving in or near a neighborhood where drugs were purchased triggers craving
  • If a person’s addiction subsides and then they re-encounter one of these- a craving for that drug may reappear.
A

Previously neutral stimuli are assigned incentive salience.

31
Q

What are the 3 main risk factors for substance use disorder?

A
  1. Genetics
  2. Environment
  3. Adverse childhood events
32
Q

Genetics may contribute ____% to ______% of an individuals risk for substance abuse disorder

Are men or women more likely?

A

40-60%

Men 2x as likely to have alcohol or drug addiction

33
Q

What 2 environmental factors result in an increase risk of an individual developing a substance use disorder

A
  • Family’s beliefs and attitudes – Exposure to Parental substance use disorders
  • Peer group that encourages drug use
34
Q

The following are under which category of risk factors for substance use disorders?

  1. Trauma, mental health, physical health, household dysfunction
  2. 5 or more childhood events are 7-10 times more likely to have SUD
A

Adverse childhood events

35
Q

5+ childhood events (sexual abuse, physical abuse, parent death, etc) are _____ times more likely to have substance use disorder

A

7-10x

36
Q

Individuals seeking treatment for alcohol use disorders show a high prevalence of what 2 things?

A

Childhood adversity

PTSD

37
Q

Substance Use Disorder- Risk Factors:

  • 40 % if onset ____ years old or younger
  • 10% if onset is _____ years old or older
A

40% if < 14y/o

10 if > 20 y/o

38
Q

What are the 3 psychiatric comorbidities of Substance Use Disorder?

A
  1. Depression
  2. Anxiety
  3. Bipolar Disorder
39
Q

_______ and _________ symptoms may be a consequence of long-term substance use

A

Anxiety and depressive

40
Q

What are the 2 DSM V groupings for Substance Use Disorders?

A
  1. Substance Use disorders
  2. Substance-induced disorders
41
Q

What are the 4 main diagnostic criteria for substance use disorders according to DSM V?

A
  • Impaired control
  • Social impairment
  • Risky use
  • Pharmacological criteria
42
Q

The following is under which main criteria for diagnosing substance use disorders?

  1. Using larger amounts or over a longer period of time than intended.
  2. Persistent desire or unsuccessful efforts to cut down or control
  3. Lots of time spent in obtaining, using, and recovering from
  4. Craving or a strong desire or urge to use
  5. Social impairment
  6. Recurrent use resulting in failure to fulfill major role obligations
  7. Continued use despite recurrent social or interpersonal problems caused or exacerbated by use
  8. Social, occupational, or recreational activities are given up/reduced due to trying to get drug
A

Impaired control

43
Q

Which criteria for Substance Use Disorders does the following fall under?

  1. Recurrent use in physically hazardous situations (ex: reusing needles)
  2. Continued use despite knowledge of having recurrent physical or psychological problems that is caused or exacerbated by use.
A

Risky use

44
Q

Which criteria for Substance Use Disorders does the following fall under?

  1. Tolerance defined by need for increased amounts to achieve desired effect or markedly diminished effect with continued use of the same amount
  2. Withdrawal ​​either with withdrawal symptoms, or continued use to relieve or avoid withdrawal
A

Pharmacological criteria

(dont have to meet this criteria to have SUD)

45
Q

Severity range of Substance Use Disorders:

How many sxs= mild

A

2-3

46
Q

Severity range of Substance Use Disorders:

How many sxs= moderate

A

4-5 sxs

47
Q

Severity range of Substance Use Disorders:

How many sxs= severe

A

6+

48
Q

T/F: a person has to meet all 11 aspects of the DSM V criteria for Substance Use Disorder?

A

FALSE

A patient only has to meet 2 out of the 11 criteria to be diagnosed with SUD (however, this would be a mild form)

49
Q

What are the 10 substance classes according to DSM V?

A
  1. Alcohol
  2. Caffeine
  3. Cannabis
  4. Hallucinogens (PCP, others)
  5. Inhalants
  6. Opioids
  7. Sedatives, hypnotics, and anxiolytics
  8. Stimulants
  9. Tobacco
  10. Gambling (was just added on)
50
Q

What are the 3 substance induced disorders?

A
  1. Intoxication
  2. Withdrawal
  3. Mental disorder
51
Q

T/F, The following mental disorders can develop due to substance use disorder

  1. Psychotic
  2. Bipolar
  3. Depressive
  4. Anxiety
  5. Sleep
  6. Neurocognitive
  7. Sexual dysfunction
A

TRUE

52
Q

The following is criteria for what?

  • Reversible substance-specific syndrome due to recent ingestion of a substance
  • Behavioral/psychological changes due to effects on CNS developing after ingestion:
    • Disturbances of perception, wakefulness, attention, thinking, judgment, psychomotor behavior and interpersonal behavior
  • Not due to another medical condition or mental disorder
  • *Does not apply to tobacco
A

Substance induced intoxication

53
Q

The following is criteria for what?

  1. Substance-specific syndrome problematic behavioral change due to stopping or reducing prolonged use
  2. Physiological & cognitive components
  3. Significant distress in social, occupational or other important areas of functioning
  4. Not due to another medical condition or mental disorder
A

Substance induced withdrawal

(note: no withdrawal w/ PCP or other hallucinogens and inhalents)

54
Q

The following is criteria for what?

  1. disorder represents symptomatic presentation of a relevant mental disorder.
  2. evidence from history, PE and labs that disorder
    1. developed w/in 1 mon of intoxication
    2. substance is capable of producing the mental disorder
  3. disorder doesn’t occur exclusively during the course of a delirium.
A

Substance induced Mental disorder

55
Q

The following is criteria for dx of what?

  1. The disorder is not better explained by an independent mental disorder (i.e., one that is not substance- or medication-induced).
    1. Disorder wasn’t there before ingestion of drug
    2. mental disorder persisted >1 mo after cessation
  2. disorder causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
A

Substance induced mental disorder

Disciplines 3 Shea (13 decks)

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