substance use disorders Flashcards

1
Q

Which class of drug are most likely to cause dependence, tolerance and withdrawal?

A

Depressants.

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2
Q

Where is alcohol mostly absorbed?

A

The small intestine.

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3
Q

Which neurotransmitters does alcohol affect?

A

increases GABA, lowers Glutamate (affecting cognitive abilities) and Serotonin (affecting cravings)

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4
Q

What is the most extreme withdrawal symptom?

A

Withdrawal delirium (delirium tremens - the DTs)

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5
Q

What are long-term effects of alcohol consumption?

A

Dementia and Wernicke-Korsakoff syndrome (WK invovles confusion, loss of muscle coordination, unintelligible speech - possible lack of thiamine).

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6
Q

With what do we metabolise alcohol?

A

Alcohol dehydrogenase.

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7
Q

Which form of alcohol dehydrogenase is prevalent in children with FAS?

A

beta-3.

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8
Q

How many americans over 12 are current drinkers?

A

around half.

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9
Q

Who drinks the most?

A

Whites. Asians the least.

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10
Q

How many with severe alcohol dependence have spontaneous remission?

A

around 20%.

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11
Q

Those who tend not to develop slurred speech, staggering and other sedative effects of alcohol are…

A

more likely to abuse it.

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12
Q

What were barbituates designed for?

A

sleep.

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13
Q

Which are safer? Benzos or barbituates?

A

Benzos.

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14
Q

What happens if you take too much of a barbituate?

A

Your diaphragm can relax so much it collapses.

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15
Q

Who seeks help for barbituates and benzos?

A

White housewives.

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16
Q

Psychoactive drugs include…

A

caffeine, nictonie, cocaine, amphetamines, MDMA.

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17
Q

At low doses, amphetamines can induce feelings of…

A

elation and vigor and can reduce fatigue. But then you get a comedown.

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18
Q

What was hitler addicted to?

A

Amphetamines.

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19
Q

Narcoleptics and children with ADHD are prescribed what?

A

Amphetamines.

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20
Q

Does tolerance build quickly for amphetamines?

A

Yes.

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21
Q

What does withdrawal of amphetamines result in?

A

Apathy, prolonged sleep, irritability and depression.

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22
Q

What makes Ice dangerous?

A

Stays in the system longer than cocaine and makes people aggressive.

23
Q

What do amphetamines do?

A

Stimulate the nervous system by enhancing:

Norepinephrine and Dopamine.

24
Q

What do amphetamines do with these neurotransmitters

A

Assists in their release and blocks reuptake.

25
Q

How does cocaine work?

A

Blocks dopamine reuptake, binds to dopamine receptor cites.

26
Q

What does chronic use of cocaine result in?

A

Aging of the brain.

27
Q

What does cocaine withdrawal look like?

A

Apathy and boredom.

28
Q

Low doses of nicotine can…

A

relieve stress and improve mood.

29
Q

High doses of nicotine can..

A

blue vision, cause confusion, lead to convulsions and sometimes even cause death.

30
Q

Rate of relapse between alcohol, heroin and cigarettes?

A

All the same.

31
Q

What does nicotine do?

A

Stimulates nicotinic acetylcholine receptors in midbrain reticular formation and limbic system - site of the brain’s pleasure pathway.

32
Q

Where is the brain’s pleasure pathway?

A

Midbrain reticular formation and limbic system.

33
Q

Recovery is considered achieved after how many years of opioid use?

A

5.

34
Q

What do opioids do?

A

Tap into the body’s natural opioid system to release more (endorphins and enkephalins). They also inhibit GABA (gaba can’t police the other neurotransmitters).

35
Q

Which drugs are opioids?

A

Morphine, Heroin, opium etc.

36
Q

Which neurotransmitter do LSD, psilocybin, lysergic acid amid and DMT resemble?

A

Serotonin.

37
Q

Mescaline resembles which neurotransmitter?

A

Norepinephrine.

38
Q

Naltrexone may be most effective for people..

A

with a particular gene variant in opioid receptors.

39
Q

What do all abused drugs activate?

A

Pleasure pathway (midbrain reticular formation and limbic system).

40
Q

Brain wave patterns are different for those at risk of…

A

alcoholism.

41
Q

What psychological factor influences whether or not someone would decide to continue using drugs?

A

Positive reinforcement.

42
Q

Expectancies and cravings are considered…

A

cognitive dimensions of drug taking.

43
Q

Neuroplasticity is evidenced in addiction in what way?

A

The brain will reorganise itself to adapt, increasing the drive to obtain the drug and decreases the desire for other nondrug experiences.

44
Q

Personal motivation to change. Is it necessary?

A

Important, but not necessary.

45
Q

Buprenorphin is what?

A

New opioid agonist, blocks the effects of opioids and seems to encourage better compliance than would a nonopiate or opiate antagonist.

46
Q

Is there a difference between intensive residentil setting programs and quality outpatient care in outcomes?

A

Not necessarily.

47
Q

People may do just as well as …. as they would as outpatients.

A

Inpatients.

48
Q

Effectiveness of AA is based on…

A

who knows.

49
Q

Who is AA good for?

A

Highly motivated individuals seeking to achieve total abstinence (on a budget).

50
Q

Does controlled drinking work?

A

accepted in UK, it’s at least as effective as abstinence but neither treatment is successful for 70-80% of patients over longterm.

51
Q

What are common barriers?

A

lack of personal awareness of problem, and unwillingness to change.

52
Q

What is Motivational enhancement therapy?

A

Change is more likely with empathetic and optimistic counsellors.

53
Q

How is CBT used to treat substance use disorders?

A

Person’s reaction to cues to use and thoughts and behaviours to resist use.

54
Q

What does the relapse prevention model do?

A

Examines learned aspects of dependence and sees relapse as a failure of cognitive and behavioural coping skills. Involves helping people remove ambivalence about stopping drug use by examining beliefs. High risk situations are identified and strategies are developed.