substance use disorders Flashcards
Which class of drug are most likely to cause dependence, tolerance and withdrawal?
Depressants.
Where is alcohol mostly absorbed?
The small intestine.
Which neurotransmitters does alcohol affect?
increases GABA, lowers Glutamate (affecting cognitive abilities) and Serotonin (affecting cravings)
What is the most extreme withdrawal symptom?
Withdrawal delirium (delirium tremens - the DTs)
What are long-term effects of alcohol consumption?
Dementia and Wernicke-Korsakoff syndrome (WK invovles confusion, loss of muscle coordination, unintelligible speech - possible lack of thiamine).
With what do we metabolise alcohol?
Alcohol dehydrogenase.
Which form of alcohol dehydrogenase is prevalent in children with FAS?
beta-3.
How many americans over 12 are current drinkers?
around half.
Who drinks the most?
Whites. Asians the least.
How many with severe alcohol dependence have spontaneous remission?
around 20%.
Those who tend not to develop slurred speech, staggering and other sedative effects of alcohol are…
more likely to abuse it.
What were barbituates designed for?
sleep.
Which are safer? Benzos or barbituates?
Benzos.
What happens if you take too much of a barbituate?
Your diaphragm can relax so much it collapses.
Who seeks help for barbituates and benzos?
White housewives.
Psychoactive drugs include…
caffeine, nictonie, cocaine, amphetamines, MDMA.
At low doses, amphetamines can induce feelings of…
elation and vigor and can reduce fatigue. But then you get a comedown.
What was hitler addicted to?
Amphetamines.
Narcoleptics and children with ADHD are prescribed what?
Amphetamines.
Does tolerance build quickly for amphetamines?
Yes.
What does withdrawal of amphetamines result in?
Apathy, prolonged sleep, irritability and depression.
What makes Ice dangerous?
Stays in the system longer than cocaine and makes people aggressive.
What do amphetamines do?
Stimulate the nervous system by enhancing:
Norepinephrine and Dopamine.
What do amphetamines do with these neurotransmitters
Assists in their release and blocks reuptake.
How does cocaine work?
Blocks dopamine reuptake, binds to dopamine receptor cites.
What does chronic use of cocaine result in?
Aging of the brain.
What does cocaine withdrawal look like?
Apathy and boredom.
Low doses of nicotine can…
relieve stress and improve mood.
High doses of nicotine can..
blue vision, cause confusion, lead to convulsions and sometimes even cause death.
Rate of relapse between alcohol, heroin and cigarettes?
All the same.
What does nicotine do?
Stimulates nicotinic acetylcholine receptors in midbrain reticular formation and limbic system - site of the brain’s pleasure pathway.
Where is the brain’s pleasure pathway?
Midbrain reticular formation and limbic system.
Recovery is considered achieved after how many years of opioid use?
5.
What do opioids do?
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).
Which drugs are opioids?
Morphine, Heroin, opium etc.
Which neurotransmitter do LSD, psilocybin, lysergic acid amid and DMT resemble?
Serotonin.
Mescaline resembles which neurotransmitter?
Norepinephrine.
Naltrexone may be most effective for people..
with a particular gene variant in opioid receptors.
What do all abused drugs activate?
Pleasure pathway (midbrain reticular formation and limbic system).
Brain wave patterns are different for those at risk of…
alcoholism.
What psychological factor influences whether or not someone would decide to continue using drugs?
Positive reinforcement.
Expectancies and cravings are considered…
cognitive dimensions of drug taking.
Neuroplasticity is evidenced in addiction in what way?
The brain will reorganise itself to adapt, increasing the drive to obtain the drug and decreases the desire for other nondrug experiences.
Personal motivation to change. Is it necessary?
Important, but not necessary.
Buprenorphin is what?
New opioid agonist, blocks the effects of opioids and seems to encourage better compliance than would a nonopiate or opiate antagonist.
Is there a difference between intensive residentil setting programs and quality outpatient care in outcomes?
Not necessarily.
People may do just as well as …. as they would as outpatients.
Inpatients.
Effectiveness of AA is based on…
who knows.
Who is AA good for?
Highly motivated individuals seeking to achieve total abstinence (on a budget).
Does controlled drinking work?
accepted in UK, it’s at least as effective as abstinence but neither treatment is successful for 70-80% of patients over longterm.
What are common barriers?
lack of personal awareness of problem, and unwillingness to change.
What is Motivational enhancement therapy?
Change is more likely with empathetic and optimistic counsellors.
How is CBT used to treat substance use disorders?
Person’s reaction to cues to use and thoughts and behaviours to resist use.
What does the relapse prevention model do?
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.
