Substance Use Disorders and Addiction Flashcards
What are substance use disorders? (SUD)
Compulsive use: Substance use disorders involve a strong, uncontrollable urge to use drugs or alcohol, even when doing so has negative impacts on one’s life
Negative consequences: Despite the harmful effects on physical and mental health, relationships, work and other areas of life, individuals with SUD’s continue to use substances
Complex Conditions: Substance use disorders are multifaceted, involving a combination of genetic, environmental and psychological factors that contribute to the development and persistence of the condition.
Causes of Addiction
Genetic Factors: Certain genes and genetic variations can increase an individual’s susceptibility to developing addictive behaviours, such as increased sensitivity to the rewarding effects of substances or reduced ability to regulate impulses.
Environmental Factors: Exposure to addictive substances, stressful life events, peer pressure and easy availability of drugs/alcohol can all contribute to the development of addiction.
Psychological factors: Mental health conditions like depression, anxiety or trauma can lead individuals to use substances as a coping mechanism, increasing the risk of addiction. Impulsivity and poor regulation skills can also play a role
Stages of Addiction
Initiation: First-time use of a substance, often driven by curiosity or peer influence.
Regular use: repeated use of a substance, leading to it becoming a habit or routine.
Problem use: Substance use begins to interfere with daily life, causing problems in relationships, work or other areas.
Dependence: The individual becomes physically and or psychologically dependent on the substance experiencing withdrawal symptoms when use is stopped.
Addiction: The individual has lost control over their substance use, with it becoming the primary focus of their life.
Cycle of Addiction
Cravings and urges–> withdrawal symptoms–> emotional triggers–> impaired judgement–> risk-taking behaviours–> relapse and relapse cycle
Neurobiological mechanisms
Substance use disorders such as addiction to drugs or alcohol, are characterized by profound changes in the structure and function of the brain. These changes primarily occur in the reward and motivation pathways, which are responsible for processing the pleasurable and motivational effects of various stimuli. Chronic substance use leads to a dysregulation of these pathways, contributing to the compulsive and uncontrollable behaviours associated with substance use disorders
Stimulants
Amphetamines: Stimulants such as amphetamine, methamphetamine and MDMA (ecstasy) that increase energy, focus and alertness but can be highly addictive and dangerous.
Cocaine: A powerful stimulant derived from the coca plant that produces a short-lived high, intense cravings and severe health risks including heart problems and overdose.
Caffeine: A natural stimulant found in coffee, tea, energy drinks and some medications that can improve mood and focus but can also cause jitteriness, anxiety and dependence.
Depressants
Depressants: Overview: Depressants are a class of drugs that slow down the central nervous system, reducing activity and producing a calming effect
Illicit Depressants: Include drugs like barbiturates, benzodiazepines and alcohol, which are often abused for their sedative and intoxicating effects
Alcohol: A widely consumed depressant that can impair cognitive and physical functions, leading to increased risk-taking and potential addiction.
Risks and Dangers: Abusing depressants can result in overdoes, respiratory depression and long-term health conseuquences such as liver damage and cognitive impairment
Cannabis
Cannabis: A psychoactive drug that comes from teh cannabis plant, containing THC as the main active ingredient. It can be consumed through smoking, vaping or edibles.
Hashish: A concentrated form of cannabis, made from the resin of the cannabis plant. It is more potent and typically smoked.
Synthetic Cannabinoids: artificial compounds that mimic the effects of THC, but can be much more potent and dangerous .
Hallucinogenin
Hallucinogens: A class of psychoactive drugs that induce altered states of perception, thought and feeling.
Types of hallucinogens: Common examples include LSD, psilocybin (magic mushrooms), DMT (Dimethyltripdamine), and Mescaline (found in peyote)
Mechanisms of Action: Hallucinogens primarily work by interacting with the serotonin 2A receptor in the brain, leading to changes in sensory perception and cognition.
Effects and Risks: Hallucinogens can cause visual and auditory hallucinations, distorted perception of time and reality and increased risk of anxiety, panic and psychosis.
Pathological Gambling
Pathological gambling is a recognized mental health disorder characterized by a persistent and compulsive urge to gamble, despite negative consequences to the individual’s personal, profesisonal or financial well-being.
Causes: Pathological gambling can be influenced by a combination of genetic, neurological and environmental factors, including brain chemistry imbalances, personality traits and exposure to gambling during childhood/adolesence
Symptoms: Preoccupation with gambling, increased gambling to achieve the same level of excitement, failed attempts to cut back or stop gambling and continued gambling despite negative impacts on relationships work or finance.
Addictive Behaviours
Addictive Behaviours: Substance abuse, behavioural addictions (internet, shopping, sex), and process addictions (exercise, work)
Treating addictive behaviours:Treatment for addictive behaviours often involves a combination of therapy cognitive behavioural, motivational interviewing, support groups, medication and lifestyle changes to address the root causes and develop healthy coping mechanisms
Diagnostic Criteria
Impaired Control: Inability to control/limit the use of the substance.
Social Impairment: Neglect of major social, occupational or recreational activities due to substance use.
Risky use: Continued substance use despite physical or psychological problems cause or exacerbated by the use of the substance.
Tolerance: A need for markedly increased amounts of the substance to achieve the desired effect or a minished effect with continued use of same amount.
Withdrawal: Characteristic withdrawal symptoms when the substance use is discontinued or reduced, or the use of the substance to avoid/relieve withdrawal symptoms
Treatment Approaches
Behavioural therapies: Evidence-based therapies such as CBT and contingency management can help individuals develop coping strategies and address the psychological aspects of addiction
Medication-assisted treatments: Medications like methadone, buprenorphine and naltrexone can help manage cravings, reduce withdrawal symptoms and block the effect of opiods, supporting long-term recovery.
Support services: Comprehensive treatment often includes access to support services such as counselling, peer support groups and case management to address the broader needs of individuals with substance use disorders
Definition of Impulse Control Disorder
Impulse control disorders are a group of mental health conditions characterized by the inability to resist urges or temptations to engage in behaviours that may be harmful to oneself or others.
Common Impulse Control Disorders
Intermittent Explosive Disorder, Kleptomania, Pyromania, pathological gambling and compulsive sexual behaviour.
Understanding Impulse Control Disorders
Causes and Risk Factors: Impulse Control Disorders can be influenced by a combination of genetic, neuroglogical and environmental factors usch as brain chemistry inbalances, traumatic experiences and substance abuse.
Impact of Mental Health: Can significantly disrupt an individual’s personal, social and professional life, leading to feelings of shame, guilt and decreased quality of life.
Treatment and Management: Effective treatment approaches include psychotherapy, medication and suport groups, which aim to help individuals develop coping strategies and regain control over their impulses
Gambling Disorder
A persistent and recurrent problematic gambling behaviour leading to clinically significant impairment/distress
Kleptomania
The recurrent failure to resist impulses to steal items that are not needed for personal use or monetary value
Symptoms: A growing tension before the theft followed by a sense of pleasure or gratification during act of stealing. Often feel remorse or guilt after theft.
Pyromania
The deliberate and purposeful fire setting on more than one occasion, without rational motivation.
Causes: Often linked to underlying issues such as mental illness, childhood trauma or a need for attention and control.
Symptoms: intense facisnation with fire, a feeling of tension/arousal before starting a fire and relief after fire is set.
Risk factors: History of family members with disorder, substance abuse and impulsivity.
Intermittent Explosive Disorder
Recurrent behavioural outbursts representing a failure to control aggressive impulses, which are grossly out of proportion to the situation
Trichotillomania (Hair-pulling disorder)
Recurrent pulling out of one’s hair, resulting in noticeable hair loss.
Excoriation (skin-picking) Disorder
Recurrent skin picking behaviour, resulting in skin lesions and significant distress or impairment
Oppositional Defiant Disorder (ODD)
ODD is a behavioral disorder characterized persistent disobedience, hostility and defiant behaviour towards authority figures, such as parents or teachers.
Common Symptoms: Children with ODD often display frequent temper tantrums, argue with adults, refuse to follow rules and deliberately annoy or upset others.
Treatment: combination of cognitive-behavioural therapy, parent training and in some cases medication
Intermittent Explosive Disorder (IED)
A mental health disorder characterized by sudden, recurrent and uncontrollable outbursts of aggressive or violent behaviour.
Symptoms: Episodes of unwarranted anger, rage or violent behaviour that are disproportionate to the situation and cause significant distress in daily life.
Treatment: A combination of psychotherapy, medication and anger management techniques to help individuals gain control over their impulses and emotions
Conduct Disorder
A mental health disorder characterized by a persistent pattern of disruptive and violent behaviour, including aggression, rule-breaking and lack of empathy towards others.
Symptoms: bullying, physical fights, lying, theft, vandalism and disregard for the safety of oneself or others.
Causes: Conduct Disorder can be infuenced by a combination of genetic, environmental and social factors, such as a dysfunctional family, exposure to violence and lack of parental supervision.
Treatment: A combination of therapy, behaviour modification and medication to address the underlying issues and develop coping mechanisms.
