Substance-Use Disorders (Tut 502 & PB)

Question 1

What are 2 groups of substance related disorders

Answer 1

Substance use disorders is a cluster of cognitive behavioural and physiological symptoms which indicate the continued use of the substance despite significant substance related problems.

Substance induced disorders like intoxication withdrawal and substance induced mental disorders are severe temporary but can persist central nervous system syndrome that develops in the context of the effect of substance abuse and include substance induced psychosis, bipolar, depression, anxiety, obsessive compulsive, sleep, sexual dysfunction, delirium and neurocognitive disorders

Question 2

How is the substance use disorders characterized and specifiers thereof

Answer 2

By levels of severity where

Mild has 2-3 symptom
Moderate has 4-5 symptoms
Severe has 6 or more

Early remission: defined as at least 3 but less than 12 months without sub use disorder criteria

Sustained remission: define as least 12 months without criteria ext craving

Controlled environment: used if individual is both in remission and in environment where access to sub is restricted

Maintenance therapy: applies to individuals who are taking long term maintenance medication such as nicotine replacement and no criteria for the substance use disorder have been met for class of medication.

Question 3

What is the criteria for intoxication

Answer 3

It includes the presence of clinically significant problematic behavioural or psychological changes that develops during or shortly after substance ingestion.

Question 4

What is the criteria for withdrawal

Answer 4

Include presence of a characteristic withdrawal syndrome characterized by insomnia increased hand tremors vomiting anxiety autonomic hyperactivity that develops within several hours to days after cessation of or reduction in heavy and prolonged use of substance.

Question 5

Give the meaning of the following words

Answer 5

Substance use disorders: condition in which cognitive behavioural and physiological symptoms contribute to continued use of alcohol or drugs despite significant substance related problems.

Substance induced disorders

Intoxication: pattern of problem behaviours or psychological changes associated with use of a substance.

Delirium tremors:life threatening withdrawal symptoms that can result from chronic alcohol use.

Psychoactive substances: a substance that alters mood thought processes or other psychological states

Withdrawal: adverse physical and psychological symptoms that occur after reducing or ceasing intake of substance

Tolerance: decrease in the effects of a substance that occur after chronic use.

Substance abuse: pattern of excessive or harmful use of any substance for mood altering purposes

Stimulants: Are substances that energizes the CNS

Opioids: a painkilling agents that depresses CNS.

Hallucinogens:A substance that induces perceptual distortions and heightens sensory awareness.

Depressant: a substance that causes a slowing of responses and generalized depression of the CNS.

Sedative:a class of drugs that have a calming or sedating effect.

Inhalants

Addiction: compulsive drug seeking behaviour and a loss of control over drug use.

Physiological dependence: state of adaptation that occurs after chronic exposure to a substance can result in craving and withdrawal symptoms.

Question 6

What is substance abuse

Answer 6

The excessive or harmful use of drugs or alcohol.

Question 7

What is the criteria for Alcohol intoxication and withdrawal

Answer 7

Slurred speech

Unsteady gait

Inappropriate sexual or aggressive behaviour

Withdrawal: produces agitation
Sweating 
Insomnia
Hand tremor
Hallucinations

Question 8

What is the criteria for cannabis intoxication and withdrawal

Answer 8

Increased appetite
Euphoria
Sensation of slowed time
Social withdrawal

Withdrawal: irritability
Anger or aggression
Decreased appetite
Depressed mood

Question 9

Discuss depressants

Answer 9

Depressant: a substance that causes a slowing of responses and generalized depression of the CNS.

Alcohol: preoccupation and deterioration and occupational functioning are characteristics of problem drinkers.
Moderate drinking: a lower risk pattern of alcohol intake
Heavy drinking: chronic alcohol intake of more than 2 drinks per day for men and more than one drink per day for women.
Binge drinking: episodic intake of five or more alcoholic beverages for men or four or more drinks for women.

Muscle coordination and judgement impaired.
Loss of consciousness and even death

Alcohol poisoning: toxic effect resulting from rapid consumption of alcohol or ingestion of large quantities of alcohol which can result in impaired breathing coma and death

Alcoholic: a person who has become dependent on alcohol and who exhibits characteristics of an alcohol use disorders

Alcoholism: broad term referring to a condition in which the individual is dependent on alcohol and has difficulty controlling drinking

Abstinence: refraining from use of alcohol drugs and other substances.

Question 10

Discuss opioids

Answer 10

Opioids are painkilling agents that depresses the CNS such as heroin and prescription pain relievers.

Gateway drug: a substance that leads to use of additional substance that are more lethal.

They produce euphoria and drowsiness. Withdrawal symptoms include restlessness muscle pain insomnia cold flashes. Lethargy fatigue anxiety and disturbed sleep may persist.

Question 11

Discuss sedatives hypnotics and anxiolytics

Answer 11

Used to treat muscle tension Insomnia agitation and anxiety.

Sedative: a class of drugs that have a calming or sedating effect.

Hypnotics: a class of medication that induce sleep

Anxiolytics: a class of medication that reduces anxiety

Symptoms include: drowsiness impaired judgement and diminished motor skills.

Withdrawal including insomnia nervousness headache and drowsiness.

Question 12

Comment on stimulants.

Answer 12

Are substances that energizes the CNS

Produce feelings of euphoria well being improved mental and physical performance reduce appetite and prevent sleep.

Can cause heart arrhythmia dizziness tremors sweating anxiety restlessness agitation hostility and paranoia.

Withdrawal produces depression anxiety extreme fatigue.

Question 13

Discuss caffeine and it’s effect

Answer 13

Intoxication can produce symptoms like restlessness nervousness insomnia cardiac arrhythmias

Withdrawal produces headache fatigue irritability and concentration difficulty.

Question 14

Discuss amphetamines and it’s effect

Answer 14

Drugs that significantly speed up CNS activity. Egs are Ritalin Adderall Dexedrine used to treat attention and sleep disorders

Can induce feelings of euphoria and confidence agitation psychosis and assaultive suicidal behaviour as well as brain damage from chronic use.

Methamphetamine is a dangerous type of amphetamines as it causes permanent damage to heart lungs and immune system. Psychological changes like psychosis depression suicide violent behaviour.

Question 15

Discuss cocaine and it’s effect

Answer 15

Induces feelings of energy and euphoria.

Withdrawal causes lethargy and depression. It stimulants the SNS irregular heartbeat stroke and death may occur and may experience delusions paranoia hallucinations anxiety depression sexual dysfunction sleep difficulty

Question 16

Comment on hallucinogens

Answer 16

A substance that induces perceptual distortions and heightens sensory awareness.

Produce vivid sensory experience including hallucinations derived from lysergic acid diethylamine LSD from grain fungus psilocybin from mushrooms mescaline from peyote cactus and salvia from herb.

Hallucinogen persisting perception disorder in which they experience distressing recurrence of hallucinations or other sensations weeks or longer after drug intake.

Good trips are associated with sharpened visual and auditory perception heightened sensation and perception of profound insight

Bad trips can produce severe depression disorientation delusions and sensory distortions that cause fear and panic

Question 17

Explain what are dissociative anesthetics

Answer 17

Is a substance that produces a dreamlike detachment.

Phencyclidine PCP and ketamine are highly dangerous and potentially addictive.

Produce a phencyclidine use disorder that has dissociative stimulant depressant amnesic hallucinogenic properties.

They cause disconnection perceptual distortion euphoria and confusion delusions hostility violent psychotic behaviour.

Dextromethorphan DXM use can lead to hyperthermia which is elevated body temperature. High blood pressure heart arrhythmia.

Question 18

Explore substances with mixed chemical properties

Answer 18

Nicotine: leads to tobacco use disorder.
Is a stimulant in low doses and a relaxant in higher doses.

Releases adrenaline and dopamine giving bursts of energy and feelings of pleasure.

Withdrawal symptoms include difficulty concentrating restlessness anxiety depressed mood irritability

Cannabis: contains delta 9 tetrahydrocannabinol THC that produces stimulant depressant and hallucinogenic effect.

Causes feelings of euphoria tranquility passivity combined with mild perceptual and sensory distortions but can increase anxiety and depression.

Withdrawal symptoms include irritability anxiety insomnia restlessness and depression physical symptoms like stomach pain tremors sweating fever and headache

Long term use can impair judgement memory and concentration. Diminished cognitive functioning involving attention memory and learning can persist for long time.

Question 19

Discuss use of inhalants and designer drugs

Answer 19

The intoxication from chemical vapours found in different household products and solvents office supplies aerosol sprays and compressed air products

Common effects include impaired coordination and judgement euphoria dizziness and slurred speech which are brief.

Hypoxia O2 deprivation results in persistent cognitive deficits like severe memory impairment and slow info processing. Can result in stroke acute respiratory distress sudden heart failure.

Designer drugs: refers to substance made as recreational drugs using various chemical created to mimic effect of hallucinogenic or stimulant drugs that includes
+Ecstasy- methylenedioxymethamphetamine MDMA
Has stimulant and hallucinogenic properties and cause euphoria mild sensory and cognitive distortion and feelings of intimacy and well being followed by intense depression.

\+Synthetic marijuana
\+MDPV 
\+DOM 
\+Bromo dragonfly
\+Methoxetamine MXE

Question 20

What are the effects of combining substances

Answer 20

Synergistic effect: the results of chemicals interacting to multiply one another’s effects.

Question 21

Why do people engage in substance use

Answer 21

An individual may attempt to experiment with drugs out of curiosity

Becomes important purpose

Brain chemistry becomes altered from substance use

Lifestyle changes occur due to chronic substance use.

Psychological dimensions: coping with stress and anxiety as well as mental disorders.

General life stress
Stress resulting from trauma or catastrophic events
Childhood maltreatment
Stress of discrimination based on being a member of a sexual racial ethnic minority

PTSD
Depression
Mood disorders

Behavioural undercontrol: personality trait associated with rebelliousness novelty seeking risk taking and impulsivity.

Question 22

Explain the social dimensions of substance use

Answer 22

Victimization and stressful childhood events like neglect and emotional Physical and sexual abuse are associated with substance use later in life.

Childhood trauma may increase impulsivity making substance coping mechanism.

Peer pressure
Desire to fit in 
Attempt to rebel 
Desire to assert independence 
Family attitude and behaviour towards drinking.

Question 23

Explain the sociocultural dimensions of substance use

Answer 23

Factors like gender age socioeconomic status ethnicity religion and nationality the use and abuse of alcohol and other substances pervades all social classes.

Social media

Question 24

Explain the biological dimensions of substance use

Answer 24

Substance use alters brain functioning eg cannabis produce changes by copying the actions of various neurotransmitter while other drugs flood brain with dopamine and alter dopamine reward centres. Feelings of euphoria.

Brain starts becoming less sensitive to effects and cause drug tolerance which means more is required to create effects.

Genetics play a role in substance use

Question 25

What are the phases of treatment

Answer 25

Detoxification:phase of alcohol or drug treatment during which body is purged of intoxicating substance
where user ceases or reduced use of substance

Prevention of relapse:a return to drug use after a period of abstention

which is the return to substance use.
Neuroplasticity which is the ability of the brain to change its structure and function in response to experience is an important concept in treatment. Abstinence can help recondition the brain.

Motivated enhancement therapy: a therapeutic approach that addresses ambivalent and help client consider advantages and disadvantages of continued substance use

Question 26

Discuss gambling disorder and others addictions.

Answer 26

Involves compulsive desire to engage in gambling activities despite negative consequences. people with this disorder experience distress or impairment in social or professional functioning due to gambling

Diagnosis: four or more of the following

• need to bet larger quantities of money to achieve the desired excitement
• feels irritable or restless following attempts to reduce or stop
• is unsuccessful when attempting to control reduce or stop
• experiences frequent preoccupation with gambling
• turns to gambling when upset
• returns for more gambling after losing money
• deceives others to conceal extent of involvement
• has risked or lost jobs relationship or important opportunities
• turns to other for money due to financial desperation

Mild 4-5 symptoms
Moderate 6-7 symptoms
Severe 8-9 symptoms

Question 27

Explain what is internet gaming disorder

Answer 27

A condition involving excessive and prolonged engagement in computerised or internet games.