SUD

Question 1

Which are the most commonly abused substances?

Answer 1

-Alcohol
-Tobacco
-Cannabis
-Stimulants (cocaine and amphetamines)
-Hallucinogens (LSD, magic mushroom, peyote)
-Opioids (heroin, methadone, oxycodone, morphine, codeine)
-Sedatives/Hypnotics/Anxiolytics (Barbiturates, Benzodiazepines, Antihistamines)

Question 2

What is use?

Answer 2

Any use of a substance (legal, medicinal, recreational or illegal)

Question 3

What is Misuse?

Answer 3

Use for therapeutic purposes in a way other than prescribed.

Question 4

What is Abuse?

Answer 4

-Intentional and excessive use of a substance for non-therapeutic effects
-Illicit drugs always fall in this category

Question 5

Which are the three most substance use in the US in 2021?

Answer 5

-Alcohol
-Tobacco
-Nicotine Vaping

Fourth is Marijuana

Question 6

Diagnostic Criteria DSM-V

Answer 6

-Impaired control (Criteria 1-4)
-Craving, take in large amounts, etc.
-Social Impairment (Criteria 5-7)
-Affects social life
-Risky use (Criteria 8-9)
-Knowing the risks and still using
-Pharmacological Criteria (Criteria 10-11)
-Tolerance and withdrawal

Question 7

True or false: Neither tolerance nor withdrawal is necessary for a diagnosis of a substance use disorder.

Answer 7

True

Question 8

What is addiction? (Termed not use anymore)

Answer 8

Compulsive drug seeking and use behavior, despite harmful consequences.
-Impairment in self-control

Question 9

What is Physical Dependence?

Answer 9

Adaptations that results in withdrawal symptoms when drugs are discontinued.

Question 10

What is Psychologic dependence? (Craving)

Answer 10

Uneasiness/dissatisfaction if the drug is unavailable.

Question 11

What is intoxication?

Answer 11

In a patient with SUD, it’s the high effect of the drug.

Question 12

Which parts of the brain are affected in patients with SUD?

Answer 12

-Frontal Cortex
-thinking, planning, problem solving
and decision making are affected
-Limbic System
-Mesolimbic Pathway

Question 13

What happens in the mesolimbic pathway?

Answer 13

Drugs activate the Vental Tregmental Area (VTA) neurons which release dopamine. (High dopamine, pleasure comes in)

-Most drugs block Dopamine transporters (reuptake) and high concentrations are left in the synaptic cleft. Our body autoregulates by reducing the number of dopamine receptors (Desensitization).

Question 14

Alcohol

Answer 14

-High: Slurred speech, uncoordinated, unsteady gait, nystagmus, impairment in attention or memory, stupor or coma.

-Withdrawal (~>2): Autonomic Hyperactivity, Increased hand tremor, Insomnia, Nausea or vomiting, Transient visual, tactile or auditory, Psychomotor agitation, Anxiety, Generalized tonic-clonic seizure

Question 15

Tobacco

Answer 15

-Effects (both stimulant and sedative): stained teeth or fingernails, wrinkles, a hoarse voice, tachycardia, hypertension, and increased respiration.

-Withdrawal signs/Symptoms: irritability, anxiety, difficulty concentrating, appetite, depression, insomnia, and restlessness.

Question 16

Cannabis

Answer 16

-High: Impaired motor coordination, Conjunctival injection, increase appetite, Dry mouth, and tachycardia

-Withdrawal (~>3): irritability, anxiety, insomnia, decreased appetite, weight loss, headache, fever, and chills.

Question 17

Stimulants

Answer 17

-High: Euphoria or anxiety. Problematic behavior and psychological changes.

-Withdrawal syndrome (~>2): Dysphoric mood, fatigue, vivid and unpleasant dreams, insomnia, agitation, and appetite

Question 18

Hallucinogens

Answer 18

-High: perceptual changers occurring while awake
-Withdrawal (~>2): pupillary dialation, tachycardia, sweating, palpitations, blurring of vision, tremors, uncoordinated.

Question 19

Opioids

Answer 19

-High: Drowsiness or coma slurred speech, impairment in attention or memory.

-Withdrawal (~>3): Dysphoric mood, nausea or vomiting, muscle aches, lacrimation, piloerection

Question 20

Sedatives, Hypnotics and Anxiolitics

Answer 20

-High: Slurred speech, incoordination, unsteady gait, Nystagmus, impairment in cognition, stupor or coma.

-Withdrawal (~>2): Autonomic hyperactivity, hand tremor, insomnia, nausea or vomiting, hallucinations, illusions, agitation, anxiety.