SUD Flashcards
Historical context of AUD
Time where the consumption of beer was so normative that pple would drink beer throughout the day (breakfast, lunch…). In part bc the water quality was so poor → beer = safer option. Pple would spent much of the day a little intoxicated.
Fredrick II of Prussia was very suspicious of which substance?
Coffee
The high consumption of beer/alcohol continued for a long time (both in Europe & North America)… Until the ________________. End of 19th and beginning of 20th century.
Temperance movements
Temperance movements
Movement largely driven by Christian religious groups + Burgeoning feminist movements
=> Both noted that men were coming home wasted at the end of the day - and oftentimes pounding on their families
=> Huge movement in North America to ban the sale of alcohol + consumption of liquor
Consuming alcohol as a character deficit
-> This alienated you from your community + God
-> If drinking too much = no chance of getting into heaven
Historical Context of Cocaine
Formerly legal & widely used drug. Used to be sold in cigarette, coca-cola, toothache drops given to children to make them feel better…
Not restricted until 1911 in Canada.
AUD in DSM-1 (3)
(1) Excessive use of alcohol/drug was a symptom of “sociopathic personality disorder”
(2) No classes of drugs specified
(3) No specific criteria
AUD in DSM-2 (3)
(1) Still a personality disorder
(2) Specifying some classes of drugs: Barbiturates, cannabis, cocaine, hallucinogens, opioids
(3) Some criteria specified: “…the inability of the patient to go one day without drinking…”; “…habitual use or a clear sense of need for the drug…”
AUD in DSM-3 (4)
(1) Introduced more specific diagnostic criteria
(2) “Substance use disorders” separated from personality (you can have one without the other)
(3) Each class of substance recognized as a distinct disorder
(4) Sets of diagnostic criteria established
In the DSM-3, diagnostic criteria for AUD was heavily based on the __________________.
FEIGHNER criteria
-> Criteria for alcohol dependence
AUD: Distinction established in the DSM-3
Introduced distinction between Abuse & dependence (not in DSM-5)
=> Alcohol abuse = pathological alcohol use, impairment in social/occupational functioning, duration of disturbance ~at least a month. (even without dependence → AUD)
(3) Alcohol dependence = meet criteria for physiological tolerance or withdrawal symptoms
Alcohol abuse vs dependence: Implication
Everyone who meets criteria for dependence must also meet criteria for abuse.
The DSM-5 no longer recognizes a distinctionbetween substance “abuse” and “disorder.” Instead…
A single disorder: e.g., alcohol use disorder (AUD) with mild, moderate, and severe sub-classifications.
A huge “social” difference between the DSM-IV and DSM-V in the diagnostic criteria of AUD is that…
Legal problems included in the DSM-IV.
E.g. In the past year, have you “More than once gotten arrested, been held at a police station, or had other legal problems bc of your drinking?”
Substance Abuse criteria
A maladaptive pattern of substance use leading to distress or impairment.
ONE or more of:
- Failure to fulfill role obligations
- Physically hazardous situations (“have you ever driven a car when you were intoxicated?”
- Legal problems (problematic criteria)
- Social problems (“do pple around you get upset w you about your consumption of those substances?”)
Substance Dependence criteria
Thought to be the next level up (after abuse). A maladaptive pattern of substance use leading to distress or impairment.
THREE or more of:
- Tolerance
- Withdrawal
- More than intended
- Failure to cut down
- Time spent
- Other activities given up
- Physical or psychological problems
In DSM-5, _________ disorder included in category for future consideration
Internet gaming disorder
Prevalence rates for use of ANY illicit drugs is the highest among ______.
College student
Prevalence alcohol USE
From 0 to 16 liters
Rates of AUD typically lower in East Asian and Jewish populations in part because…
Bc of a genetic polymorphism that deals with alcohol dehydrogenase → makes it much more uncomfortable to consume alcohol
=> Rates of abuse ofothersubstances similar or higher
Stimulants are the most ______ and _____ class of drugs
widely used, abused
Stimulants include… (4)
(1) Amphetamines
(2) Cocaine
(3) Nicotine
(4) Caffeine
(Tobacco & caffeine classified diff in DSM-5 bc their effects differ somewhat - less severe effects)
Stimulants increase _____, improve _____, increase ______ (at least in the short term).
alertness, memory, energy
Benzedrine (amphetamine) historical context
Something pple would take for stuffy noses. Were in common use.
“Wonder pills”
=> Used on both sides in WW2 to keep soldiers alert in very brutal conditions on very little sleep
=> Particularly Germany during WW2 used very high levels of Benzedrines to keep soldiers engaged in warfare
Pervitin historical context
Contains methamphetamine. Crystal meth.
Also used in coffee by a lot of the armies during WW2 - formally distributed to german soldiers.
