SUD Flashcards
the MOST common drug of choice in Aus is __________ . Most common illicit drug us ___________.
Alcohol; Cannabis
The majority of the harms associated with substance use arise from substance use disorders.
T/F
FALSE
Diagnosis of a SUD requires person to have _______ symptom count and __________ duration
2+ ; 1 year
What are the classification changes related to SUD in the DSM-5?
Condensed to one diagnosis, from ‘substance abuse + substance dependence’ because of a lack of reliability. Limited evidence for differential diagnosis
DSM-5’s newest criteria for SUD is__________
craving for substance
Gambling disorder is a new addition to the DSM-5
T/F
TRUE
DSM-5 categories of SUD are;
a) depressants, stimulants, gambling
b) legal, prescription, illicit
c) alcohol, opioid, tobacco
C) alcohol, opioid, tobacco
Severity scales for SUD -
a) mild-1-3, mod - 3-5, severe - 5+
b) mild 2-3, mod 4-5, severe 6+
c) mild 2-3, mod 4-6, severe 6+
B) b) mild 2-3, mod 4-5, severe 6+
Which one is INCORRECT about withdrawal;
a) it is one of the physiological symptoms of SUDs
b) separate withdrawal syndromes are defined for each substance in the DSM-5.
c) it involves needing a greater dose to achieve desired results
d) is associated with stopping or reducing the amount of substance use
C - this is a symptom of TOLERANCE, other physiological symptom of SUD.
Alcohol use disorders are most common in;
a) 18+
b) 16-24
c) 25-40
d) 40+
B
The National Health Research Council recommends __________ to reduce lifetime prevalence of alcohol related injury/disease, and __________ to reduce chances of injury on a single occasion
Less than 2 drinks a day;
Less than 4 drinks a day
Lifetime + occasion alcohol abuse is equal among gender
T/F
False, both more common in MALES
Recent findings suggest that the gender gap in alcohol use disorder is closing, which demographic is recommended for early intervention?
Young females
How does Ethnicity // home country influence AUD
Those from non-English speaking countries of birth are 3X less likely to get AUD
How much is classified as 1 standard drink?
10mg pure alcohol
List some factors that blood alcohol concentration depends on
- Volume consumed
- Amount ingested at a time
- Weight + body fat
- Amount of food in stomach
- Efficiency of liver
- Genetics
What produces the relaxing effect of alcohol?
alcohol x GABA interaction. GABA is an inhibitory neurotransmitter, stimulation = ‘relaxing effect’
What produces the pleasurable effects of alcohol?
Increases in DA + 5-HT
What causes the cognitive deficits associated with short-term alcohol consumption?
Glutamate receptor inhibition
Long term alcohol consumption is associated with;
a) digestion of food and absorption of vitamins
b) deficiency of B-complex vitamins
c) structural and functional brain changes
d) all the above
D - ALL
Cirrhosis is _____________
Liver disease after prolonged AUD, cells get enlarged with protein & fat, leads to cell death, inflammation and loss of blood flow
Foetal alchohol syndrome is associated with;
a) mild drinking in pregnancy
b) moderate drinking in pregnancy
c) heavy drinking in pregnancy
d) none of above
C - heavy drinking
Key gestational features and abnormalities associated with FAS
Slowed foetal growth, behavioural + emotional issues, facial, cranial, limb abnormalities
The largest preventable cause of death in Australia is ________________
Smoking
Tobacco smoke is made up of few substances that are addictive
T/F
False, contains more tha 4,000 vapours + chemicals with Nicotine being the most addictive psychoactive one
INCORRECT one is;
a) prevalence of daily smokers has decreasing
b) Age of onset of smoking declining
c) Average number of cigarettes smoked a day declining
d) They are all true
B - age of onset is elevating
Are there consequences associated with secondhand smoke?
Yes - more ammonia, carbon monoxide,nicotine, tar
Why are e-cigarettes regarded as a safer alternative?
Do not have to contain Nicotine, but those that do, do not contain tar and carbon monoxide
Purchase, possession and importing e-cigarettes is legal in Australia
T/F
False, all illegal
The main distinction between cannabis and hashish is ______________
Hashish is more potent, different preparation
What is the research consensus on cannabis being a gateway drug?
NOT true, no causal link established though heroin + cocaine users do report using this first
What causes the learning + memory deficits associated with cannabis use?
Cannabis affect on the CB1 + CB2 receptors in the hipocampus
Why was cannabis considered non-additive?
didnt have any visible withdrawal effects
What is the consensus on medical cannabis in Aus
Legal, but limited. NSW - palliative care only. VIC - children with epilepsy
What are the most common opiates used in Aus
Prescription pain killers
Men are more likely to be in tmt for __________ opioids
Females are more likely to be in tmt for ____________ opioids
oxycodone + fentanyl;
codeine
The body naturally produces opioids
T/F
True - endorphins and enkephalins
How are the pleasurable effects of opioids achieved?
Bind to opioid receptors in the brain, may engage the DA system
List some withdrawal symptoms of THC abuse;
irritability, anxiety; sleep difficulty (e.g., insomnia, disturbing dreams); decreased appetite // weight loss;
restlessness; depressed mood; physical symptoms causing significant discomfort i.e abdominal pain, shakiness/tremors, sweating, fever, chills or headache
Which illicit drug/ class of drugs has the greatest burden of disease
Heroin + opiates
When do opiate withdrawal symptoms begin to wane
5-10 days
Amphetamines are natural stimulants; cocaine is a synthetic stimulant
T/F
False, other way around
Stimulants;
a) motor activity + alertness
b) memory + processing speed
c) problem solving + reduce sleepiness
d) both A and C
A
Does caffeineimprove cognitive functioning?
No, for all - low, med, high drinkers
How to amphetamines produce pleasurable effects
Stimulate norepinepherine + DA release and block their reuptake.
The mot common type and form of stimulant is________
Methamphetamine; crystal
Crystal form of methamphetamine has the advantage of
Being more potent, lasting longer
Which gender population is more vulnerable to meth addiction?
MEN
Describe some cognitive deficits associated with long term meth use
memory poor decision making paaranoia psychosis depression
What is the most popular type and method of using cocaine in Aus
Snorting powder
Which population most vulnerable to cocaine use
Young males
Why do some people die from cocaine from a relatively low dose
is a vasoconstrictor so can incr chance of stroke + heart attack
What are the effects of prenatal cocaine use
Smaller frontal lobe + smaller areas controlling cognitive control & emotion regulation
What is SUD called a developmental process
begin with a positive attitude towards a substance, then start to experiment with using it, then begin using it regularly, then use it heavily and finally become dependent on it
Describe evidence for genetic aetiology of SUD
Monozyg twin concordance - predicts a generalised risk factor for any SUD, not substance specific
the vulnerability model proposes _____________ whereas the toxic effect model ______________
there is a predisposing factor in DA system making select person vulnerable to SUD;
SUD causes changes to the DA system
Incentive sensitisation theory proposes
transition from liking to wanting drug, through the hypersensitisation of DA system this shift maintains addiction
SUD cues elicit responses like those associated with actually using the drug + activates reward + pleasure centres.
T/F
True
Valuing short-term association with _________activation, whereas long-term activation linked to ___________activation
Amygdala, nucleus accumbens;
PFC
Are on drugs taken to reduce stress?
Research says yes, either alleviate negative emotions or follow a negative life stressor
Does smoking reduce tension?
Depends how long person has been a smoker.
New smokers report greater stress reduction.
Greatest stress reduction response was following abstinence, (compared to other stressors)
May also be effect of inhalation process and not actual nicotine intake
What are the psychological factors that contribute to drug taking behaviours?
Personality, expectations, mood alteration
How do expectations affect drug use?
expectation that alcohol to reduce stress + anx predicts increased use
Expectation that drinking will increase sociability predicts increased alco consumption
Which types of personality traits have been associated with binge drinking?
Neurotic - anx + depression, hopelessness
Disinhibitory - impulsivity, sensation seeking
Which type of intervention has been proposed for reducing alcohol related harms
Personality based
What are the 2 general socio-cultural theories regarding social setting and drug taking?
social influence model- person’s social network predicts individual drinking
social selection model - individual drinking predicts subsequent social network drinking
How do distractions affect tension reduction in drug taking
Tension reduction is more likely to occur when distractions are present because person is not so concentrated on stressors
OVERALL drug use results from;
- high need for stimulation
* expectancies that drugs will increase positive affect.
Withdrawal management used _______ hours after last use, involves _________
6-12h;
Ambulatory; residential-based; inpatient.
Psychoeducation, counselling, nutrition / rehydration,
Wernicke’s encephalopathy associated with deficiency of ____________
Thiamine, B1
Contingency management is a _________ type of therapy and involves __________
Cognitive-behavioural;
Reinforces behaviours inconsistent with drug taking, teaches avoidance of situations associated with drinking, job hunting; TOKEN ECONOMY
Relapse prevention teaches_____
lapse is not a total RELAPSE, instead should be a learning experience. Assertion training
Contrast naltrexone and acomprostate treatments for AUD
Naltrexone - binds to receptors + blocks effects of endorphins (natural opioids) which alcohol stimulates = reduces cravings
Acamprosate - attaches to GABA + glutamate receptors. Reduces cravings
Disulfiram works by ____________
making you sick
What is the MOST effective tmt for smoking
Doctor telling you to stop
What is the purpose of NRT
Deliver nicotine in way that minimises carcinogen intake, reduce withdrawal symptoms
Are e-cigarettes effective way to stop smoking
No
What is the current treatment for cocaine abuse?
Desipramine + CBT.
Medication good for LOW dependence
CBT good for HIGH dep.
Antagonists _________________whereas agonists ____________
drug binding + blocking NT activity;
drug binding + mimicking effects of substance
Broad categories of heroin tmt ___________
Heroin substitute - methadone / suboxone
Opiate antagonist - Naltrexone, blocks effects of heroin
Prenatal exposure to cannabis leads to changes in the ___________ whereas tobacco exposure leads to _________ chnages
Cannabis - altered DA receptor expression
Tobacco - altered opioid transporter expression
Which areas of the brain get activated with nicotine?
locus coeruleus
frontal lobes
cingulate gyrus
