THEME 4: SUD Flashcards
Drug/substance/
Any natural or synthesised product that has psychoactive effects. It alters perceptions, thoughts and behaviors.
4 conditions defining substance use:
1-Intoxication
2-Withdrawal
3-Abuse
4-Dependency
Intoxication
behavioral and psychological changes that occur as a result of the physiological effects of a substance in the central nervous system
Withdrawal
Physiological or behavioral changes that occurs when you take a break or reduce the drug after using it for a long time.
-DSM 5 doesn’t include the difference between substance abuse and substance dependence.
DSM-5 SUD
-Substance abuse and dependence combined into a single diagnosis
-Because it is hard to differentiate abuse and dependence in a clinical setting
-Includes impaired control, continued substance use despite negative social, occupational nd health consequences risky use and evidence of tolerance or withdrawal.
Depressants
Slow down the CNS. They make people relaxed, sleepy, reduce concentration and impair thinking.
Example: Alcohol, Benzodiazepines, barbiturates
Alcohol
10% of the withdrawal cases can be fatal.
-People drink less when they get older
-Long-terms serious effects stomach, oeshoagus, pancreas and liver cancer.
Benzodiazepines- barbiturates
They are legally prescribed drugs.
-Sold as sedatives to treat anxiety and insomnia.
-Muscle relaxants, feelings of euphoria, agitation caused by other drugs
-When overdosed likely to lead death by cardiac arrest especially when mixed w alcohol.
Stimulants
Activates CNS. Feeling of energy, happiness and power.
Cocaine, Amphetamines, methamphetamine, Nicotine, caffeine
Cocaine
-Most addictive substance known Immediate rush/euphoria followed by increased self-esteem, competence and creativity.
High dose:
-delusions, hyper sexuality, compulsivity, impulsivity and anxiety.
Withdrawal effects:
-exhaustion, depression
-Reward-pleasure area of the brain
Amphetamines- methamphetamine,
-Treat attention problems narcolepsy and chronic fatigue.
Symptopms:
-illusions, memory loss, mood instability
-Cardiovascular problems
Nicotine
Both CNS and PNS
-Similar to fight-flight response
Symptoms of withdrawal:
-depression
-irritability
-anger
-frustration
-cuases lung cancer
Caffeine
Most commonly used stimulant
-CNS
-Increases the level of dopamine, noradrenaline and serotonin.
-Increases metabolism, body temperature and blood pressure
-It can only be diagnosed if there is significant distress or impaired functioning.
Opiods
Used to relieve pain
(Morphine, Heroin, codeine and methadone)
Symptomps: euphoria, drowsiness, vivid dreams
Withdrawal symptoms: dysphori, aching in the back and legs, increased sensitivity to pain, vomitting etc.
Hallucinogens and PCP(angel dust)
- It causes perceptual changes
-Includes LSD
-psychedelic drug
-Bad trip can be so strong that people can re-experience
-PCP is not classified as hallucinogen but it causes euphoria, lack of concern and delayed reaction.
Cannabis
-Relaxation and calmness.
Side affects:
-irregular heart beat, increased appetite, dry mouth
-High dose can cause perceptual distortions, feelings of depersonalisation and paranoid thoughts
-It significantly increases the chances to develop a psychotic disorder.
-THC attaches to the cannabinoid receptors and impairs the brain in long/short term.
Biological treatment
Prescription of medication.
Antidepressants block the effects of addictive drugs.
-Nicotine-antidepressants bupropion
-Heroine-methadone
Psychosocial treatment
1- Behavioral treatment
2-Interventions based on cognitive models
3-Relapse prevention programmes.
Gambling disorder
-Included in drug-related addictive disorders
-Behavioral addiction
-More common in men
-Related to reward region in the brain
-Early onset gambling is associated with later drug use
Developmental changes during adolescence
-During adolescents brain is still developing. When looking at the Pre-frontal cortex region (associated with cognition, emotion, behavior) associated with executive control and those associated with reward seeking. Changed in neurotransmitters during adolescence creates a sensitivity for reward seeking.
Substance use
Ingestion of a drug
Substance abuse
excessive use of or dependence on an addictive substance.
Physical dependence
accompanied by susceptibility to withdrawal symtomps and only occurs in combination with tolerance.
Psychological dependence
a need or urge to use despite the potential for significant adverse effects and it’s not always accompanied by withdrawal symptoms.
Externalizing/Internalizing substance disorder
-Externalizing affects are common for both boys and girls but Internalising affects are more common for girls.
What is the most vulnerable age for SUD?
-Early adolescence and later adolescence between 18-25.
-Early users are at greater risks of poor outcomes
Popular ages to use alcohol
Increase during adolescent, peak early adulthood.
Non-escalating marijuana trajectories
1-Low users
2-Moderate users
3-High users
Gateway hypothesis
The use of alcohol or marijuana acts as a gateway to the use of harder drugs such as: cocaine, heroin or methamphetamine.
Example: Nicotine is a gateway drug to marijuana
Common liability model
There is a non-specific propensity to use drugs. Shared individual and social factors (such as norms)contribute to the use and abuse of multiple substances.
Genetics - Environment
Both genetics and environment play a crucial role for the motivation to drink, alcohol sensitivity, amount of alcohol consumed and eventual dependence.
Incentive- sensetisation theory:
Different substances alter the organisation and function of the brain in regards to motivation and reward: the cues to drugs become increasingly difficult to ignore, and craving becomes an important factor riving further use.
ADHD & CD (Externalizing disorders are highly associated with further substance use)
Cognitive deficit model
repeated, chronic drug use results in abnormalities in the PFC and impaired judgement, decision making and impulse control.
Diagnosis
Full assessment of psychological functioning, including deficit related to cognition.
-monitor abstract thinking, emotion and memory
-Underlying personality
Prevention methods
1-Prevention programmes (not very effective, even sometimes increase the interest to drugs fro adolescents)
2-Outpatient therapy
3-Inpatient programme
4-Day treatment
5-Special school setting and juvenile justice system.
6- Cognitive behavioral therapy
7-juvenile justice system.
