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Clinical Psychology > W7: Substance Related & Addictive Disorders > Flashcards

W7: Substance Related & Addictive Disorders Flashcards

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1
Q

What is a psychoactive substance

A

Any chemical compound which passes through the blood brain barrier and alters mood and/or behaviour

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2
Q

What is substance use

A

The ingestion whether that be inhalation, Injection, transdermal of a substance

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3
Q

What is intoxication

A

The physiological response to the substance

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4
Q

What is tolerance

A

Needing a larger dose for the same effect 

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5
Q

What is withdrawal

A

A strong, negative physiological and often psychological reaction which occurs when a psychoactive substance is removed

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6
Q

The DSM four had two categories of substance use disorders what were these

A

Substance abuse and substance dependence

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7
Q

The DSM-V now only has one category of substance disorders what is it

A

Substance use disorder that is characterised by specific substances



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8
Q

What is the DSM criteria for substance use disorder

A

 problematic pattern of use that in pairs functioning with two or more of the following within 12 months:
– Substance taken in larger amounts or for a longer period than planned
– Persistent desire and/or failed attempts to reduce or control use
-A large amount of time is spent either trying to attain the substance or recover from its use
– Cravings
– Use is resulting in inability to fulfil obligations at work or at home
– Continued use despite ongoing exacerbation of psychosocial problems
– Social hobbies or work activities are given up or reduced
– Recurrent use in situations which maybe dangerous such as driving under the influence
– Continue used despite knowing the problems are caused by the substance
– Tolerance
– Withdrawal



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9
Q

What are the Drug types specified in the DSM under substance use disorder(9)

A 
Alcohol 
Sedative 
Stimulant 
Tabacco 
Caffeine 
Opioid 
Cannabis 
Other hallucinogens 
Inhalant
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10
Q

How many symptoms for a mild substance use disorder?

A

2-3

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11
Q

How many symptoms for a moderate substance use disorder?

A

4-5

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12
Q

How many symptoms for a severe substance use disorder?

A

6+

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13
Q

What are the four broad drug categories

A

Depressants that decrease physiological arousal such as alcohol

Stimulates that increase physiological arousal such as cocaine and nicotine

Opiates for pain relief such as morphine and heroin

Hallucinogens and psychedelics that alter sensation and perception such as cannabis and LSD

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14
Q

How much do Australians spend on illicit drugs

A

$7 billion p.a

This is more than five times that on licit substances

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15
Q

Illicit does not equal

A

It doesn’t equal more addictive or more deadly

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16
Q

Explain alcohol use disorder

A

It is diagnosed if physiologically dependent on alcohol or a heavy user

Delerium tremens can occur when blood alcohol levels drop suddenly and result in deliriousness tremulousness and hallucinations that are primarily visual but they may be tactile 

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17
Q

What is polydrug abuse

A

Many users abuse multiple substances for example 85% of alcohol abuser are smokers

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18
Q

What is the prevalence of alcohol abuse

A

8.6%

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19
Q

What is binge drinking

A

Having five standard drinks in a short period (1hr)



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20
Q

Who is binge drinking most prevalent amongst

A

College and university students at 43.5%

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21
Q

What is heavy use drinking

A

Five drinks five or more times in a 30 day period

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22
Q

Which areas is alcohol dependence higher

A

In rural areas

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23
Q

What percentage of those with alcohol use disorder also have at least one mental disorder

A

21.3%

This could be self-medicating or it could be contributing to it

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24
Q

What are the short term effects of alcohol in terms of neurotransmitters

A

It stimulates GABA receptors that are the key inhibitory neurotransmitter – reduces tension

Increases dopamine and serotonin to produce pleasurable effects

Inhibits glutamate receptors – glutamate is a key neurotransmitter in a range of functions notably memory and learning so it produces cognitive difficulties this is one memory can become impaired

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25
Q

What are the short term effects of ingesting large amounts of alcohol

A

Significant motor impairment

Poor decision-making

Poor awareness of errors made

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26
Q

What are the long-term effects of alcohol

A

Malnutrition – Calories from alcohol lack nutrients and alcohol interferes with digestion and absorption of vitamins from food
E.g. deficiency of the complex vitamins cause amnesic syndrome such as Korsakoff syndrome

Cirrhosis of the liver
– Liver cells in engorged with fat and protein impeding functioning the cells dies triggering scar tissue which obstructs bloodflow

Damage to endocrine glands and pancreas

Heart failure

Hypertension

Stroke

Capillary haemorrhages

Destruction of brain cells especially in areas important to memory

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27
Q

What is fetal alcohol syndrome

A

Causes physiological cognitive and behavioural changes during gestation we could have lifelong impacts

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28
Q

What is marijuana

A

It is classed as a hallucinogen

It is derived from dried and ground leaves and stems of the female hemp plant

The most frequently used illicit drug in Australia – Greater use by men than women

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29
Q

What is hashish

A

It is stronger than marijuana and is produced by drying the resin of the tops of plants and buds

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30
Q

There is evidence for a range of benefits of marijuana what are they

A

Relieving discomfort of chronic pain

Reducing frequency of epileptic seizures

Reduces nausea and loss of appetite caused by chemotherapy

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31
Q

What is the major psycho active ingredient in marijuana

A

THC (delta-9-tetrahydrocannabinol)

32
Q

What are the psychological effects of marijuana

A

Relaxation and sociability
Rapid shifts of emotion
Interferes with attention, memory and thinking with a decline in IQ over time
Heavy doses can induce hallucinations and panic
Interferes with cognitive functioning impaired memory and complex motor skills

33
Q

Why is it difficult to regulate the dosage of marijuana

A

The effects take 30 minutes to appear so you may smoke more than intended waiting for the effects

34
Q

Where are the cannabinoid receptors in the brain

A

CB1 and CB2

High concentration in the hippocampus

35
Q

There is evidence that cannabis increases the risk of what

A

Psychosis for people with a genetic predisposition for psychosis

36
Q

What is synthetic cannabis

A

It is the same chemical compound but a synthetic reproduction

It is early days but evidence of more severe side-effects compare to cannabis and more frequent admission to A&E for drug related events

Increased risk of stroke and heart failure

37
Q

What are opiates

A

They are a group of addictive sedatives that in moderate doses relieve pain and induced sleep such as opium, morphine, heroin, codeine

Can be legally prescribe this pain medications in hydrocodone and oxycodone

38
Q

How many Australians use heroin in a 12 month period

A

.1%

39
Q

What is the big concern with opiate use

A

Important to recognise the miss use stemming from legal prescriptions for example oxycodone prescriptions dropped 1800% between 1996 and 2000



40
Q

What are the psychological and physical effects of opiates

A

Produces euphoria, drowsiness, and a lack of coordination
Loss of inhibition and increase of confidence however there is a severe let down after about 4 to 6 hours

Heroine and OxyContin produces a rush of intense feelings of warmth and ecstasy following injection

They stimulate receptors of the bodies opioid system the nucleus accumbens which is important in reward

Tolerance develops and withdrawal occurs
Muscle soreness and twitching tearfulness and yawning becomes more severe and may also include cramps choose sweating increase in heart rate and blood pressure insomnia and vomiting withdrawal last for about 72 hours

41
Q

29 year follow-up of 500 heroin addicts found

A

28% were dead before the age of 40 Half by suicide homicide or accident
And 1/3 by overdose

42
Q

Explain the exposure to infectious disease via shared needles

A

Exposure to things such as HIV

Evidence suggests that free needles reduce infectious diseases associated with intravenous drug use

43
Q

What is methamphetamine

A

Classed as a stimulus – increases alertness and motor activity and reduces fatigue

Produces high levels of energy and sleeplessness, reduced appetite, increased heart rate

44
Q

Explain the effect on neurotransmitters methamphetamine has

A

It triggers a release of an block of re-uptake of norepinephrine and dopamine

45
Q

What can high doses of methamphetamine lead to

A

Nervousness, agitation, irritability, confusion, paranoia and hostility

46
Q

After how many days of use do you see tolerance develop for methamphetamine

A

Only six days use

47
Q

How does chronic use of methamphetamine damage the brain

A

It impacts dopamine and serotonin systems with a reduction in hippocampus volume 

48
Q

What is ecstasy

A

Sometimes classed as a hallucinogens that is a type of amphetamine

Induces a sense of well-being, feeling close to others, increased tactile sensation.  

Often experience depression in the following days

49
Q

What Neurotransmitters does ecstasy act on

A

Serotonin

Dopamine

Norepinephrine 

50
Q

What does cocaine do

A

It blocks the re-uptake of dopamine in the mesolimbic areas of the brain

51
Q

What is involved in an overdose of cocaine

A

Chills, nausea, insomnia, paranoia, hallucinations, possibly heart attack and death

52
Q

What is phencyclidine (PCP)?

A

 initially used as an anaesthetic but stopped in 1965 due to negative after effects which were mainly severe hallucinations

Was considered a relatively popular recreational drug but has been steadily declining

Causes severe paranoia, violence, selfharm and depersonalisation 

53
Q

What is ketamine

A

Used in surgical and veterinary procedures - anaesthetic and analgesic properties

But is also used as a party drug and sometimes sold as ecstasy

It does have the potential for dependency

54
Q

What are ketamine and PCP

A

Dissociative anaesthetics

55
Q

What do dissociative anaesthetics do

A

They block the action of NMDA receptors and increase the availability of serotonin dopamine and norepinephrine by reducing re-uptake

56
Q

What is LSD

A

It is a hallucinogen with effects such as colourful visual hallucinations and psychedelic trips which are an expansion of consciousness

57
Q

what is psilocybin

A

Extracted from mushrooms and is a hallucinogen

58
Q

There is emerging evidence for the use of illicit drugs for psychological disorders. Give some examples

A

Ketamine - depression
Ecstasy- PTSD, anxiety
Cannabis - complex pain
Psilocybin - anxiety

59
Q

Explain genetics in alcohol use

A

Relatives and children of problem drinks have higher than expected rates of alcohol abuse or dependence

Ability to tolerate large quantities of alcohol maybe inherited – people from Asian countries have low rates of alcohol use

60
Q

There is some evidence that people dependent on drugs or alcohol have a deficiency in

A

Dopamine D2 receptor

61
Q

What do all drugs stimulate in the brain

A

The dopamine mesolimbic pathway - produces rewarding or pleasurable feelings

62
Q

Depressants target what area in the brain

A

The ventral tegmental area

63
Q

Stimulants target what area in the brain

A

The nucleus accumbens

64
Q

What role does availability play in substance use disorders

A

Usage is higher when alcohol and drugs are easily available

Drug use among youths who had been approached by drug dealers for 35% compare to just under 7% of you two had not been approach there is a role in opportunity

65
Q

What family factors increase substance use disorders

A

Parental alcohol use (modelling)

Marital discord, psychiatric or legal problems in the family linked to substance abuse

Lack of emotional support from parents increases the use of cigarettes, marijuana and alcohol as a coping mechanism

Lack of parental monitoring

66
Q

How might your social network increase substance related disorders

A

There is evidence for having peers who drink influencing drinking behaviours but individuals also choose friends with drinking patterns similar to our own so it is probably a bit of both of social influence and social selection

67
Q

How does advertising or media influence Substance related disorders

A

Countries that ban ads have 16% less consumption than those that don’t

68
Q

What is agonist treatment of Substance related disorders

A

Replacing the harmful drug with a safe one – for example, heroin substitutes such as synthetic narcotics are used to wean heroin users from dependence

69
Q

What are antagonist treatment of substance related disorders

A

Using medication that will block the effects of the drug

For example in opiates there’s naltrexone that prevents you from feeling high so if you don’t experience the positive feelings you are less inclined to use the drug

70
Q

What is aversive treatment of substance use disorders

A

Aversive treatment runs along classical conditioning

For example with alcohol there is a medication that you can give people (Antabuse, disulfiram) that produces nausea and vomiting if alcohol is consumed this is most effective when combined with CBT to break a cycle of beliefs

71
Q

Explain in patient hospital treatment

A

It is a form of detoxification

Withdrawal from the alcohol or other under medical supervision

This may be necessary for those without social support or with other serious psychological problems

72
Q

What is alcoholics Anonymous

A

It is the largest self-help group for problem drinkers consisting of regular meetings to provide support, understanding and acceptance

They promote complete abstinence

Although some studies have shown participation predicts better outcome recent studies suggest it is no more affective than other forms of therapy

73
Q

What are motivational interventions

A

There is an emphasis on empathy and understanding in the client council relationship and it focuses on the positive outcomes associated with cessation

74
Q

What is contingency management therapy

A

Patient and family reinforced behaviours inconsistent with drinking for example avoiding places associated with drinking

They teach the problem drinker how to deal with uncomfortable situations such as refusing the offer of a drink

And give vouchers that can be traded for desirable goods are given to use him staying this is a form of positive reinforcement for the desired behaviour 


75
Q

What a self-help residential homes

A

They are a non-drug environment that May be inclusive of group therapy and guidance or support from former users 

76
Q

What elements can be used to prevent substance use disorders

A 
Enhancing self-esteem
Social skills training
Peer pressure resistance training
Parental involvement in school programs
Warning labels on alcohol bottles
Education regarding alcohol impairment
Testing for drugs and alcohol at school or work
Correction of beliefs and expectations
Peer leadership

Not always done particularly well and not always a lot of success in this

Clinical Psychology (15 decks)

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