Week 11 - Alcohol & Inhalants

Question 1

What factors matter in substance use?

Answer 1

Context matters
* including who is using the substance
* how much is being used
* where it is used (socially or in private), and
* safety
* cues.

Why and what started the use are also important considerations.

Question 2

What are the general principles regarding substance use?

Answer 2

• Use is not abuse;
• every drug has multiple effects;
• dose/amount matters;
• emotional expectations and experience influence the experience

Drugs are neutral until they interact with humans.
Frequency of use can determine if it is perceived as good or bad.

Question 3

How does Dr. Lacy refer to addiction?

Answer 3

Dr. Lacy does not use the term ‘addict’ unless the client mentions they are an addict.

The term “addict” reflects a medical model of addiction.

Question 4

What is one theory of how substance abuse develops?

Answer 4

The mesolimbic dopamine pathway is involved, where an increase in dopamine leads to increased glutamatergic reactivity, resulting in increased cravings for the substance.

Question 5

What are the classes of substances for Substance Use Disorder?

Answer 5

1. Alcohol,
2. Caffeine,
3. Cannabis,
4. Hallucinogens & Phencyclidine,
5. Inhalants,
6. Opioids,
7. Sedatives,
8. Hypnotic & Anxiolytics,
9. Stimulants,
10. Tobacco,
11. Other.

Question 6

What disorders are listed for each substance?

Answer 6

1. ‘Substance’ Use Disorder,
2. Intoxication,
3. Withdrawal,
4. Substance-Induced Mental Disorders,
5. Unspecified.

Question 7

What are the diagnostic considerations for Substance Use Disorder?

Answer 7

1. Impaired control,
2. social impairment,
3. risky use,
4. tolerance,
5. withdrawal, and
6. cravings.

Question 8

What criteria are typically needed for a diagnosis of Substance Use Disorder?

Answer 8

At least 2 criteria indicating clinically significant impairment within 12 months, including:
1. time/quantity spent on recovery,
2. failed attempts to quit,
3. cravings, and
4. use impacts roles or
5. dangerous.

Question 9

What is hypofrontality in relation to drug effects?

Answer 9

Hypofrontality refers to decreased activity or cerebral blood flow to the prefrontal cortex (PFC), observed in drug users when exposed to normal rewards, leading to powerful cravings and relapse.

Question 10

What is the effect of alcohol on the brain?

Answer 10

Alcohol is a depressant that enhances GABA activity, *leading to downregulation of GABA * when used excessively, which can cause seizures upon withdrawal.

Understanding tolerance and withdrawal symptoms is crucial.

Question 11

What are withdrawal symptoms of alcohol?

Answer 11

Delirium tremens, which can be fatal, usually starts 2-5 days after the last drink and includes
shaking,
confusion,
high blood pressure,
fever, and
hallucinations.

Question 12

What are inhalants and their symptoms?

Answer 12

Inhalants can cause immediate highs and are often used by younger individuals.

Symptoms include tolerance but not necessarily withdrawal.

Dangerous as they can replace oxygen in the lungs.

Question 13

What is ‘sudden sniffing death’ syndrome?

Answer 13

A condition where inhaling substances can lead to death within minutes due to** heart failure.**

Question 14

What are the stages of change in treatment?

Answer 14

1. Precontemplation,
2. Contemplation,
3. Preparation,
4. Action,
5. Maintenance,
6. Termination, and
7. Potential Relapse.

Question 15

What occurs in the contemplation phase of change?

Answer 15

Individuals think about creating change, weighing pros and cons, and considering their ability to change, often involving motivational interviewing.