Week 12 Chapter 10 Substance Use Disorders Alcohol (Caff)

Question 1

Drug use in normative in all cultures with the exception of inuit Eskimos. In 2009 how many Americans over the age of 12 reported having used an illicit drug in the past month?

Answer 1

Over 21.8 Million people

• Additionally over 130 Million reported alcohol use of some kind
• 59.6 Million reported at least one episode of Binge Drinking

Question 2

What is the percentage of Americans reporting drug use in the past month (2009)

Answer 2

Alcohol = 51.9%
Cigarettes = 27.7%
Marijuana = 6.6%
Non-medical psychotherapeutics = 2.8%
Cocaine = 0.7%
Hallucinogens = 0.5%
Inhalants = 0.01%

Question 3

What is the DSM-5 criteria for Substance/Medication-Induced Mental Disorder?

Answer 3

A. The disorder represents a clinically significant symptomatic presentation of a relevant mental disorder
B. There is evidence from the history, physical examination, or laboratory findings of both of the following:
1. The disorder developed during or within 1 month of a substance intoxications or withdrawal or taking a medication; &
2. The involved substance/Medication is capable of producing the mental disorder
C. The disorder is not better explained by an independent mental disorder (i.e. one that is not substance or medication induced). Such evidence of an independent mental disorder could include the following:
1. The disorder preceded the onset of severe intoxication or withdrawal or exposure to the medication; or
2. The full mental disorder persisted for a substantial period of time (e.g. at least 1 month) after the cessation of acute withdrawal or severe intoxication or taking the medication. This criterion does not apply to substance-induced neurocognitive disorders or hallucinogen persisting perception disorder, which persists beyond the cessation of acute intoxication or withdrawal.
D. The disorder does not occur exclusively during the course of a delirium.
E. The disorder causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Question 4

What is the general DSM-5 Criteria for Substance use disorder?

Answer 4

Substance use disorders span a wide variety of problems arising from substance use, and cover 11 different criteria:

1. Taking the substance in larger amounts or for longer than the you meant to
2. Wanting to cut down or stop using the substance but not managing to
3. Spending a lot of time getting, using, or recovering from use of the substance
4. Cravings and urges to use the substance
5. Not managing to do what you should at work, home or school, because of substance use
6. Continuing to use, even when it causes problems in relationships
7. Giving up important social, occupational or recreational activities because of substance use
8. Using substances again and again, even when it puts the you in danger
9. Continuing to use, even when the you know you have a physical or psychological problem that could have been caused or made worse by the substance
10. Needing more of the substance to get the effect you want (tolerance)
11. Development of withdrawal symptoms, which can be relieved by taking more of the substance.

Question 5

Define “Addiction”

Answer 5

Addiction typically refers to a more severe substance use disorder that is characterised by having more symptoms, tolerances, and withdrawal, by using more of the substance than intended, by trying unsuccessfully to stop, by having physical or psychological problems made worse by the drug, & by experiencing problems at work or with friends.

Question 6

Define “Tolerance”

Answer 6

Tolerance is indicated by either 1., larger doses of the substance being needed to produce the desired effect or 2., the effects of the drug becoming markedly less if the usual amount is taken.

Question 7

Define “Withdrawal”

Answer 7

Withdrawal refers to the negative physical and psychological effects that develop when a person stops taking the substance or reduces the amount.
Substance withdrawal symptoms can include muscle pains and twitching, sweats, vomiting, diarrhea, and insomnia.
Generally being physiologically dependent on a drug is associated with more severe problems

Question 8

Aside from an individual choosing to try a drug in the first instance, what factors can contribute to that individual becoming dependent?

Answer 8

The substance interacts with an individual’s neurobiology, social setting, culture, and other environmental factors to create dependence.
Such factors put some people at higher risk for substance dependence than others.
It is a mistake to consider substance-use disorders as somehow solely the result of moral failing or personal choice.

Question 9

People who are physiologically dependent on alcohol generally have more severe symptoms, such as tolerance or withdrawal. In relatively rare cases, a person whoo has been drinking heavily for a number of years may experience Delirium Tremens (DT’s). What is this?

Answer 9

Delirium Tremens or DT’s occurs when the level of alcohol in the blood drops suddenly.
The person becomes delirious as well as tremulous and has hallucinations that are primarily visual but may be tactile as well.
Unpleasant & very active creatures (snakes, cockroaches, spiders, etc) may appear to be crawling up the wall or over the person’s body, or filling the room

Question 10

What is “Polydrug Abuse”?

Answer 10

PolyDrug Abuse is abusing more than one drug at a time.
It is estimated that 80-85% of people who abuse alcohol are smokers. This is a very high comorbidity which may occur because alcohol & nicotine are cross-tolerant; that is, nicotine can induce tolerance for the rewarding effects of alcohol & vice-versa.

Question 11

According to a 2001-2002 US epidemiological study, what are the lifetime prevalence rates for alcohol dependence & alcohol abuse?

Answer 11

The lifetime prevalence rates for alcohol dependence were greater than 12% & over 17% for alcohol abuse

Question 12

In 2009 the binge-drinking & heavy use prevalence rates for male & female full-time college students were 43.5% & 16% respectively. What is the difference between binge-drinking and heavy-use?

Answer 12

Binge-drinking is defined as having 5 drinks in a short period of time (e.g. less than an hour).
Heavy-use drinking is defined as having 5 drinks on the same occasion five or more times in a 30-day period.

Question 13

What are some of the gender differences with regard alcohol abuse?

Answer 13

• More men than women have problems with alcohol
• Women begin drinking at an older age than men
• Women become physiologically dependent as quickly as men do.

Question 14

What are some of the ethnic differences with regard alcohol abuse?

Answer 14

• White & Hispanics are more likely to binge drink than African Americans
• Asian Americans are least likely to Binge-drink or become heavy users of alcohol

Question 15

Alcohol use disorders are comorbid with several personality disorders, mood disorders, schizophrenia, & anxiety disorders, as well as with polydrug use. What is the percentage of people suffering from alcohol dependence who also have at least one additional mental disorder?

Answer 15

21.3% of people suffering from alcohol dependence have at least one additional mental disorder

Question 16

What are some of the short-term effects of alcohol?

Answer 16

• Alcohol begins being metabolised by enzymes in the stomach & is absorbed in the blood stream.
• It is then broken down by the liver which can metabolise about 1 ounce of 100% proof (50% alcohol) liquor per hour.
• Alcohol interacts with several neural systems in the brain: it stimulates GABA receptors (reducing tension)
• Alcohol increases levels of serotonin & dopamine (pleasurable effects)
• Finally, alcohol inhibits glutamate receptors (cause cognitive effects: slowed thinking, memory loss).

Question 17

What are some of the long-term effects of alcohol?

Answer 17

Almost every tissue & organ in the body is adversely affected by prolonged consumption of alcohol

• due to the heavy calorie load a drinker may reduce their calorie intake from nutritional sources so can develop malnutrition.
• Alcohol impairs digestion & absorption of vitamins
• A lack in vitamin B complex can cause amnestic syndrome - severe memory loss
• Prolonged alcohol use & poor protein intake leads to liver cirrhosis
• Damage to endocrine gland, pancreas, heart failure, erectile dysfunction, hypertension, stroke, capillary hemorrhages.
• Pregnant women who drink heavily can produce babies with fetal alcohol syndrome

Question 18

What are some of the positive effects of light alcohol consumption?

Answer 18

• Lower risk for coronary heart disease & stroke

* Lowering bad cholesterol (LDL) and raising good Cholesterol (HDL)