Week 13 - Addiction, Substance Use & Misuse

Question 1

core issues in substance abuse?

Answer 1

• use
• hazardous use
• harmful use
• dependence

Question 2

what are the 6 constituents of the ICP-10 dependence syndrome checklist?

Answer 2

• difficulty in controlling use of drug in terms of onset, termination and level of consumption
• increasing tolerance for drug (declining tolerance as a late phenomenon)
• physiological withdrawal state on cessation or use of drug to avoid withdrawals
• strong desire or sense of compulsion to alcohol use
• progressive neglect of other interests
• persisting with use despite clear evidence of harmful consequence that the user is aware of

*requires at least 3 phenomena in past year

Question 3

describe the DSM V classification system (US) for dependence

Answer 3

• persistent desire or efforts to cut down
• great deal of time spend on alcohol related activity
• neglecting responsibilities

Question 4

what is the key to the development of dependence?

Answer 4

• increase of dopamine activity in mesolimbic system
• “feel good” systems become less responsive with continued exposure, level of stimulation needs to increase to maintain reward

Question 5

4 “L”s of harms due to substance abuse?

Answer 5

liver - health effects
lover - relationships
livelihood - work
law - offending

Question 6

health consequences: which factors contribute to death from alcohol and drug related problems?

Answer 6

• accidents & injury (including suicide)
• liver disease
• cardiovascular disease
• cancers (upper GI, liver, breast)

Question 7

relationship problems: alcohol & drugs significant factor in?
how many children in scotland affected by adult drug use?

Answer 7

• 60% of murders and 60%+ domestic violence

- 1 in 20

Question 8

work & functional performance: how is it affected with alcohol and drug issues?

Answer 8

• sickness absence
• reduced productivity
• accidents
• premature death

Question 9

what strategies and measures have been implemented to control alcohol abuse?

Answer 9

1. price controls:
   - taxation
   - controlling cheapest price available
2. treatment:
   - brief interventions
   - intensive tx for dependence
3. availability
   - enforced age limit
   - restricted sale hours
   - retail monopolies
   - outlet density
4. safer environment
   - enforcement of licensing codes
   - server training
5. marketing
   - limiting exposure to advertising
6. education & information
   - integrated campaigns
   - classroom education
   - public campaigns/warning labels