Week 5 Flashcards
What is the history of alcohol? (3)
It has been around for a long time
We’ve been fermenting fruits throughout history
Even animals can recognize fermented fruits for their intoxicating properties
What is the prevalence of alcohol consumption in Canada? (5)
We consume a lot of alcohol, specifically in the Western world
In 2015, there was an 80% prevalence of alcohol consumption over the last year for people 15+
25-34 age group and males most prevalent
Almost 50% of those 15-18 have consumed it in the past year
Number 1 substance consumed in the past year by Canadians
What is the overall trend with alcohol consumption for youth?
There is an overall downward trend in alcohol consumption among grades 7-12 and it is lower than adults (but still high)
What is the AUDIT? (2) What are the 3 subscales of questions? What does your score mean?
Alcohol use disorder identification test
10 questions, typically used in a clinical setting as it is a short test that is easy to give to a lot of people
3 subscales of questions:
Hazardous alcohol consumption (frequency and amount)
Dependence symptoms (control)
Harmful alcohol use (psychological and physiological harm)
The score you receive determines whether you are engaging in drinking in any of the three categories and are at risk of AUD
What is the prevalence of AUD in Canada? (4)
18.1% of the general population has met the criteria for an AUD sometime in their life (6.3 million people)
3.2% for the past 12 months (1 million people)
So a lot of people qualify for an AUD
Known sex difference in that men have a significantly higher prevalence
What is the cost of AU in Canada? (2)
From a public health POV, AUD costs society billions in indirect costs (productivity loss), healthcare costs from health problems resulting, law enforcement costs from crime resulting and other direct costs
39.8 billion for SUDs in 2002, even more now with inflation
What did the Nutt study on conceptualizing, identifying and categorizing harms resulting from addictive substances do? (6)
Looked at how different substances weigh into perpetuating different kinds of harm
Addiction professionals identified 16 harm criteria and categorized types of harm
9 were related to physical, psychological and social harm to the self (mortality, dependence, impairment of mental functioning, loss of relationships)
7 related to physical, psychological and social harms to others (injury, crime, family adversities)
Rated 20 drugs on a 100 point scale based on each harm criteria
Also assessed relative importance of the criteria within each cluster and across clusters
What did the Nutt study on conceptualizing, identifying and categorizing harms resulting from addictive substances find? (4) what can it be used for?
Found that alcohol ranks highest as most harmful overall, both to self and others
Due to it being so accessible, normalized and so widely/frequently used
Found that certain drugs like meth cause mostly harm to self while drugs like alcohol cause more harm to others (high for both kinds of harm but on another level for harm to others)
Most frequent AUD harms are economic cost and injury to others
Can inform the use of interventions to prevent AUDs and regulate the sale and consumption of alcohol
According to the BPS model, why do people drink alcohol?
Combination of biology (genes, nutrition), psychological (emotions, behaviors) and social (stress, trauma, environmental)
According to positive reinforcement theory, why do people drink alcohol?
Because it is exciting and enhances your life
To get a high
According to negative reinforcement model, why do people drink alcohol?
To forget/remove painful memories
To stop me from feeling negative feelings associated with anxiety and depression
To reduce anxiety and forget worries
According to social theory, why do people drink alcohol? According to conformity theory, why do people drink alcohol?
As a way to celebrate and be sociable
Due to peer pressure and so I won’t feel left out
How does personality impact AUD severity? (3)
Certain personality traits (neuroticism, impulsivity, etc.) can lead to alcohol consumption at increased levels
This is because they lead to certain drinking motives that lead to addiction
These motives connect with risk factors (biopsychosocial) to form susceptibility and risk for addiction
How does alcohol impact the brain? (6)
Inhibitory neurotransmitters (GABA) are active throughout the brain to control neural activity and decrease communication between cells in the brain, making them less likely to fire
Another neurotransmitter in another area of the brain, glutamate, does the opposite as a general-purpose excitatory neurotransmitter than increases communication between the cells
When alcohol enters the brain, it binds to GABA receptors and makes the inhibitory signal of GABA even stronger, making us more relaxed and sedated
It activates opioid receptors that induce the release of endorphins, which then bind to receptors and on dopamine neurons in the reward centers to trigger dopamine release and pleasure/reward
Alcohol also binds to the glutamate receptors to block glutamate from exciting the cell, resulting in functioning problems like slurred speech, coordination and reaction issues
The more alcohol you drink over time, your brain will need more and more alcohol for the same effects because it will kill the receptors
What are the consequences of alcohol concerning neurodegeneration? (4)
Reduction and mutations in the production of new neurons as alcohol exposure continues
Reduction in brain systems (which can be somewhat reversed with even a short time abstaining)
Changes in the volume of brain areas associated with executive functioning and decision-making
Deficits in decision-making impairs the inhibition of impulsive behavior, contributing to further drug seeking behavior
What are the consequences of alcohol concerning withdrawal? (4)
Withdrawal is painful and people can die from it
Symptoms can appear within days of stopping and the physical ones usually stop within the week but the psychological ones last way longer
Physiological symptoms include sweating, seizures, fever and tremors
Delirium tremens is an extreme form of withdrawal that often results in hospitalization due to confusion, hallucinations, disorientation, fever, tremors, death
What are the consequences of alcohol concerning death from acute alcohol intoxication? (4)
Younger and older people are at greater risk
Alcohol poisoning results from drinking more alcohol than our bodies can handle, shutting it down
It is metabolized by the liver at a rate of about 1 drink per hour and consuming more creates intoxication
Consuming more than the body can metabolize creates alcohol poisoning, passing out and other physiological harms
What are the consequences of alcohol concerning alcohol liver disease? (2)
Mortality related
Fatty liver, alcoholic hepatitis, and cirrhosis
What are the consequences of alcohol concerning Alcoholic Korsakoff syndrome? (5)
Chronic memory disorder
Severe thiamine deficiency in the brain due to alcohol consumption
Problems learning new information
Inability to remember recent events
Long term memory gaps
What is the Low-Risk Alcohol Drinking Guidelines?
Guidelines for how much one should consume, risk factors to look out for, and other AUD factors based on research
What is the origin of cocaine use? (4)
German chemist Albert Nieman was the first to isolate cocaine extracted from cocoa leaves in 1860 (even though indigenous people had been chewing on the leaves for centuries)
It became popular in the 1880s in the medical community as an anesthetic for cataract surgery
Freud was fascinated with and addicted to cocaine and promoted it in papers as a “magical substance”
Cocaine was readily available, non-regulated and accessible, even in Coca Cola (which was so popular only whites could drink it)
What is the American Crack Epidemic of the 1980s? (5)
Cocaine was no longer readily available and it was highly regulated
This resulted in crack cocaine, which is crystallized cocaine mixed with baking soda as a way of making more money by selling cocaine without using as much actual coke
When boiled, the vapor was pure cocaine that resulted in an intense but short-lived high
Increase of CC use in major cities across the US in the 80s and 90s, resulting in an increase in crime and violence
Lead to “tough on crime” policies and the “war on drugs” led by the Kennedys
What is the legal status of cocaine in Canada? (4)
Schedule I drug under the Canadian Controlled Drugs and Substances Act (CCDSA)
Possession can result in 7 years imprisonment
Trafficking and production can result in life imprisonment
DUI of cocaine is a criminal offense
What is the prevalence of cocaine consumption and addiction? (6)
3 substances used in the past year by Canadians
In 2015, 1.3% of Canadians had used in the past year
This is much lower internationally (0.4%)
More than 2% in US and Australia
Overall decline in past-year cocaine use in Canada, especially for youths
Use is most prevalent among high risk populations (homeless, street-involved youth, younger, trauma, mental health, other drug use)
What is the study on the risk and protective factors for drug use and abuse? (3)
A study found risk and protective factors in the context of addiction from an epidemiological perspective
Tracked youths over time to see what substances they were using, how much and how often to examine factors that may be associated with drug use over time
Found that scores for both risk and protective indexes correlated with the frequency and quantity of drug use (protective negatively correlated with use, risk negatively correlated with use)
What are protective factors according to the Protective Factor Index? (7)
High GPA
Low depression
Having supportive relationships at home
Perceiving many sanctions for drug use
High religiosity
High self-acceptance
High law abidance
What are risk factors according to the Risk Factor Index? (7)
Low educational aspirations
High perceived adult drug use
High perceived peer drug use
Many deviant behaviors
High perception of community support for drug use
Easy availability of drugs
Low perceived opportunity
What is the multiple risk and protective factors model demonstrate? (8)
Risk factors are additive and combine to create heightened risk but they also interact with protective factors
RFI and PFI interaction was not predictive of concurrent outcomes
It was predictive of hard drug frequency for everyone and cocaine/cigarette use for women
Found a buffering effect, where high risk and low protection was linked to high drug use and low risk and high protection was linked to low drug use
Predicted greater cocaine and cannabis use 4 years later and alcohol problems 8 years later
In youth, high risk factors were not mediated by protective factors
Cannot attribute addiction to one or even a few causes/factors since we are all so different
Drug use and addiction increase as numbers of vulnerability conditions to which a person is exposed and with which they must cope increase
What is the neurobiology of cocaine consumption and addiction? (3)
fMRI studies show that the longer one uses cocaine, the less dopamine D2 receptors there are
This may contribute to the loss of control and impulsivity in cocaine users
There is evidence that the effect can reverse slightly due to abstinence
How else does cocaine affect the brain? (2)
Cocaine enters the brain and block the uptake and recycling of dopamine by blocking the dopamine transporters at the synapse at the end of each cell
Means dopamine builds between the cells, giving you the high of release
What are the health consequences of cocaine? (6)
Cocaine intoxication can produce a wide variety of psychiatric symptoms that can persist for months, even for months following the termination of cocaine use
Delusions, paranoia, hallucinations, severe anxiety
Psychosis and psychotic disorders
Suicidality
Withdrawal (which has sleep impacts, psych effects, craving, cardiovascular problems)
Overdose (seizures, hypertension, shaking, rapid heartbeat, coma and death)
What is the history of tobacco use? (6)
James Bonsack invented the cigarette making machine in 1881, which could make 120,000 cigarettes a day
This industrialized smoking and made it easily accessible and mainstream, mostly for men
During and after WWII, women were entering the workforce which resulted in them taking up smoking
Ads for smoking were everywhere, like by Camel
Smoking wasn’t seen as dangerous because companies would hire actors to pose as doctors in ads and say they smoke them too and are doctor approved
When people started to realize the risk, companies then sold devices to moderate risk
What is the prevalence of tobacco smoking in Canada? (3)
In 2016, people who smoke the most are males in the 20-34 category (1 in 4 having smoked that year)
Known sex different across all age groups, with males more at risk
Negative relationship between smoking and household income (the more income you have, the less likely you are to smoke) which speaks to the socio-structural aspects of smoking addiction
What is the prevalence of tobacco smoking and other substance use in Canada for youth? (6)
See they are more vulnerable to risky behavior because their brains are still developing and they are more impulsive
Over a quarter were using tobacco in the past year
Tobacco is associated with more frequent use of alcohol, cannabis and other illicit drugs relative to non-smoking youth and adults regardless of smoking
This impact is seen the most by teens and youth (loses its effect after 20)
Cannot necessarily say tobacco is a gateway drug to other drug use and addiction but it is correlated and it is an indicator of other risky behaviors in youth
It is also self-report which could be a limitation due to bias
What is nicotine dependence? (5)
Nicotine dependence is the most common SUD and it is known at the chameleon drug
It acts as a sedative when the smoker is anxious and as a stimulant when they are fatigued
Reaches the brain within seconds
On average, a smoke takes about 200 puffs a day, which is a lot and very different from cocaine addicts who would die if they did that
Similar to slot machine playing, which is fast action anticipating a reward
How do you measure nicotine addiction? (3)
The Fagerstrom Test for Nicotine Dependence
Test asks 6 questions, it is highly reliable and valid for screening for nicotine dependence
Very short and can be administered quickly to a lot of people
What is the neurobiology of nicotine addiction? (2) non scientifically
Dopamine theory had been the prevailing narrative but recent evidence suggests a more nuanced understanding
In the nucleus accumbens, nicotine pushes the accelerator (dopamine) and disables the breaks (GABA) and this ratio increases the release of dopamine
What is nicotine’s double effect on DA release? (4)
Nicotine affects two neurons that modulate DA level in the nucleus accumbens
It stimulates the release of glutamate, which triggers additional dopamine
It blocks the release of GABA, which sustains DA level
It increases the ratio of glutamate to GABA in the ventral tegmental area (VTA), which amplifies the rewarding properties of nicotine
What are the health consequences of tobacco smoking? (5)
Impotence
Strokes
Cancer (lung especially deadly)
Environmental impacts
There are chemicals like PAINT, methanol and arsenic in there which can kill you
What is nicotine withdrawal? (3)
Characterized by fatigue, irritability, gastrointestinal upset and cravings
Acute withdrawal resolves in about 5 days but cravings can last months
Relapse rates are high and many people spend years and decades of their lives trying to overcome addiction
