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3009PSY Abnormal > week 8 > Flashcards

week 8 Flashcards

1
Q

prevelance of any illicit drug use in past year-

A 
12-15 year olds: ~5-10%
16-17 yolds: ~20-25%
18-19 yolds: ~30-35%
20-29yolds: ~30-35%
30-39 yolds = ~20%
40+ = ~5-10%
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2
Q

Legal Status
psychoactive substances can be classified into how many groups?
what are the groups?

A

Medications

  • -Available via prescription only
  • –eg.Morphine

Illegal / Illicit Use

  • —Use and possession is unlawful for non-medical purposes
  • —-eg—-Heroin, cannabis, d-LSD25, amphetamine

Legal
Use for any purpose, including non-medical is lawful
egAlcohol, tobacco, caffeine

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3
Q

Harmful Effects of Substances

4 categories

A

Harmful effects can be grouped into four categories
Chronic Health Effects
Cirrhosis, Lung cancer

Acute / Short Term Biological Effects
Overdose, Impaired judgement

Acute Social Problems
Relationship breakup, arrest

Chronic Social Problems
Problems in work life, problems in family role

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4
Q

WHO Definitions

harmful use and hazardous use

A

Harmful Use
A pattern of psychoactive substance use that is causing damage (physical or psychological) to health.

Hazardous Use
A pattern of psychoactive substance use that increases risk of harmful consequences for the user.

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5
Q

WHO Definitions

Substance Abuse

A

Substance Abuse
Persistent or sporadic use inconsistent with or unrelated to current medical practice. A maladaptive pattern of substance use leading to clinically significant impairment or distress
—Failure to fulfill major role obligations
—Use in situations where it is physically hazardous
—Recurrent legal problems
—Continued use despite problematic consequences

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6
Q

Tolerance

A

Either…
A need for increased amounts of the substance to achieve intoxication or the desired effect; or
Markedly diminished effect with continued use of the same amount of the substance.

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7
Q

Withdrawal

A 
Either:
 The characteristic withdrawal syndrome for the substance; or
  The same (or closely related) substance is taken to relieve or avoid withdrawal symptoms.
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8
Q

Substance Dependence (DSM)

A

Three or more of the following in the same 12 month period

  • -Tolerance
  • -Withdrawal
  • -Substance taken in larger amounts, or for longer periods than intended
  • -Desire or unsuccessful efforts to cut down on use
  • -Excessive time spent in activities related to the substance
  • -Reduction in important social, occupational, etc. activities
  • -Continued use despite negative consequences of use.
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9
Q

Other Features

A

Narrowing of interest
Narrowing of social circle
Rapid reinstatement

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10
Q

Rapid Reinstatement

A

“An addict may be ten years off junk, but he can get a new habit in less than a week; whereas someone who has never been addicted would have to take two shots a day for two months to get any habit at all.”

William S. Burroughs, Junky

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11
Q

Psych Mechanisms:

Classical Conditioning

A

Associative learning between drug cues and drug use.
Automatic elicitation of urges to use through associated cues
>e.g., Increase in urges to drink alcohol when others are drinking
>e.g., Increase in urges to smoke when seeing a film with an actor smoking.

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12
Q

Operant Conditioning

A

Reinforcement of substance use
>Positive reinforcement of drug use through subjective positive effects (e.g., euphoria) – Speed of effect
>Negative reinforcement of drug use through removal of negative emotional states (e.g., reduction in anxiety).
>Punishment of refusal (e.g., through increased urges, frustration, anger, etc.).

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13
Q

Modelling

A

Modelling of drug use behaviour by significant others
>Observing positive effects in friends
>Children witnessing drug use behaviour in adults

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14
Q

Expectancies

A

Cognitions involving conditional statements regarding the effect of the substance
>If I have a cigarette, then I will feel more relaxed
>If I have a drink, then I will become more sociable
>If I have a pill, then I will have a better time.
>If I don’t smoke a joint, then my friends will think I am a nerd.
>If I don’t shoot up, then I am going to go into withdrawal and that will be unbearable.

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15
Q

Refusal Self-Efficacy

A

An individual’s beliefs about their ability to refuse a substance under different conditions.
>If I am at a pub then there is no way I can refuse a drink
>If I am really angry after a hard day at work then I cannot go without a stiff whiskey
>Even if my friends are passing a joint, I can still say no.

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16
Q

High Risk Situations

A

Situations in which the individual’s ability to abstain from substance use are reduced
>Driving past the pub
>Going out with certain friends
>Cooking using wine

Idiosyncratic to individuals

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17
Q

Seemingly Irrelevant Decisions

A

Decisions made without full conscious awareness that place the individual in high risk situations
»Having the choice to go to a number of parties, but choosing to attend one where other substance-users are present
»Having the choice to drive home via many different routes, but choosing to drive home past a bottle shop.

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18
Q

Abstinence Violation Effect

A

> > The tendency to continue substance use once abstinence has been violated
Cognitions that equate lapse with relapse

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19
Q

Major Classes of Substances

A

Stimulants

depressants

hallucinogens

opioids

20
Q

Alcohol

A

In Australia
>9% drink daily
>41% drink weekly
>34% drink less than weekly
These figures have been constant since 1991
>35% of adults drink to levels that increase risk of health problems
>In 2004-5FY the government made $5 billion in revenue from sale of alcohol

21
Q

Costs of Alcohol Use in Australia

A

($AUD millions)

road accidents : 1875.5 
Crime: 1,235.3
Health: 225
lost production in the workplace: 1949.9
lost production in the home: 402.6
22
Q

Severe Alcohol Withdrawal

A 
Delirium Tremens (“DTs”)
Commencing a few hours after cessation
Peaking 48-72 hours later
Life-threatening in up to 35% of cases
Symptoms
Seizure
Confusion
Hallucinations
Severe agitation
23
Q

Alcohol Safe-Use Guidelines

A

Men
≤ 4 standard drinks per day; and
≤ 6 standard drinks in any one day; and
1 or 2 alcohol free days per week

Women
≤ 2 standard drinks per day; and
≤ 4 standard drinks in any one day; and
1 or 2 alcohol free days per week

24
Q

weed

A 
In Australia...
Cannabis is the most
	commonly used illicit drug.
34% of adults have tried cannabis.
Cannabis accounts for 71% of illicit drug arrests
25
Q

Cannabis Effects

A 
Sense of well-being and relaxation
Intensification of sensory experience
Increased heart rate and blood pressure
Dry mouth
Increased appetite
Sedation
Bronchodilation
Anxiety
Paranoia
Changes in subjective time
Memory effects
26
Q

Heroin - overdose rates

A

In Australia…
46% of IV drug users have
overdosed at some time.

27
Q

Opiate Effects

A 
Intense euphoria
Analgesia
Sedation
Sluggish movement and reflexes
Pupil constriction
Slowed respiration
28
Q

Amphetamine

A

In Australia…
9% of those over 14 have
tried amphetamine
3% of those over 14 have used amphetamine in the last year

29
Q

Stimulant Effects

A 
Euphoria, well-being
Confidence
Increased activity
Talkativeness
Improved attention
Alertness, wakefulness
Increased heart rate, respiration rate
Increased body temperature (‘hyperthermia’)
Appetite suppression
30
Q

Effects of Large Doses

A 
Unlike other substances (e.g., cannabis), sufficiently large doses of amphetamine will produce psychotic symptoms in all users
Paranoid delusions
Agitation
Confusion
Compulsive symptoms, stereotypies
31
Q

CocaineCoke, Charlie, Crack, White, Blow

A

In Australia…
Less widely used than in USA
Increased availability since 1990s

32
Q

Stimulant Effects

A 
Euphoria, well-being
Confidence
Increased activity
Talkativeness
Improved attention
Alertnesss, wakefulness
Increased heart rate, respiration rate
Increased body temperature (‘hyperpyrexia’)
Appetite suppression
Local anaesthesia
33
Q

MDMAEcstacy, E, Pills

A 
In Australia...
MDMA use has steadily 
		increased
7.5% have tried MDMA (2004)
3.4% have used MDMA in the last month
The mean age of first use of MDMA is 22.8 years
34
Q

Ecstasy Use in Past Year by age group

2007 data

A 
12-15     ~0-2%
16-17      ~2-4%
18-19      ~8.5% (6-12%)
20-29    ~12% (11-14%)
30-39%  ~4%
40+ ~ 0-1%
35
Q

overall percent using in past year (ecstasy)

A 
1991 - 1
93 - 1.5
95 - 1
98 - 2.5
2001 - 3
2004 - 3.5
36
Q

MDMA Effects

A 
Euphoria
Enhanced empathy
Enhanced interoceptive perception
Pupil dilation
Reduced appetite
Dry mouth
Tachycardia
Hyperthermia
Polydipsia
37
Q

mdma midweek blues

A

come down

saturday - take pills - wednesday = highest depression scores

38
Q

Lysergic AcidLSD, Acid, Trips

A

In Australia…
Low prevalence compared
with other drugs
Low abuse and dependence rates

39
Q

Hallucinogen Effects

A 
Visual hallucinations
--Geometric shapes, patterns, movement, traces
Increased intensity of stimuli
---Enhancement of colour
Synaesthesia
Depersonalization and derealisation
Appetite suppression
Euphoria
Subjective insightfulness
Paranoia
Anxiety, panic (‘bad trip’)
40
Q

Elephants on Acid

A

West, Pierce & Thomas (1962)
LSD administration to Tusky the Elephant
297mg (approx 3000x normal human dose)

“Tusky reacted as if he had been shot by a gun. He trumpeted around his pen for a few minutes and then keeled over.”

41
Q

Hallucinatory Movement

A

Optical Illusions that simulate typical illusory movements

42
Q

Treatment of Substance Problems

Harm Minimization

A

Based upon recognition of substance use as a pervasive behaviour observed in all societies throughout history

Rather than aiming for abstinence, focus is on attempting to reduce risk of harm through continued use.
—Shooting galleries, needle exchanges, legalisation of substances

Controversy, ignorance and denial

43
Q

Transtheoretical Model

A 
precontemplation
contemplation
preparation
action
maintenance

going back up the path = relapse, down -= progress

44
Q

Motivational Interviewing

A

Aims to assist a person in moving towards action and abstinence

  • Examination of advantages and disadvantages of continued use versus change in behaviour
  • Examination of likely long-term trajectory of current use patterns
  • Examination of compatibility of current use pattern with long-term goals
  • Attempts to reach a commitment for change
45
Q

Aversive Conditioning

A

Application of aversive consequences for substance use behaviours
Disulfiram (“Antabuse”)
—Produces unpleasant reaction when alcohol is consumed
—Inhibits metabolism of acetaldehyde
—-Flushing, nausea, headache
—–“Instant hangover”
Problems
Poor generalization
Planned drinking after non-adherence to disulfiram

46
Q

Stimulus Control

A

Reduction or elimination of stimuli associated with substance use
Avoiding pubs
Ensuring that alcohol is absent from the home
Reducing contact with other users

47
Q

Cue Exposure

A 
Following period of stimulus avoidance
Graduated exposure to cues that are associated with substance use
--Extinction processes
---Increases in refusal self-efficacy
----Rehearsal of refusal behaviours.

3009PSY Abnormal (11 decks)

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