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Clinical Psychology > W7: Substance Related & Addictive Disorders > Flashcards

W7: Substance Related & Addictive Disorders Flashcards

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1
Q

What is a psychoactive substance

A

Any chemical compound which passes through the blood brain barrier and alters mood and/or behaviour

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2
Q

What is substance use

A

The ingestion whether that be inhalation, Injection, transdermal of a substance

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3
Q

What is intoxication

A

The physiological response to the substance

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4
Q

What is tolerance

A

Needing a larger dose for the same effect 

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5
Q

What is withdrawal

A

A strong, negative physiological and often psychological reaction which occurs when a psychoactive substance is removed

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6
Q

The DSM four had two categories of substance use disorders what were these

A

Substance abuse and substance dependence

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7
Q

The DSM-V now only has one category of substance disorders what is it

A

Substance use disorder that is characterised by specific substances



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8
Q

What is the DSM criteria for substance use disorder

A

 problematic pattern of use that in pairs functioning with two or more of the following within 12 months:
– Substance taken in larger amounts or for a longer period than planned
– Persistent desire and/or failed attempts to reduce or control use
-A large amount of time is spent either trying to attain the substance or recover from its use
– Cravings
– Use is resulting in inability to fulfil obligations at work or at home
– Continued use despite ongoing exacerbation of psychosocial problems
– Social hobbies or work activities are given up or reduced
– Recurrent use in situations which maybe dangerous such as driving under the influence
– Continue used despite knowing the problems are caused by the substance
– Tolerance
– Withdrawal



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9
Q

What are the Drug types specified in the DSM under substance use disorder(9)

A 
Alcohol 
Sedative 
Stimulant 
Tabacco 
Caffeine 
Opioid 
Cannabis 
Other hallucinogens 
Inhalant
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10
Q

How many symptoms for a mild substance use disorder?

A

2-3

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11
Q

How many symptoms for a moderate substance use disorder?

A

4-5

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12
Q

How many symptoms for a severe substance use disorder?

A

6+

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13
Q

What are the four broad drug categories

A

Depressants that decrease physiological arousal such as alcohol

Stimulates that increase physiological arousal such as cocaine and nicotine

Opiates for pain relief such as morphine and heroin

Hallucinogens and psychedelics that alter sensation and perception such as cannabis and LSD

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14
Q

How much do Australians spend on illicit drugs

A

$7 billion p.a

This is more than five times that on licit substances

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15
Q

Illicit does not equal

A

It doesn’t equal more addictive or more deadly

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16
Q

Explain alcohol use disorder

A

It is diagnosed if physiologically dependent on alcohol or a heavy user

Delerium tremens can occur when blood alcohol levels drop suddenly and result in deliriousness tremulousness and hallucinations that are primarily visual but they may be tactile 

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17
Q

What is polydrug abuse

A

Many users abuse multiple substances for example 85% of alcohol abuser are smokers

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18
Q

What is the prevalence of alcohol abuse

A

8.6%

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19
Q

What is binge drinking

A

Having five standard drinks in a short period (1hr)



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20
Q

Who is binge drinking most prevalent amongst

A

College and university students at 43.5%

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21
Q

What is heavy use drinking

A

Five drinks five or more times in a 30 day period

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22
Q

Which areas is alcohol dependence higher

A

In rural areas

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23
Q

What percentage of those with alcohol use disorder also have at least one mental disorder

A

21.3%

This could be self-medicating or it could be contributing to it

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24
Q

What are the short term effects of alcohol in terms of neurotransmitters

A

It stimulates GABA receptors that are the key inhibitory neurotransmitter – reduces tension

Increases dopamine and serotonin to produce pleasurable effects

Inhibits glutamate receptors – glutamate is a key neurotransmitter in a range of functions notably memory and learning so it produces cognitive difficulties this is one memory can become impaired

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25
What are the short term effects of ingesting large amounts of alcohol
Significant motor impairment Poor decision-making Poor awareness of errors made
26
What are the long-term effects of alcohol
Malnutrition – Calories from alcohol lack nutrients and alcohol interferes with digestion and absorption of vitamins from food E.g. deficiency of the complex vitamins cause amnesic syndrome such as Korsakoff syndrome Cirrhosis of the liver – Liver cells in engorged with fat and protein impeding functioning the cells dies triggering scar tissue which obstructs bloodflow Damage to endocrine glands and pancreas Heart failure Hypertension Stroke Capillary haemorrhages Destruction of brain cells especially in areas important to memory
27
What is fetal alcohol syndrome
Causes physiological cognitive and behavioural changes during gestation we could have lifelong impacts
28
What is marijuana
It is classed as a hallucinogen It is derived from dried and ground leaves and stems of the female hemp plant The most frequently used illicit drug in Australia – Greater use by men than women
29
What is hashish
It is stronger than marijuana and is produced by drying the resin of the tops of plants and buds
30
There is evidence for a range of benefits of marijuana what are they
Relieving discomfort of chronic pain Reducing frequency of epileptic seizures Reduces nausea and loss of appetite caused by chemotherapy
31
What is the major psycho active ingredient in marijuana
THC (delta-9-tetrahydrocannabinol)
32
What are the psychological effects of marijuana
Relaxation and sociability Rapid shifts of emotion Interferes with attention, memory and thinking with a decline in IQ over time Heavy doses can induce hallucinations and panic Interferes with cognitive functioning impaired memory and complex motor skills
33
Why is it difficult to regulate the dosage of marijuana
The effects take 30 minutes to appear so you may smoke more than intended waiting for the effects
34
Where are the cannabinoid receptors in the brain
CB1 and CB2 | High concentration in the hippocampus
35
There is evidence that cannabis increases the risk of what
Psychosis for people with a genetic predisposition for psychosis
36
What is synthetic cannabis
It is the same chemical compound but a synthetic reproduction It is early days but evidence of more severe side-effects compare to cannabis and more frequent admission to A&E for drug related events Increased risk of stroke and heart failure
37
What are opiates
They are a group of addictive sedatives that in moderate doses relieve pain and induced sleep such as opium, morphine, heroin, codeine Can be legally prescribe this pain medications in hydrocodone and oxycodone
38
How many Australians use heroin in a 12 month period
.1%
39
What is the big concern with opiate use
Important to recognise the miss use stemming from legal prescriptions for example oxycodone prescriptions dropped 1800% between 1996 and 2000 
40
What are the psychological and physical effects of opiates
Produces euphoria, drowsiness, and a lack of coordination Loss of inhibition and increase of confidence however there is a severe let down after about 4 to 6 hours Heroine and OxyContin produces a rush of intense feelings of warmth and ecstasy following injection They stimulate receptors of the bodies opioid system the nucleus accumbens which is important in reward Tolerance develops and withdrawal occurs Muscle soreness and twitching tearfulness and yawning becomes more severe and may also include cramps choose sweating increase in heart rate and blood pressure insomnia and vomiting withdrawal last for about 72 hours
41
29 year follow-up of 500 heroin addicts found
28% were dead before the age of 40 Half by suicide homicide or accident And 1/3 by overdose
42
Explain the exposure to infectious disease via shared needles
Exposure to things such as HIV Evidence suggests that free needles reduce infectious diseases associated with intravenous drug use
43
What is methamphetamine
Classed as a stimulus – increases alertness and motor activity and reduces fatigue Produces high levels of energy and sleeplessness, reduced appetite, increased heart rate
44
Explain the effect on neurotransmitters methamphetamine has
It triggers a release of an block of re-uptake of norepinephrine and dopamine
45
What can high doses of methamphetamine lead to
Nervousness, agitation, irritability, confusion, paranoia and hostility
46
After how many days of use do you see tolerance develop for methamphetamine
Only six days use
47
How does chronic use of methamphetamine damage the brain
It impacts dopamine and serotonin systems with a reduction in hippocampus volume 
48
What is ecstasy
Sometimes classed as a hallucinogens that is a type of amphetamine Induces a sense of well-being, feeling close to others, increased tactile sensation.   Often experience depression in the following days
49
What Neurotransmitters does ecstasy act on
Serotonin Dopamine Norepinephrine 
50
What does cocaine do
It blocks the re-uptake of dopamine in the mesolimbic areas of the brain
51
What is involved in an overdose of cocaine
Chills, nausea, insomnia, paranoia, hallucinations, possibly heart attack and death
52
What is phencyclidine (PCP)?
 initially used as an anaesthetic but stopped in 1965 due to negative after effects which were mainly severe hallucinations Was considered a relatively popular recreational drug but has been steadily declining Causes severe paranoia, violence, selfharm and depersonalisation 
53
What is ketamine
Used in surgical and veterinary procedures - anaesthetic and analgesic properties But is also used as a party drug and sometimes sold as ecstasy It does have the potential for dependency
54
What are ketamine and PCP
Dissociative anaesthetics
55
What do dissociative anaesthetics do
They block the action of NMDA receptors and increase the availability of serotonin dopamine and norepinephrine by reducing re-uptake
56
What is LSD
It is a hallucinogen with effects such as colourful visual hallucinations and psychedelic trips which are an expansion of consciousness
57
what is psilocybin
Extracted from mushrooms and is a hallucinogen
58
There is emerging evidence for the use of illicit drugs for psychological disorders. Give some examples
Ketamine - depression Ecstasy- PTSD, anxiety Cannabis - complex pain Psilocybin - anxiety
59
Explain genetics in alcohol use
Relatives and children of problem drinks have higher than expected rates of alcohol abuse or dependence Ability to tolerate large quantities of alcohol maybe inherited – people from Asian countries have low rates of alcohol use
60
There is some evidence that people dependent on drugs or alcohol have a deficiency in
Dopamine D2 receptor
61
What do all drugs stimulate in the brain
The dopamine mesolimbic pathway - produces rewarding or pleasurable feelings
62
Depressants target what area in the brain
The ventral tegmental area
63
Stimulants target what area in the brain
The nucleus accumbens
64
What role does availability play in substance use disorders
Usage is higher when alcohol and drugs are easily available Drug use among youths who had been approached by drug dealers for 35% compare to just under 7% of you two had not been approach there is a role in opportunity
65
What family factors increase substance use disorders
Parental alcohol use (modelling) Marital discord, psychiatric or legal problems in the family linked to substance abuse Lack of emotional support from parents increases the use of cigarettes, marijuana and alcohol as a coping mechanism Lack of parental monitoring
66
How might your social network increase substance related disorders
There is evidence for having peers who drink influencing drinking behaviours but individuals also choose friends with drinking patterns similar to our own so it is probably a bit of both of social influence and social selection
67
How does advertising or media influence Substance related disorders
Countries that ban ads have 16% less consumption than those that don’t
68
What is agonist treatment of Substance related disorders
Replacing the harmful drug with a safe one – for example, heroin substitutes such as synthetic narcotics are used to wean heroin users from dependence
69
What are antagonist treatment of substance related disorders
Using medication that will block the effects of the drug For example in opiates there’s naltrexone that prevents you from feeling high so if you don’t experience the positive feelings you are less inclined to use the drug
70
What is aversive treatment of substance use disorders
Aversive treatment runs along classical conditioning For example with alcohol there is a medication that you can give people (Antabuse, disulfiram) that produces nausea and vomiting if alcohol is consumed this is most effective when combined with CBT to break a cycle of beliefs
71
Explain in patient hospital treatment
It is a form of detoxification Withdrawal from the alcohol or other under medical supervision This may be necessary for those without social support or with other serious psychological problems
72
What is alcoholics Anonymous
It is the largest self-help group for problem drinkers consisting of regular meetings to provide support, understanding and acceptance They promote complete abstinence Although some studies have shown participation predicts better outcome recent studies suggest it is no more affective than other forms of therapy
73
What are motivational interventions
There is an emphasis on empathy and understanding in the client council relationship and it focuses on the positive outcomes associated with cessation
74
What is contingency management therapy
Patient and family reinforced behaviours inconsistent with drinking for example avoiding places associated with drinking They teach the problem drinker how to deal with uncomfortable situations such as refusing the offer of a drink And give vouchers that can be traded for desirable goods are given to use him staying this is a form of positive reinforcement for the desired behaviour  
75
What a self-help residential homes
They are a non-drug environment that May be inclusive of group therapy and guidance or support from former users 
76
What elements can be used to prevent substance use disorders
``` Enhancing self-esteem Social skills training Peer pressure resistance training Parental involvement in school programs Warning labels on alcohol bottles Education regarding alcohol impairment Testing for drugs and alcohol at school or work Correction of beliefs and expectations Peer leadership ``` Not always done particularly well and not always a lot of success in this

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