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Interventions to Improve Mental Health and Wellbeing > Lecture 5 - Alcohol and Substance Use Disorders > Flashcards

Lecture 5 - Alcohol and Substance Use Disorders Flashcards

1
Q

What does it mean by Substance Use?

A

Not just illegal drugs
- Alcohol
- Misuse of prescribed meds (sedatives, diazepam, nitrazepam - used as downers to offset stimulants)
- Steroid misuse, solvents

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2
Q

What are some physical health effects of substance use?

A
  • Direct = liver, lung, cancer
    Breast cancer increased due to alcohol consumption
  • Indirect = injury, self neglect, harm from risky behaviours
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3
Q

What are other consequences of substance use?

A
  • Financial effects = drugs are expensive, also not turning up to work due to after effects means less money
  • Social and Interpersonal = conflict with others (family members), exclusion, stigma, homelessness
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4
Q

What are some impacts of substance use on mental health?

A
  • Transient psychosis - cannabis induced psychosis
  • Alcohol can cause psychotic symptoms, depression, anxiety (acts as a depressant)
  • Established mental health issues can get worse - poorer functioning, relapses, suicide
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5
Q

How many hospital admissions relating to drug related disorders were there in 2019/20

A

7,027 - primary diagnosis of drug-related mental health and behaviour disorders
(135 people per week)
21% higher than 2009/10

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6
Q

What are the statistics of the societal and economic burden of drug and alcohol abuse?

A

NHS costs and welfare costs
358,000 admissions to hospital in 2018/19 from drinking too much alcohol
(1,000 per day)
6% higher than 2017/18
19% higher than 2008/9

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7
Q

How common is Substance Use Disorder?

A
  • Varies due to setting and geographical locations e.g more in London compared to Rural areas
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8
Q

What percentage of 16-59 year olds had taken drugs at some point in their lifetime?

A
  • 35%
  • 9% had taken an illicit drug in the last year
  • 21% young adults (16-24) had taken an illicit drug in the last year
  • 4.3% classed as frequent drug users (monthly)
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9
Q

Is drug use rising?

A

Yes - it fell 1995-2013 but is now rising. Large increase of class A drugs in 16-24 year olds

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10
Q

What are the NHS states on alcohol use: How many men had drunk alcohol in the past week? (2020 study)

A

65%

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11
Q

What are the NHS stats on alcohol use: How many women had drunk alcohol in the past week? (2020 study)

A

50%

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12
Q

How many men aged 55-64 were drinking above safe limits? (14 units +)

A

38%

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13
Q

How many women aged 55-64 were drinking above safe limits? (14 units +)

A

19%

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14
Q

What areas are drug related hospital admissions more likely?

A

Deprived areas - 5 X more likely

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15
Q

Why is it hard to help someone with mental health problems who also have substance use disorders?

A

MH needs to be sorted before substance use can but MH services can’t help when someone is using drugs

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16
Q

What is Comorbidity?

A

When 2 disorders or illnesses occur simultaneously (substance use and MH problems)

17
Q

What is Dual Diagnosis?

A

Used to describe people with severe mental illness (psychosis) and problematic drug and alcohol use

18
Q

How much more likely are you to have a drug diagnosis if you have Schizophrenia?

A

6 X more likely

19
Q

How much more likely are you to have a drug diagnosis if you have Bipolar Disorder?

A

8.3 X more likely

20
Q

What percentage of people with psychosis use substances?

A

50%

21
Q

What percentage of people with psychosis smoke cigarettes?

A

85%

22
Q

What are the outcomes for substance users with psychosis?

A

More symptoms
More relapses
More hospitalisation
Poor functioning
Increased suicidality

23
Q

What is Psychosis?

A
  • Loss of contact with reality
  • False beliefs about what is taking place (delusions)
  • Seeing or hearing things that aren’t there (hallucinations)
  • Disorganised speech
  • Catatonic behaviour
  • Negative symptoms
  • Social and occupational dysfunction
  • Lasting 6 months
  • 2 symptoms = Schizophrenia diagnosis
24
Q

What are the proposed causes of comorbidity (SUD and Psychosis)

A
  • Substance use causes psychosis
  • Substance use as a consequence of psychosis - coping / self medicating / reducing symptoms
  • Common origin (genetic)
  • Bidirectional - psychosis and substance use interact and maintain each other
25
Q

What is the relationship between heroin and psychosis?

A

Heroin masks symptoms of psychosis
When withdrawing = become way more psychotic

26
Q

What drugs can induce psychosis?

A

Amphetamine, cocaine, cannabis

27
Q

What does THC (psychoactive ingredient of cannabis) produce?

A
  • Schizophrenia-like positive symptoms in healthy individuals
  • Transiently increases symptoms in people with Schizophrenia
  • People with Sz more vulnerable to the effects of THC
  • Develop or worsen psychotic symptoms 20 mins after taking cannabis
28
Q

What evidence suggests that substance use precedes psychotic symptoms? (longitudinal cohort studies)

A
  • Andreasson et al. 1987
  • 50+ cannabis users used before age of 18. 6 X greater likelihood of hospitalisation for SZ at age 33
  • Soldiers after army - those that used cannabis more than 50 times had 6 X greater likelihood of being hospitalised for Sz
29
Q

What has a birth cohort study found (1970s) about the link between psychosis and cannabis?

A
  • Users of cannabis before age 15 had more Sz symptoms at 26
  • Genetic predisposition moderated risk
  • People with psychosis report using substances to self medicate (reduce symptoms)
30
Q

What is evidence for genetic factors predisposing individuals to mental health and substance use? - Dunedin cohort study

A

Adults with COMT polymorphism (val allele) 10 X MORE LIKELY to have SZ disorder at age 26

31
Q

What is the DSM criteria for Substance Use Disorder?

A
  • Large amounts / long period
  • Persistent desire / unsuccessful efforts to cut down or control
  • Loads of time spent obtaining the substance, including using or recovering from use
  • Cravings and desires
  • Social / interpersonal problems but still continue using
  • Give up activities
  • Failure in job / work / school
  • Physical or psychological problems
  • Dangerous situations - driving while using
  • Increased tolerance / diminished effect
  • Withdrawal
32
Q

What is the minimum amount of criteria for SUD

A

2-3 (mild SUD)
4-5 (moderate SUD)
6-7 (severe SUD)

33
Q

What does the DSM focus on?

A

Impact rather than amount

Interventions to Improve Mental Health and Wellbeing (11 decks)

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