Substance Use Disorders

Question 1

addiction

Answer 1

A cluster of cognitive, behavioral, and physiological signs that indicate compulsive use of a substance and inability to control intake despite negative consequences (eg., medical illness, failure in life roles, interpersonal difficulties)

Question 2

dependence

Answer 2

Upon cession of drug, an individual experiences pathological signs and symptoms (eg., tolerance and withdrawal)

Question 3

tolerance

Answer 3

Requiring a markedly increased dose of the substance to achieve the desired effect, or a markedly reduced effect when the usual dose is consumed

Question 4

withdrawal

Answer 4

A shrug specific syndrome that occurs when blood or tissue concentrations of a substance decline in someone who had maintained prolonged heavy use

Question 5

most addictive drug?

Answer 5

Nicotine
Heroin is the next one

Question 6

most used illicit drug?

Answer 6

marijuana

Question 7

epidemiology

Answer 7

21 million people 12 years and over age in need of SUDS treatment (1 in 13, or 7% of US)

Greater use in adolescence translates into greater use as an adult (the earlier you start, the more likely it is to persist into later life)
- More use from multiracial, lgbtq+, transgender
- More use from small/large metropolitan areas

Question 8

risk factors (family and peers)

Answer 8

• Chaotic home environment especially parent substance use and mental illness
• Lack of parental monitoring
• Use by siblings
• Peer substance use
• Affiliation with deviant peer group

Question 9

risk factors (environmental/cultural)

Answer 9

• Perceptions of approval of drug using behaviors in school, peer, and community environments
• Drug availability
• Trafficking patterns
• Urban settings
• Homelessness
• Low socioeconomic status - poverty

Question 10

risk factors (life events)

Answer 10

• School/academic failure
• Poor social coping skills
• Verbal, physical, or emotional abuse or neglect
• Early first use under 15
• Chronic pain or disability

Question 11

besides nicotine, what is the most used drug

Answer 11

What is mostly available is mostly abused

Question 12

influence of early drug/alcohol use

Answer 12

Used as kids, will use in teen years, etc
- early onset
- starting earlier is worse

Question 13

the “gateway” concept

Answer 13

–> Most people try alcohol and tobacco before they try marijuana
–> But most people who use marijuana don’t regularly use other drugs

MEANING:
- Softer drugs, not lead to harder drugs

Question 14

protective factors

Answer 14

• Strong bonds with family
• Parental monitoring
• Success in school performance
• Strong bonds with pro-social
• Exposure to use prevention programs

Question 15

role of education in drug abuse/addiction

Answer 15

–> Illicit drug use is lower for college graduates (5.1%) than those who did not graduate from high school (9.3%), high school graduates (8.6%) nd those with some college (8.9%)
–> By contrast, college graduates are more likely to try illicit drugs in their lifetime than adults who have not completed high school (52% vs 36%)

MEANING:
If you are more educated, you are less likely to use alcohol and drugs

Question 16

dopamine theory of addiction

Answer 16

D1 and D2 receptors

D1:
- turns on neurons and gives a “feel good” signal, teaching us about positive outcomes
- Pay attention; this thing really matters

D2:
- turns off neurons and gives us a “feel bad” signal, teaching us about negative outcomes
- Pay attention; stay away from this thing

MEANING:
People who habitually use drugs have lower levels of dopamine D2 receptors
- Indicates they get less of a feel bad message from the drug

Question 17

negative health effects of alcohol

Answer 17

Dehydration
Addiction
Accidents and injury
Depression and psychosis
Ulcers
Cancer of mouth/throat/stomach
Cirrhosis
Brain damage
Pancreatic damage
Decreased fertility
Fetal alcohol syndrome
High blood pressure
Increase risk of breast cancer

Question 18

warning signs of drug and alcohol abuse

Answer 18

CHANGES IN:
- school performance
- peer group
- activity level
- physical appearance
- eating habits
- sleeping habits

Question 19

SUDS and mental health

Answer 19

substance use and mental health

Comorbid → call them co-occurring

Dual diagnoses
- Mental diagnosis and you have a substance abuse or addictive disorder diagnosis

Risk factors for the others

Mental illness will precede use of drugs

Question 20

CRAFFT screening tool

Answer 20

public domain; administered verbally during routine visit

→ C: Have you ever gotten into a CAR driven by someone (including yourself) who was “high” or using EtOH or drugs?

→ R: Do you use EtOH or drugs to RELAX?

→ A: Do you ever use EtOH or drugs while you are by yourself, ALONE?

→ F: Has any FRIEND, FAMILY member, or other person ever thought you had a problem with EtOH or drugs?

→ F: Do you ever FORGET (or regret) things you did while using?

→ T: Have you ever gotten into TROUBLE while using EtOH or drugs, or done something you wouldn’t normally do?

Question 21

results of CRAFFT screening tool

Answer 21

If two or more of those factors are registered for positive = high substance use