ETOH1- 17A Flashcards
What are the exceptions to the substance-related and Addictive Disorders
- caffeine: no use disorder
- hallucinogens: no withdrawal disorders
- inhalants: no withdrawal disorder
- tobacco: no intoxication disorder
How to make diagnosis of SUD
- requires 2 criteria
- happening within a 12 month periods
Categories of the SUD criteria
- impaired control (includes craving)
- social impairment
- risky use
- neuroadaptive/physiologic
What are the severity specifiers for SUD
- mild: 2-3 symptoms
- moderate: 4-5 symptoms
- severe: 6 or more symptoms
What are the 5 C’s of addiction?
- craving
- compulsion
- loss of control
- continued use despite adverse consequences
- chronic maladaptive behaviors associated with use
What is the single non-substance related disorder listed in DSM 5?
-Gambling Disorder
Criteria for diagnosis of Gambling Disorder
-at least 4 criteria in a 12-month period
-increasing amounts of money
-irritable when cutting down
-preoccupied with gambling
-feeling distressed while gambling
-chasing losses
-lies to conceal
-significant loss
-relies on others to relieve desperate financial situations
Not better explained by manic episode
Severity specifiers for Gambling Disorder
- mild: 4-5 criteria
- moderate: 6-7 criteria
- severe: 8-9 criteria
Reward pathway for addictive drugs
VTA ———-> Nucleus Accumbens
Drug activation of the reward pathway
- opioids activate the VTA which then activates the Nuc. Acc
- Opioids, cocaine, nicotine active the Nuc. Acc. directly
- Alcohol activates the frontal cortex, which activates the Nuc. Acc.
2 behaviors that support addictions
- compulsion
- perseveration
How is dopamine connected to the development of tolerance?
-baseline levels of DA in the addicted brain are very low, due to rebalancing by the brain due to extreme DA highs of substances
Psychiatric co-morbidities with SUD
- conduct disorder
- ASPD
- Bipolar I disorder
- Schizophrenia
