Addictive Disorders Flashcards
(25 cards)
What is included in the addictive disorders section of the DSM5
- Substance-related disorders: 10 classes of drugs that activate the brain reward systems so much so that normal activities may be neglected.
- Gambling disorder: Evidence suggests it also activates reward systems similarly to drugs and result in similar behavioural symptoms
What is a substance use disorder?
Treatable mental disorder where person has inability to control their use of substances
Mild to severe, dependence is severe
Likely comorbidity in either direction
What is substance use disorder comorbidity associated with?
- Worse prognosis
- Higher utilisation of services
- Greater stigma
- Higher illness burden
What are the most common MHDs with an SUD?
Personality disorders, bipolar, schizophrenia
What are the two categories of substance-related disorders?
Substance-induced and substance-use
Substance-use Disorder Diagnostic Criteria
(A): Impaired control over substance use
1. Larger amounts or over longer period than originally intended
2. Desire to cut down or regulate
3. Great effort/time to obtain the substance, lots of time using and recovering from the effects
4. Craving
(B): Social impairment
5. Failure to fulfil major role obligations
6. Social or interpersonal issues as a result of substance use
7. Activities reduced or given up on because of substance use
(C): Risky use
8. Use in situations that are hazardous
9. Continued use despite unwanted physical/psychological side-effects
(D): Pharmalogical criteria of dependence
10. Tolerance - markedly increased dose required for the desired effect
11. Withdrawal symptoms
Severities and Specifiers of Substance use disorder
- Mild is 2-3 symptoms
- Moderate is 4-5
- Severe is 6+
Course Specifiers: - In early remission
- In sustained remission
- In a controlled environment
Alcohol Use Disorder Criteria
Problematic pattern of alcohol use leading to distress manifested by at least 2 of the following within 12 months:
- Alcohol taken in larger amounts over over longer period than intended
- Desire to cut down
- Great deal of time obtaining, using and recovering from alcohol
- Cravings
- Failure to fulfill major role obligations due to alcohol use
- Alcohol use causes social or interpersonal issues
- Activites reduced or given up on because of alcohol
- Use in physically hazardous situations
- Use despite knowledge of unwanted physical or psychological effects
- Tolerance
- Withdrawal
Specify Severity and Remission
What are the three categories of substance induced disorders?
Intoxication, withdrawal, other
Substance-induced disorder (intoxication) criteria
- Reversible substance-specific syndrome due to recent ingestion
- Clinically significant problematic behavioural/psychological changes associated with intoxication (belligerence, mood lability, impaired judgement) attributable to using the substance
- Not attributable to smth else
Alcohol Intoxication Criteria
(A): Recent ingestion
(B): Problematic behavioural or psychological changes
(C): 1+ of the following:
1. Slurred Speech
2. Incoordination
3. Unsteady Gait
4. Nystagmus (uncontrolled eye movements)
5. Impaired attention/memory
6. Stupor/coma
(D): Not attributable to smth else
Alcohol withdrawal criteria
(A): Cessation/reduction in alcohol use that is heavy and prolonged
(B): 2+ of the following
1. Autonomic hyperactivity
2. Hand tremor
3. Insomnia
4. Nausea/vomiting
5. Hallucinations
6. Psychomotor agitation
7. Anxiety
8. Generalised tonic-clonic seizures
(C): B causes distress
(D): Not attributable to smth else
Specify perceptual disturbances where hallucinations (usually visual or tactile) cause reality testing or occur with absence of a delirium
Caffeine Withdrawal Fun Fact
THIS SHITS IN evERyOEN
What do all substance-induced disorders have in common?
- REPRESENT a relevant mental disorder
- WITHIN 1 month of ingestion
- Substance is CAPABLE of causing mental disorder
- NOT better explained by an independent mental disorder
- Not exclusively during the course of a DELIRIUM
- causes DISTRESS
RWCNDD
What are the substance-induced mental disorders?
- Substance Intoxication Delirium
- Substance Withdrawal Delirium
- S-I Persisting Dementia
- S-I Persisting Amnestic Disorder
- S-I Psychotic Disorder
- S-I Mood Disorder
- S-I Anxiety Disorder
- S-I Sexual Dysfunction
- S-I Sleep Disorder
SUD Epidemiology
18-25, Males, Urban, Regional differences
“Moral” Models of Drug Use
“Addictive Personality”
- Sensation seeking
- Impulsivity
- Consideration of Future Consequences
- Harm Avoidance/Reward Dependence
“Disease” Models of Drug Use
Addiction is caused by some pathology and causes further problems
What are some other aetiologies of drug use?
Education, social learning, operant conditioning, classical conditioning, biological, biopsychosocial
Public Health Model of Drug Use
Drug, Individual, Environment all contribute to drug use experience
SUD Treatment
- Prohibition is not it
- AA meetings
- Behavioural therapy
- CBT
- Harm Reduction
- Motivational enhancement therapy
Stages of SUD Change
- Nothing
- Think about change a lil
- Intent to change
- Motivated to change and efforts
- Successfully maintaining change
- Relapse to 2 or lasting change
Gambling Disorder Criteria
4+ of
1. Increasing amount of money for desired excitement
2. Withdrawal
3. Repeated unsuccessful efforts to stop
4. Frequent thoughts about gambling
5. Gambling as a coping mechanism
6. Chasing losses
7. Lying to conceal gambling
8. Jeopardizing relationship/job/career
9. Relying on others to help with money problems
Gambling epidemiology
- Males
- 18-35
- Aboriginal
- Lower socioeconomic groups
- Poor relationships
