chapter 10 Flashcards
(42 cards)
1
Q
Drug
A
Any substance other than food affecting our bodies or minds, including alcohol, tobacco, and caffeine
2
Q
Substance intoxication
A
Cluster of changes in behavior, emotion, or thought caused by substances (DSM-5)
3
Q
Substance use disorders
A
Maladaptive behavior patterns and reactions caused by repeated substance use
4
Q
Substance Use and Addictive Disorders checklist
A
• Individual displays a maladaptive pattern of substance use
leading to significant impairment or distress
• Presence of at least 2 of the following symptoms within a 1- year period
• Substance is often taken in larger amounts or over a longer period than intended
• Unsuccessful efforts or persistent desire to reduce or control substance use
• Much time spent trying to obtain, use, or recover from the effects of substance use
• Failure to fulfill major role obligations at work, school, or home as a result of repeated substance use
• Continued use of substance despite persistent social or interpersonal problems caused by it
• Cessation or reduction of important social, occupational, or recreational activities because of substance use
• Continuing to use substance in situations in which use poses physical risks
• Continuing to use substance despite awareness that it is causing or worsening a physical or psychological problem
• Craving for substance
• Toleranceeffects
• Withdrawal reactions
5
Q
Tolerance
A
Need for increasing doses of substances to produce desired effect
6
Q
Withdrawal
A
Unpleasant and sometimes dangerous symptoms occurring with drug stopping or cutting back
7
Q
Depressants-functions and mostly widely used depressants
A
- Slow the activity of the central nervous system (CNS)
- Reduce tension and inhibitions
- May interfere with judgment, motor activity, and concentration
- Most widely used depressants • Alcohol
- Sedative-hypnotic drugs • Opioids
-increase GABA
8
Q
• Alcohol (depressants) effect determined by level of impairment tied to effects subside after \_\_\_\_\_activy of GABA Gender affects
A
- Extent of the effect of ethyl alcohol is determined by its concentration (proportion) in the blood; intoxication = 0.09 percent
- Level of impairment is closely tied to the concentration of ethyl alcohol in the blood
- Effects of alcohol subside only after alcohol is metabolized by the liver
- Alcohol increases the activity of the neurotransmitter GABA at key sites in the brain
- Gender affects blood alcohol concentration
9
Q
• What are the personal and social impacts of alcoholism?
plays a role in
Korsakoff’s
A
- Alcoholism destroys families, social relationships, and careers
- Plays a role in suicides, homicides, assaults, rapes, and accidents
- Long-term excessive drinking can seriously damage physical health and cause major nutritional problems (Korsakoff’s syndrome)
- The 30 million children of alcoholics are likely to experience a wide range of social and psychological struggles, including risk from fetal alcohol syndrome (FAS)-born with abnormalities and miscarriage
10
Q
• Sedative-hypnotic (anxiolytic) drugs (depressants)
_____GABA
A
- Produce feelings of relaxation and drowsiness
- Low doses = calming or sedative effect
- High doses = sleep inducers or hypnotics
- Barbiturates
- Widely prescribed for the first half of the twentieth century
- Benzodiazepines
- Safer and less likely to lead to intoxication, tolerance effects, and withdrawal reactions
- Increase GABA activity
11
Q
• Opioids (depressants) different types collectively known as each drug has diff how are they used? cause CNS\_\_\_\_\_\_ drugs attach to
A
• Include natural (opium, heroin, morphine, codeine) and
synthetic (methadone) compounds • Known collectively as “narcotics”
• By1917, opium-derived drugs were deemed addictive and illegal
• Each drug has a different strength, speed of action, and tolerance level
• Most are smoked, inhaled, snorted, injected (skin-pop or mainline), or swallowed
• Cause CNS depression; drugs attach to endorphin-related brain receptors
12
Q
Opioid use disorder: an example • Heroin
A
- After just a few weeks, users may become caught in a pattern of abuse (and often dependence)
- Tolerance for the drug quickly builds and withdrawal occurs when drug ingestion stops
- Early withdrawal symptoms include anxiety and restlessness; later symptoms include twitching, aches, fever, vomiting, diarrhea, and weight loss from dehydration
- Increased doses are required to avoid withdrawal
pattern of abuse-dependence->tolerance->withdrawal- anxiety vominting weight losss->increased doses to avoid withdrawal
13
Q
• Opioid use disorder
A
- Affects 2.6 million people in the United States within a given year
- 80 percent are addicted to pain relievers; 20 percent are addicted to heroin
- Mortality rate is 63 percent higher than in a non- addicted person when untreated
14
Q
Stimulants function and common ones
A
- Stimulants increase the activity of the central nervous system (CNS)
- Cause increases in blood pressure, heart rate, and alertness
- Cause rapid behavior and thinking
- Most common stimulants
- Cocaine
- Amphetamines
- Caffeine
-increase dopamine
15
Q
• Cocaine (stimulant)
produces
______the supply of ______
how is it used?
A
- Most powerful known natural stimulant
- Produces a euphoric rush of well-being
- Increases the supply of dopamine at key neurons throughout the brain as well as norepinephrine and serotonin levels
- Can be snorted, injected, or smoked
- Tried by 39 million people; currently used by 1.9 million people
16
Q
• Effects of high doses of cocaine -cocain intoxication cocain induced psychotic disorder crashing -more powerful cheaper forms led to
A
- Cocaine intoxication-poor muscle coordination, bad judgement, anger
- Cocaine-induced psychotic disorder-hallucinations, confusion
- Depression-like letdown (crashing)-headaches, dizziness
- More powerful, cheaper forms have been available since 1984-increase use
- Freebasing -pure cocaine separated from processed cocaine
- Crack-freebase crystalline balls
17
Q
• What are the physical dangers of cocaine?
A
- Overdose—greatest risk
- Excessive doses —depress the brain’s respiratory function and stop breathing
- Heart failure
- Increased likelihood of miscarriage and of having children with abnormalities
18
Q
• Amphetamines (stimulant) are what kinds of drugs most often taken in small doses high doses causes what as they leave body
A
- Laboratory-manufactured stimulant drugs
- Amphetamine, dextroamphetamine, methamphetamine
- Most often taken in pill or capsule form • Effects
- Small doses: Increase energy and alertness and reduce appetite
- High doses: Produce a rush, intoxication, and psychosis
- Cause an emotional letdown as they leave the body
19
Q
• Methamphetamine (ice; crystal meth)
dangers when used
A
- Recent surge in its popularity: Used at least once by 6 percent of all U.S. residents older than age 11; spreading across the United States
- Equally popular among men and women and among a wide range of people
- Designated as a club drug and often tied to raves
- Use dangers
- Serious negative effects on physical, mental, and social life
- Linked to increased ER visits
- May cause neurotoxicity-damages nerve endings
20
Q
• Stimulant use disorder dominates poor tolerance and withdrawal reactions tied to higher rates cocaine or amphetamines?
A
- Stimulant dominates the individual’s life
- Leads to poor functioning in social relationships and at work
- Tolerance and withdrawal reactions tied to increased doses • Annual rates among people older than age 11
- Disorders centered on cocaine:0.1percent
- Disorders centered on amphetamines:0.3percent
21
Q
• Hallucinogens (psychedelic drugs) function and common ones
A
• Produce powerful changes primarily in sensory perception (trips)-sensations out of the ordinary • Natural hallucinogens: • Lysergic acid diethylamide (LSD) • Mescaline • Psilocybin • MDMA(Ecstasy)
22
Q
• LSD (lysergic acid diethylamide) One of the most \_\_\_\_\_ hallucinogens brings on state of- effect wear off in \_\_\_\_\_ and \_\_\_\_\_ sensory perception produces these symptoms by binding to these neurons help control
A
- One of most powerful hallucinogens derived from ergot alkaloids
- Brings on a state of hallucinogen intoxication (hallucinosis)-gneral strengthening of perceptions (visual) along with psychological changes and physical symptoms
- Increased and altered sensory perception, psychological changes, and physical symptoms
- Hallucinationsand/orsynesthesia
- Effects wear off in about 6hours
- Produces these symptoms by binding to serotonin receptors
- These neurons help control visual information and emotions, thereby causing the various effects of the drug on the user
- Psilocybin -
23
Q
• Cannabis produced from major active ingredient potency influenced by when smoked produces effects last
A
- Produced from varieties of hemp plants
- Hashish: Solidified resin of the cannabis plant
- Marijuana: Mixture of buds, crushed leaves, and flowering tops
- Major active ingredient: tetrahydrocannabinol (THC)
- Potency influenced by environmental conditions
- When smoked, produces a mixture of hallucinogenic, depressant, and stimulant effects, known as cannabis intoxication
- Most of the effects last 2 to 6 hours
24
Q
• Cannabis use disorder and dangers
- how does it affect lives?
- how strong are they now
Dangers?
A
is influenced by regular use
• Social and occupational lives of 1.5 percent of people in the United States are affected, including a large number of high school students
• The current varieties of marijuana are 4 times more powerful than those found in 1970s, due to the higher THC content (8 percent)
• Dangers
• Tolerance and withdrawal symptoms
• Occasional panic reactions, automobile accidents, and decreased memory while high
• Long-term health problems; reproduction problems
25
• Cannabis’s role in society
- historically
- research
- majority believe
• Historically, marijuana was replaced by more effective drugs in
the medical field and then outlawed
• THC-related research opened cannabis use for new medical applications and legalization
• Medical use now allowed in 29 states
• Recreational use legalized in 8 states
• The majority of people in the United States believe marijuana should be legalized
26
People often take more than one drug at a time, known as
polysubstance use
• Cross-tolerance
• Synergistic effects-increase in effects that occur when more Ethan one substance is taken
• Similar actions-two or more drugs have similar action- both depress-lower and lower
• Opposite (antagonistic) actions-upper and lower
• Each year tens of thousands of people are hospitalized because of polysubstance use
• May be accidental or intentional
27
What Causes Substance Use Disorders?• Sociocultural views
* People who are most likely to develop these disorders:
* Living in stressful socioeconomic conditions
* Have families that value or tolerate drug use
* Are confronted regularly by other kinds of stress
28
• Psychodynamic views
* People who are most likely to develop these disorders:
* Have powerful childhood dependency needs
* Display a substance abuse personality
29
• Cognitive-behavioral views
* People who are most likely to develop these disorders:
* Operant conditioned by tension-reduction, rewarding effects of drugs (self-medication)
* Have rewards-produced expectancy that substances will be rewarding
* Influenced by classical conditioning when cues or objects are present during drug use
30
• Biological views
```
• Biological factors play a
major role in drug misuse
• Genetic predisposition
• Neurotransmitters
• Braincircuits
```
31
• Genetic predisposition
* Similarity of alcohol preferences among alcohol-preferring animals and their offspring
* Alcoholism concordance rate in identical twins
* Biological parent–adoptee child alcohol abuse rate
* Abnormal form of dopamine-2 (D-2) receptor gene in people with substance use disorders
32
• Neurotransmitters
| drug tolerance and withdrawal symptoms are caused by
* Drug tolerance and withdrawal symptoms are caused by cutbacks in the brain’s production of particular neurotransmitters during excessive and chronic drug use
* Lower GABA production: Alcohol or benzodiazepines
* Lower endorphin production: Cocaine or amphetamines
* Reduced anandamide production: Marijuana
33
• Brain circuits
| what is the key Neurotramsitter
* Reward circuit (reward center)
* Pleasure pathway
* Dopamine is the key NT
* Drugs stimulate structures directly and indirectly(through dopamine activity)
34
• Incentive-sensitization theory
-reward deficiency syndrome
defects in what receptor
* When substances repeatedly stimulate the reward center, the center develops a hypersensitivity to the substances- contributes to future desire
* Reward-deficiency syndrome
* The reward center is not readily activated by “normal” life events so the person turns to drugs to stimulate this pleasure pathway, particularly in times of stress
* Defects in D-2 receptors have been cited as a possible cause
35
• Developmental psychopathology view
| externalizing or internalizing temperament
* Substance use disorders
* Genetically inherited predisposition
* Externalizing(impulsivity, aggression-family,school conflicts, social problems-onset for drug use) or internalizing temperament(depression, sadness low self concept-turn to drugs)
* Numerous stressors throughout childhood
* Inadequate parenting
* Rewarding substance use experiences
* Relationships with. peers who use drugs
36
How Are Substance Use Disorders Treated?
• The value of treatment for substance abuse or dependence can be difficult to determine
• Different substance use disorders pose different problems
• Many people with substance abuse patterns drop out of treatment early
• Some people recover without any intervention at all
• Different criteria are used by different clinical researchers
-difficult to determine, drop out of treatment, recover without
37
Psychodynamic therapies
• Clients are helped to become aware of and correct underlying
needs and conflicts related to drug use
38
• Cognitive-behavioral techniques
• Therapists use aversion therapy-unpleasant stimuli when performing undesirable behaviors of taking drugs
-contingency management-incentives to drug free urine specimen
relapse-prevention training-treat alcohol use disorder in which clients are taught to plan ahead and apply coping strategies in situations that trigger drinking
, and acceptance and commitment therapy-accept thoughts rather than eliminate them
39
• Biological treatments
antagonist
detoxification
• Drug maintenance therapy
• Methadone maintenance programs are designed to provide a safe, legally and medically supervised substitute for heroin
detoxification-medically supervised withdrawal from a drug
antagonist- drugs that block or change effects of an addictive drug
40
• Sociocultural therapies
* Sociocultural theorists (family-social and multicultural theorists) believe psychological problems emerge in a social setting and are best treated in a social context
* Self-help-alcohol anonymous and residential treatment programs - place where people who were formally addicted to drugs live, work and socialize in a drug free environment
* Culture-and gender-sensitive programs
* Community prevention programs
41
```
• Gambling disorder
defined by the
-biological factors
_____dopamine activity
treatment same as others
```
* Defined by the addictive nature of the behavior
* Genetic predisposition
* Heightened dopamine activity and dysfunction when gambling
* Impulsive, novelty-seeking personality style
* Repeated and cognitive mistakes
* Treatment
* Cognitive-behavioral approaches (relapse-prevention training)
* Biological approaches (opioid antagonists)
* Self-help programs (Gamblers Anonymous)
* Prevalence
* 3 to10 percent of teenagers and college students
* Internet gaming disorder
* Under study for possible inclusion in future DSM edition
42
• Internet gaming disorder: awaiting official status
* People increasingly turn to the Internet for activities that used to take place in the “real world”, giving rise to an uncontrollable need to be online
* Internet use disorder, internet addiction
* Specific symptoms of this pattern parallel those found in substance use disorders or gambling disorders, extending from the loss of outside interests to possible withdrawal reactions when Internet use is not possible (APA, 2013).
