Chapter 11 - Substance-Related Disorders Flashcards Preview

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Flashcards in Chapter 11 - Substance-Related Disorders Deck (99):
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substance use disorders

alcohol and drug addiction - recurrent use of one of specific substance that leads to consequences

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10 different classes of substance use disorders

1) alcohol
2) caffeine
3) cannibis
4) hallucinogens
5) inhalants
6) opiods
7) sedatives
8) hypnotics and anxiolytics
9) stimulants
10) tobacco

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4 general groupings of indicators

social impairment, impairment of control over use, risky use and pharmacological criteria

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impairment of control

taking substance in greater amounts or for longer than intended, desire to cut down or quit, lots of time spent trying to obtain or recover from the substance, craving

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social impairment

failure to fulfill major role obligations at work, home or school - continued despite clear negative consequences on relationships

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risky use

use when it is physically dangerous, continued use despite having a problem that is made worse by the substance

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pharmacological dependence

tolerance and withdrawal

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tolerance

increased amounts of substance to achieve same effect

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withdrawal

experience unpleasant and sometimes dangerous symptoms when substance is removed from body

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which two methods of ingesting substance are the quickest to reach the brain

inhaling and injection (IV)

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substance-induced disorders

associated with each of the 10 drug classes, including intoxication, withdrawal, and other substances

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polysubstance abuse

simultaneous misuse or dependence upon two or more substances

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low-risk drinking guidelines

indication of upper limits on drinking so that drinking is not likely to lead to physical impairment

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ethyl alcohol

effective chemical compound in alcoholic beverages - reduces anxiety, produces euphoria, and creates a sense of well-being

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Blood alcohol level

0.08% - usual

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alcohol dehydrogenase

breaks down alcohol - women have less of this

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what does alcohol do to your cycle of sleep

supresses REM phase of sleep, so first part of night is good then will rebound

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Korsakoff's psychosis

chronic disease characterized by impaired memory and a loss of contact with reality

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fetal alcohol syndrome

patter of facial dysmorphology, growth retardation and CNS dysfunction caused by mother's drinking habits

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twins studies for alcohol

male monozygotic twins are more similar in their tendencies to develop problems with alcohol abuse and dependence

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behavioral disinhibition

people with alcohol problems tend to have a relative inability to inhibit behavioural impulses

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negative emotionality

tendency to experience psychological distress, anxiety, and depression

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tension-reduction

hypothesis that drinking is reinforced by its ability to reduce tension, anxiety, anger, depression and other unpleasant emotions

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alcohol expectancy theory

drinking behaviour is largely determined by the reinforcement that an individual expects to receive from it

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behavioural tolerance

need for a greater amount for the same effect - greatest when conditioned environmental cues are present

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acetaldehyde

breaks down alcohol - then it is further broken down by the enzyme aldehyde hydrogenase

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short-term consequences of alcohol

cognitive, driving, health

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long-term consequences of alcohol

related to genetic vulnerability, frequency/duration of alcohol use, severity of and frequency of binge drinking

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Minnesota Model

popular treatment for people who show signs of withdrawal, treatment begins in a hospital or detoxification clinic under medical supervision - abstinence is the goal

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Pharmacotherapy

assist in detoxification to reduce the pleasurable effects associated with drinking and to produce nausea when alcohol is consumed

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antagonist drug

targets the neurotransmitters that mediate alcohol's effects on the rain and "blocks" the pleasurable effects of alcohol

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agonist drug

facilitates the inhibitory action of the neurotransmitter GABA at its receptors

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antabuse

block the action of the metabolizing enzyme acetaldehyde dehydrogenase, resulting in a buildup of it in the body

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advantage of antabuse

helping family member regain trust in the individual's resolve to not drink

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success of agonist drug

depends on the compliance of the individual

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success of antagonist drug

reduces sensation of craving

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alcoholics anonymous

goal is complete abstinence - believe there is no cure for alcoholism - believe in "higher power" to help them

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success of alcoholics anonymous

effective treatment for some - others find a hard time with the spirituality aspect

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behavioral treatment

based on operant conditioning principles - treats problem drinking as a learned behavior

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contingency management

used to manipulate reinforcement contingencies for alcohol use

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community reinforcement approach

a spouse, friend or relative who is not a substance user is recruited to participate in the program - both learn behavioural coping skills and how to develop contingency contracts

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behavioural self-management

teaches people with alcohol use disorder to manage their own drinking through behavioural contracting, restructuring of thoughts about drinking and have individuals recognize patters of their drinking

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brief interventions

1-3 sessions in length offering time-limited and specific advice regarding the need to reduce or eliminate alcohol consumption

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motivational interviewing

approach that can be used with clients who present with varying levels of readiness to change their behaviour

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depressants

inhibit neurotransmitter activity in CNS

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benzodiazepines

more frequently prescribed for sleep and anxiety problems

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long acting forms of benzodiazepines and barbiturates

prolonged sedation

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short acting forms of benzodiazepines and barbiturates

used to treat insomnia

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large doses of benzodiazepines and barbiturates

slurred speech, poor motor coordination, impaired judgement and concentration, induce sleep

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small dose of benzodiazepines and barbiturates

euphoria

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long term use of benzodiazepines and barbiturates

causes depression, chronic fatigue, mood swings, and paranoia

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dependency of benzodiazepines and barbiturates

tolerance develops rapidly, dangerous if withdrawal occurs

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abstinence syndrome

characterized by insomnia, headaches, aching all over the body, anxiety, and depression

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stimulants

class of drugs that have a stimulating/arousing effect on the CNS and create their effects by influencing the rate of uptake of the neurotransmitters at receptor sites in the brain ex. cocaine

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tobacco

stimulant drug

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short term consequences of tobacco

minimal effects

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long term consequences of tobacco

extensive effects

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nicotine

CNS stimulant related to the amphetamines

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dependency on tobacco

develops quickly

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treatment of tobacco

psychological/pharmacological treatments

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psychological treatments for tobacco

formal face-to-face counselling, online support groups for quitting, provision of self-help materials for quitting - goal setting, self-monitoring, reinforcement

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pharmacological treatments

over the counter nicotine replacements and medications, block reinforcing properties, help with detoxification, reduce cravings, aversion therapy

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amphetamines

effects on the body similar to those of adrenalin

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low doses of amphetamines

increase alertness and allow the user to focus attention effectively

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high doses of amphetamines

induce feelings of exhilaration, extroversion, confidence and at very high doses, restlessness and anxiety can occur

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toxic psychosis

repeated high doses can cause hallucinations, delirium and paranoia

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physical effects of amphetamines

increased or irregular heartbeat, fluctuations in blood pressure, hot or cold flashes, nausea, weakness, and dilation of pupils

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caffeine

most popular stimulant drug

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opioids

class of CNS depressants - main effects are the reduction of pain and sleep inducement ex.heroin

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endogenous opiates

body's natural painkillers

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exogenous opiates

narcotics affect receptor sites located throughout the body including the CNS and bloodstream

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dependency on opioids

withdrawal is dangerous

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methadone

heroin replacement

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treatment for opioids

medications, individual/group psychological programs, peer supports

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therapeutic effects of cannabis

cancer, AIDS, glaucoma, terminal illness, chronic pain, anxiety

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amotivational syndrome

continuing pattern of apathy, profound self-absorption, detachment from friends and family and abandonment of goals

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dependency on marijuana

can become tolerant and dependent

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hallucinogens

drugs that change a person's mental state by inducing perceptual and sensory distortion or hallucinations

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effects of hallucinogens

psychotic-like epsiodes

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factors affecting experience of hallucinogens

personality, setting, expectations

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dependence on hallucinogens

do not tend to cause dependence

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sex differences in addiction

affects more men than women

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what kind of experience do women have with addictions

"telescoping effect" - more progressive

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what are women more sensitive to in addictions

more sensitive to rewarding effects, less sensitive to negative effects of drugs

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risk factors - biological

family history, low sensitivity to alcohol

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risk factors - psychosocial

impulsivity, negative/positive urgency, problematic coping strategies, positive expectations

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risk factors - social

family acceptance of substance use, cultural permissive attitudes, availability, abuse, low SES, academic failure

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harm reduction model

propose reducing consequences/dangerous behaviours but not necessarily quitting

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self-help

step-by-step instructions to an individual, enabling them to carry out an established treatment protocol either independently or with minimal expert support

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mutual help groups

support group for addictions

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self-help - personalized feedback

assessment of current use and comparison with normative and for your age and gender

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self-help - structured interventions

generally include numerous strategies - self-assessment, goal setting, self-monitoring, coping strategies, online forums

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effectiveness of structured interventions

good for alcohol, questionable for cocaine

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effectiveness of personalized feedback

questionable on it own with alcohol and gambling, effective if combined with self-help book about alcohol use

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12-Step group

involves meetings, completing the 12 steps, obtaining a sponsor, doing service ex. AA, NA

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SMART recovery

focus on building and maintaining motivation, coping with urges, managing thoughts, feelings and behaviours, and living a balanced life - goal is abstinence

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modern management

goal is moderation, not abstinence

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cognitive behavioral program

self-monitoring, goal setting, learning behavioural management skills, managing triggers, finding non-drinking activities, relapse prevention

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residential treatment

many different programs, high variability, usually based on 12-step principles