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PSC 168 > Chapter 12: Substance-Related Disorders > Flashcards

Chapter 12: Substance-Related Disorders Flashcards

1
Q

Define dual diagnosis.

A

Having both a mental illness and a substance abuse disorder

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2
Q

How is the relationship between drugs and mental illness difficult to determine?

A
  • Drugs may be an attempt to “self medicate” for a mental disorder
  • Psychiatric probs may be caused by drugs in the first place
  • There may be an interaction of the mental disorder and drug
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3
Q

List examples of how drugs may be an attempt to “self medicate” for a mental disorder.

A
  • Alcohol abuse in a social phobic to face social situations
  • Cigarette smoking to calm down schizophrenic voices
  • Caffein to help focus w/ ADHD
  • Smoking marijuana to reduce OCD symptoms
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4
Q

List examples of how psychiatric probs may be caused by drugs in the first place.

A
  • Mania caused by cocaine intoxication in a person who isn’t bipolar
  • Intense anxiety during withdrawal from benzodiazepine dependence
  • Depression in a chronic alcoholic (subsides after quitting drinking)
  • Permanent psychosis caused by brain damage from meth or PCP abuse
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5
Q

List examples of how there may be an interaction of mental disorder and drug.

A
  • Stimulants and marijuana make a paranoid individual more paranoid
  • Drinking alcohol makes a depressed person even more depressed
  • Caffeine abuse can drive hypomania into mania
  • Hallucinogens can trigger the onset of schizophrenia in a predisposed individual
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6
Q

Explain physical dependence on drugs.

A
  • Psychological need for drug
  • Drug discontinued –> unpleasant withdrawal symptoms develop
  • Physical dependence goes along w/ tolerance
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7
Q

What characteristics of a drug make it more addictive? What does addiction speed depend on?

A
  • Fast acting
  • Shorter half-life
  • Depends on way of consumption (injecting, smoking, eating)
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8
Q

Explain psychological dependence on drugs.

A
  • Psychological need to use drug
  • Not being able to relax w/o using the drug
  • Not daring to be sociable w/o the drug
  • Psychological dependence may or may not go along w/ physical dependence
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9
Q

What is the DSM-V criteria for substance-related disorders?

A
  • Recurrent use of a drug
  • Drug has caused probs in important areas of life (work, relationships, health, endangering self or others, legal probs)
  • User has made unsuccessful efforts to control drug use
  • User continues to use drug despite of knowledge of its harmful effects
  • Typically includes physical dependence w/ tolerance and withdrawal
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10
Q

What are the classes of drugs?

A
  • Depressants
  • Stimulants
  • Hallucinogens
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11
Q

What do depressants do?

A

Slow down activity of CNS

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12
Q

List depressant drugs.

A
  • Alcohol
  • Barbiturates
  • Benzodiazepines
  • Opiates
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13
Q

What are the effects of alcohol on the brain?

A
  • Primarily facilitating the GABA system
  • Inhibits frontal inhibitory synapses first
  • Blocks actions of glutamate
  • Secondary effect = release of dopamine’s pleasure pathway
  • Genetic vulnerability to addiction
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14
Q

What are the effects of light alcohol intoxication?

A
  • More relaxed
  • Increased sociability
  • Reduced self-awareness
  • Release of inhibitions, slowed reaction times
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15
Q

What are the effects of increased amounts of alcohol intoxication?

A
  • Motor coordination impaired
  • Slurred speech
  • Repeating oneself
  • Double vision
  • Memory probs, black outs
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16
Q

What does the speed of alcohol intoxication depend on?

A
  • Body weight
  • Food consumed
  • Rate of drinking
  • Sex = women absorb alcohol faster into bloodstream
  • Genetics
  • Simultaneous consumption of other depressants
  • One’s history of drinking
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17
Q

Why do women absorb alcohol faster into the bloodstream?

A
  • Less body water content
  • Interaction w/ hormone cycle
  • Less enzymes (in liver and stomach) that break down alcohol
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18
Q

What are the warning signs for alcoholism?

A
  • Probs at work or home b/c of drinking
  • DUI
  • Lying about drinking
  • Isolating in order to drink
  • Feeling guilty after drinking
  • Becoming angry or violent on alcohol
  • Drinking to change one’s emotional state
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19
Q

Binge drinker vs. maintenane drinker

A

LOOKUP

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20
Q

Describe Fetal Alcohol Syndrome

A
  • Fetal growth retardation
  • Cognitive deficits
  • Behavioral probs
  • Learning difficulties
  • Characteristic facial features (thin upper lip, short nose, etc.)
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21
Q

What is Korsakoff’s Syndrome?

A

-Persistent alcohol amnestic disorder due to vitamin B1 deficiency

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22
Q

What is Delirium Tremens?

A

During alcohol withdrawal

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23
Q

What are barbiturates? Characteristics? Med of choice for? NTs?

A
  • Sedatives
  • Work first on GABA system in reticular formation
  • Med of choice for insomnia and anxiety prior to benzodiazepines
  • Highly physically addictive
  • High OD potential, especially if combined w/ alcohol
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24
Q

What are benzodiazepines? NTs? Characteristics? What does it treat?

A
  • Tranquilizers, anti-anxiety pills
  • Works on GABA system
  • Treatment of anxiety and insomnia
  • High tolerance and physical dependence
  • Psychologically addictive
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25
Q

List the opiates?

A
  • Opium
  • Morphine
  • Codeine
  • Heroin
  • Methadone
  • Oxycodone
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26
Q

What are the effects of opiates in early users?

A
  • Pleasant sensations
  • Eliminates all anxiety and pain
  • No hallucinations or delusions
  • Cognitive functions largely intact except for memory probs
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27
Q

What are the effects of opiates in chronic users?

A
  • Positive effects wear off w/ rapid tolerance

- Main reason for using is to avoid withdrawal symptoms

28
Q

What are the visible signs of opiate intoxication?

A
  • Constricted pupils
  • Drooling
  • Apathetic look
  • Speech is slowed or slurred
29
Q

What are the opiate withdrawal symptoms? When do they start and end?

A
  • Start 3 days after last use
  • Subside after one week
  • Similar to bad flu = diarrhea, stomach cramps, body aches, fever, chills, runny nose
  • High anxiety
30
Q

What makes opiates highly physically addictive? Effects?

A
  • Opiate molecules vary similar to endorphins
  • Opiates attached themselves to endorphin receptor sites
  • Signals brain to stop endorphin production
  • Prolonged opiate abuse can cause permanent depletion of endorphins
  • Results in chronic pain, anxiety, depression
  • Opiates work on both pain path and pleasure path
31
Q

What are the societal problems associated w/ heroin use?

A

Increase in crimes as opiates are expensive

-Spread of HIV and hepatitis C through shared needles

32
Q

How is methadone a treatment for heroin addiction? Target users?

A
  • Methadone similar to heron, but has longer half-life

- For chronic heron addicts who failed other treatments?

33
Q

Which narcotic is abused through being prescribed?

A

Oxycodone

34
Q

What do stimulants do?

A
  • Speed up brain activity

- Increase heart rate and breathing, decrease appetite, give burst of energy

35
Q

List the stimulants.

A
  • Caffeine
  • Nicotine
  • Cocaine
  • Crack
  • Ephedra
  • Amphetamines
  • Methamphetamines
36
Q

Where does cocaine come from? Origin?

A
  • Occurs naturally in the leaves of the coca plant

- Used in western world for at least 100 years

37
Q

What is crack? Why is it named that? Vs. cocaine?

A
  • Flammable compound that can be smoked
  • Comes from cracking sounds the rocks make when smoked in a pipe
  • Cheaper than cocaine
38
Q

Where do amphetamines and methamphetamines come from? Uses?

A
  • Synthetic drugs
  • Medicinal and military uses
  • Lab production of milder amphetamines for medical use –> Ritalin for ADHD, appetite suppressant
  • Meth cooked in illegal labs
39
Q

What are the intoxication of cocaine and methamphetamines in mild doses?

A
  • Decreases boredom, fatigue, need for sleep, appetite
  • Better concentration for monotonous tasks
  • Increased physical strength
40
Q

What are the intoxication of cocaine and methamphetamines in moderate doses?

A
  • Sense of elation, freedom, energy
  • Pleasant but unrealistic overestimation of one’s abilities
  • Feeling witty, self-confident
  • Increased sexual arousal
  • Euphoric rush
41
Q

What are the intoxication of cocaine and methamphetamines in heavy doses?

A
  • Manic activity level, rapid speech, restless, on the go
  • Impairment of mental abilities; can produce erratic thoughts & behaviors
  • Psychotic states (paranoid delusions and hallucinations)
  • Hallucinations may be auditory, visual, tactile
  • Aggressive behaviors
  • Weight loss
  • Body sores from scratching
  • Bizarre repetitive movements
  • Dilated pupils
  • Can cause seizures and heart arrhythmia
42
Q

What are the intoxication of cocaine and methamphetamines with chronic users?

A
  • Less and less euphoria

- Need to use stimulant drug simply to get out of bed and do ordinary things

43
Q

What are the withdrawal symptoms of cocaine and methamphetamines?

A
  • Fatigue
  • Depression
  • Suicide thoughts
  • Anxiety
  • Hunger, weight gain
  • Bizarre dreams
44
Q

What are the effects of cocaine and methamphetamines on the brain?

A
  • Work directly on dopamine and norepinephrine system
  • Dopamine reuptake inhibitor
  • Stimulate release of dopamine
  • Overstimulate reward system circuitry of brain
  • Possibility of permanent depression due to permanent alteration of the dopamine systems and damage to receptor sites
  • Cause permanent cognitive deficits (short term memory, concentration, problem solving)
45
Q

What is the addiction potential of cocaine and methamphetamines?

A
  • Highly psychologically and physiologically addictive

- Tolerance builds up fast

46
Q

What are the differences between cocaine and methamphetamines?

A

METH:
-more aggressive behavior
-longer lasting high (6-12 hrs vs. 20 mins-3 hrs)
-paranoia lasts longer after cessation of drug (7-14 days vs. 4-8 hrs)
-possibility of permanent paranoia and psychosis
-greater risk of brain damage b/c meth alters structure of neurons while cocaine generally stays more on neuron’s outside
COCAINE
-has stronger effects on cardiovascular system w/ possibility of permanent heart damage

47
Q

What do hallucinogens do? What conditions can it trigger?

A
  • Have strongest effect on altering consciousness
  • Usually change a user’s perception of both the internal and external world
  • Mind expansion vs. potential triggering of psychosis in vulnerable individuals
  • Can trigger onset of schizophrenia and depersonalization
48
Q

List hallucinogens.

A
  • Mescaline
  • Psilocybin
  • LSD
  • Cannabis
  • PCP
49
Q

What is mescaline derived from? What does it do?

A
  • Derived from the Peyote Cactus

- Strong sensual and perceptual experiences

50
Q

What is an example of a psilocybin? What do they do?

A
  • Shrooms

- Intense visual hallucinations

51
Q

What are the intoxication symptoms of LSD?

A
  • Visual hallucinations and perceptual distortions
  • Heightened aesthetic experiences
  • Time perception may be altered
  • Synesthesia
  • Magnification of feelings –> “horror trip”
  • Depersonalization, out of body experiences
  • Thoughts can become incoherent
  • Loss of reality contact
52
Q

What is the addiction potential of LSD?

A
  • May be psychologically addictive

- No tolerance or withdrawal symptoms

53
Q

What is the danger of LSD?

A

Can trigger schizophrenia in predisposed individuals

54
Q

What are the short term effects of cannabis?

A
  • Slowed reaction times even at low doses
  • Sensitivity to colors, music, smells, touch
  • Silly mood
  • Red watery eyes, dead head look
  • Memory probs
  • Increased appetite
  • Reduced pain
55
Q

What are the long term effects of cannabis?

A
  • Lung disease
  • Decrease of male sperm count
  • Lack of motivation
  • Depression
  • Paranoia
  • Weight gain
56
Q

What are the withdrawal symptoms of cannabis? How long can they last?

A
  • Insomnia
  • Restlessness
  • Irritability
  • Loss of appetite
  • Nausea
  • Diarrhea
  • Can last up to 90 days
57
Q

What is PCP? Other names?

A
  • “Angel dust” “super acid”
  • Hallucinogen and a stimulant
  • Has some analgesic properties
58
Q

What are the behavioral intoxication symptoms of PCP?

A
  • Energy, increased strength
  • Psychosis, paranoid thoughts and delusions
  • Bizarre, violent behaviors
  • Dissociation, disorientation
  • Impaired memory
59
Q

What are the psychological intoxication symptoms of PCP?

A
  • Increased blood pressure and HR
  • Sweating
  • Numbness
  • Floating sensations
  • Slowed reflexes
  • Sometimes coma and immobility
60
Q

What makes PCP a very dangerous drug?

A
  • Danger of heart attacks and strokes
  • High potential of permanent brain damage
  • Cognitive deficits are virtually always apparent in habitual users
  • Often added to marijuana, ecstasy, meth, or cocaine w/o user’s knowledge
61
Q

What is ecstasy?

A

Mostly a stimulant but also has some psychedelic properties

62
Q

What are the intoxication symptoms of ecstasy?

A
  • Creates calm, pleasurable orgastic, peaceful feelings
  • Outpourings of empathy
  • Hallucinations only in higher doses
  • Teeth clenching, grinding
63
Q

What are the dangers of ecstasy?

A
  • Hyperthermia –> kidney failure, stroke, etc.
  • Reduced sweat production –> danger of hyponatremia
  • Being mixed w/ other drugs –> causes brain and organ damage
64
Q

What NT systems does ecstasy work on?

A

Dopamine and serotonin

65
Q

What is the effect of ecstasy on long term users?

A
  • Addiction w/ withdrawal symptoms
  • Reduction in serotonin receptors and damage to nerve endings
  • Permanent depression, sleep disturbance, irritability, anxiety
  • Short term memory impairments
  • Chronic users = ecstasy works more and more like methamphetamine

PSC 168 (18 decks)

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