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

Chapter 12: Substance-Related Disorders Flashcards

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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
List the opiates?
- Opium - Morphine - Codeine - Heroin - Methadone - Oxycodone
26
What are the effects of opiates in early users?
- Pleasant sensations - Eliminates all anxiety and pain - No hallucinations or delusions - Cognitive functions largely intact except for memory probs
27
What are the effects of opiates in chronic users?
- Positive effects wear off w/ rapid tolerance | - Main reason for using is to avoid withdrawal symptoms
28
What are the visible signs of opiate intoxication?
- Constricted pupils - Drooling - Apathetic look - Speech is slowed or slurred
29
What are the opiate withdrawal symptoms? When do they start and end?
- 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
What makes opiates highly physically addictive? Effects?
- 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
What are the societal problems associated w/ heroin use?
Increase in crimes as opiates are expensive | -Spread of HIV and hepatitis C through shared needles
32
How is methadone a treatment for heroin addiction? Target users?
- Methadone similar to heron, but has longer half-life | - For chronic heron addicts who failed other treatments?
33
Which narcotic is abused through being prescribed?
Oxycodone
34
What do stimulants do?
- Speed up brain activity | - Increase heart rate and breathing, decrease appetite, give burst of energy
35
List the stimulants.
- Caffeine - Nicotine - Cocaine - Crack - Ephedra - Amphetamines - Methamphetamines
36
Where does cocaine come from? Origin?
- Occurs naturally in the leaves of the coca plant | - Used in western world for at least 100 years
37
What is crack? Why is it named that? Vs. cocaine?
- Flammable compound that can be smoked - Comes from cracking sounds the rocks make when smoked in a pipe - Cheaper than cocaine
38
Where do amphetamines and methamphetamines come from? Uses?
- 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
What are the intoxication of cocaine and methamphetamines in mild doses?
- Decreases boredom, fatigue, need for sleep, appetite - Better concentration for monotonous tasks - Increased physical strength
40
What are the intoxication of cocaine and methamphetamines in moderate doses?
- Sense of elation, freedom, energy - Pleasant but unrealistic overestimation of one's abilities - Feeling witty, self-confident - Increased sexual arousal - Euphoric rush
41
What are the intoxication of cocaine and methamphetamines in heavy doses?
- 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
What are the intoxication of cocaine and methamphetamines with chronic users?
- Less and less euphoria | - Need to use stimulant drug simply to get out of bed and do ordinary things
43
What are the withdrawal symptoms of cocaine and methamphetamines?
- Fatigue - Depression - Suicide thoughts - Anxiety - Hunger, weight gain - Bizarre dreams
44
What are the effects of cocaine and methamphetamines on the brain?
- 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
What is the addiction potential of cocaine and methamphetamines?
- Highly psychologically and physiologically addictive | - Tolerance builds up fast
46
What are the differences between cocaine and methamphetamines?
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
What do hallucinogens do? What conditions can it trigger?
- 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
List hallucinogens.
- Mescaline - Psilocybin - LSD - Cannabis - PCP
49
What is mescaline derived from? What does it do?
- Derived from the Peyote Cactus | - Strong sensual and perceptual experiences
50
What is an example of a psilocybin? What do they do?
- Shrooms | - Intense visual hallucinations
51
What are the intoxication symptoms of LSD?
- 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
What is the addiction potential of LSD?
- May be psychologically addictive | - No tolerance or withdrawal symptoms
53
What is the danger of LSD?
Can trigger schizophrenia in predisposed individuals
54
What are the short term effects of cannabis?
- 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
What are the long term effects of cannabis?
- Lung disease - Decrease of male sperm count - Lack of motivation - Depression - Paranoia - Weight gain
56
What are the withdrawal symptoms of cannabis? How long can they last?
- Insomnia - Restlessness - Irritability - Loss of appetite - Nausea - Diarrhea - Can last up to 90 days
57
What is PCP? Other names?
- "Angel dust" "super acid" - Hallucinogen and a stimulant - Has some analgesic properties
58
What are the behavioral intoxication symptoms of PCP?
- Energy, increased strength - Psychosis, paranoid thoughts and delusions - Bizarre, violent behaviors - Dissociation, disorientation - Impaired memory
59
What are the psychological intoxication symptoms of PCP?
- Increased blood pressure and HR - Sweating - Numbness - Floating sensations - Slowed reflexes - Sometimes coma and immobility
60
What makes PCP a very dangerous drug?
- 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
What is ecstasy?
Mostly a stimulant but also has some psychedelic properties
62
What are the intoxication symptoms of ecstasy?
- Creates calm, pleasurable orgastic, peaceful feelings - Outpourings of empathy - Hallucinations only in higher doses - Teeth clenching, grinding
63
What are the dangers of ecstasy?
- Hyperthermia --> kidney failure, stroke, etc. - Reduced sweat production --> danger of hyponatremia - Being mixed w/ other drugs --> causes brain and organ damage
64
What NT systems does ecstasy work on?
Dopamine and serotonin
65
What is the effect of ecstasy on long term users?
- 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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