Chapter 7: Substance Abuse

Question 1

The DSM uses what 2 major categories of substance-related disorders?

Answer 1

Substance Use disorder

Substance Induced Disorder

Question 2

Substance use disorder

Answer 2

USE
Patterns of maladaptive behaviour involving the use of a psychoactive substance.
Includes Substance-abuse disorders and Substance dependence disorders

Question 3

Substance-induced disorder

Answer 3

PRODUCE
Disorders induced by the use of psychoactive substances
i.e. intoxication, withdrawal syndromes, mood disorders, delirium, and amnesia

Question 4

Substance use disorder is often characterized by what?

Answer 4

Physiological dependence

Question 5

Hallmarks of Substance Abuse and dependence

Answer 5

Tolerance
Withdrawal syndrome
tachycardia
delirium tremens (hallucinations/ restlessness/ disorientation)
Delirium 
Disorientation 
Addition
Physio dependence
psychological dependance

Question 6

Addiction

Answer 6

Impaired control over the use of a chemical substance accompanied by physiological dependence

Question 7

Physiological dependence

Answer 7

State of physical dependence on a drug which the user’s body comes to depend on a steady supply

Question 8

Psychological dependence

Answer 8

reliance on a substance, although one may not be physically dependent
CRAVINGS

Question 9

Top three commonly used drugs in North American

Answer 9

Tobacco (25% of population)
Alcohol (15% of population)
Marijuana (5% of population)

Question 10

Pathways to Drug Dependence

Answer 10

Experimentation
Routine Use (denial, behaviours and values change, mood swings)
Addiction or Dependence (powerless to the drug at tis point)

Question 11

Depressants

Answer 11

ex. Alcohol

Question 12

Alcohol risk factors

Answer 12

Gender: females and males (12 and 11%). Men start younger, females catch up
Age: start late adolescence (earlier you start the harder it is to stop)
Antisocial personality disorder
Family history: father who drinks, genetics
Sociodemographic factors: stressors, bad coping mechanisms, lower income/education, first nations

Question 13

__% of homeless people will suffer from alcohol addition

Answer 13

26%

Question 14

AA sees alcoholism as what?

Answer 14

As being a disease

Question 15

Learning theorists see alcoholism as what?

Answer 15

As being a learned behaviour

Question 16

Psychological effects of alcohol

Answer 16

Euphoria, relaxation, increased confidence

Question 17

Physical health and alcohol

Answer 17

Alcohol-induced persisting amnestic 
Korsakoff's syndrome (thiamine deficiency, leads to amnesia, confabulation)
higher rates of cancer 
ulcers
hypertension
gout

Question 18

Is there a health benefit to moderate alcohol consumption?

Answer 18

Yes, but no more than 2 drinks a day have a protective impact on the heart (decrease BP, vasodilator)

Question 19

Alcohol and ethnic diversity

Answer 19

Bad with First Nations
Jewish people have low alcohol related problems (children are exposed to the ritual use of wine in childhood and impose cultural restraints on excessive drinking
Asian people drink less heavily than other Canadians (less biological tolerance of alcohol and therefore have a greater flushing response)

Question 20

Alcohol plays a role in deaths due to…

Answer 20

Snowmobile accidents (77%)
Homicides (>50%)
Traffic accidents (>40%)
boating accidents (40%)
suicides (>20%)

Question 21

Barbiturates

Answer 21

Sedatives
dangerous when mixed with alcohol 
effect for 3-6 hours
very addictive
reduce tension
treat: epilepsy/high BP
most popular street drug 
1%
Middle age females take it most often to help them sleep 
4x more potent than alcohol 
significant withdrawal is sopped cold turkey

Question 22

Opiates

Answer 22

Narcotics
Analgesia 
Endorphins 
produces rush for 5-15 minutes
euphoria for 3-5 hours
ex. form poppy plant
ex. Vicodin, Oxycontin are the most widely abused 
0.7% of population abuses them 
Withdrawal is flu-like symptoms (increased HR and fever)

Question 23

Stimulants

Answer 23

Amphetamines
Amphetamine Psychosis
Pill, crushed
suicide rates go up when you’re on the way down from the high
can cause withdrawal effects like insomnia, psychotic state like schizophrenia

Question 24

Cocaine

Answer 24

• crack (more popular with adolescents)
• freebasing (power form)
  effects
• binge states (12-46 hours),
  2-5 days coming down
  withdrawal: depression
  highly addictive!!!

Question 25

Nicotine

Answer 25

Nicotine dependence feel more alert withdrawal symptoms: depression, weight gain, light headed, increased appetite, can't concentrate, fever, sweating 20-24 years old younger you are at the start the harder it is to stop lots of health impacts: miscarriages, cancer (90% of lung cancers caused by smoking >leading cause of women's death (has surpassed breast cancer)

Question 26

Hallucinogens

Answer 26

Psychedelics, LSD Flashbacks sensory deprivation, hallucinations, alter consciousness withdrawal symptoms: anxiety and depression unpredictable (can have a good or bad trip)

Question 27

Factors for cigarette smoking in Canada

Answer 27

the prevalence of smoking among adults is higher among Aboriginals than non-Aborignials (regardless of whether they live in rural or urban environments) Smoking is more common among the poorer and less educated segments of the population

Question 28

Phencyclidine (PCP)

Answer 28

``` Angel Dust Anesthetic hallucinations readily available, inexpensive produces dissociations, delirium, paranoia, agitation, absent state ```

Question 29

Marijuana

Answer 29

Delta-9-tetrahydrocannabinol (THC) Hashish 5-6% of population, more common in males 18-30 year olds low doses = relaxation higher doses = more isolation > less ability to recall facts

Question 30

Inhalants

Answer 30

``` adhesives, aerosols, cleaning fluids, markers, predice, euphoria unpredictable leads to death is inhale too mush impact memory and learning leads to illness ```

Question 31

The proportion of Marijuana users in Canada is...

Answer 31

much higher among young adults than in the population as a whole

Question 32

Gambling disorder

Answer 32

Impulse control disorder in former DSM editions in DSM 5 gambling disorer is classified with other substance use disorders has commonalities in expression, aetiology, comorbidity, and treatment with substance abuse disorders

Question 33

Aetiology

Answer 33

aka Etiology | the study of causation/origination

Question 34

Biological perspective

Answer 34

NTS Brain's reward centres genetic factors ``` nicotine/alcohol/heroin/cocaine/marijuana all increase DA levels - impact brains natural DA production - can lead to psychotic state Cocaine - impacts 5HT levels of brain Heroin - effect endorphin levels ``` connected to brain's reward pathway genetic factors - family members, alcohol, smoking = you are more likely to use - monozygotic twins more likely!

Question 35

Learning Perspective

Answer 35

``` Operant conditioning (trial and error, social influences) Alcohol and tension reduction (it's a short term solution but a long term problem) Negative reinforcement and withdrawal (keep abusing drugs to avoid withdrawal) ``` The conditional model of cravings Observational learning -what is your social network like? - what is the environment? - if you smoke at parties, then you'll crave drug at parties - CUES are very IMPORTANT - treatment involved learning and recognizing the cues

Question 36

Cognitive Perspective

Answer 36

What you believe is what you get Outcome expectancies, decision making and substance self efficacy expectations does one slip cause people with substance abuse or dependence to go on binges?

Question 37

Psychodynamic Perspectives

Answer 37

Stuck in oral fixation phase

Question 38

Sociocultural perspectives

Answer 38

religious beliefs

Question 39

Biological Approaches

Answer 39

Detoxification Disulfiram - no good > doesn't alter your behaviour - adverse side effects when taken with alcohol, to prevent alcohol consumption Antidepressants (reduce cravings for cocaine) Nicotine replacement therapy (the patch, gum) Methadone maintenance programs - methadone (prevents craving) Naloxene and Naltrexone - blocks high - prevents craving

Question 40

Treatment

Answer 40

Nonprofessional support groups - AA Residential approaches Psychodynamic approaches Behavioural approaches Relapse prevention training

Question 41

Behavioural approaches

Answer 41

Self control strategies - limit opportunities to see cues - resopnse prevention control consequnnces Aversive conditioning - behavioural, pair it with an unpleasant thing social skills training

Question 42

Relapse prevention training

Answer 42

Relapse Relapse-prevention training Abstinence violation effect

Question 43

Most habit forming drug?

Answer 43

Cocaine

Question 44

Stages of change

Answer 44

see slide Pre-contemplation 1: no intention to change, unaware of the problem 2: contemplation (aware the problem exists and serious evaluation of options but not committed to take action) 3: preparation (intends to take action, makes small changes, needs to set goals and priorities) 4: Action (dedicates time and energy, make overt/viable changes, developed strategies to deal with barriers 5: adaptation/maintenance - works to adapt and adjust to facilitate maintenance of change what stage is the person in? not every client is going to be ready for the action stage, some times you just need them to accept their problem and begin to formulate plans