Drug and Alcohol Addiction

Question 1

What is abuse?

What is dependence?

Answer 1

Abuse is an intense desire to obtain increasing amounts of a particular drug to the exclusion of all other activities

Dependence is the body’s physical need (addition) to a specific drug

Question 2

Substance abuse disorders are distinguished by the presence of what characteristics compared to non-pathological substance use?

Answer 2

tolerance

withdrawal

compulsive use

substance related problems

Question 3

What is withdrawal?

Answer 3

the presence of the characteristic withdrawal syndrome for the substance - so that the same or closely related substance is used to avoid or relieve withdrawal symptoms

Question 4

What is tolerance?

Answer 4

a state of progressively decreased responsiveness to a substance and markedly increased amounts of the substance ingested to achieve the desired effect

Question 5

WHat is the prevalence of substance use disorders in clinics?

Answer 5

20%!

Question 6

What is the most common illicit drug used in the US?

Answer 6

marijuana

Question 7

Of prescription medications, what are the most commonly abused?

Answer 7

pain relievers - opioids

Question 8

Which age group uses the most drugs?

Answer 8

18-25 yr olds

Question 9

Is there a gender difference in marijuana use?

Answer 9

not much - females a little less

Question 10

What are the main risk factors for drug abuse

Answer 10

early exposure

peer pressure and social environment

alcohol advertising and marketing

biological and genetic factors

Question 11

What are the particularly high risk groups for drug use?

Answer 11

adolescents

older adults

men

american indians and whites

mental illness

homeless

upper midwest

family history

Question 12

Employed individuals have ___ number of users while unemployed have ___ rates of use.

Answer 12

higher

Question 13

In general, inheritability for drug abuse ranges from what?

Answer 13

40-60%

Question 14

WHat neurotransmitters are associated with the positive hedonic effects of drug abuse?

Answer 14

dopamine

opioid peptides

serotonin

GABA

Question 15

What withdrawal effects are associated with the following:

dopamine

opioid peptides

serotonin

GABA

Answer 15

dopamine = dysophoria

opioid peptides = pain

serotonin = dysphoria

GABA = anxiety, panic attacks

Question 16

In what ways are cannabinoids used medicinally?

Answer 16

antiemetic, increase appetite

anticonvulsant

analgesic

Question 17

What percentage of marijuana users become addicted?

Answer 17

9%

Question 18

What are the endocrine effects of cannabinoids?

Answer 18

decreased testosterone (and sperm count)

inhibit LH, prolactin, growth hormone, but not FSH

Reduces TSH and T4 in animals

Question 19

What are the two main stimulants used most often in north america?

Answer 19

cocaine and methamphetamine

Question 20

All stimulants increase what group of NTs?

Answer 20

monoamines:

domapine initially, but chronically depletes

noreprinephrine

serotonin (MDMA blocks reuptake and cocaine increases firing)

Question 21

What are the two major classes of sedatives/hypnotics?

Answer 21

barbiturates

benzodiazepines

Question 22

The symptoms rebound (withdrawal) from sedatives usually lasts for how long and in what percentage of patients?

Answer 22

up to 3 weeks - in about 50% of patients taking BDZs for more than a few months

Question 23

What is symptoms reemergence and how is it different from symptom rebound?

Answer 23

it is NOT a withdrawal symdrome,…

it is the reoccurrence of the original disorder to the same level as before treatment

Question 24

protracted withdrawal can last ___

Answer 24

several months

Question 25

What neurotransmitter pathway reinforces alcohol abuse?

Answer 25

excitation of the VTA dopaminergic neurons this facilitates glutaminergic transmission in mesolimbic and mesocortical areas reinforces behavior

Question 26

The average adult metabolizes 1 ounce every ___ hour(s) depending on body weight.

Answer 26

3 hours

Question 27

How much higher is a woman's BAL compared to a man for the same amount of ingested alcohol?

Answer 27

20-25%

Question 28

What two NTs does alcohol enhance to have an inhibitory function?

Answer 28

GABA and glycine

Question 29

ALcohol also ____ conduction of serotonin receptors.

Answer 29

enhances

Question 30

What symptoms would you expect to see with alcohol withdrawal?

Answer 30

seizures, tachy, HTN, fever later on you can have hallucinations

Question 31

What is the primary challenge with opioid dependence and difficulty in quitting?

Answer 31

the opioid receptors in the brbain are affected in such a way that it takes the affected areas of the brain 3 months to heal, during which time they have anhedonia - the absence of pleasure or the ability to experience it huge risk for relapse