What is abuse?
What is dependence?
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
Substance abuse disorders are distinguished by the presence of what characteristics compared to non-pathological substance use?
substance related problems
What is withdrawal?
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
What is tolerance?
a state of progressively decreased responsiveness to a substance and markedly increased amounts of the substance ingested to achieve the desired effect
WHat is the prevalence of substance use disorders in clinics?
What is the most common illicit drug used in the US?
Of prescription medications, what are the most commonly abused?
pain relievers - opioids
Which age group uses the most drugs?
18-25 yr olds
Is there a gender difference in marijuana use?
not much - females a little less
What are the main risk factors for drug abuse
peer pressure and social environment
alcohol advertising and marketing
biological and genetic factors
What are the particularly high risk groups for drug use?
american indians and whites
Employed individuals have ___ number of users while unemployed have ___ rates of use.
In general, inheritability for drug abuse ranges from what?
WHat neurotransmitters are associated with the positive hedonic effects of drug abuse?
What withdrawal effects are associated with the following:
dopamine = dysophoria
opioid peptides = pain
serotonin = dysphoria
GABA = anxiety, panic attacks
In what ways are cannabinoids used medicinally?
antiemetic, increase appetite
What percentage of marijuana users become addicted?
What are the endocrine effects of cannabinoids?
decreased testosterone (and sperm count)
inhibit LH, prolactin, growth hormone, but not FSH
Reduces TSH and T4 in animals
What are the two main stimulants used most often in north america?
cocaine and methamphetamine
All stimulants increase what group of NTs?
domapine initially, but chronically depletes
serotonin (MDMA blocks reuptake and cocaine increases firing)
What are the two major classes of sedatives/hypnotics?
The symptoms rebound (withdrawal) from sedatives usually lasts for how long and in what percentage of patients?
up to 3 weeks - in about 50% of patients taking BDZs for more than a few months
What is symptoms reemergence and how is it different from symptom rebound?
it is NOT a withdrawal symdrome,...
it is the reoccurrence of the original disorder to the same level as before treatment
protracted withdrawal can last ___
What neurotransmitter pathway reinforces alcohol abuse?
excitation of the VTA dopaminergic neurons
this facilitates glutaminergic transmission in mesolimbic and mesocortical areas
The average adult metabolizes 1 ounce every ___ hour(s) depending on body weight.
How much higher is a woman's BAL compared to a man for the same amount of ingested alcohol?
What two NTs does alcohol enhance to have an inhibitory function?
GABA and glycine
ALcohol also ____ conduction of serotonin receptors.
What symptoms would you expect to see with alcohol withdrawal?
seizures, tachy, HTN, fever
later on you can have hallucinations