Flashcards in L7 - Substance Use, Misuse and Abuse (McKinlay) Deck (29):
Describe the continuum of substance use.
Experimentation -> Recreational/Social use -> Regular Use/Binging -> Problematic Use (mild to severe)
What is tolerance?
This describes changes in ways that the body reacts to a drug. When someone develops a tolerance, they need increasing doses to achieve the same effect.
What are withdrawal symptoms?
These are compensatory reactions in the body that oppose the primary effects of the drug, and happen in the absence of the drug.
What is craving?
This is a PSYCHOLOGICAL urge to administer a discontinued medication or drug.
How do drugs become addictive?
Taking the drug activates the BRAIN REWARD SYSTEM.
This REINFORCES drug taking (Brain may change in response to drug taking, and urge to take the drug)
Produces INTENSE activation of the reward system.
--> feeling "high", reduces inhibitory control!
What is the difference between addiction and dependence?
- drug dependence means person needs drug to function normally
- drug addiction - compulsive use of the substance, despite negative/harmful effects
- a person may have physical dependence WITHOUT having an addition
What is alcoholism?
- intoxication, disorder, withdrawal.
- can be mild, moderate or severe.
What are DSM-V characteristics of substance-induced disorders?
- intoxication, disorder, withdrawal
- impaired control
- social impairment (failure to fulfil obligations, withdraw from people)
- risky use (use in hazardous situations)
- pharmacological (tolerance and withdrawal)
What are problems in diagnosis of substance use disorders?
- less than 1/3 of substance abuse is recorded
- clinicians don't suspect a problem because people w/ tolerance may not appear to be having a problem.
- People have to acknowledge they have a problem and stop using, and deal with the stigma
- lack of skills, from the clinician
- embarassment or fear of offending patient
- frequently comorbid depression, anxiety, psychosis - OVERSHADOWS the substance use
What are some theories of addiction?
- Dopamine hypothesis
- family causation
- socio-cultural influence
- bio-psycho-social model
- disease as damage
- family interaction model
What is disease theory?
Theorises that drug use changes the way the brain responds to the stimulus, therefore more likely to use again.
(Refer to paper for more!!)
What are the 3 main times of learning?
- operant conditioning
- classical conditioning
- social learning
What is operant conditioning?
This is learning which occurs through reinforced behaviour being more likely to be repeated.
Behaviours that are not reinforced tends to die out or be extinguished.
Accidental response --> reinforcement --> deliberate response
What is classical conditioning?
This occurs through a process of association.
Repeated pairings of UNCONDITIONED STIMULUS with CONDITIONED STIMULUS, will eventually elicit UNCONDITIONED RESPONSE in the absense of CONDITIONED STIMULUS, with only unconditioned stimulus.
Describe social learning.
When we learn through observing others. This is the most common way people learn
- observing others use drugs in a bad way...
Explain the biopsychosocial model in terms of drug use.
- drug abuse is multifactorial, including biological, psychological and social components.
- emergence of substance abuse depends on the amount of exposure and social pressure, as well as personal vulnerability.
- Explains why some people in a similar situation don't get affected
- looks at what maintains the addiction.... genetics.. previous learning.. own personality
What are some biopsychosocial influences??
Bio - we're born with a drive... some are high risk, some aren't
social - we receive rewards and punishment for various things
psychosocial - desires, norms..
develop preferred methods and tend to persist in attempts.
set and setting shape experiences.
Why is it so hard for those who are addicted to drop their habits even when they are presented with a direct consequence (eg. heart failure)
Meaning of the drug is highly important..
- social element?
- psychological meaning - they can attach it to their IDENTITY.
-physical dependence - can you tolerate living if you can't function properly?
What are the long term effects of alcohol on the body?
HEART - increase BP, enlarges heart, irregular HR
MUSCLES - shrink
SKIN - redness, sweating more
LIVER - cancer, extreme pain and swelling
BRAIN - damage, memory loss, confusion, hallucinations
LUNGS - increase change of infection
STOMACH - bleeding, ulcers
How much is a standard drink?
any drink with 10g of alcohol.
How long does it take the body to clear one standard drink?
Averages about 1 hour to clear the body from one standard drink, but depends on liver size, body mass and composition and alcohol tolerance.
What is binge drinking?
This is drinking too much on a single occasion of drinking. - more than the recommended level for adults.
or continuously drinking for a number of days, weeks or irregular bouts.
Risks associated with binge drinking?
- memory loss
- injury to self and others
- loss of coordination
- diarrhoea, vomitting
- lack of judgement
- alcohol poisoning - sometimes fatal
What is the problem with indigenous australians and alcohol use?
- burden of disease due to alcohol use is double than that of general aus population
- in 2003, alcohol accounted for 6.2% of overall burden of disease among indig aus.
- higher percentages of risky comsumption and short and long term high risk consumption for indigenous than general aus population
What are the national health and medical research council's alcohol guidelines?
1. no more than 2 standard drinks in 1 day reduces lifetime risk
2. no more than 4 standard drinks on any one occasion reduces risk of injury
3. not drinking alcohol before 15 - more likely to undertake more risky and antisocial behaviour.
4. no drinking while pregnant or breastfeeding.
Describe withdrawal syndrome for alcohol.
- begins within 24 hours
- lasts up to 5 days
- happens when theres a regular intake of 6 (f) to 8 (m) drinks.
- alcohol withdrawal seizures
- considered medical emergency
What are some treatment options for substance use disorders?
- Support groups
- Beyond 12step groups (for alcohol)
- smart recovery groups
- harm reduction programs - doesn't push total abstinence, helps you come to a negotiated agreement!!
- traditional talking therapies
- therapeutic community models
Relapse rate over time for heroin, smoking and alcohol?
BUT OBVIOUSLY, THERE IS SOME EFFECT OF TREATMENT..
ABOUT 80% relapse for smoking and heroin and 70% for alcohol.