L9: Substance misuse Flashcards
Define substance misuse?
Harmful or hazardous use of psychoactive substances, including alcohol and illicit drugs
Lead to dependence syndrome
Strong desire to keep taking it
Difficulties controlling its use
Prioritising it over other activities and obligations, increased tolerance, and sometimes a physical withdrawal state
What is meant by dependence syndrome?
Behavioural, cognitive and physiological phenomena that develop after repeated substance use
What are the different types of substances?
Stimulants
Hallucinigens
Depressants
What are stimulants?
Make you feel more alert and like you have more energy and confidence
What are hallucinogens?
Sometimes described as mind altering
Change/impact your perceptions, mood and sense
What are depressants?
Make you feel relaxed
What is dependence?
Physical or psychological
Physical→ symptoms associated with withdrawal from the substance
Psychological→ having impaired control
How is dependence described?
Desire; often strong, sometimes overpowering, to take psychoactive drugs (which may or maynot have been medically prescribed), alcohol or tobacco
Return to substance after period of abstinence leads to a more rapid reappearance of other features of the syndrome than occurs with non dependent individuals
How is dependence diagnosed?
ICD-10 diagnostic guidelines
Three or more of the following present together at some time during the previous year:
- Strong desire or compulsion to take the substance
- Difficulties controlling substance-taking behaviour
- Physiological withdrawal state
- Evidence of tolerance
- Progressive neglect of alternative pleasures or interests because of psychoactive substance use
- Persisting with substance use despite clear evidence of overtly harmful consequences
Similar tool called the DSM V diagnositic tool can also be used
How is alcohol dependence diagnosed?
Audit-C
Questionnaire on drinking habits
What are the risk factors for drug use?
Issues relating to family life: neglect, drug misuse and/or emotional or physical abuse has taken place
Mental health: depression, anxiety and attention deficit disorder are associated with drug misuse
Employment and education attainment: unemployment poor educational attainment are associated with increased risk of drug use
Social groups: spending time and socialising with drug users increases risk
Previous drug use: previous drug use shown to increase likelihood of going on to have problematic use
Biology: positive effects from drug misuse are more likely to continue using drugs
How do adverse childhood experience (ACEs) contribute to dependence?
ACE higher risk of drinking, unintended teenage pregnancy, smoke e-cigarettes or tobacco, have sex under 16 years, smoke cannabis, victim of violence over the last 12 months, committed violence against another person, used crack cocaine or heroin, incarcerated at any point in their life
What are the learning theories of dependence?
Classical conditioning (Pavlovs dogs) → main one for drug use
Environmental stimuli paired with effect
Unconditional stimulus linked with unconditional response
Cue or conditioned stimulus linked with conditioned response
e.g. falling alcohol levels lead to withdrawal and alcohol cues (pub, smell, sight of drink) leads to conditioned withdrawal
What is the imitation theory of dependence?
Learning through observation and listening to others
Peers and role models
Modelling: risk of drug use increases if we see others around doing it
Expectation: positive reward makes drug use more likely
Self-efficacy:how you view your ability to abstain or deal with situations impacts on behaviour
Treatment- CBT (cognitive behavioural therapy) → reduces expectation of positive reward and develops self efficacy
- The twelve step programme→ positive role models and promotes coping skills
What is the rational choice theory?
Dependence involves making rational choices that favours the benefits of dependence over the costs
Individual are motivated by their ‘preferences’ which are their wants or goals
