Lecture 12 Flashcards
(196 cards)
1
Q
The cost of substance misuse is more than ____ billion each year in the United States alone
A
$600
2
Q
In 1962, only __ million people in the United States had ever used an illegal substance; today the number has climbed to more than ___ million
A
4; 100
3
Q
Any substance other than good that affects our bodies or mind
A
Drug
4
Q
What is Substance Intoxication?
A
A cluster of temporary undesirable behavioral or psychological changes that develop during or shortly after the ingestion of a substance
5
Q
A pattern of longer-term maladaptive behaviors and reactions brought about by repeated use of a substance
A
Substance use disorder
6
Q
What does it mean when a person develops a tolerance?
A
The brain and body’s need for ever larger doses of a drug to produce earlier effects
7
Q
Unpleasant, sometimes dangerous reactions that may occur when people who use a drug regularly stop taking or reduce their dosage of the drug
A
Withdrawal
8
Q
What percentage of all teens and adults in the U.S. have a substance use disorder?
A
8.9%
9
Q
Which race has the highest rate of substance use disorders in the United States?
A
American Indians- 21.8%
10
Q
Which race has the lowest rate of substance use disorders in the United States?
A
Asian Americans- 3.2%
11
Q
What is the rate of substance use disorders of white Americans, Hispanic Americans, and African Americans?
A
9%
12
Q
Only __ of all those with substance use disorders receive treatment from a mental health professional
A
11% (around 2.5 million people)
13
Q
What are the categories of the substances people misuse?
A
- Depressants
- Stimulants
- Hallucinogens
- Cannabis
14
Q
What do depressants do to the body?
A
Slow the activity of the central nervous system. Reduce tension and inhibitions and may interfere with a person’s judgment, motor activity, and concentration
15
Q
The three most widely used groups of depressants are?
A
- Alcohol
- Sedative hypnotic drugs
- Opiods
16
Q
Any beverage containing ethyl alcohol, including beer, wine, and liquor
A
Alcohol
17
Q
When people consume five or more drinks on a single occasion it is called a _____ ______ episode
A
Binge drinking
18
Q
__ percent of people in the United States over the age of 11, most of them male, binge drink each month
A
23%
19
Q
Around __ percent of people over 11 years binge drink at least 5 times each month
A
6.5%
20
Q
Among heavy drinkers, males outnumber the females by at least _ to _
A
3 to 2
21
Q
One important group of neurons to which ethyl alcohol bonds are those that normal receive the neurotransmitter _____
A
GABA
22
Q
What does ethyl alcohol do at first?
A
Depresses the areas of the brain that control judgment and inhibition
23
Q
What happens when more alcohol is absorbed?
A
It slows down additional areas in the central nervous system, leaving the drinkers less able to make sound judgments, their speech less careful and less coherent, and their memory weaker
24
Q
Motor difficulties ______ as a person continues drinking and reaction times _____
A
Increase, slow
25
Women have less of the stomach enzyme _____ _________, which breaks down ______ in the stomach before it enters the blood
Alcohol dehydrogenase; alcohol
26
When the alcohol concentration reaches __ percent of the blood volume, a person usually feels relaxed and comfortable
0.06%
27
At what alcohol concentration does the drinker cross the line into intoxication?
0.09%
28
More than _____ people in the United States die each year from too high a blood alcohol level
1,000
29
Surveys indicate that over a 1 year period, __ percent of all adults in the United States display alcohol use disorder (aka alcoholism)
6.8%
30
Men with alcoholism outnumber women by at least _ to _
2 to 1
31
What are some factors of the clinical picture of alcohol use disorder?
- Drink large amounts regularly and rely on it to enable them to do things that would otherwise make them anxious
- Damage in various regions of their brain
- Impairments in their memory, speed of thinking, attention skills, and balance
32
Studies show that __ percent of college students binge drink at least once each year, __ of them 6 times or more per month
40%; 1/3
33
A dramatic withdrawal reaction that some people who are dependent on alcohol have. It consists of confusion, clouded consciousness, and terrifying visual hallucinations
Delirium tremens (“the DTs”)
34
Alcoholism plays a role in more than __ of all suicides, _______, assaults, rape, and accidental deaths, including __ percent of all fatal automobile accidents in the United States
1/3, homicides; 30%
35
How many deaths per year are intoxicated drivers responsible for?
12,000 deaths
36
What effects does alcoholism have on children of people with the disorder?
- Home life includes conflict and perhaps sexual or other forms of abuse
- Higher rates of psychological problems
- Low self esteem, poor communication skills, poor sociability, and marital problems
37
What is cirrhosis?
Irreversible condition in which the liver becomes scarred and dysfunctional from long term excessive drinking
38
What other damages can alcohol use disorder have on a person’s physical health?
-May also damage the heart and lower the immune system’s ability to fight off cancer, bacterial infections, and AIDS
- Major nutritional problems
39
An alcohol related disorder marked by extreme confusion, memory impairment, and other neurological symptoms
Korsakoff’s syndrome
40
People with Korsakoff’s syndrome cannot remember the past or learn new information and may make up for their memory loss by ___________
Confabulating- reciting made up events to fill in the gaps
41
A cluster of problems in a child, including low birth weight, irregularities in the head and face, and intellectual deficits, caused by excessive alcohol intake by the mother during pregnancy
Fetal alcohol syndrome
42
In the overall population, around _ of every __ babies is born with fetal alcohol syndrome
1 of every 1,000
43
A drug used in low doses to reduce anxiety and in higher doses to help people sleep
Sedative hypnotic drug (aka anxiolytic drug)
44
Addictive sedative hypnotic drugs that reduce anxiety and help people sleep
Barbiturates
45
Which drug is safer and replaced barbiturates?
Benzodiazepines
46
How many deaths occur a year by accidental or suicidal overdoses of barbiturates?
Several thousand deaths
47
At too high a level, barbiturates can do what to a person’s body?
Halt breathing, lower blood pressure, and lead to coma and death
48
What is a major danger of barbiturate tolerance?
The lethal dose of the drug remains the same even while the body is building up a tolerance for its sedating effects
49
What may a person experience during withdrawals from barbiturates?
Nausea, anxiety, sleep problems, and convulsions
50
The most common group of anti anxiety drugs, which include Valium and Xanax
Benzodiazepines
51
Benzodiazepines relieve anxiety without making people as ______ as other kinds of sedative hypnotics
Drowsy
52
Benzodiazepines are _____ likely to slow a person’s ______, so they are less likely to cause death in the event of an overdose
Less, breathing
53
What is caused at high enough doses of benzodiazepines?
Intoxication and lead to an addictive pattern
54
Over a 1 year period, __ percent of all adults in the United States have either barbiturate or benzodiazepine use disorder and as many as __ percent have one of these disorders over the course of their lives
0.03%, 1%
55
Opium or any of the drugs derived from opium, including morphine, heroine, and codeine
Opiod
56
What was used in the past in the treatments of medical disorders because of its ability to reduce both physical and emotional pain?
Opium
57
A highly addictive substance made from the sap of the opium poppy
Opium
58
A highly addictive substance derived from opium that is particularly effective in relieving pain
Morphine
59
One of the most addictive substances derived from opium
Heroine
60
What are all the opioid drugs- natural and synthetic- collectively known as?
Narcotics
61
How do the effects of opioids created?
By depressing the central nervous system, particularly the centers that help control emotion
62
Neurotransmitters that help relieve pain and reduce emotional tension. They are sometimes referred to as the body’s own opioids
Endorphins
63
Opioids attach to the brain receptor sites that ordinarily receive ________
Endorphins
64
When neurons at these receptor sites receive opioids, they produce ______ and ________ feelings just as they would do if they were receiving endorphins
Pleasurable, calming
65
In addition to reducing pain and tension, opioids can also cause what?
Nausea, narrowing of the pupils (“pinpoint pupils”), and constipation
66
Surveys suggest that more than __ percent of adults in the United States display an opioid use disorder within a given year
1%
67
__ percent of these people are addicted to the pain reliever opioids such as oxycodone and morphine
80%
68
Around __ percent of those with opioid use disorder (a half million people) are addicted to heroin
20%
69
Where do people obtain pain killers for non medical use?
- More than half get from friends or relatives
- More than 20% from a doctor
- Less than 5% buy from a drug dealer
70
What is the most immediate danger of heroine use?
An overdose- closes down the respiratory center in the brain, almost paralyzing breathing and in many cases causing death
71
Each year approximately __ percent of those addicted to heroin and other opioids die under the drug’s influence usually from an overdose
2%
72
Dirty needles and other unsterilized equipment spread _________ such as AIDS, hepatitis __, and skin abscesses
Infections; C
73
I’m some areas of the United States, the HIV infection rate among active heroin users is reported to be as high as __ percent
60%
74
Substances that increase activity of the central nervous system, resulting in increased blood pressure and heart rate, more alertness, and sped up behavior and thinking
Stimulants
75
What are the most troublesome stimulants?
Cocaine and amphetamines
76
Which two stimulants are widely used and legal?
Coffee and nicotine
77
An addictive stimulant obtained from the coca plant. It is the most powerful natural stimulant known
Cocaine
78
In the early 1960s, an estimated ____ people in the United States had tried cocain
10,000
79
Today __ million people have tried it, and __ million - most of them teenagers or young adults- are using it currently
28; 1.6
80
At first cocaine stimulates the _____ centers of the _______ nervous systems, making users feel excited, energetic, talkative, and even euphoric
Higher; central
81
As more cocaine is taken, it stimulates _____ centers of the central nervous system, producing a faster pulse, _______ blood pressure, and deeper breathing and further arousal and wakefulness
Other; higher
82
How does cocaine produce the effects to the human body?
-By increasing supplies of the neurotransmitter Dopamine at key neurons throughout the brain
- Also increase the activity of norepinephrine and serotonin in some areas of the brain
83
Symptoms are poor muscle coordination, grandiosity, bad judgment, anger, aggression, compulsive behavior, anxiety, and confusion
Cocaine intoxication
84
What is cocaine induced psychosis?
When people have hallucinations, delusions, or both due to high doses of cocaine
85
A technique for ingesting cocaine in which the pure cocaine basic alkaloid is chemically separated from processed cocaine, vaporized by heat from a flame, and inhaled with a pipe
Freebase
86
A powerful, ready to smoke freebase cocaine
Crack
87
Excessive doses of cocaine have a strong effect on the ___________ center of the brain, at first stimulating it and then depressing it to the point where _______ may stop
Respiratory, breathing
88
What other effects on the body can high doses of cocaine have?
Can also create major, even fatal, heart irregularities or brain seizures that bring breathing or heart functioning to a sudden stop
89
A stimulant drugs that is manufactured in the laboratory
Amphetamine
90
Like cocaine, __________ increase energy and alertness and reduce appetite when taken in small doses
Amphetamine
91
Amphetamine produce a rush, intoxication, and psychosis in ____ doses
High
92
Almost __ percent of all people over the age of 11 in the United States have used methamphetamine at least once
6%
93
A powerful amphetamine drug that has surged in popularity in recent years, posing major health and law enforcement problems
Methamphetamine
94
Available in the form of crystals (aka ice and crystal meth) which users smoke
Methamphetamine
95
What percentage of meth users are women?
40%
96
What is neurotoxicity? Which drug is a particular concern of this?
- Damages nerve endings
- Methamphetamine
97
In a given year, __ percent of all people over the age of 11 display stimulant use disorder that is centered on cocaine, and 0.2% display stimulant use disorder centered on __________
0.4%; amphetamines
98
The world’s most widely used stimulant, most often consumed in coffee
Caffeine
99
What percentage of the world’s population consumes caffeine daily?
80%
100
Around __ percent of ingested caffeine is absorbed by the body and reaches its peak concentration within an ___
99%, hour
101
Caffeine at high doses increases _____ ____ secretions in the stomach and the rate of _________
Gastric acid; breathing
102
How many cups of coffee can produce a caffeine intoxication?
More than 2-3 cups of brewed coffee
103
If added to the DSM, what is the key criteria of caffeine use disorder?
- 1 year pattern of problematic caffeine use
- Unsuccessful efforts to reduce caffeine use
- Awareness that one’s continued caffeine use is causing repeated physical or psychological problem
- Withdrawal symptoms if one stops caffeine use
- Significant impairment or distress
104
First produced in the 1930s to help treat _____, amphetamines soon became popular among people trying to ____ _______ and trying to stay _____
Asthma; lose weight; awake
105
A substance that causes powerful changes primarily in sensory perception and producing illusions and hallucinations
Hallucinogen (aka psychedelic drug)
106
Hallucinogens include what drugs?
LSD, mescaline, psilocybin, and MDMA (Ecstasy)
107
Where do hallucinogen substances come from?
Come from plants or animals; others are produced in laboratories
108
A hallucinogenic drug derived from ergot alkaloids
LSD (lysergic acid diethylamide)
109
Within 2 hours of being swallowed, LSD brings in a state of _____________, marked by a general strengthening of perceptions, along with psychological changes and physical symptoms
Hallucinogen intoxication aka hallucinosis
110
LSD symptoms are produced primarily by binding to some of the neurons that normally received which neurotransmitter?
Serotonin
111
The neurons LSD bind to ordinarily help the brain send what type of information and control what?
Send visual information and control emotions
112
More than __ percent of all people in the United States have used LSD or another hallucinogen at some point in their lives
14%
113
Around __ percent are currently using LSD or another hallucinogen
0.4%
114
Do people develop a tolerance to LSD or have withdrawal symptoms when they stop?
No
115
How does LSD poses dangers?
- No matter how small a dose can lead to a bad trip
- Long term effect -> flashbacks
116
Drugs produced from the varieties of the hemp plant Cannabis sativa. They cause a mixture of hallucinogenic, depressant, and stimulant effects
Cannabis drugs
117
Which is the most powerful of cannabis? The weaker one?
Hashish; marijuana
118
One of the cannabis drugs derived from the buds, leaves, and flowering tops of the hemp plant Cannabis sativa
Marijuana
119
What percent of the population currently smoke marijuana at least monthly?
7.3%
120
The main active ingredient of cannabis substances
THC (tetrahydrocannabinol)
121
At low doses, the cannabis smoker typically has feelings of ___ and relaxation and may become either _____ or talkative
Joy; quiet
122
What are the physical changes for smoking cannabis?
Reddening of the eyes, fast heartbeat, increased blood pressure and appetite, dryness in the mouth, and dizziness
123
In high doses what does cannabis produce?
Odd visual experiences, changes in body image, and hallucinations
124
Why have more and more marijuana users developed cannabis use disorder over the past 3 decades?
Because marijuana has changed- more powerful
125
The average THC content of today’s marijuana is __ percent compared with __ percent in the late 1960s
8%; 2%
126
How can marijuana be dangerous?
- Can cause hallucinations and some may fear they are losing their minds
- Interfere with the performance of complex sensorimotor tasks and with cognitive functioning -> car accidents
- Fail to remember information
127
What was cannabis used for?
As a surgical anesthetic by Chinese physicians 2,000 years ago
128
What is synesthesia?
When a drug (such as LSD) causes different senses to cross
Ex: colors can be heard or felt
129
When people often take more than one drug at a time it’s called _________ ___
Polysubstance use
130
What two important discoveries emerged from studying the ways in which drugs interact with one another?
1. Cross tolerance
2. Synergistic effects
131
Tolerance for a substance one has not taken before as a result of using another substance similar to it
Cross tolerance
132
In pharmacology an increase of effects that occurs when more than one substance is acting on the body at the same time
Synergistic effect
133
A different kind of synergistic effect results when the drug have opposite, or ________, actions
Antagonistic
134
Clinical theorists have developed what three types of explanations for why people develop substance use disorders?
Sociocultural, psychological, and biological explanations
135
Studies have found that what type of regions have higher alcoholism rates?
Regions with higher unemployment levels
136
People is what socioeconomic classes have higher rates of substance use disorder?
Low
137
A range of studies conducted with Hispanic and African American people found what?
Higher rates of substance use disorders among those participants who live or work in environments of intense discrimination
138
Psychodynamic theorists believe that people with substance use disorders have powerful ________ needs that can be traced to their early years
Dependency
139
Some psychodynamic theorists also believe that certain people respond to their early deprivations by developing a _____ ____ ________ that leaves them prone to drug abuse
Substance abuse personality
140
According to behaviorista, ______ _________ may play a key role in substance use disorders
Operant conditioning
141
Behaviorists argue that the temporary reduction of tension or raising of spirits produced by a drug has what type of effect? What happens next?
- Rewarding effect
- Increase the likelihood that the user will seek this reaction again and may eventually lead users to try higher dosages or more powerful methods of ingestion
142
At least __ percent of all adults who suffer from psychological disorders also display substance use disorders
19%
143
A number of behaviorista have also proposed that ______ __________ may also play a role in substance use disorders
Classical conditioning
144
Has classical conditioning receive widespread research support as the key factor in substance use disorders?
No, although it certainly appears to be at work in particular cases of substance use disorders
145
One classic study found an alcohol concordance rate of __ percent in a group of identical twins. In contract, a group of fraternal twins had a concordance rate of only __ percent
54%; 28%
146
Which genetic linkage strategies provide more direct evidence in support of a genetic explanation in substance use disorders?
Dopamine-2 (D2) receptor gene has been found in a majority of research participants with substance use disorders but in less than 20% of participants who do not have such disorders
147
Repeated excessive use of alcohol or benzodiazepines may lower the brain’s production of which neurotransmitter?
GABA
148
Regular use of opioids may reduce the brain’s production of which neurotransmitter?
Endorphins
149
Regular use of cocaine or amphetamines may lower the brain’s production of which neurotransmitter?
Dopamine
150
Excessive use of marijuana may reduce the production of which neurotransmitter?
Anandamide
151
A dopamine rich pathway in the brain that produces feelings of pleasure when activated
Reward center
152
A number of theorists believe that when substances repeatedly stimulate the reward center, the center develops a hypersensitivity to the substances
Incentive-sensitization theory of addiction
153
Other theorists believe the reward center is not readily activated by the usual events in a person’s life so they turn to drugs to stimulate this pleasure pathway (reward center), particularly in times of stress
Reward deficiency syndrome
154
___________ therapists first guide clients to uncover and work through the underlying needs and conflicts that they believe have led to the substance use disorder
Psychodynamic
155
A treatment in which clients are repeatedly presented with unpleasant stimuli while they are performing undesirable behaviors such as taking a drug
Aversion therapy
156
What three sociocultural approaches have been used to help people overcome substance use disorders?
1. Self help programs
2. Culture and gender sensitive programs
3. Community prevention programs
157
By listing gambling disorder as an addictive disorder alongside the substance use disorders in the DSM 5, what is it suggesting?
That people may become addicted to behaviors and activities beyond substance use
158
What type of effect can be produced if someone takes alcohol, benzodiazepine, barbiturates, and opioids? Why?
Synergistic effect because all of these drugs are depressants and may severely depress the central nervous system when mixed
159
As many as 90% of those who use one illegal drug are also doing what?
Also using another to some extent
160
_________ theorists further argue that such rewards eventually produce an __________ that substances will be rewarding, and this helps motivate people to increase drug use at times of tension
Cognitive; expectancy
161
Why can the effectiveness of treatment for substance use disorders be difficult to determine?
1. Different substance us disorders pose different problems
2. Many people drop out of treatment early
3. Some people recover without any intervention at all, while others recover and then relapse
4. Different criteria are used by different clinical researchers
162
What type of therapy is Aversion therapy?
Behavioral therapy
163
Which behavioral approach has been effective in the short term treatment of people who are addicted to cocaine and several other drugs? What is it?
Contingency management- makes incentives contingent on the submission of drug free urine specimens
164
In one study, __ percent of cocaine abusers who completed a 6 month contingency training program achieved at lest __ weeks of continuous abstinence
68%; 8
165
When behavioral interventions for substance use disorders are the sole of treatment, how successful are they?
Limited successful
166
A cognitive behavioral approach to treating alcohol use disorder in which clients are taught to keep track of their drinking behavior, apply coping strategies in situations that typically trigger excessive drinking, and plan ahead of risky situations and reactions
Relapse prevention training
167
What are the three strategies included in relapse prevention training for alcohol use disorder?
1. Therapists have clients keep track of their drinking
2. Therapists teach clients coping strategies to use when such situations arise
3. Therapists teach clients to plan ahead of time
168
What is another form of cognitive behavioral therapy that increases people’s awareness and acceptance of their drug cravings, worries, and depressive thoughts?
Acceptance and commitment therapy (ACT)
169
Systematic and medically supervised withdrawal from a drug
Detoxification (Biological treatment)
170
Relapse rates tend to be ____ for those who don’t receive a follow up form of treatment- psychological, biological, or sociocultural- after successfully detoxifying
High
171
Drugs that block or change the effects of an addictive drug
Antagonist drugs
172
What happens when disulfiram is given to people who are trying to stay away from alcohol?
It’s an antagonist drug and at low doses it has few negative effects, but when a person drinks alcohol they will have intens nausea, vomiting, blushing, a faster heart rate, dizziness, and perhaps fainting
173
Why must narcotic antagonists be given very carefully?
Because of their ability to throw such persons into severe withdrawal
174
Narcotic antagonists that produce less severe withdrawal symptoms
Partial antagonists
175
The use of antagonists to help people withdraw is often called _____ ______________ because?
Rapid detoxification because the antagonists speed things along
176
Where does much of the damage caused by heroin addiction come from?
From overdoses, unsterilized needles, and an accompanying life of crime
177
A treatment approach in which clients are given legally and medically supervised doses of methadone- a heroin substitute- to treat heroin centered substance use disorder
Methadone maintenance program
178
Why did methadone programs become less popular during the 1980s?
Many clinicians came to believe that substituting one addiction for another is not an acceptable “solution” for a substance use disorder, and many people with an addiction complained that methadone addiction was creating an additional drug problem that simply complicated their original one
179
Research suggests that methadone maintenance programs are more effective when they are combined with?
Education, psychotherapy, family therapy, and employment counseling
180
What are the 3 biological treatments mentioned for substance use disorders?
Detoxification, antagonist drugs, and methadone maintenance programs
181
A self help organization that provides support and guidance for people with alcohol use disorder
Alcoholics Anonymous (AA)
182
It offers peer support along with moral and spiritual guidelines to help people overcome alcoholism
Alcohol anonymous
183
Studies suggest that _________ may be a more appropriate goal for people who have a long standing alcohol use disorder
Abstinence
184
Controlled drinking can be helpful to _______ drinkers whose pattern does not include tolerance and withdrawal reactions
Younger
185
A place where people formerly addicted to drugs live, work, and socialize in a drug free environment. Also called a therapeutic community
Residential treatment center
186
Why might women prefer gender sensitive clinics or residential homes?
Because women and men often have different physical and psychological reactions to drugs. Also, treatment of women with substance use disorders may be complicated by the impact of sexual abuse, possibility that they are pregnant, the stresses of raising children, and the fear of criminal prosecution for abusing drugs during pregnancy
187
Perhaps the most effective to substance us disorders is to?
To prevent them
188
Prevention programs may focus on what five things?
- Individual (providing education about unpleasant drug effects)
- Family (teaching parenting skills)
- Peer group (teaching resistance to peer pressure)
- School (setting up firm enforcement of drug policies)
- Community at large
189
What are the two leading community based prevention programs today?
TheTruth.com and Above the Influence
190
A disorder marked by persistent and recurrent gambling behavior, leading to a range of life problems
Gambling disorder
191
It is estimated that as many as __ percent of adults and __ to __ percent of teenagers and college students suffer from gambling disorder
4%; 3 to 10%
192
The explanations proposed for gambling disorder often parallel those for substance use disorders by what 4 explanations?
1. Inherit a genetic predisposition to develop the disorder
2. Experience heightened dopamine activity and operation of the brain’s reward center when they gamble
3. Have impulsive and other personality styles that leave them prone to gambling disorder
4. Make repeated and cognitive mistakes such as inaccurate expectations and misinterpretations of their emotions and bodily states
193
Which leading treatments for substance us disorder have been adapted for use with gambling disorder?
- Cognitive behavioral approaches like relapse prevention training
- Biological approaches such as narcotic antagonists
- Self help group program Gamblers anonymous
194
At least __ percent of all people have internet use disorder
1%
195
Is internet use disorder included in the DSM 5?
No
196
A disorder marked by persistent, recurrent, and excessive internet gaming. Recommended for further study by the DSM 5 task force
Internet gaming disorder
