Part 1: Substance Use & Addiction Flashcards
(130 cards)
1
Q
Drug
A
substance taken by body that alters body processes
2
Q
4 steps that drug is processed
A
administration, distribution, metabolism, elimination
3
Q
Types of drug administration
A
ingestion, inhalation, injection, absorption
4
Q
Types of drug injection methods
A
intramuscular, subcutaneous, intravenous
5
Q
Define drug distribution
A
how efficiently drug moves through body (solubility, blood-brain barrier)
6
Q
Define drug metabolism
A
drug reached site, experience drug effects
7
Q
Main types of drug elimination
A
sweat, urination
8
Q
Psychoactive substances
A
chem compounds that affect CNS (penetrate BB barrier)
9
Q
Reasons for taking psychoactive substances
A
- medical
- recreational
- entheogen (spiritual/transcendence, change consciousness)
- purposeful (performance)
- research (efficiency? side effects?)
10
Q
Effects of psychoactive substances
A
alter mood, behavior, consciousness
11
Q
Levels of drug involvement
A
use, intoxication, abuse, dependence (and/or addiction)
12
Q
Describe use - psychoactive
A
intake does not sig interfere w social/educ/occupational fxning
13
Q
Describe intoxication + changes - psychoactive
A
physiological rxns
changes depend on substace/person:
energy, HR, mood, motor ability, speech, state of consciousness
14
Q
Describe drug abuse
A
how sig it interferes w life, harmful use (drunk driving, job, attendance)
15
Q
Characteristics of drug dependence
A
-tolerance: diminishing effect from repeated administration
//
-withdrawal: body’s rxn to obstaining
mediated by neg reinforcement
16
Q
What phenomenon mediates drug dependence? How?
A
neg reinforcement: continue taking substance to avoid neg state
17
Q
Describe drug addiction
A
compulsive use despite neg consequences = change in beh
18
Q
What phenomenon mediates drug addiction? How?
A
pos reinforcement: pursue pos effects of high (euphoria)
19
Q
Symptoms of psychological withdrawal (4)
A
emo-motivational symptoms:
-dysphoria, anx, anhedonia, dissatisfaction
20
Q
Symptoms of physical withdrawal (7)
A
phys-somatic symptoms:
- fatigue, vomit, chills, pain, diarrhea, headache
- alcohol withdrawal delirium (tremens)
21
Q
Which psychoactive substance causes no phys withdrawal?
A
LSD
22
Q
Drug-seeking behaviours of dependence-addiction
A
repeated use, desperate need, likelihood that use will resume post-abstinence
23
Q
Substance use: DSM-IV
A
DSM-IV:
- separated abuse & dependence
- separate symptoms for abuse vs dependence
24
Q
Substance use: DSM-5
A
DSM-5:
- combined abuse/depend. into substance use disorders
- severity of symptoms (mild = 2-3, med = 4-5, severe 6+)
- diff substances as separate use disorders
25
What is the diagnostic issue with SUDs?
unclear cause-effect relationship with other comorbid disorders (50%)
26
Reasons for high comorbidity of SUDs (3)
1. intoxication-withdrawal cause other disorder symptoms: dep, ANX, psychosis, risk-taking
2. disorders can cause substance use disorder
3. chance
27
What are the different bases of SUD classification? (4)
1. substance from which it's derived
2. effect on CNS* (stimulant/hallucinogen)
3. route of administration (inhalant/injection)
4. other: recreational/street, illicit/legal, soft/hard
28
Name the 10 categories of DSM-5 substances
1. depressants: sedatives, hypnotics, anxiolytics
2. inhalants
3. stimulants
4. caffeine
5. tobacco
6. alcohol
7. hallucinogens
8. cannabis
9. opioids
10. other
29
Diagnostic criteria: SUD (11 symptoms)
impairment/distress, 2+ symptoms in a 12-month period
1. take more/for longer than intended
2. unfulfilled desire/efforts o cut down
3. lots of time spent obtaining, using, recovering
4. craving
5. results in failure to fulfill obligations
6. use despite interpersonal problems
7. social/job-related/recreational activities given up
8. use in phys hazardous situations
9. despite knowledge of phys/psyc consequences
10. tolerance
11. withdrawal
30
Depressants: name them, CNS effect, NTs
- sedatives, hypnotics, anxiolytics
- DEC CNS activity (calm, relax, sleep)
- promote GABA/suppress glutamate
31
Which substance category is most likely to product tolerance-withdrawal?
sedatives, hypnotics, anxiolytics
32
Barbiturates & benzos are part of which substance category?
depressants
33
Which depressant induces/acts on sleep?
sedatives
34
Inhalants: CNS effect, AOO, list effects (9)
- DEC CNS activity (depressants)
- adolescence
- mild-extreme: dizzy, slurred speech, impaired motor fxn, blurred vision, lethargy, tremors, peri-nasal abrasions, brain damage, kidney failure
35
Stimulants: CNS effect, NTs, name 3 types
- INC CNS activity (active, alert, euphoria, fatigue-resistant)
- block dopa + nore reuptake
- methamphetamines, cocaine, caffeine
36
Caffeine: CNS effect, DSM category, concerns
- stimulating effect (mood, HR)
- "conditions for further study:
- over-diagnosis, overlooking benefits
37
Tobacco: CNS effect, disorder name, onset
- nicotine = stimulating
- tobacco use disorder
- adolescence
38
Alcohol effects & NTs
Stimulating, but mostly sedative effects of ethanol
| -dopa then GABA
39
Factors that influence extent of alcohol effects (6)
- prenatal alcohol exposure
- fam history
- initial age & how long (danger of adolescence)
- how much/often
- length of binge
- BAC
40
Alcohol: short-term effects (5)
- reduce inhibition, outgoing, relaxed
- impaired motor fxn
- blurry vision, lower hearing
- impeded decision-making
- blackout
41
Alcohol: long-term effects (6)
- hand tremors
- ANX
- nausea
- insomnia
- withdrawal delirium
- organic damages (hepatitis)
42
Describe Cirrhosis
- liver damage from chronic alcohol use
| - replaced by scar tissue
43
Brain damage from alcoholism (3)
- brain shrinkage
- reduced PFC volume
- reduced cogn abilities
44
Describe Wernicke's encephalopathy (3 symptoms)
- disease of brain dysfxn
- mental confusion
- oculomotor disturbances (paralyzed eye mvmt nerves)
- muscle coordination difficulty
45
What % of drinkers report some related problem?
Who's more likely to experience alcohol problems?
9%
young, single males w lower income
46
Gender ratio of alcohol drinking
men drink more
47
What % of ppl w alcohol-dependence/abuse present spontaneous remission?
20% cured unexpectedly
48
Hallucinogens: effects (4), types (3), withdrawal
- alter sensory perc, hallucinations, delusions, out-of-body exp
- LSD, DMT, psilocybin [magic mush, natural mushroom]
- low/no withdrawal
49
Which substance is most used by adolescent males?
cannabis
50
Properties & effects of cannabis (4)
- mostly depressant (relax) w stimulant (concentration) & hallucinogenic properties (higher dose)
- reactions vary (history, predisp, THC dose)
51
Tolerance-withdrawal of cannabis
tolerance builds quickly (reduced binding potential) / low-no withdrawal
52
Describe amotivation
- chronic weed use
| - general loss of motivation
53
Fxns of endocannabinoid receptors
-physio processes: appetite reg, mood, memory, attention, pain sensation
54
Describe the NT process of opioids
- works on endogenous neuropeptides
- endorphins
-EXCESSIVE dopa (euphoria) + activates opioid rec (sedative)
55
Opioid effects
- euphoric rush & sedative effects (pain-killing)
| - slows down respiration = OD
56
Genetic & heredity influences of SUDs [biological approach]
- twin, family, adoption studies
| - contribution of endophenotypes & gene combos
57
Name 3 genes involved in SUDs [biological approach]
ALDH gene, GABA rec gene, dopa rec gene
58
What's the opioid epidemic?
most common cause of OD deaths
59
Name 3 substances classified as "other"
- prescription meds
- over-the-counter drugs
- anabolic steroids: synthetic T, can use medically (low weight puberty), enhance performance, too much = lose muscle
60
Genetic & heredity influences of SUDs [biological approach]
- esp alcoholism
- run in family (twin, fam, adoption studies)
- strong genetic basis of endophenotypes (impulsive endopheno = more likely)
- combo of genes
shared genetic vulnerability w ASPD, schizo, BD
61
Name 3 genes involved in SUDs [biological approach]
ALDH gene (alcohol), GABA rec gene (ASPD), dopa rec gene (sensitive to reward)
62
Name 2 heritable traits that are risk factors for SUDs [biological approach]
- impulsivity
| - low alcohol sensitivity (drink more, lower ability to tolerate consequences, bad hangover)
63
Which brain pathway influences SUDs? How?[neurobiological approach]
stimulates mesolimbic reward pathway
(dopa: VTA, Nucleus Accumbus, PFC, OFC, amyg, hippo)
- affect dopa lvls/rec
- affect reward-seeking, motivation, beh
- sensitization (inc effects); desensitization; tolerance
- PFC activity DEC over time (cogn ctrl)
64
Define expectancy effect [cognitive factor, psyc approach]
expecting a given result from drug unconsciously affects outcome
65
Describe the opponent process theory [psyc approach]
- emo/physio responses come in opposite pairs
- drug addiction/dep: intense pleasure followed by *stronger* withdrawal/neg feelings (dysphoria)
- over time, process A becomes weaker / process B conditioned to env, starts sooner
66
Describe the study findings about SUD stigma
"substance abuser": blamed for problem, seen as socially threatening, believed to not benefit from punishment/treatment
67
Cognitive factors of drug cravings [psyc approach]
- cravings influenced by conditioned cues (internal/external)
- INC OD risk in unfamiliar env (unconditioned effect)
68
Define expectancy effect [cognitive factor, psyc approach]
expecting a given result from drug unconsciously affects outcome
ex. expecting inc sexual arousal from alcohol intake
69
Social approach of SUDs
- exposure via family, peers, media
- poor adult supervision
- cultural influences (norms)
- flush face from alcohol: low alcoholism
70
Brain disease theory vs Moral weakness theory [social approach]
- SUD is brain disease = no ctrl over it
| - weak person, unwilling to ctrl beh (stigma)
71
Which SUD treatment works on the basis of cross-tolerance?
agonist substitution
72
Describe the lifestyle balance model of SUDs
- life imbalance inc risk & exposure to substance use through desire of gratification
- means of coping OR resilience factor
73
Inpatient facilities: pro and con
- helps w initial withdrawal
| - expensive
74
Agonist substitution treatment + example
- safer drug w similar makeup that works on same receptors
- nicotine patch
- risk of cross-tolerance
75
Antagonist treatment
block effects of substance
| naloxone for heroin: binds to & blocks opioid rec
76
Aversion therapy
substance use paired w unplasant stim
77
Aversive treatment + example (psychosocial)
- make ingestion of substance unpleasant
| - Disulfiram's antabuse effect (alcohol)
78
Community reinforcement approach & fam training
- treatment monitoring
| - teach ABCs: Antecedents (triggers), Behavior (drug use), Consequences
79
Relapse prevention therapy
- target pos beliefs & consequences of drug use
- develop coping strategies for cravings
- can recover from relapse
80
Harm reduction therapy + effectiveness
- main goal: minimize harm
- social skills training
- education- & community-based
- more promising than "say no to drugs", can end in abstinence
81
Diagnostic criteria of gambling addiction
4+ symptoms in 12-month period:
1. gambles w INC $$ to feel excitement
2. restless/irritable when trying to cut down/stop
3. failed efforts to ctrl/stop
4. often preoccupied w gambling
5. often gambles when distressed
6. often returns after losing money to get even
7. lies to conceal extent
8. jeopardized or lost rel/job/opportunity
9. relies on others for $ from losing it to gambling
- not mania
82
Describe severity categories of gambling disorder
- mild: 4-5 symptoms
- moderate: 6-7
- severe: 8-9
83
Gambling disorder: prevalence, gender, AOO
2%, M>F, in 20s
84
Name 4 consequences of gambling disorder + %
- 14% job loss
- 19% bankruptcy
- 21% incarcerated
- 32% arrested
85
Potential pathway of gambling disorder (4 steps)
1. Ecological factors: INC availability + accessibility;
2. CC/OC: subj arousal/physio excitement, irrational beliefs + illusion of ctrl [cogn schemas];
3. Habituation
4. Chasing wins, losing more than expected
86
Name 2 unofficial behavioral addictions
- internet gaming disorder
| - eating addiction
87
Describe the 3-step process of impulse-ctrl disorders
tension to do smt; instant gratification; relieve tension
88
Name the 3 ICDs
klepto, pyro, intermittent explosive disorder
89
What did pyro + kleptomania used to be categorized as? And now?
- OCD
| - disruptive, IC & conduct disorders
90
Name 4 consequences of gambling disorder
- job loss
- bankruptcy
- incarcerated
- arrest
91
Problem with ICD treatments
too little documented data
92
Klepto: prevalence, gender, AOO
- 0.6%
- mostly female
- 14 to 20 yrs (earlier for M)
93
Pyro: prevalence, gender, AOO
.03%, mostly male, 18 yrs
94
Criteria for intermittent explosive disorder
- explosive violent & angry outbursts disproportionate to sit
- verbal/phys aggro 2x/week for 3+ months
- 3+ anger outbursts in a year
- not premeditated
- relieved but remorseful
95
IED: lifetime prevalence, AOO
- 0.8 to 6.2%: > in military, clinical pop, males
| - 10 to 15 yrs
96
Protective factor of IEDs
higher education lvls
97
Describe comorbidity of IEDs (order)
- IED comes first
| - then: mood disorders, ANX, SUDs, PDs, PTSD
98
List the cognitive-affective impairments of IED (4)
-maladaptive defense mechanisms
-poor emo reg
-hostile attribution bias
> neg affect / < pos affect
99
Neurobiological underpinnings of IED (circuity, activity, NT)
- impaired corticolimbic circuity
- INC amyg / DEC OFC activity to angry faces
- altered serotonin fxning
100
Social/env factors of IED
trauma & PTSD
101
Effects of metamphetamines in therapeutic doses (3)
- improved cogn ctrl
- INC libido
- euphoria
102
Effects of methamphetamine abuse (3)
- DEC cogn abilities
- depression
- poor sleep/fatigue
103
Describe Korsakoff's psychosis (2 symptoms) + lobe affected?
- learning & anterograde memory impairment (forming new ones)
- temporal lobe
104
Comorbidity of wernicke & korsakoff
90% comorbidity
105
Describe Korsakoff's psychosis (2 symptoms) + lobe affected?
- learning impairment
- anterograde amnesia (new memories)
- temporal lobe
106
Alcohol brain disease associated with thiamine deficiency
Wernicke-Korsakoff
107
Drinking tendencies of average person
- in moderation
| - drinking pattern fluctuates
108
Which pattern of levels of involvement (alcohol) is assoc w aggression/violence?
progressive pattern
109
Which hallucinogen is referred to as "business trip"? Why?
DMT: effects last 10-15 min
110
Distinguish btw the 2 categories of hallucinogens
- classical = psychedelics: changes in mood/perc/thoughs
| - recent = dissociatives: out-of-body experience (depers-dereal)
111
Distinguish btw the 2 categories of hallucinogens
- classical = *psychedelics*: changes in mood/perc/thoughs
| - recent = *dissociatives*: out-of-body experience (depers-dereal)
112
Describe delirium from hallucinogens (3)
confusion, confabulation (memory error), agitation
113
Which hallucinogen has been showed to help treat depression? Brain effects?
- psilocybin
- dec amyg blood flow
- greater brain connectivity
114
Positive effects of LSD?
- chance cognitive perspectives
- alleviate fears, anx/dep
- single dose assoc w optimism
115
Hallucinogens are chemically similar to what NT and how?
- common site of action = agonists of serotonin rec
- functionally (effect) & structural (binding)
- cortical excitation (sensory perc)
116
To which substance category does cannabis belong? Where does it originate from?
its own
cannabis sativa
117
Consequences of chronic cannabis use
agitation/paranoia, impaired problem-solving/decision-making
118
Describe tolerance in terms of endocannabinoids
modifies concentration of default/endogenous endocannabinoids
body doesn't produce correct amount anymore + lower binding potential = tolerance and imbalance
119
Medicinal purposes of cannabis
reduce some unpleasant symptoms: chemo, chronic pain, reg appetite
120
Endocannabinoid effects on other NTs
indirectly INC dopa by inhibiting GABA
121
Process of THC in brain
THC competes to bind to cannabinoid rec that affect dopa
reduces GABA in striatum; dopa INC; pos feelings
122
THC consequences on the brain
THC activates cannabinoids throughout brain; affect emos, mvmt, learning, memory, decision-making
123
Consequences (brain) of using cannabis in adolescence
overstimulates reward system; changes wiring; addiction, mental disorder, lower IQ
124
Describe NT process of THC in brain
THC competes to bind to cannabinoid rec that affect dopa
reduces GABA in striatum; dopa INC; pos feelings
125
Where is the reward circuit & what does it do?
limbic system; regulates ability to feel pleasure
126
Natural NT response when we receive reward
burst of dopa; transporters quickly remove excess
127
Describe NT process of cocaine in brain
blocks transporters on presyn cell; dopa accumulates in synapse; abnormally high levels, remains longer
reward circuit hyperactivated = euphoria
128
Describe NT process of meth in brain
low doses: meth blocks re-entry of dopa in presyn cell
higher dose: INC release of dopa + blocked transporters
postsyn cell activated to dangerously high levels
euphoria = very addictive
129
Mildest opioid
morphine
130
Opioid 3 neg consequences
addiction, OD, HIV infection
