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Substance Use/Abuse Disorders > Substance abuse > Flashcards

Substance abuse Flashcards

(56 cards)

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1
Q

Most common substance abuse disorders

A

Alcohol, tobacco, cannabis,stimulant, hallucinogen, opioid

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2
Q

Psychoactive drug

A

affect emotion, mind, behavior

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3
Q

Substance Use/Abuse Concepts

A 
Addiction vs substance use disorder
Clinical and functional impairment
Neurobiology model
-binge and intoxication
-withdrawal and negative effect
-preoccupation and anticipation
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4
Q

Brainstem

A

controls basic functions ( hear rate, breathing)

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5
Q

Cerebellum

A

motor control

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6
Q

Limbic system

A

reward center and feelings of pleasure
hippocampus: storage and retrieval of memory
Amygdala: sensory information and emotions

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7
Q

Diencephalon

A

Hypothalamus: regulation of basic drives and autonomic nervous system
Thalamus: sensory perception and movement

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8
Q

Cerebral cortex

A

sensory, motor and association areas

frontal, parietal, occipital and temporal lobes

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9
Q

Synapse

A

electrical synapse

chemical synapse

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10
Q

Neurotransmitters (can reinforce effects of drugs)

A

dopamine, opioid peptides, GABA, Glutamate, Serotonin, Acetylcholine

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11
Q

Addiction

A

Overwhelming compulsion; repetitive drug-taking behavior despite serious health & social consequences

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12
Q

Substance Dependence

A

Overwhelming desire to take a drug, cannot stop taking drug, 2 categories (physical & psychological)

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13
Q

Physical Dependence

A

Altered physical condition caused when nervous system adapts to repeated substance use, uncomfortable symptoms result when the agent is discontinued—known as withdrawal

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14
Q

Psychological Dependence

A

No obvious physical discomfort when substance discontinued, overwhelming desire to continue substance use; may be associated with home or social environment, craving continues for months or years, craving responsible for relapse

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15
Q

Tolerance

A

Biologic condition; body adapts to repeated administration of a drug, Requires higher doses of drug to produce initial effect, Common in substances that affect nervous system, Does not indicate addiction or substance abuse

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16
Q

Heroin

A

The most addictive drug, heroin is a very dangerous substance. It is less widely used than some of the other substances, likely because it is typically taken by injection.

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17
Q

Ecstasy

A

This drug, also known as MDMA (3,4-methylenedioxy-methamphetamine), is most often associated with clubs and raves, especially because the dopamine it helps to release simulates a feeling of connection between users. It is especially risky because the pills are generally less than 30 percent pure and can contain other serious drugs.

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18
Q

Crystal Meth

A

Crystal meth is almost 3X stronger than cocaine. It provides a much longer high as well as extreme crashes that make the user want to use again.

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19
Q

Cocaine

A

This white powder is one of the most notorious illicit drugs. It causes bursts of energy and euphoria, which are very tasking on the heart and brain.

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20
Q

Marijuana

A

The leaves of the cannabis plant are by far the most popular illicit drug among teens and younger people. The THC in the plant causes sensations of relaxation and sometimes mild hallucinations.

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21
Q

LSD

A

LSD “acid” is one of the most famous drugs of the Woodstock era, becoming mainstream in the 1960s. Trips can last for several hours and include very powerful hallucinations. Made synthetically and processed into strips.

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22
Q

Ventral tegmental area (VTA)

A

Connects to basal ganglia within limbic system

Basal ganglia function involved in emotions and motivation

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23
Q

Drug activation for VTA

Study These Flashcards
A

Dopamine
Reward pathway
Median forebrain

24
Q

Increased levels of Dopamine

Study These Flashcards
A

Feelings of well-being, exhilaration, and pleasure
Psychologic dependence
Physical dependence
Tolerance

25
Body held in depressive state (alcohol)
Decreased GABA release More drug needed for desired effect Withdrawal
26
Modulation of dopamine
Serotonin -Regulates release of dopamine at the VTA of the brain GABA -Inhibitory effects on dopamine release onto dopaminergic neuron
27
Addiction
User-related factors Genetics, personality, prior experience, disorders Environmental factors Societal and community norms, role models, peer influences, educational level Agent or drug factors Cost, availability, dose, mode of administration, speed of onset/termination, length of drug use Impossible to predict accurately if person will become substance abuser
28
Alcohol
Leading cause of preventable death Risk factors Genetic, Psychologic, Environmental Alcohol intoxication Physical abnormalities consistent with behavioral changes Alcohol overdose Impairments that increase the risk of harm Alcohol withdrawal Onset of manifestations 24-72 hours after cessation of drinking Life-threatening Goal: cessation of drinking Treatment Types: Behavioral treatments, Medications, Mutual support groups
29
Alcohol Effects
``` Brain effects Enhances effects of inhibitory GABA Decreases effects of excitatory glutamate Increases dopamine in reward center Acts as a sedative and depressant Interrupts REM sleep Fetal alcohol spectrum disorders Physical problems Behavioral issues Learning difficulties Effects of early alcohol use Impaired growth and development Increased risk for dependency Increased risk taking Liver Failure Hypoglycemia: inhibits glycogenolysis ```
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Alcohol abuse manifestations: Intoxication
Increased risk taking Cognitive changes Ataxia Nausea/vomiting
31
Alcohol abuse manifestations: Overdose
Unconsciousness Coma Respiratory depression Death
32
Alcohol abuse manifestations: Withdrawal
Mild: Insomnia, irritability, headache, nausea Moderate: Tremors, anxiety, insomnia, nausea, confusion, sweating Severe: Uncontrollable shaking, agitation, vomiting, sweating hallucinations, seizures, death
33
Alcohol: Heavy Use
Chronic malnutrition Cancer Hormonal changes Brain tissue loss from alcohol toxicity Organic brain syndrome Wernicke-Korsakoff syndrome Chronic alcoholism → thiamine deficiency → brain tissue ischemia & cell death Wernicke’s: Acute confusion, ataxia, ophthalmoplegia (weakness of eye muscles) Korsakoff’s: amnesia, psychosis, confabulation (misinterpreted memories) Delirium tremens (DT) with very long-term consumption Hallucinations, confusion, disorientation Medical emergency Withdrawal can be treated with antiseizure medications Nursing: CIWA Scale
34
Clinical Institute Withdrawal Assessment
``` Assigns a point value for: anxiety agitation headache hallucinations N/V auditory disturbances tactile disturbances visual disturbances altered senses diaphoresis tremors ```
35
Tobacco Use (Nicotine)
``` Characterized by: Persistent tobacco use, Compulsive tobacco use, Physiologic dependence on tobacco Associated with poorer general health Key statistics 42 million Americans continue to smoke Vaping by middle & high school students increased by 50% Comorbidities Psychiatric conditions Decreased immunity Associated diseases/conditions COPD Cardiovascular disorders Cancers Nicotine: Highly carcinogenic (>1000 chemicals) ```
36
Tobacco (Nicotine): Effects
``` Activation of specific areas of brain Visual attention Arousal Motor activation Stimulation and sedation Impaired reproductive health Fertility issues Increased risk of miscarriage Health problems for the mother and baby Immediate physiological effects Tachycardia, Hypertension, Increased respiration Physical assessment Hoarse voice, Stained nails and teeth ```
37
Tobacco (Nicotine): Withdrawl
``` Irritability/frustration/anger Anxiety Difficulty concentrating, headache Increased appetite Restlessness, increased heart rate, increased B/P Depressed mood Insomnia ```
38
Tobacco (Nicotine): Cessation treatments
Smoking cessation aids Nicotine replacement medication Behavioral therapy Bupropion (Zyban) & varenicline (Chantix) used to help quit
39
Cannabis
Third most commonly used drug in United States Marijuana Derived from hemp plant Main psychoactive chemical: tetrahydrocannabinol (THC) Can be smoked or mixed into foods Total tissue elimination of a single dose = 30 days THC: Increases dopamine release Via binding to CB1 & CB2 receptors Results in impaired judgment Increases risk-taking
40
Cannabis intoxication
≥2 signs or symptoms within two hours of using cannabis
41
Cannabis withdrawal
Cessation of frequent and prolonged cannabis usage ≥3 signs and symptoms over ~1 week Irritability & restlessness, Insomnia & tremors, Chills & weight loss
42
Cannabis use disorder
Significant impairment/distress in multiple areas | Development of tolerance/withdrawal over 12 months
43
Cannabis: Treatment
cognitive-behavioral therapy
44
Stimulants
Most commonly abused stimulants Amphetamines, Methamphetamine & Cocaine methylphenidate (Ritalin) ADHD: calms children, opposite for adults Can be synthetic or plant-based Can be inhaled or taken orally or intravenously Cardiovascular consequences of cocaine Sympathetic nervous system (SNS) effects Effects on cardiomyocytes Vasculature effects Long-term consequences Treatment: Medications, Counseling, Inpatient, residential, outpatient treatment, Peer support, 12-step programs Withdrawal: Mental depression & anxiety, extreme fatigue & hunger
45
Amphetamines and synthetic cathiones
Cross blood-brain barrier Rapid onset of effects when injected or inhaled Increases synaptic activity of dopamine and norepinephrine Pharmacologic use: narcolepsy and attention-deficit/hyperactivity disorder
46
Methamphetamine
Crosses blood-brain barrier Onset of action within seconds after smoking or injecting Increases dopamine, norepinephrine, and serotonin
47
Cocaine
Absorbed through mucous membranes Onset of action within seconds up to 90 minutes Blocks reuptake of dopamine and norepinephrine causing euphoria
48
Hallucinogens
All Schedule I Drugs (cannot be prescribed) Alter sensory perception, mood, & thought patterns Types Psilocybin (mushrooms), Mescaline, Peyote, Lysergic acid diethylamide (LSD), Phencyclidine (PCP) , 3,4-methylenedioxy methamphetamine (MDMA, Ecstasy), Ketamine (date-rape drug) Appear to involve interaction of: Serotonin, Dopamine, Glutamate Treatments No approved medications Behavioral therapy and counseling Withdrawal: Rarely observed, depends on specific drug Flashbacks, tolerance, moderate-to-high psychological dependence with little to no physical dependence
49
Hallucinogen Intoxication: | Cardiovascular
Tachycardia, palpitations, hypertension/hypotension
50
Hallucinogen Intoxication: Neurologic
Tremors | Hyperreflexia
51
Hallucinogen Intoxication: Mood, cognition, emotions
``` Paranoia Suicidal ideation Anxiety Depression Euphoria Intensification of feelings Acute cognitive impairments Megalomania Depersonalization ```
52
Opioids
Chemical structure similar to alkaloids, Analgesics, Interact at one of three receptor main opioid receptor systems
53
Opioid use disorder
Chronic, relapsing illness of a pattern of opioid use, negative health consequences Naturally occurring Morphine & codeine Semisynthetic Hydromorphone, oxycodone, hydrocodone, and heroin Synthetic Meperidine, methadone, tramadol, and fentanyl Various routes of administration Potent analgesic & CNS depressive effects Can produce euphoria, Highly addictive, Rapid progression to physiologic dependence followed by tolerance & subsequent withdrawal
54
Opioids cont.
Cause substantial morbidity & mortality Overdose is a life-threatening emergency General clinical manifestations of opioid toxicity Decreased or unchanged vital signs, Decreased bowel sounds, Sedation or coma, Seizures, Miosis Other signs Track marks, Perforated nasal septum Treatment for opioid use disorders Medication-assisted treatment with buprenorphine or methadone Withdrawal Symptoms: (intense but not life-threatening) Excessive sweating, restlessness, and pinpointed pupils, Agitation, goose bumps, tremor, and violent yawning ,Increased heart rate, orthostatic hypotension, Nausea/vomiting and abdominal cramps and pain, Muscle spasms with kicking movements and weight loss
55
Opioid Antagonist
``` Therapeutic Class: Opioid antagonist Examples: naloxone(Narcan) Mechanism of Action: binds to opiate receptors (competes) Actions & Uses: Reversal of known or suspected opioid overdose, including respiratory and/or CNS depression Adverse Effects: Increased blood pressure, pain, headache, nasal effects (dryness, edema, congestion, inflammation), opioid withdrawal Interactions: Caution with cardiotoxic drugs Pregnancy Category: C ```
56
Disulfiram
``` Examples: disulfiram (Antabuse) Mechanism of Action: Interferes with the hepatic oxidation of acetaldehyde Actions & Uses: Management of ethanol abuse Interactions: Alcohol ```

Substance Use/Abuse Disorders (4 decks)

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