Substance Disorders Flashcards
(69 cards)
Drug addition occurs in what age range of individuals?
16-25 y.o
Are males or females more likely to be drug addicts?
Males 2:1
what is the etiology of drug addiction?
Addiction as a brain disease
1) Initiation –> initial drug use is a conscious decision not a disease
2) Maintenance and Relapse –> continued drug use is due to 5 drug induced effects on brain function
There are five drug induced effects on brain function. The first effect of drugs on the brain is what?
1) Drugs stimulate the brains reward circuitry therefore signaling the person to repeat the behavior
What pathway is involved in the reward circuitry of the brain?
Dopaminergic (DA) pathway (aka mesolimbic pathway)
ventral tegmental area to the the nucleus accumbens
The second effect of drugs on the brain is what?
Stimulation of the reward pathway affects functioning of the prefrontal cortex, altering self control
The third effect of drugs on the brain is what?
drug use may cause brain changes that result in physical withdrawal symptoms upon drug cessation (therefore relapse occurs)
The fourth effect of drugs on the brain is known as the protracted abstinence syndrome, describe
repeated drug use decreases the availability of dopamine. This is associated with prolonged feelings of anhedonia (therefore relapse)
The fifth and final effect of drugs on the brain is..?
drug use has been paired with environmental cues and these cues cause physiological changes that trigger drug seeking behavior
Does everyone who tries drugs become addicted?
Of course not
What percent do genes account for in vulnerability to addiction?
40-60%
What are some various psychosocial factors of addiction?
age of first use
method of drug administration (IV)
occupation biases (docs)
other mental illness
At what level of care does drug screening happen?
primary care level due to profound health and economic effects
How would a physician perform a drug screening?
Good history taking
What are key questions to ask in a drug screening assessment?
CAGE QUESTIONS (alcohol) 1) C: do you feel like you need to CUT back 2) A: do you get ANNOYED when others criticize your drinking 3) G: do you feel GUILTY about drinking 4) E: do you need an EYE opener (aka morning drink) yes to >2 then suspicion of addiction
Describe the FOY questions
Has your drinking behavior been expressed by Family, Others, or Yourself
What test does both CAGE and FOY questions come from?
Michigan Alcoholism Screening Test (MAST)
For a man what is the drink per day limit? and drink per week limit?
4 per day
14 per week
For a women what is the drink per day limit? and drink per week limit?
3 per day
7 per week
The first phase of treatment is the acute phase, there are 3 areas of focus, what are they?
1) Detox –> aka getting person off drugs
2) Medical conditions –> STDs, lesions
3) Psychiatric co-morbidity –> depression, anxiety
The second phase of treatment is the recovery phase, this phase focuses on what?
Preventing Relapse
difficult to reverse engrained habits
Rehabilitation involves a multi-modal approach, what does this mean?
individual, group and family therapy
self help groups
medication
What is the “magic” number of days for treatment?
first 90 days are critical
recovery does continue for a life time
In regards to therapy cognitive behavioral therapy (CBT), how does this work?
helps patients learn to recognize, avoid or cope with high risk relapse situations
