Flashcards in Substance Use Disorders Deck (71):
What are the two major categories of substance related disorders?
1) Substance use disorders
2) Substance-induced disorders
What is a substance USE disorder?
Pattern of maladaptive behaviour involving the use of a psychoactive substance.
-Include substance-abuse and substance dependence disorders
What is a substance INDUCED disorder?
Disorders induced by the use of psychoactive substances
-Include intoxication, withdrawal symptoms, mood disorders, delirium, amnesia
What does the person do in a substance abuse/use disorder?
Continue using psychoactive drug even though they know it is contributing to a recurrent problem.
-Have impaired control over the use of the drug, often characterized by physiological dependence
Determining feature of substance abuse = whether a pattern of drug using behaviour becomes repeatedly linked to damaging consequences
3 types of dependence that result from Substance Abuse?
1) Addiction- impaired control over habitual use of chemical substance accompanied by physiological dependence
2) Physiological Dependence- physical dependence on drug which the user's body comes to depend on a steady supply of --> development of tolerance
3) Psychological Dependence- reliance on a substance, although one may not be physically dependent, you believe you need it
What are the 3 most commonly used drugs in North America?
1) Tobacco (25%)
2) Alcohol (15%)
3) Marijuana (5%)
Alcohol and tobacco cause more deaths than any other drugs combined
What are the 3 Pathways to Drug Dependence?
-Addiction or Dependence
What substance is an example of a depressant?
What are risk factors for alcohol?
-Gender: men start earlier but women catch up quick
-Age: onset prior to age 40
-Antisocial personality disorder: increases risk
-Family history: genetic component as result of modelling
-Sociodemographic factors: low income, education, increases risk of alcohol use
Can therapy be done when someone is drunk or high?
No, therapy is typically done when people are in recovery stage, not in active addiction stages
What are some results of Substance abuse?
What is tolerance?
Body needs more of that substance to produce same physiological repsonse
What is withdrawal syndrome?
When you stop a substance you have been on for a while, you see symptoms such as nausea, sweating, depression
What is tachycardia?
An abnormally rapid heart rate
What is Delirium Tremens?
When you stop taking drug, characterized by extreme restlessness, sweating, hallucinations, disorientation
What is Delirium?
Mental confusion, disorientation, difficulty focusing
What is Disorientation?
State of mental confusion, lack of awareness with respect to time, place or identity of oneself or others
What is experimentation?
Try it, feel good, gives you state of euphoria, feel in control, may be a result of peer pressure
-drug temporarily makes user feel good. User feels in control
What is Routine Use?
DENIAL that you have a problem. Begin to structure lives around the pursity and use of drugs. Person begins changing daily lives and values for the substance, selling things for money, not showing up to work, lying about things
What is Addiction or Dependence stage?
Feel powerless to the drug, no longer in control, body is craving it
-little or nothing else matters
What is the leading cause of death in young people?
Usually involves alcohol
-Alcohol is connected with suicides and car accidents
What are the psychological effects of alcohol?
Believe that the drug is going to make you more social, calm, funny, relaxed
What does AA believe about alcoholism?
It is a disease, you are always in recovery, never cured
What is Alcohol-Induced Persisting Amnestic?
Brain damage, loss of memory and replace with fake ones as a result of too much alcohol
What is the relationship between alcohol and cancer?
Alcoholism leads to higher rates of cancer
Is there a health benefit to moderate drinking?
Does have benefit on the heart, but no more than 2 drinks per day
Alcohol in relation to ethnicity
Heaviest toll on First Nations
-Jewish have low alcohol related problems
-Asian people less
What are Barbiturates?
-1% population abuse these
-Relaxing, reduce anxiety, induce sleep
-Get prescribed these to help with sleep, then keep using them (usually middle aged people)
-popular street drugs because give mild state of "high"
-abrupt withdrawal can produce states of delirium that are life threatening
What happens when you mix barbiturates (sedatives) with alcohol?
Makes them 4x more powerful --> lead to more death
What are Opiates?
-causes a rush of euphoria that lasts for few hours
-Narcotics (heroin), morphine
-withdrawal symptoms are flu-like
-Main objective is analgesia (relief from pain)
-produce rush or intense feelings of pleasure
-endorphins: human body produces substances similar to opiates, that regulate pleasure and pain
-opiates mimic actions of endorphins
-positive effects are immediate
What are Stimulants?
Gives you a rush, then you crash
-can produce psychotic state
-Ex) speed, meth
-amphetamine psychosis mimics the features of paranoid schizophrenia
2 Types of Cocaine
-natural stimulant extracted from the leaves of the coca plant
1) crack- hardened form suitable for smoking
2) freebasing- intensifies effects, power form is heated with ether
What are the effects of cocaine?
Most habit forming
-involves binges from 12-36 hours, followed by 2-5 days abstinence
-increases availability of dopamine, producing pleasurable "high"
What are the effects of Nicotine dependence?
-common among 20-24 yr olds
-3 million people die per year from this
-Lung cancer kills more than breast cancer
-Withdrawal: jittery, weight gain, nervous, lack of energy
-stimulates release of epinephrine
What are Hallucinogens?
-Cause sensory deprivation
-Psychadelics: drugs that produce sensory distortions or hallucinations
-Flashbacks, re-experiencing some event
-marijuana and PCP are similar to psychadelics
Who is smoking popular among?
-higher in Aboriginals
-Higher among poor and less educated population
What is PCP (Phencyclidine)?
-originally an anaesthetic
-Causes hallucinations, readily available and inexpensive
-Classified as a deliriant: Dissociating effects and delirium
Effects of Marijuana?
-Used most between 18-30 year olds
-Produces mild hallucinations
-Most common dependence on illicit drugs
-Lower doses are relaxing
-Higher doses makes time slow down, may feel more creative, influence thinking process
-no withdrawal symptoms
What are Inhalants?
Aerosols, lighter fluid, paint, etc.
-Used by soaking cloth with substance and just inhaling it
-Feeling of intoxication and euphoria
-Trouble with this is no control over dosage
Was considered an impulse control disorder, but is now classified with other substance use disorders
-Serotonin: activates pleasure and reward circuits in response to cocaine
-Endorphins: pain blocking properties (opiates)
-Dopamine: explains the pleasure inducing effects of many drugs (nicotine, alcohol, marijuana, cocaine)
Brain's Reward Centres
1) Operant Conditioning (positive reinforcement/pleasure that drugs produce)
2) Alcohol and Tension Reduction: belief you will be relaxed, released from tension
3) Negative Reinforcement and Withdrawal: keep using it to avoid withdrawal
4) The Conditioning Model of Cravings: if you always do it at parties, might have this craving if put in that situation
5) Observational Learning- modelling, increased alcoholism among people with parents who drink
1) Outcome Expectancies, Decision Making- what do we believe will happen if we take this substance --> influence your decisions to use them or not. If you have positive expectancies, then more likely to use it
2) Self-Efficacy Expectancies- what do we believe about ourselves. Rely on substances in challenging situations when they doubt own abilities
3) Does one slip cause them to go on binges?
-becomes self-fulfilling prophecy if they think they will lose control after just one drink
-"falling of the wagon" after one drink --> absolutist thinking
Freud thinks it is an oral fixation, that is why people smoke
Do we see variations in different ethnic groups
What is detoxification?
Get it out of system, live through the withdrawal symptoms
-carried out in hospital
-benzodiazepines may help block some withdrawal symptoms
-detox takes about a week
What is Disulfiram?
Drug that discourages alcohol consumption by creating strong aversive reaction to it. But if they really want to drink, people can just stop taking the pill
How can antidepressants be used as treatments?
Help with cravings for cocaine
What is nicotine replacement therapy?
The patch, or gum. Try to wean yourself off of nicotine slowly
-ineffective in long term unless combined with behavioural therapy
What are Methadone Maintenance Programs?
Methadone treats heroine, prevents increase withdrawals, combine with therapy
What are Naloxene and Naltrexone?
They block the high produced by opiates and treats alcohol
What is the Residential Approach?
In house treatments at a certain site, when patients cannot exercise self-control in their usual environments
-but majority of people are helped in outpatient
What are Psychodynamic approaches to treatment?
-resolve underlying conflicts
What are Behavioural Approaches to Treatment?
Modify abusive and dependent behaviour patterns
1) Self-Control- Cues or triggers that prompt abuse (A's), The abusive behaviours (B's), and the consequences (C's)
2) Aversive conditioning- pair drug with something negative
3) Social skills training
What is Relapse Prevention Training?
-50-90% will relapse at least once, triggered by stressors or pressures
Training teaches you how to avoid triggers and use relaxation techniques, resist social pressures
What is the Abstinence Violation Effect?
Tendency to overreact when you fall off wagon, feel guilty and then have full blown relapse
States of Change
1) Precontemplation stage- no intent to change, unaware of problem
2) Contemplation- aware, but not committed to take action
3) Preparation- intends to take action
4) Action- dedicates time and effort to changes
5) Adaptation/Maintenance- works to adapt and adjust to change
6) Evaluation- assessment and feedback
Most popular drug on campus
Most easily accessible substances
alcohol and tobacco- responsible for more deaths than all other illicit drugs combined
What defines binge drinking
5+ drinks for men, 4+ drinks for women
What can substance abuse progress to?
What is substance dependence?
physiological signs of dependence (withdrawal), and/or compulsive use of the substance
LACK control over drug use, feel helpless or powerless to stop
Substance abuse is continued use despite knowing it is bad, substance dependence is impaired control over the use
Which drugs do not produce withdrawal symptoms?
Marijuana and hallucinogens
Can you be psychologically dependent on a drug without being physiologically dependent?
Yes, and vice versa
What is a depressant?
Drug that slows down or curbs the activity of the CNS
-reduces feelings of anxiety or tension
Who are likely alcoholics?
People you see everyday, found in all walks of life and socioeconomic classes
Alcohol dependence and other substance use disorders are strongly correlated with _____
What is Korsakoff's syndrome?
characterized by glaring confusion, disorientation, and memory loss
Alcohol is the second leading cause of premature death, behind what...
Smoking is implicated in how many cancer deaths
1 in 3
Smokers stand twice the risk of dying from cancer than regular people