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PSY305 - Clinical Psychology > Week Seven - Substance Related & Addictive Disorders > Flashcards

Week Seven - Substance Related & Addictive Disorders Flashcards

1
Q

Psychoactive substance

A

Any chemical compound which passes through the blood-brain barrier and alters mood and/or behaviour

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2
Q

Substance use

A

ingestion (inhalation/injection/transdermal) of a substance

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3
Q

Intoxication

A

Physiological reaction to the substance

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4
Q

Tolerance

A

Need larger doses for same effect

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5
Q

Withdrawal

A

A strong, negative physiological (and often
psychological) reaction which occurs when a psychoactive
substance is removed

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6
Q

Substance use disorder

A

Problematic pattern of use that impairs functioning, with two or more of the following within 12 months:
1. The substance is taken in larger amount or for a longer period than planned
2. Persistent desire and/or failed attempts to reduce/control use
3. A large amount of time is spent either trying to attain the substance, or to recover from it’s use
4. Cravings/strong desire
5. Use is resulting in inability to fulfil obligations at work/home
6. Continued use despite ongoing exacerbation of psycho-social problems
7. Social, hobbies, or work activities are given up or reduced
8. Recurrent use in situation which may be dangerous
9. Continued use despite knowing the problems caused by the substance
10. Tolerance – an increasing need to use more of the substance to gain the same effects, AND/OR a marked diminished effect whenusing the same amount
11. Withdrawal – as manifested by a severe negative physiological
response to cessation, or the need to continue use to avoid
negative symptoms

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7
Q

Substance use disorder is specified by?

A

Type and severity

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8
Q

types of substances

A
  • Alcohol
  • Sedative/hypnotic/anxiolytic
  • Stimulant
  • Tobacco
  • Caffeine
  • Opioid
  • Cannabis
  • Other Hallucinogens
  • Inhalant
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9
Q

Severity of SUD

A

Mild: 2-3 symptoms
Moderate: 4-5 symptoms
Severe: 6 + symptoms

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10
Q

Drug categories

A
  • Depressants – increase physiological arousal. Eg Alcohol and barbiturates
  • Stimulants – increase physiological arousal. Eg cocaine and nicotine
  • Opiates – pain relief. Eg morphine and heroin

• Hallucinogens/Psychedelics – alter sensation and perception.
Eg cannabis and LSD

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11
Q

How much do Aus spend pa on illicit drugs?

A

7 billion, more on legal

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12
Q

Alcohol Use Disorder?

A

Alcohol is classed as a depressant

• Diagnosed if physiologically dependent or heavy user

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13
Q

Consequences of AUD

A

Delirium tremens (DTs) can occur when blood alcohol levels
drop suddenly. Results in:
• Deliriousness
• Tremulousness
• Hallucinations - Primarily visual; may be tactile

Polydrug abuse
– Many users abuse multiple substances
• e.g., cigarettes, cocaine, marijuana
• 85% of alcohol abusers are smokers

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14
Q

Prevalence of Alcohol Abuse

A

Lifetime prevalence: 8.6%

• Binge drinking
– 5 drinks in short period (e.g., within an hour)
– 43.5% prevalence among college/university students

• Heavy use drinking
– 5 drinks, 5 or more times in a 30-day period
• 16% prevalence among college students

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15
Q

Short-term effects of alcohol on brain?

A

Interacts with several neural systems:
– Stimulates GABA receptors (GABA is a key inhibitory neurotransmitter)
• Reduces tension
– Increases dopamine and serotonin
• Produces pleasurable effects
– Inhibits glutamate receptors (glutamate is a key neurotransmitter in a
range of functions, notably memory and learning)
• Produces cognitive difficulties

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16
Q

Long-term effects of alcohol

A
  • Malnutrition

* Cirrhosis of the liver

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17
Q

Marijuana/Cannabis

A

Marijuana is classed as a hallucinogen

• Hashish
– Stronger than marijuana

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18
Q

Marijuana: Prevalence

A

• Most frequently used illicit drug in Australia.
• Greater use by men than women
• Ongoing debate about legalisation and medical use –
medical cannabis legalised at a federal level in 2016

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19
Q

Effects of Marijuana

A

Major psychoactive ingredient is THC (delta-9 tetrahydrocannabinol)

Psychological Effects:
– Feelings of relaxation and sociability
– Rapid shifts of emotion
– Interferes with attention, memory, and thinking
• Decline in IQ over time
– Heavy doses can induce hallucinations and panic

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20
Q

Marijuana and the Brain

A 
Two cannabinoid brain receptors - CB1 and CB2
– High concentration in hippocampus
Increased blood flow to emotion regions
– Amygdala and anterior cingulate
Habitual use leads to tolerance
– Withdrawal symptoms also observed
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21
Q

Marijuana and Mental Health

A

Evidence that cannabis use increases risk of psychosis for some people with a genetic predisposition for psychosis

Heavy use associated with:
• Chronic memory problems

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22
Q

Synthetic Cannabis

A

AKA Spice, Kronic
• Early days, but evidence of more severe sideeffects as compared to cannabis
• More frequent admission to A&E for drug-related events

23
Q

Opiates/Analgesics

A 
Group of addictive sedatives that in moderate doses relieve
pain and induce sleep:
– Opium
– Morphine
– Heroin
– Codeine

Opiates legally prescribed as pain medications

24
Q

Prevalence of Opiate Use

A

Heroin

• Used by .1% of Australians in 12 month period (2013)

25
Q

Psychological and Physical Effects of Opiates

A

• Produces euphoria, drowsiness, and lack of coordination
– Severe letdown after about 4 to 6 hours
- Stimulates receptors (nucleus accumbent - reward) of the body’s opioid system

Heroin and OxyContin
– Rush: Intense feelings of warmth and ecstasy following
injection

Tolerance develops and withdrawal occurs
- W lasts 72 hours

26
Q

Meth/Amphetamines

A

Amphetamines are classed as stimulants.
Increase alertness and motor activity; reduce fatigue
– Trigger release of and block reuptake of norepinephrine and
dopamine
– Produce high levels of energy, sleeplessness
– Reduce appetite, increase HR, constrict blood vessels in skin and mucous membranes

27
Q

Tolerance with Meth/Amphetamines

A

after only 6 days of use

28
Q

Chronic use of Meth/Amphetamines

A

damages brain
– Impacts dopamine and serotonin systems
– Reduction in hippocampus volume

29
Q

Ecstasy

A

also sometimes classed as a hallucinogen, but is a type of
amphetamine

Induces a sense of wellbeing, feeling close to others,
increased tactile sensation.

30
Q

Ecstasy users experience what in the following days

A

depression

31
Q

Cocaine and what does it do

A 
Cocaine and crack cocaine are stimulants
– Reduces pain
– Produces euphoria
– Heightens sexual desire
– Increases self-confidence and self-worth
32
Q

Cocaine and brain

A

• Blocks reuptake of dopamine in mesolimbic areas of brain

  • Not all users develop tolerance – Some become more sensitive
  • May increase risk of OD
33
Q

Dissociative Anaesthetics (2)

A

Phencyclidine

Ketamine

34
Q

Phencyclidine (PCP)

A

• Initially used as an anaesthetic but stopped in 1965 due to negative after-effects, mainly severe hallucinations.
• Was considered a relatively popular recreational drug
but has been steadily declining
• Animal tranquilizer
• Causes severe paranoia, violence, self harm,
depersonalisation.

35
Q

Ketamine

A

Used in surgical and veterinary procedures –
anaesthetic and analgesic properties
• Used as a party drug

36
Q

PCP and Ketamine in the brain

A

• Both Ketamine and PCP block the action of NMDA
receptors (one of the receptors which binds to the
neurotransmitter glutamate)
• Both increase the availability of serotonin, dopamine
and norepinephrine, by reducing re-uptake

37
Q

LSD

A

LSD is a hallucinogen
– Colorful visual hallucinations
– Psychedelic trip: expansion of consciousness
- experience of flashbacks (HPPD)

38
Q

Etiology of Substance-Related Disorders: Genetic Factors

A

Relatives and children of problem drinkers have higher-than expected rates of alcohol abuse or dependence

Greater concordance in MZ than DZ twins

Ability to tolerate large quantities of alcohol may be an inherited diathesis

Some evidence that people dependent on drugs or alcohol
have a deficiency in the dopamine receptor DRD2

39
Q

Etiology of Substance-Related Disorders: Neurobiological Factors

A

Nearly all drugs, including alcohol, stimulate the dopamine
system in the brain, particularly the mesolimbic pathway
– Produce rewarding or pleasurable feelings

40
Q

Etiology of Substance-Related Disorders: Psychological Factors

A

People take drugs to avoid the bad feelings associated with withdrawal
– Explains frequency of relapse

41
Q

Incentive-sensitization theory

A 
Distinguish Wanting (craving for drug) from Liking (pleasure
obtained by taking the drug)

Dopamine system becomes sensitive to the drug and the cues associated with drug (e.g., needles, rolling papers, etc.)

Sensitivity to cues induces and strengthens wanting

42
Q

Etiology of Substance-Use Disorders: Sociocultural Factors

A

Men consume more alcohol than women but differences vary by country

• Availability
– Usage is higher when alcohol and drugs are easily available

43
Q

Etiology of Substance-Use Disorders: Sociocultural Factors (family factors)

A

– Parental alcohol use
– Marital discord, psychiatric or legal problems in the
family linked to substance use
– Lack of emotional support from parents increases use
of cigarettes, marijuana, and alcohol
– Lack of parental monitoring linked to higher drug usage

44
Q

Etiology of Substance-Use Disorders: Sociocultural Factors (social network/media)

A

Social network
• Having peers who drink influences drinking behavior (social influence) but individuals also choose friends with drinking patterns similar to their own (social selection)

Advertising and media
– Countries that ban ads have 16% less consumption than
those that don’t

45
Q

A Biopsychosocial Model of Addiction

A

Social Influences
• Family
• Media
• Peer etc

Psychological Influences
• Incentive Sensitisation Theory
• Expectancies

Biological Influences
• Genetic predisposition
• Sensitivity
• Other disorders

46
Q

Biological Treatment for heroin

A

Agonist Treatment

- narcotics (used to wean heroin users from dependence)

47
Q

Biological Treatment for opiates

A

Antagonist Treatment
- Naltrexone
• Prevents feeling high

48
Q

Biological Treatment for alcohol

A

Aversive Treatment
- Antabuse (disulfiram)
• Produces nausea and vomiting if alcohol is
consumed

49
Q

Psychosocial Treatment

A

Inpatient hospital treatment
– Detoxification
• Withdrawal from alcohol under medical supervision
• The therapeutic results of hospital treatment are not
superior to those of outpatient treatment
• May be necessary for those without social support or
with other serious psychological problems

50
Q

Psychological Treatment

A

Alcoholics Anonymous (AA)

Motivational interventions
– Emphasises empathy and understanding in the client counsellor relationship

Cognitive and Behavioral Treatments

51
Q

Cognitive and Behavioral Treatments for drinking

A

– Contingency-Management Therapy
• Patient and family reinforce behaviors inconsistent with
drinking e.g., avoiding places associated with drinking
• Teach how to say no
– Relapse prevention
• Strategies to prevent relapse

52
Q

Marlatt and Gordon’s Relapse Prevention Model

A

coping vs no coping response

53
Q

Combination therapy – CBT and Medication

A

– Desipramine (antidepressant) and CBT showed
effectiveness for cocaine use
• CBT especially helpful for users with high dependence
levels

PSY305 - Clinical Psychology (12 decks)

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