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44 Cards in this Set
- Front
- Back
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Tolerance |
= the reduced effectiveness of a drug after repeated administration (of the same amount of drug); larger doses required to secure a desired effect. |
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Withdrawal |
= a maladaptive behavioral change characterized by an abstinence/withdrawal syndrome: a consistent set of symptoms that appears after discontinuing use of a drug, therefore blood or tissue concentrations of a substance decline in a person who had maintained prolonged or heavy use of substance. Withdrawal can be characterized by symptoms that are physiological or cognitive, and therefore examples include insomnia or paranoia. |
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low risk drinking guide lines |
= a set of guidelines that give weekly alcohol limits per gender to avoid risk of injury or other harms (10 a week or 2 a day for females) and (15 a week or 3 a day for males) these guidelines also recommend to drink in safe environments,and not drink more than 3 drinks every 2 hours. These guidelines can be seen as a harm reduction approach, a strategy or idea put in place to reduce the harms associated with drinking alcohol. |
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Neurotransmitter |
= a chemical messenger that is released by a neuron and that alters the electrical activity in another neuron, its effects are brief and local. There are 6 well known NTs (DANS-GG): dopamine (pleasure), acetylcholine (motor functions), norepinephrine (stress, increased HR), serotonin (happiness),GABA (inhibitory) and glutamate (excitatory).**DANSGG Usually an electrical impulse will causes a NT to release and float over a synapse to bind to specific receptors on the other neuron, transmit information, and then the NT will be reabsorbed or be destroyed. However a drug can disrupt this process at any step of the way. For example, Adderall causes NT’s to release dopamine and norepinephrine and blocks the reuptake of other NTs. |
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Routes of administration |
=Included in a drug’s pharmacokinetics (ADME=absorption, distribution,metabolism, and elimination). = Routes used to get drugs external to the body, internally and into the bloodstream, so they can ultimately reach brain tissue. 4 major ones: 1) oral (pill form like advil), 2) absorption (through mucous membranes like nose, mouth or rectum, cocaine use), 3) injection (an intravenous injection into fatty tissue or muscle, like using heroin) & 4) inhalation (exp is huffing spray paint that goes into lungs). The route of administration affects the rate at which the drug enters the bloodstream and reaches the brain.The faster the drug reaches the brain the more intense its effect but the shorter the half-life. Theres pros and cons to each route of admin. Oral is most safe/convenient/commonly used. IV is used a lot by healthcare professionals, and addicts prefer IV too since the bloodstream takes the drug to the brain. Absorption can damage the mucous membranes, and inhalation can damage the lungs with chronic use too. |
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CNS stimulants |
= increase activity of CNS, producing elevated mood, vigilance and relieving fatigue. E.g. caffeine,cocaine, amphetamine (can be used to suppress appetite, decongest and treat ADHD) |
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CNS depressants |
= drugs that reduce activity of CNS, producing disinhibition and relieving anxiety. Memory and concentration are dulled, can lead to sedation, coma, death. E.g. alcohol & benzodiazepines (used for anxiety, sleeping aid, and as anaesthetics and sedatives) |
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Half-life |
= Included in a drug’s pharmacokinetics (ADME=absorption, distribution, metabolism, andelimination). Half life can be measured as the period of time it takes for the drug concentration to reduce to one half its initial concentration; half life measures the rate at which the drug will metabolize. !! Halflife of caffeine is 3.5-5 hours in most adults The faster the route of admin, the shorter the half life (!) and the more intense the drug effect ---> greater potential for drug abuse= a shorter half life may also require frequent dosing (i.e. cigarettes have a short half life). The longer the half life, the longer the drug will exert its effect=the half life of caffeine is longer 3.5-5 hours). Alcohol doesn't have a half-life! |
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Binge Drinking |
= “Episodic heavy drinking" --> negative long term consequences,i.e. lower grades Males: 5 or more drinks on one occasion Females: 4 or more drinks on one occasion (= 2 more than low-risk guidelines) |
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Harm reduction |
= a set of practical strategies and ideas aimed at reducing negative consequences associated with substance use. I.e. to reduce alcohol related harms on campus: target a specific audience of university students who are known to consume a lot. Target the substance’s accessibility/availability,affordability and advertising, as these are the three main policy pillars that create the most influence. Examples of each could be banning alcohol during frosh week, increasing the price of drinks at student run establishments like QP, and banning advertising of alcohol/ alcohol related events on campus property. |
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Hallucinogens |
= also called psychedelics, produces major changes in perception, cognition and mood(produce a generalized disruption in the brain)a drug like LSD or mescaline that produces profound alterations in perception is an example. |
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CBT |
a) Used to deal with a wide range of issues b) Focuses on cognition as “covert behavior”; that an individual’s problems arise from their beliefs and interpretations of themselves and events in their lives c) Focuses on the mental processes mediating environment and individual responses d) Behavior can change based on how the client sees themselves
CBT could be used in a situation where a persons suffers from stress/anxiety, i.e. a person could use mental imagery and visualize his or her self as stress free, changing the way he or she views himself or herself in the situation, which will hopefully affect behavior to be more relaxed, less anxious. |
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Methadone maintenance treatment |
= a program for treatment of narcotic addicts in which the synthetic drug methadone is provided to addicts in oral form so that they can maintain their addiction legally Physicians require an exemption under section 56 of a Health CAN act, to prescribe methadone.They also require special training/ a license to administer methadone. Methadone alleviates withdrawal and at therapeutic levels reduces/eliminates narcotic hunger/cravings. At maintenance level it acts as a narcotic blockade,preventing or reducing the effects of other opioids taken. Methadone has minimal side effects. Many benefits of MMT like less criminal activity and improved health conditions/less death and disease. Treatment outcomes are positive and people spend less time using narcotics daily and less time spent in dealing |
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Dependence |
= characterized by signs that include: 1) other life pursuits sacrificed, 2) inordinate amount of time and planning goes into substance use, 3) an impact on daily life/others in your life/your job, 4) you have physical tolerance, and 5) withdrawal, psychological cravings and preoccupation. |
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Addiction |
-habit -fixation on one manner of coping -loss of control; you cant resist the substance -a physical or psychological need -used despite negative consequences -sacrifice other life pursuits for it 4 Dimensions: Biological, Psychological, Sociological, and Spiritual *addiction can be to anything, not just drugs, it could be to food, or alcohol or to sex, gambling |
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AA |
= Alcoholics Anonymous: worldwide organisation of self-help groups based on alcoholics helping each other achieve and maintain sobriety. AA is focused on 12 steps used to abstain from drinking. The steps can involve turning to God, admitting wrong acts, asking God to remove shortcomings,wanting to make amends with people you've hurt, the use of prayer/mediation and an overall spiritual awakening. It can be seen as a harm reductions method. Moderation management is an AA offshoot program that supports moderate drinking and is a 9 step process towards wellness and balance, using 30 days of abstaining from alcohol before choosing harm reduction or abstinence routes. MM focuses on learning priorities, making goals after learning moderate drinking practices, and then reviewing progress. |
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opioids |
CNS depressant so slows CNS activity. “opioid" = any synthetic narcotic that has opiate-like activities (opiate = sth derived from opium) but is not derived from opium opioids can have a sedative action to mask pain and suppress cough, can be used for acute short term pain relief, to reduce suffering in chronic/terminal illnesses and for gastrointernal distress. An example of an opioid would be methadone. |
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Synapses |
= The brain is filled with nerve cells and fibers connecting them. Information is transmitted from one cell to another along the fibers (using electrical charges). Gaps between fibers are called synapses. |
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Receptors |
= specialized structures that “recognize”neurotransmitter molecules. When activated, they lead to a change in electrical activity of neurons |
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Psychoactive drugs |
enter the brain and affect neurotransmitters and their actions. |
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DSM criteria for substance dependence: |
1) Tolerance 2) Withdrawal 3) More use than intended 4) Craving for the substance 5) Unsuccessful efforts to cut down 6) Spends excessive time in acquisition 7) Activities given up because of use 8) Uses despite negative effects 9) Failure to fulfill major role obligations 10) Recurrent use in hazardous situations 11) Continues use despite consistent social or interpersonal problems |
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“stages of change” - definition |
=Predominant theory of how people change Stages represent distinct, but related periods of time that seem to be marked by different kinds of activities. Stages differ along 2 dimensions: behavior and attitude Change = not just stopping the drug use, but MODIFYING IT --> harm reduction methods, baby-steps |
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"stages of change" -description |
1) Pre-contemplation = actively using, may be aware that its problematic,but not ready to make the change 2) Contemplation = beginning to contemplate the behavior change, ppl become aware that there is a problem, admit that things are not OK, try to understand problem/causes/cures, seriously thinking about change but not committing yet (open to information, seek reassurance) 3) Preparation = preparing to make some changes, preparing to get into treatment 4) Action =entering into rehab, ppl change their overt behavior & the environmental conditions affecting them, self-esteem rises since ppl act on their beliefs in their own self-efficacy (!), changes are more visible which may prompt more reocogcnition from others 5) Maintenance = ppl work to continue gains attained and to prevent relapse. Not an absence of but rather a continuation of change. 6) Relapse = when maintenance fails, = the return to the problematic behavior may return to contemplation or pre-contemplation, have to deal with feelings of failure, guilt etc. Termination(so stopping change process) = when the person experiences no more temptation to return to problematic behavior and no longer has to make any efforts to prevent a relapse. |
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Pathways to change: |
- Not linear - Most common= circular - Revolvingdoor: 3 exits out of addiction: 1) choosing not to change, 2) choosing tochange & doing so, 3) frustration about cont’d failure stops motivation tochange |
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Processes of change: |
- = Basic coping activities to modify a problem, therapeutic techniques - What needs to be done to produce change - 10 processes - Most frequently used: “consciousness raising”, give information to clients (feedback & education) |
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link of marijuana use andpsychosis |
6longitudinal studies in 5 countries show regular cannabis use predicts an increased risk of reporting of symptoms of psychosis even after controlling for personal characteristics and other drug use. The relation didn't seem to be a result of cannabis use to self medicate for symptoms of psychosis. The cannabinoid system interacts with the dopamine system, which is implicated in psychotic disorders. Therefore its plausible that cannabis use can cause schizophrenia in ppl who are vulnerable because of personal or family history of schizophrenia. |
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Nicotine in tobacco is most harmful drug,discuss and explain why. |
Nicotine = psychoactive agent in tobacco Extremely toxic; common ingredient in insecticides; -short half life, intenserush, requires freq dosing = abuse potential = addiction -wake up in withdrawal, next cig alleviates withdrawal (reinforcing) -control over dose administration (vary puffs, hold smoke in) -creates positive rewards (bliss/stimulate/calm/wellbeing/enhanced psychological state/eat less/ability to handle stress/alleviate withdrawal) -creates physiological and psychological dependence = very addicting |
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What is binge drinking and whys it a problem? |
=binge drinking is heavy episodic drinking and equates to 5 or more drinks on one occasion for males and 4 or more drinks on occasion for females. Binge drinking is a problem because of what it is associated with: lower grades, falling behind, problems sleeping, increased contact with: hospitals (ER), police and school authorities as well as relationship problems. There are gender specific issues like females are at a greater risk of gender based violence, and may partake in drunkorexia to save calories to be able to bing drink. Binge drinking can also cause harm to others, because being overly drunk may affect how you conduct yourself: others are susceptible to sleep and noise disturbances, having to take care of binge drinkers, having experienced unwanted sex/ even date rape, insults/humiliation,arguments, physical altercations, property damage and increased garbage. |
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From a prevention perspective it is important to target adolescents. Why? Make mention of particular substances. |
adolescents can partake in substance abuse for many reasons: to fit in, feel good (pleasure), feel better (depressed), do better, to experiment social pressure: 40% of young females report using smoking to control body weight peer pressure: drinking alcohol is social & 'cool' adolescents = impressionable
There are also more health risks associated with starting smoking, alcohol and weed use before age 20. --> brain development Also, drug use in adolescence may be esp strong predictor of later addictions: I.e. Percentage of smokers who began in adolescence = 90% |
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Describe& discuss ecstasy |
= an illegal synthetic psychoactive drug mainly comprised of MDMA in the past,but now has little traces of it. Also known as E or the Love Drug. Can be swallowed (pill) or snorted (powder), and is known to be a designer drug used to get high and thus used commonly at raves, concerts and clubs to enhance mood and keep dancing - first patented as an appetite suppressant. - usually mixed or cut with other amphetamines or hallucinogens, i.e. LSD. - provides a hallucinogenic and stimulant like effect which results in euphoria lasting approx. 5-8 hours. - increases release of dopamine, norepinephrine & serotonin. Effects: closeness to others, empathy, mild hallucinations, teeth grinding, nausea, anorexia typical Long term: affects serotonin system & memory? Ecstasy has the potential to be addictive and produce withdrawal symptoms (but low incidence?). However, tolerance develops fairly fast. |
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What is the ACE study and why is it important? |
= the largest scientificresearch study analyzing the relationship between multiple categories of childhood trauma and health and behavioural outcomes later in life. (ACEs= adverse childhood experiences like growing up experiencing physical or emotional abuse) This study is important because of the findings discovered. They found a dose-response pattern: the likelihood of using street drugs like nicotine and alcohol increases strongly and in a graded fashion as the ACE score increases. Essentially, adverse childhood experiences before the age of 18 may increase the likelihood for addiction later in life. Other findings include: ACEs are common, and may be concealed and unrecognized. ACEs can have a large effect 50 years later. ACEs are the main determinant of the health and social well being of the nation. These findings are important because they challenge the usual concept of addiction. Usual concepts of addiction focus on the molecular structure of substances as being the cause for addiction. But this confuses cause with mechanism! The ACE findings may imply the basic causes of addiction lie within us and in the way we treat each other, not in drug dealers or dangerous chemicals. Addiction explained in terms of psychodynamics (psychological forces that underlie human behavior, feelings,and emotions) allows us to realize addiction may exist to seek relief from the ongoing effects of old trauma. |
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Explain the link between substance use and crime |
crimes can be attributable to alcohol and illicit drugs use since the act of committing a crime could be during the time period when a person is intoxicated. OR the crime could be committed because a person wants to obtain a substance and their craving could cause them to break into a pharmacy or liquor store. “The proportion of crimes committed by federal and provincial inmates that are attributed to the use of alcohol and/or illicit drugs in Canada was estimated as being between 40 and 50%"! |
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What are the social determinants of health? Why are they important? |
= the social and economic factors that influence health, i.e. conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life. Examples: income, education, gender and culture etc. SDHs are important because they can greatly affect individuals physiological, psychological and social functioning, thus affecting overall health. SDHs can both positively and negatively influence health (i.e. social class & income may affect access to health care). Example: in the ACE study, the social determinant = the adverse environment, which was likely to determine addictions people developed later in life (possibly to cope with the early trauma’s effects). |
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Describe and discuss the factors influencing the effect of any drug on a user |
The effect of any drug on an individual is the result of three interacting factors: 1) the drug itself (drug)= drug as agonist or antagonist and drug’s actual effect, dosage, abused or adhered to, routes of admin(IV faster than pill) & previous experience with the drug 2) the individual user (set)= gender/weight, if you've recently eaten, age, medical status, other drug interactions, persons mindset before drug & during (i.e. depression then alcohol, first euphoric but then more depressed) 3) the environment in which drug use occurs (setting) = in familiar environment/ppl there is conditioned drug tolerance from cues available and you usually need more than before. But if you take that same amount in new environment you can overdose! |
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Discuss the current controversy regarding electronic cigarettes |
Pros: 1) Effective as a replacement for tobacco smoking 2) Use as Nicotine Replacement Therapy 3) Less harmful than cigarettes/ no combustion 4) Anecdotal evidence that it is changing lives for the better 5) Harm reduction technique and public health benefits Cons: 1) Unproven, untested & unregulated 2) Health concerns with propylene glycol 3) May renormalize smoking 4) May addict new smokers 5) gateway for youth into smoking 6) lessen public health gains 7) undermine tobacco control strategies |
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Describethe key differences regarding substance use disorders between the DSM-IV andthe DSM-V |
1) Use of word “disorder” instead of “dependence” or “abuse” · Low validity of “abuse” · Pharmacological dependence remains (not considered a disorder) · No more abuse vs. dependence, now basedon severity scale (mild, moderate, severe) 2) 'Recurrent legal issues' removed as a criteria 3) Gambling disorder, Internet-gaming, Caffeine use disorder & Cannabis withdrawal added |
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Discuss health promotion strategies to limit harms related to overconsumption of alcohol in uni kids |
1) examine alcohol use & strategy a) conduct regular surveys to develop an accurate picture of drinking patterns, attitudes and harms & implement a cognitive behavioral skills-based program to be delivered to students b) develop + implement at-risk alcohol screening program, then re-educate/train staff, faculty, and peer educators to engage in convos about alcohol and give brief motivational intervention programs in-person and on-line, for the at-risk populations 2) Target 3 A's (accessibility, affordability, advertising) ---> alcohol ban in res/froshweek, limit alcoholic events, limits to amount person can purchase at one time, increase prices, restrict advertising 3) Target possible harms/dangers ---> partner with emergency health services to enhance on campussafety and make resources available toparents 4) Ensure policies are inforced |
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3 C’s of Problematic Use |
1) Loss of control 2) Compulsion to use 3) Adverse consequences |
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Describe and discuss opioid overdose prevention programs |
there is an antidote to opioid overdose: Naloxone = an opioid antagonist, and is available in Ontario through the Ontario Naloxone Program. These programs can include the administration of naloxone via a medical directive to anyone at risk of opioid overdose through TWO programs: HCV and needle syringe. Naloxone can reverse opioid overdose by knocking opioids off the receptors, and it only works on opioids. In order to get Naloxone at the StreetHealthCentre, certain criteria that must be fulfilled, like being a registered client, being 16 or older and complete training Naloxone is injected into the muscle (thigh/upper arm/outer bum) and works in 1-5 minutes, and wears off anywhere from 20-90 minutes. Therefore, any opiates that remain in the body may cause overdose again. |
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Writethe serenity prayer in its entirety |
God grant me the serenityto accept the things I cannotchange; The courage to change the thingsI can; And the wisdom to know thedifference. |
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Explain Jamaican - Ganja Study |
Jamaica has highest density of cannabis users of any country inthe WEST. Cannabis use is ritualized, and ganja is a core element of beliefsystem; the set and setting differ form N.Am users. Theres little hard drug usecorrelated with ganja use, and theres no long term damaging effects on brain orpersonality. In this context ganja is an adaptive mechanism used to cope in harshenvironment. This study shows us how important informal social controls are incontrolling and defining patterns or use with meanings, harms or benefits. Informalsocial controls=the reactions of people that bring about conformity to norms andlaws. |
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Stigma; what is it and what is its impact? |
= a mark of disgrace associated withperson, quality or circumstance, stigma isolates and excludes people, itcan be overt negative behavior and so you can hurt the other person=depression/suicide,stigma can cause ppl to have low self esteem and keep abusing drug, stigmalimits ppls abilities from getting job, fit in at school, get proper healthcare, take part in social activities, make friends and have a social life. SOits impt to know facts, educate others, watch words, support and include others,be mindful and positive |
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Explain "Pharmacokinetics" |
= movement of drugs from external world into body to get to the sitewhere it exerts its effect (route of admin); and then how the substance gets tothe CNS (distribution through body), and then how the drug is broken down andeliminated from the body. Drugs are distributed through the body via the bloodstream anddrugs that reach the brain have to penetrate the BBB, drugs that are fatsoluble will better penetrate the BBB than water soluble ones. Drugs will startbeing metabolized by the liver. The liver will remove the drug from thebloodstream and then the drug will be eliminated from the body by the kidneys(pee)or through feces. Drugs can also be eliminated through lungs, sweat, salvia orbreast milk. |
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5main groups of drug classification |
1)stimulants 2) hallucinogens 3) opioids 4) psychotherapeutic agents (drugs that are prescribed for their effects in relieving symptoms of mental health disorders) 5) depressants **S,H,O,P,D |
