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substance related disorders are divided into__ and ___ and involved __ classes of sunstances
substance use disorders and substance-induced disorders;
10 classes: alcohol, caffeine, cannabis, hallucinogens, sedatives, inhalants opioids, stimulants, tobacco, and unknown substances
all drugs except caffeine and antidepressants activate...
the mesolimbic dopamine system from the prefrontal cortex to the--> VTA--> nucleus accumbens
- lots of things activate this system, but drugs do this a lot and quick
- the problem is that drugs increase this system beyond what natural rewards would and this leads to addiction
incentive salience & dopamine
as you keep taking the drug, it is your drive to take the drug that increases, not necessarily the pleasure from it.
- want vs like- dopamine seems to drive more the wanting of the drug than the liking of the drug
How do opiates and amphetamine work? alcohol?
- opiates act on GABA neurons which inhibit dopamine neurons, so that more dopamine is released in nucleus accumbens
- amphetamine blocks dopamine reuptake
Acohol promotes dopamine release in nucleus accumbens too
- one day they just got orange juice, and one day OJ with alcohol- those with the alcohol had more dopamine release in the nucleus accumbens
DSMV criteria for substance use disorder
1) IMPAIRED CONTROL
- taken over longer time than intended
- persistent desire to stop but cant
- craving
2) SOCIAL IMPAIRMENT
- failure to fulfill major obligations
- continued use despite issues
- important activities given up
3) RISKY USE
- recurrent use when physical health at risk
- use despite knowledge of psych or physical risk
4) PHARMACOLOGICAL CRITERIA
- tolerance
- withdrawl
(not necessary for diagnosis since drugs like hallucinogens dont show these)
Craving, conditioning and environmental cues
Craving has been looked at in relation to classical conditioning.
People would come into ER saying they had taken their usual dose of the drug but in a dif place than usual and then they had OD. When you ingest a drug in same place over and over, your body sees this cue and down regulates things so that your body doesn’t get overwhelmed. so when u take it in a new place you might OD on same dose. this cuing can also lead to cravings obviously. (US= drug, CS= environment)
DSM severity and remission levels for substance use disorder
Severity: mild= 2-3 symptoms, moderate is 4-5 symptoms, severe is >6 symptoms
Remission: early= 3-12 months without drug, sustained is >12 months
PREVALENCE
Canadian alcohol and drug use monitoring survey (CADMUS) results
cannabis: lifetime: 42%, more in males. Use within past year: 10.2% especially in 15-24 year olds
Alcohol: lifetime: 91% more in >25 years old. Use within past year: 78.4% more in males
Centre for Disease Control (CDCs) youth Behavioural survey system results- what % of highschool kids binge drink?
what about marijuana?
total 21.9%
female- 19.8%
male - 23.8%
white 24%
black 12.4%
hispanic 24%
total 23%
female 20%
male 25.9%
white 21.7%
black 25%
hispanic 24.4%
__ % of colllege students had a DSM 1V disorder last year, what were most common?
Look at prevalence of drug dependance %
46%- most common alcohol use, nicotine dependence, drugs, personality, anxiety, mood
o Nicotine 32%
o Heroin 23%
o Cocaine 17%
o Alcohol 15%
o Stimulants 11%
o Cannabis 9%
o Psychedelics 5%
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