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205 Cards in this Set

  • Front
  • Back
Substance Use Dsorders is a term used in which DSM?
In what two categories do pathological uses of substances fall into in the DSM-IV-TR?
Substance Abuse & Substance Dependence
What is the main change regarding substances in the DSM-5?
Substance Abuse & Substance Dependence are being combined into one category called Substance Use Disorder
What are the three main reasons substance abuse and dependance are being combined into one category in the DSM-5?
1. Reliability of substance abuse category is poor;
2. Most people who meet abuse criteria go on to develop dependence;
3. Analysis of the disorders shows that they represent one disorder and not two
Worldwide prevalence of tobacco, alcohol & illicit drugs?
tobacco 4.1%;
alcohol 4%;
Illicit drugs 0.8%
What term refers to having more symptoms, tolerence and withdrawal by using more of the substance than intendedm by trying to unsuccessfully stop, by having physiological or psychological problems made worse by the drug, and by experienceing problems at work or with friends?
addiction or dependence
Tolerence is indicated by what two factors?
1. larger doses of the substance being needed to produce the desired effects, and

2. the effects of the drug become markedly less if the usual amount is taken
What term is used to refer to the negative physical and psychological effects that develop when the perosn stops taking the substance or reduces the amount?
What are the six most abused substances?
tobacco, alcohol, marijuana, opiates, stimulants, and hallucinogens
What are some affects that abrupt withdrawal from alcohol can produce?
CNS excitability resulting in seizures, anxiety, depression, insomnia, muscles tremors in fingers, face, eyelids, lips and tongue, and blood pressure, pulse, and temperature may be elevated
What does DT stand for?
Delirium Tremens
What are the symptoms of DT?
profound confusion, delusional state, agitation, fluctuating consciousness, hallucinations & motor and autonomic dysfunction
What percentage of people who abuse alcohol are also smokers?
80 to 85%
What is meant by the term 'nicotine and alcohol are cross-tolerent'.
nicotine can induce tolerence for the rewarding effects of alcohol and vice versa, that is, the consumption of both drugs may be increased to maintain their rewarding effects
What does EtOH represent?
What is meant by the inverted U effect of alcohol?
in low doses it acts as a stimulant, in high doses is acts as a depressant
What is meant by 'rarely are dosage effects linear'?
effects are differentially related to dosage
Is alcohol classed as a CNS depressent or a stimulant?
a CNS depressant, however in small doses it acts like a stimulant
Is the rate of alcohol metabolism by the liver constant or variable?
At what rate does the liver metabolise alcohol?
1 ounce of 100-proof (50 % alcohol) liquor per hour
Quantities of alcohol in excess of the rate that can metabolised by the liver are stored in which part of the body?
the blood stream
Why might woman and men differ in their blood alcohol concentration after adjusting for differences in body wight?
they have different levels of body water content
What parts of the body metabolise alcohol?
enzymes in mouth and stomach, and the liver
What are the main behavioural affects of alcohol where BAC is between 0.05 and 0.09%?
1. a mix of stimulant and dpressive effects,
2. disinhibition - can be relaxed and euphoric, or withdrawn or aggressive,
3. Expectancy effects,
4. increased talkativeness and socialability,
5. decreased judgement, attention, control, and information processing
What syndrome resulting from a deficiency in B-complex vitamins is found in older people who have chronically abused alcohol?
amnesic syndrome
What is amnesic syndrome?
the severe loss of memory for both recent and past events which may result in confabulation
What causes cirrhosis of the liver?
liver cells become engorged with fat and protein which impede their function, and cause cells to die which triggers an infalmmatory response, when scar tissue develops the blood flow is obstructed
What causes redness in the face, especially the nose, in people who abuse alcohol?
capillery hemorrhages as a result of alcohol damage
What is the leading known cause of intellectual development disorder among children?
Fetal Alcohol Syndrome?
What are the effects of Fetal Alcohol Syndrome?
slowed fetal growth, cranial, facial and limb anomalies, and impairments in learning and memory
What has been shown to mitigate impairments in learning and memory in children with fetal alcohol syndrome?
being raised in a stable and healthy environment
What is one standard tool for alcohol screening?
The chronic use of alcohol affects what organs and tissues in the body?
all of them
What is the brain disorder, resulting from chronic alcohol abuse, where the a loss of specific brain functions is caused by a thiamine deficiency?
Wernicke-Korsakoff Syndrome
What are the two separate sets of symtoms in Wernicke-Korsakoff syndrome?
1. Wernicke's encephalopahty - damage to multiple nerves in both the central and peripheral nervous system; and
2. Korsakoff syndrome - impairment of memory out of proportion to problems with other cognitive functions due to damage to areas of the brain involved with memory
Cigarette smoking can both exacerbate alcohol-induced damage as well as what?
independantly cause brain damage
Are myelineated neurons white or grey matter?
white matter
Excessive consumption of alcohol leads to damage of myelinated neurons and causes what?
brain shrinkage
What does BAC stand for?
Blood Alcohol Concentration
What factors determine BAC?
concentration of EtOH, rate of drinking, presence of food in the stomach, weight, body fat, age, and liver efficiency
When does BAC usually peak?
30 to 90 minutes after consumption
What is a common myth about metabolising alcohol?
that it can be sped up
What is a low to moderate dose of alcohol?
1 to 3 drinks per hour
What is a moderate to high dose of alcohol?
more than 3 drinks per hour
What are the physiological effects of low to moderate doses of alcohol?
increased HR, urination and sleepiness, and decreased body temperature, muscular coordination, and reaction time
What are the physiological effects of moderate to high doses of alcohol where BAC is more that 0.15%?
disorientation, confusion, slurred speech, blurred vision, poor muscle control, nausea and vomiting, decreased testosterone, stupor, sleep, coma, death
What are the 7 criteria for substance dependance in the DSM-IV-TR?
1. Evidence of tolerance;
2. Evidence of withdrawal;
3. Larger amounts of substance taken over a longer periods of time than intended;
4. Persistent desire or one or more unsuccessful attempts to cut down;
5. Much time spent in acquiring, taking, or recovering from the effects of the drug;
6. Other important life activites given up as a result of the substance;
7. Persistent use despite social, psychological or physical problems
What are the three classes of drugs?
depressants, stimulants, and hallucinogens
What are three common CNS depressants?
alcohol, benzodiazepines, and opiates
What are four common CND stimulants?
cocaine, amphetamine, nicotine, and caffeine
What are four comon hallucinogens?
LSD, PCP, ectasy, and cannabis
What is the difference between pharmacology and psychopharmacology?
pharmacology is the action of drugs in a living system, and psychopharmacology is the action of drugs on the CNS
The number of harmful users of drugs is disproportionate to the number of people receiving what?
How are people typically exposed to drugs?
through social processes
Describe the 6 steps to becoming a drug user?
1. Positive attitude towards drugs usually shaped by thte environment;
2. Rewarding effects of drugs reinforcement by developing expectancies;
3. Experimentation;
4. Regular use;
5. Heavy use;
6. Physical dependence of drug
What is the most predictive factor imapcting the developing of a substance use problem?
socio-cultural variables
People interest in and access to drugs are influenced by what 5 socio-cultural factors?
peers, parents, media, cultural norms, and availability
Do men or woman consume more alcohol?
What does a lack of parental monitoring lead to?
increased association with drug-abusing peers and subsequent higher use of drugs
Your preconsumption psychological state can impact what when consuming a substance?
the effects
What difference in genetic and environemnt risk factors have been found between types of drugs?
none. The genetic and shared environment risk factors tend to be the same.
The ability to tolerate large quanities of alcohol may be what?
A deficiency in which inherited enzyme may lead to a reduced tolerence for alcohol?
ADH (alcohol dehydrogenases)
Nearly all drugs stimulate what in the brain?
dopamine systems
Some evidence shows that people dependant on drugs or alcohol have a deficiency in which type of receptor?
dopmaine receptor DRD2
Drugs not only enhance positive mood, but they can also diminish what?
negative mood
According to the incentive-sensitisation neurobiological theory the dopamine system becomes sensitive to not just the direct effect of drugs but also what?
the cues associated with drugs
Brain imaging studies have show that cues for a drug activate what?
the reward and pelasure areas of the brain implicated by the drug use
What is the main psychological motive for using drugs?
to alter mood
What has been found to reduce aggressive behaviour in people who are intoxicated?
cognitive distraction
People who expect alcohol to reduce stress and anxiety are likely to be what sort of users?
frequent users
What are the two types of expectancies?
positive and negative
The belief that a drug will stimulate aggression and increase sexual responsiveness predicts what?
increased drug use
What does low constraint and high negative emotionality predict?
the onset in alcohol, nicotine and illcit drug use for both men and woman
Peer behaviour is divided into what two contructs?
Peer influence and peer selection
Nocotine media campaigns were generally directed at which age group?
Which cultural group have no record of traditional drug use?
inuit eskimos
What effect does alcohol have on GABA, serotonin, dopamine and glutamate recpetors?
stimulates GABA reducing tension,
stimulate serotonin & dopamine increasing pleaurable effects, and
inhibits glutamate which may cause cognitive effects such as slowed thinking and memory loss
How does alcohol consumption contribute to malnutrition?
it impairs the digestion of food and the absorption of vitamins
According to the biopsychosocial model drug effects are an interaction of what three factors?
the substance, the user, and the context
Which drug has no therapeutic applications in medicine?
One in how many people who try smoking will eventually die of a smoking-related illness?
1 in 6
The pharmacological and behavioural process that result in addiction are similair for nicotine and what two other drugs?
heroin and cocaine
Withdrawal from nicotine is characterised by what non-life threatening symptoms?
severe craving fro nicotine, irritability, anxiety, anger, difficulty in concentrating, restlessness, impatience, increased appetite, weight gain , and insomnia
Nicotine stumulates which neurons?
Smoking is the leading preventable cause of what?
death, illness and disability
What are the three most harmful components in the smoke from burning tobacco?
nicotine, carbon monoxide, and tar
Which type of cigarettes are found to be more harmful and why?
menthol because people it more deeply and hold it in their lungs for longer periods
Babies of woman exposed to secondhand smoke during pregnancy are more likely to be what?
born prematurely, and have lower birth weights and birth defects
What has been found to be a risk factor for SIDS?
secondhand smoke
Children of smokers are more likely to have what more often than children of nonsmokers?
upper respiratory infections, asthma, bronchitis, and inner-ear infections
How is hashish produced?
by removing and drying the resin exudate of the tops of the cannabis plants
What are comon nicotine replacements?
nicotine gum, transdermal nicotine patches, nicotine nasal sprays and inhalers
What is the most effective treatment forsmoking cessation?
a combination of drug therapy and counselling
What are three types of dependance counselling that are particularly effective in smoking cessation?
practical counselling, social support as part of treatment, and social support arranged outside of treatment
The use of marijuana in adolescents is associated with poorer achievement and psychosocial problems although these factors do not appear to be what?
How long does it take for the effects of marijuana to appear?
up to half an hour
What is the major psycoactive ingredient of marijuana?
THC - delta-9-tetrahydrocannabinol
The THC conent of marijuana ranges between what?
0 to 30%
What changes in IQ were found in regular users aged 17 to 23?
4 point drop
What are the main behavioural effects of marijuana?
feelings of well-being, mild euphoria, relaxed inhibitions, impaired attention and ST memory, altered senory awareness, motor control, and posture
Is there strong evidence that marijuana impairs learning and memory in the long term?
How is marijuana linked to schizophrenia?
it is an environmental factor that can influence phenotype expression in predisposed individuals
What are some of the short term physical effects of marijuana?
blood shot and itchy eyes, dry mouth and throat, increased appetite, reduced pressure within the eye, and somehwat raised blood pressure.
Long-term use of marijuana seriously impairs the strucure and function of which organ?
the lungs
One marijuana cigarette smoked in the typical way is equivalent to what?
five tabacco cigarettes in carbon monoxide, four in tar intake, and ten in terms of damage to cells lining the airways
What are the two canniboid receptors in the brain?
CB1 and CB2
CB1 cannaboid receptor are found in highest number in what part of the brain?
What changes in blood flow in the brain were found in people smoking marihjuana?
increased flow in the amygdala and anterior cingulate, and decreased flow in regions of temporal lobe associated with auditory attention.
Marijuana can reduce the nausea and loss of appetite associated with what?
Marijuana is an effective treatment for the discomfort associated with which 5 medical conditions?
AIDS, glaucoma, chronic pain, muscle spasms, and seizures
What are some of the clinical uses of opioids?
analgesia, anit-tussive, slows bowel, and anxiolitic
What affect do opiates have on the CNS?
Opiates or Opioids are considered what?
What are some derivatives of opiates?
morphine, heroin, and codeine
How is heroin ingested?
injected, smoked, snorted or taken orally
What opiates are legally prescribed pain medications that have become drugs of abuse?
hydrocodone & oxycodone
What effects do opiates have on the gastrointestinal system?
When does withdrawal from heroin typically begin?
within 8 hours of last injection
When do users of herion experience the peak?
20 to 45 minutes after injection
How do opiates produce their effects?
by stimulating the bodies naturally producing opoids endorphins and enkephalins
What are the typical withdrawal symptoms associated with opiates?
tremors, panis, chills, sweating, cramps, nausea, watery eyes & nose, yawning
An overdose of opiates causes what?
cardiac arrest
What are the behavioural effects of Opiates?
euphoria, analgesia, sedation without being hypnotic
How long do symptoms of withdrawal persist when coming off opiates?
72 hours and then diminish gradually over a 5 to 10 day period
What are the two main types of pharmacological treatments for heroin abuse?
heroin substitutes (opiate agonists) and opiate antagonists
What effect do agonists and antagonists have on neurotransmitters?
agonists stimulate the neurotransmitters and antagonists dampens the acitivty of the neurotransmitters
What three drugs are heroin substitutes?
methadone, levomethadyl acetate, and bupreophine
What is the main problem with heroin substitutes?
the are cross-dependant with heroin, they become a substitute for the dependancy but the dependancy is maintained.
What are the two types of opiate antagonists?
naloxone and naltrexone
When is naloxone typically adminstered?
when someone has overdosed on opiates
What must happen before a person can be adminstered naltrexone?
the person must be first weaned off heroin
What effect does naltrexone have?
prevents the person from experiencing any high should they later take heroin
What factors can increase both clinical effectiveness and treatment compliance of people taking naltrexone?
adding a contingency management component to treatment such as a voucher system for attendance and clear urine samples
Why do many people drop out of methodone programs?
because of side effects such as insomnia, constipation, excessive sweating, and diminshed sexual functioning
What effect do stimulants have on the CNS?
increase levels of dopamine - cocaine inhibits reuptake, ampetamines increase release, and ecstasy increases both dopamine and serotonin
What are some of the behavioural effects of cocaine?
increases well-being, confidence, sexual desire, and indefatiguability
What can chronic use of cocaine lead to?
heightened irritability, impaired social relationships, paranoid thinking, and disturbance in eating and sleeping
Can users develop a tolerance to cocaine?
Which stimulant is a vasconstrictor, potent local anaesthetic, and psychomotor stimulant?
Large doses of amphetamines can cause what symptoms?
nervousness, agitation, confusion, heart palpitations, headaches, dizziness, and sleeplessness
Sometime heavy users of amphetamines become what?
extremely suspicious and hostile
Can amphetamines cause compulsive drug seeking behaviour?
Which drug is the most harzardous drug of abuse?
In a clear crystal form methamphetamine is commonly known as what?
crystal meth or ice
Cravings for methamphetamine are strong and can last for how long after the drug is discontinued?
several years
What is the half life of methamphetamine?
greater than 12 hours
Chronic use of methamphetamine causes what?
brain damage affecting the dopamine and serontonin systems, and hippocampus shrinkage.
Use of methamphetamine is associated with what?
violence, psychosis, and personality changes
Methamphetamine causes a reduction in dopamine reuptake to to levels found in what neurological disease?
What are the initial effects of amphetamines?
increased alertness, energy, euphoria, insomnia, and decreased appetite
What are the subsequent effects of amphetamines after the initial effects wear off?
hallucinations, psychosis, and violence
What are the withdrawal effects of amphetamines?
hypersomnia, increased appetite, apathy, lethargy, fatigue, depressed mood, and irritability
Ecstasy is a mixture of what two types of drugs?
stimulants and hallucinogens
What is an enactogen?
a drug that induces feelings of warmth and closeness to others
Which drug is an enactogen?
What is ecstasy made from ?
What was ecstasy used for in WW1?
an appetite suppressant
Ecstasy acts primarily by contributing to both the release and reuptake of which neurotransmitter?
What effect does ecstasy have on the serotonin system?
Prolonged use of ecstasy can cause what?
damage to the seronin axons and nerve terminals
What are some of the positive effects felt by people who ingest ecstasy?
intimacy and insight enhancement, improvements in interpersonal relationships, elevated mood and self-confidence, and increased aesthetic awareness
What are some of the negative effects that may be experienced by people who ingest ecstasy?
muscle tension, rapid eye movements, jaw clenching, mausea, faintness, chills or sweating, anxiety, depression, depersonalisation and confusion
What is the biggest risk in taking ecstasy?
What cognitive deficits can be caused by MDMA?
impaired visual and verbal memory, and decision making, increased impulsivity and lack of self control, sleep disturbances, and sometimes anxiety and depression
Explain withdrawal and tolerence of LSD and PCP?
no evidence of withdrawal symptoms, and tolerence develops rapidly
What is the common name for PCP?
angel dust
What use was PCP originally developed for?
as a horse tranquiliser
What are the severe negative reactions associated with the use of PCP?
severe paranoia and violence
What are the effects of hallucinogens?
disturbances in thinking and sense of time, illusions, hallucinations, impaired ego functioning, sounds may be perceived as visual stimuli, decreased vigilence and logical thoughts, and rapid shifts in mood
Hullucinogen related deaths are often a result of what three things?
accidents, homicide and suicide
Does dependance develop with hallucinogens?
What are some adverse outcomes caused by hallucinogenic use?
chronic or intermittent psychotic states, affective disorders, exacerbation of pre-existing psychiatric illnesses, post hallucinogenic perceptual disorder for months or years afterwards
What is the common name for post-hallucinogenic perceptual disorder?
What are three problems with the medical model of substance abuse?
1. drug dependence is seen as chronic and relapsing sickness or disease, fatalistic;
2. Removes responsibility from the abuser;
3. Widely accepted but not evidence based
How does operant conditioning impact on drug use?
Positive reinforcement initiates and maintain the drug either through positive reinforcement by increasing positive affect or through negative reinforcement by reducing negative affect
Drug taking in a new environment may trigger what? How?
an overdose due to a lack of cues to signal onset of drug effect
An environment or social situation may be associated with good feelings of drug taking and trigger what in a user?
a relapse
An environment associated with pain of withdrawal may trigger what?
a relapse
What is the main problem with self report measures in assessing substance intake?
responders socially contruct their answers based on cues from the 'experts'
The first step for treatment of substance abuse is what?
The biopsychosocial model involves the dynamic interaction of what three factors?
biology, psychology and sociology
What are the risk and protective factors associated with harm from substance abuse prior to birth?
Risk factors - family socioeconomic deprivation, sole parent housegold, paternal genetic risk for alcoholism, and maternal drug use during pregnancy. No protective factors
What are the risk and protective factors associated with harm from substance abuse in infancy and preschool?
Risk factors - environmental tobacco smokea nd child neglect/abuse.
Protective factors - easy temperament
What are the risk and protective factors associated with harm from substance abuse in children aged 4 to 11l?
Risk factors - early school failure, conduct disorder, and aggression.
Protective factors - social and emotional competence, and shy and cautious temperament
What are the risk and protective factors associated with harm from substance abuse in children aged 12 to 17?
Risk factors - low involvement in activites with adults, perceived and actual drug use, community diasadvantage and disorganisation, availability of drugs, positive media portrayal of drugs, parent-adoloscent conflict, and favourable parental attitude towards drugs.
Protective factors - religious involvement, family attachment, low parental conflict, and parent-adult communication
What are the risk and protective factors associated with harm from substance abuse in early adulthood aged 18 to 24?
Risk factors - frequent drug use around high school period.
Protective factor - a well managed comminity environment for alcohol use and arriage in early adulthood
Rational recovery from alcohol abuse focuses on propmoting what?
promoting renewed self-reliance rather than reliance on a higher power like in AA
What are the 7 main treatments for alcohol abuse?
1. In hospital treatment; 2. Alcoholics Anonymouse or similar; 3. Couple Therapy; 4. CBT; 5. Motivational Interventions; 6. Moderation in Drinking; and 7; Medication
Which CBT treatment involved teaching people and those close to them to reinforce behaviours inconsistent with drinking and avoiding situations associated with drinking in the past?
Contingency management therapy
What term refers to a pattern of alcohol consumption that is moderate, avoiding extremes of total abstinence and inebriation?
controlled drinking
Which opiate atanagonist is also used for treating alcohol abuse?
Which medication used to treat alcohol abuse discouraging drinking by causing violent vomiting if alcohol is ingested?
What is the most effective psychological treatment for smoking?
the physician telling the person to stop smoking
What strategy for smoking cessation involves reducing nicotine intake over several weeks and increasing the time between each cigarette?
scheduled smoking
What are the four phases in the treatment process for substance abuse?
engagement, psychosocial change, recovery and reintegration, and beyond treatment
Describe the engagement phase of the treatment process model for substance abuse?
motivating clients and buildiing a therapeutic model
Describe the psychosocialchange phase of the treatment process model for substance abuse?
developing psychological strengths and addressing issues with thinking
Describe the recovery and reintegration phase of the treatment process model for substance abuse?
development of social networks, long term planning, and community engagement
Describe the beyond treatment phase of the treatment process model for substance abuse?
long-term personal development and building community supports, family linkage ans aspirations
What are four important factors in the prevention of substance abuse?
peer-pressure resistance training, correction of belifes and expectations, inoculation against mass media messages, and peer leadership
What is the biggest predictor of successful substance abuse recovery?
leaving behind their old social network and selecting a new more congruent social network
Interventions aimed at preventing substance use need to be aimed at who?
children and their families
Does effective education and resistence training delivered by police officers reduce drug abuse?
Is drug replacement therapy effective for cocaine abuse?