PSYC 337: Lecture 11 part 1 (substance abuse disorder)

Rising, adolescence, alcohol, nicotine, cannabis, prescription Rx, affordable, accessible, normalized, liquor cabinet,

There is a ____ risk of substance abuse in ___. These substances include ___, ___, ___ and ___ ___. This might be due to the fact that, nowadays drugs are more ___ (in the past, they used to be only for affluent people). They are also more ___ and ___. A lot of people in their houses have a ___ ___, which makes the alcohol readily accessible

Denial, acknowledge, help seeking, self refer

Substance abuse and impulse control are conditions of ___. People with these often do not want to ___ that the have a problem. “I can stop anytime I want”. This interferes with the ___ process. This is also why they often do not ___ to therapy

Alcohol, entertainment, diabetes, drinking, mind, wake up, life, thinking, behaviour

The most commonly abused substance is ___ (also very hard to treat). Often, people in the ___ industry will have a tendency to go for such substances.

But alcoholics often have health problems such as ___. But rather than stopping, they will often keep ___, which can be potentially life threatening for them. The problem is that substances will take over your ___: they will be the first thing you think about when you ___. Planning. You are willing to give up your ___ over a substance, it takes over your ___ and your ___.

72, kill, benzodiazepines

When people are sent to rehab centres, it is often said that they will feel the most terrible symptoms of withdrawal for the first ___ hours. And the centres are often not the most useful: as soon as people get out, they often start drinking again. Sometimes, withdrawal can even ___ you, which is why you need to slowly take people off of the substance. ___ are often used to lower the severity of withdrawal symptoms.

Snorting, rapid, blood vessels, 60

For stimulants, the ___ method is the most effective, it is the one with the most ___ onset (because the drug comes in contact with your ___ very rapidly). Ingesting a drug is less effective because approximately ___% of it will be destroyed by stomach acids.

7, glue, 9, genetic, demoralization, hope

Among First Nations, rate of hospitalization for substance abuse are ___ times higher than in the non indigenous population. The average age of onset of sniffing ___ on reservations is ___ years old (that means some younger than this will sniff it)

• this high rate of hospitalization might be due to some ___ issues (don’t do well with certain drugs)

• Reserves also leave people with a culture of ___ and lack of ___: so they try to numb out these feelings with substances

Vital organs, heart, liver, lungs, brain, infectious diseases, intravenous, needles, neurological, cognitive, diabetes, thiamine, overdose, rush, high, larger

Physical consequences of substance abuse

• damage to ___ ___ (such as the ___, ___, ___ and ___) —> over a long period of use

• Increased risk of ___ ___ (such as HIV or hepatitis) if associated with ___ drug use (when drugs are injected and people share ___).

• ___ impairments and ___ deficits. These are often irreversible. Possible causes involve ___ and ___ deficiency.

• Increased risk of ___, which can be fatal. Certain ways of consuming drugs are associated with a ___ (a heavenly feeling), which is then followed by the ___. This high is less good than the rush: a lot of people will want to feel the rush again so they take ___ quantities of the drug and then they overdose

  
  

  
  

Anxiety, depression, mood, self medicate, mood swings, instability, judgement, decision making, mental health, risk, psychotic

Psychological consequences of substance abuse:

• ___ , ___, and other ___ disorders. It is thought that substances might be used as a way to ___ when people already have these conditions.

• ___ ___ and emotional ___ (this happens when you don’t Have access to the drug)

• Impaired ___ and ___ (you don’t process information in a rational or logical manner)

• Development or worsening of ___ ___ problems. This is especially true for people who are at ___: this increases their probability to precipitate certain conditions. Often, someone’s first ___ episode will be associated with the use of a substance.

Strained, broken, family, friends, colleagues, isolation, withdrawal, best, school, work, legal

Social consequences of substance abuse:

• ___ or ___ relationships with ___, ___ and ___ (might happen because you cannot control your anger, irritation when you don’t have access to the drug)

• Social ___ and ___. Usually, drugs tend to not bring out the ___ of people, so friends and family don’t want to be with you anymore.

• Difficulties at ___ or ___ (compromised after drinking)

• ___ problems related to substance related activities (i.e: driving under the influence, stealing to get drugs, etc.)

Financial, gambling, employment, academic, pregnancy, incarceration

Life impact of substance abuse:

• ___ problems due to spending on substances. These drugs are usually very expensive, especially if you use so much of it so often. Also, substance abuse might even be associated with ___ problems.

• Loss of ___ or ___ opportunities

• ___ (because associated with reckless behaviour when you are intoxicated)

• ___

Involvement, Use, moderate, social, educational, occupational, intoxication, substance abuse

There are different levels of ___ with the substances:

• ___ : ingestion of psychoactive substances in ___ amounts that do not necessarily interfere with ___, ___ or ___ functioning. No negative impacts here

• ___ : physiological reactions such as becoming drunk or high

• ___ : when individuals can no longer control their use of a particular substance

Aspirin, disabling

Cannabis has the same analgesic properties as ___. So it’s pretty mediocre. When you’re stoned, it also has ___ effects.

Physiological, greater same effect, tolerance, negative physical, withdrawal, blood

___ dependence on the drug or drugs means using of increasingly ___ amounts of the drug to experience the ___ ___ (___) and a ___ ___ response when the substance is no longer ingested (___, negative symptoms that arise when ___ levels fall below a certain threshold)

psychological, behavioural, drug seeking, stealing, resume, craving, behaviour, intention

___ dependence: ___ responses reflecting a desperate need to ingest more of the substance such as ___ ___ behaviour, ___ to buy drugs and the likelihood that use will ___ after a period of abstinence. ___ is the psychological intent to get the drug, the pathway is ___ (and behind it is always ___)

2, 12, larger, longer, unsuccessful, obtaining, using, recovering, craving, desire, role obligations, social, interpersonal, activities, use, hazardous, health, tolerance, withdrawal

Diagnosis of substance use disorder:

The presence of at least ___ of the following within a ___ month period:

• using ___ amounts or over a ___ period than intended

• ___ efforts to cut down or control use

• Significant time spend ___, ___ or ___ from substances

• ___ or strong ___ to use

• Failure to fulfill major ___ ___

• Continued use despite persistent ___ or ___ problems

• Giving up ___ in favor of ___

• Using in physically ___ situations (such as driving under the influence)

• Continued use despite ___ problems. “I don’t have diabetes”

• ___ (needing more of the substance)

• ___ symptoms

The diagnostic criteria are basically the same for all substances

Depressants, stimulants, opioids, hallucinogens, others

Name the 5 broad major categories of substances of abuse

Alcohol, barbiturates, benzodiazepines, calm, down, GABA

Depressants: drugs such as ___, ___ and ___. These will ___ you ___ by having effects on the neurotransmitter ___

Amphetamines, cocaine, nicotine, caffeine, norepinephrine, dopamine

Stimulants: ___, ___, ___ and ___. These mostly have their effect on the neurotransmitters ___ and ___

Heroin, opium, morphine, oxycodone, codeine, numb, out

Opioids: ___, ___, ___, ___ and ___. These drugs will ___ you ___

LSD, psylocibin

Hallucinogens: ___ and ___

Glue, steroids, nitrous oxide

Other drugs of abuse: ___, ___ and ___

Central nervous system, alcohol, sedative, hypnotic, anxiolytic, tolerance, withdrawal, tolerance

Depressants: they primarily decrease ___ activity. Included in this group are ___ and the ___, ___ and ___ drugs (categories). Those substances are among those most likely to produce symptoms of ___ and ___. They basically decrease tension and take the edge off. This type of drug is the most likely to lead to ___.

2, 12, mild, moderate, severe, craving, impaired control, preoccupation, tolerance, withdrawal, sweating, shaking, nausea, anxiety, neglect of responsibilities, problems, social, interpersonal, health

Alcohol use disorder: need ___ criteria over ___ months period. Rated as either ___, ___ or ___

• ___ : a strong desire or urge to drink

• ___ : drinking more or for longer than intended, or unsuccessful efforts to cut down

• ___ : spending a lot of time obtaining, using or recovering from alcohol

• ___ : needing more alcohol to achieve the same effect or diminished effect with continued use

• ___ : experiencing symptoms such as ___, ___, ___ or ___ when not drinking

• ___ : failing to meet obligations at work, school, or home due to alcohol

• Continued use despite ___: persisting in drinking despite ___, ___ or ___ issues caused or worsened by alcohol

1, 24

Alcoholic Anonymous saying: ___ is too many, ___ is not enough (once you take your first drink, it is almost impossible for you to not take another one)

Ingestion, stomach, small intestine, blood stream, heart, liver, damaging

Alcohol is absorbed first by the process of ___. Then, it goes to the ___ (where approximately ___% of the alcohol is absorbed), then the ___, then enter the ___ ___ to go to the ___ and then the ___ (these two last ones don’t like alcohol, it has ___ effects on them)

Brain tissues, liver

Long term alcohol use

• effects on the brain: alcohol leads to major loss of ___ ___ that is irreversible (loss of mass)

• Alcohol will also greatly damage your ___.

Agitation, insomnia, disorientation, time, place, hallucinations, rehab, 72

Alcohol withdrawal delirium involves: EXAM!

• ___

• ___

• ___ to ___ and ___

• ___

These might happen when you are a heavy drinker and you go to ___. The symptoms will usually be worse during the first ___ hours.

Wernicke Korsakoff syndrome

Name a syndrome associated with prolonged alcohol use

Thiamine, physical, cognitive, confusion, planning, problem solving, attention, muscle coordination, unintelligible, confabulation

Wernicke Korsakoff syndrome:

• associated with severe ___ deficiency. Alcohol basically has a negative impact on your ability to absorb it. But thiamine is a component the brain needs: so the deficiency will lead to ___ and ___ problems.

• ___ (state)

• Difficulty with ___, ___ and maintaining ___

• Loss of ___ ___

• ___ speech

• ___ (making stuff up)

Fetal alcohol syndrome

Name a syndrome associated with a pregnant woman drinking alcohol

Excessively, retardation, behavioural, learning, small, flat, epicanthal, philtrum, upper lip, eye openings, nose, nasal bridge, jaw

Fetal alcohol syndrome:

• occurs in infants whose mothers drank ___ during pregnancy

• Fetal growth ___

• ___ problems

• ___ difficulties

Some characteristics of the syndrome involve a baby with a ___ head, a ___ face, ___ folds, a smooth ___, a thin ___ ___, small ___ ___, a short ___, a low ___ ___ and an underdeveloped ___

• the syndrome has irreversible effects and comprises of various morphological problems.

Barbiturates, benzodiazepines, calming, sleep inducing, anxiety reducing

Sedative, hypnotic and anxiolytic related disorders: this group includes: ___ and ___ (drugs)

• sedative means a ___ effect

• Hypnotic means ___ ___

• Anxiolytic means ___ ___ drugs

Central nervous system, sedatives, hypnotics, anticonvulsants, increase, GABA, inhibitory, anesthesia, anxiety, seizures, dependence, overdose, respiratory, withdrawal, prescription

Barbiturates: are a class of ___ depressants that act as ___, ___ and ___

• mechanism of action: they ___ activity of the ___ (an ___ neurotransmitter), resulting in sedative and calming effects

• Uses: historically used for ___, ___ relief and to treat ___

• Examples: phenobarbital, pentobarbital, amobarbital, secobarbital

• Risks: ___, ___, ___ depression and ___ symptoms. One problem is that they are accessible through ___.

Central nervous system, enhance, gaba, gaba-A, calming, sedative, anxiolytic, muscle relaxant, anticonvulsant

Benzodiazepines: class of medications that act on the ___ as depressants. They ___ the effect of the neurotransmitter ___ at the ___ receptor, producing ___, ___, ___, ___ ___ and ___ effects

Diazepam, alprazolam, lorazepam, clonazepam, temazepam, am

Examples of benzodiazepines: ___ (Valium), ___ (Xanax), ___ (Ativan), ___ (Klonopin) and ___ (Restoril). Basically drugs that end in “___”

Psychological, physical, unsuccessful, impairment, distress, tolerance, withdrawal, physically hazardous

Diagnosis of sedative, hypnotic or anxiolytic related disorders

• use despite ___ or __ problems caused or worsened by the substance

• Repeated ___ effort to reduce or control use

• Significant ___ or ___ resulting from use

• ___ : needing increased amounts to achieve the desired state

• ___ symptoms upon cessation or reduction of use

• Recurrent use in ___ ___ situations (ex: driving while impaired)

Increased, intoxication, reduced, same

Tolerance is defined by either of the following:

• a need for markedly ___ amounts of sedative, hypnotic or anxiolytic to achieve ___ or desired effect

• A markedly ___ effect with continued use of the ___ amount of the drug

Characteristic, alcohol, relieve, avoid, vary

Withdrawal as manifested by either of the following:

• The ___ withdrawal symptoms for sedatives, hypnotics or anxiolytics

• Sedatives, hypnotics or anxiolytics (or closely related substances, such as ___) are taken to ___ or ___ withdrawal symptoms

Host of negative symptoms which will ___ depending on the drug

Increased, increase, benzodiazepines , sleeping, over prescription, elderly, substance use, negative

___ prescription rates: over the past years, there has been a noticeable ___ in the prescription rates of sedative and hypnotic drugs, such as ___ and ___ pills. Maybe this is because people feel more stressed out all the time and have more anxiety than ever.

___ to vulnerable populations: certain vulnerable populations, such as the ___ and individuals with a history ___ ___ disorders, are more at risk of experiencing ___ effects from the over prescription of these drugs

• even if it is importing to worry over the potential risks of long term use, some physicians will continue to prescribe the drug to patients for a long time

Stimulants, caffeine, nicotine, amphetamines, cocaine

Of all the psychoactive drugs used in Canada, the most consumed are the ___. Included in this group are ___, ___, ___ and ___

2, 12, excessive, quit, time, cravings, fulfill roles, interpersonal, social, activities, dangerous, problems, tolerance, withdrawal

Diagnosis of stimulant use disorder: at least ___ of the following within a ___ month period:

• ___ use

• Unsuccessful ___ attempts

• ___ spent

• ___

• Failure to ___ ___

• ___ or ___ problems

• Reduced ___

• Use in ___ situations

• Continued use despite ___

• ___ symptoms

• ___ symptoms

Asthma, decongestant, weight loss, energy, awake, alert, pilots, drivers, students, narcolepsy, ADHD, alert, focuses

Amphetamines:

• first used in the treatment of ___ and as a nasal ___

• Used as ___ ___ drugs

• Used for ___ and to remain ___ or ___ (used by ___, ___ and or ___)

• Used against ___

• used against ___ (Ritalin leads you to being more ___ and in a more ___ state)

Euphoria, sociability, anxiety, tension, anger, stereotyped, judgement, social, occupational, hallucinations

Amphetamine intoxication:

Psychological:

• ___

• Changes in ___ (usually, people tend to be more talkative)

• ___ , some ___ and ___ (states)

• ___ behaviours (do something over and over again)

• Impaired ___

• Impaired ___ or ___ functioning

• ___

Heart rate, blood pressure, perspiration, chills, nausea, vomitting, weight loss, respiratory, seizures, coma

Amphetamine intoxication

Physiological:

• increases in ___ ___

• ___ ___ change

• ___ or ___ (related to sweating I guess)

• ___ or ___

• ___ ___

• ___ depression

• ____

• ____

Stimulant, coca, addictive, cost, affluent, snorted, injected, crack cocaine

Cocaine:

• a ___ drug derived from the leaves of the ___ plant

• Initially, the ___ properties of cocaine were not recognized

• High ___ led to use primarily with individuals who were ___

• Method of injection: is ___ or ___

• ___ ___ is smoked

Cardiovascular, seizures, strokes, neurotoxicity, paranoia, dependence, addiction, respiratory, gastrointestinal, dental, crack mouth, auditory

Cocaine: long term use:

• ___ damage

Neurological effects: ___, ___ and ___

• psychological and cognitive impact: ___, ___

• Lead to ___ and ___

• ___ problems: damage nasal tissues, cause chronic runny nose

• ___ problems: decreased blood flow and bowel ischemia

• ___ decay: ___ ___ syndrome involves severe tooth decay and gum disease

• Effects on infants if mother used it while pregnant: deficits in ___ information processing

Dopamine, norepinephrine, reuptake, dopamine, reuptake, dopamine, pleasure, euphoric, dopamine, generic, satisfaction

Amphetamine and cocaine

• amphetamine stimulates the release of ___ and ___ and blocks their ___

• Effects of cocaine is primarily in blocking the ___ of ___ (neurotransmitter implicated in ___ experiences)

• Effects on dopamine likely contribute to the ___ experience of these two drugs

• The ___ theory of addiction suggests inviduals with a ___ predisposition to experience less ___ from natural rewards might be most prone to addiction from these two drugs

Nicotine, dependence, tolerance, withdrawal, 3, downwards, 10, men, women, depressed, insomnia, anxiety, irritability, concentrating, restlessness, appetite, weight gain, slows down, craving,

Tobacco related disorders: the ___ in tobacco is a psychoactive substance that produces patterns of ___, ___ and ___. Over the past ___ decades, there has been a ___ trend in the percentage of the population that smokes. Recent surveys suffers approximately ___ % of the Canadian population smokes, with slightly more ___ (12%) than ___ (9%)

Withdrawal symptoms include ___ mood, ___ (sleeping), ___, ___, difficulty ___, ___ and increased ___ and ___ ___ (this is because, when you stop smoking, your metabolism ___ ___, making it so that if you continue eating the same amount of food, you will gain a lot of weight). Unfortunately, the ___ part for tobacco will last a long time, making it even harder to discontinue its use.

Common, 90, gentle, harmful, coffee, tea, chocolate, energy, elevate, fatigue, headache, drowsiness, irritability, adenosine

Caffeine related disorders: caffeine is fhe most ___ of the psychoactive substances, used regularly by about ___% of North Americans. Called the ___ stimulant because it is thought tot be the least ___ of all the addictive drugs. Caffeine is found in ___, ___, ___ and ___ drinks. Low doses ___ mood and decrease ___. Higher diesel can contribute to ___ and ___ disturbance. Withdrawal symptoms include ___, ___ and ___. Caffeine central effect involves its influence on the neuromodulator ___

Opiates, poppy, fibers, opium, morphine, codeine, heroin

___ : chemical compounds that are extracted or refined from natural plant matter (___ saps and ___). Includes ___, ___, ___ and ___.

Opioids, opiates, OxyContin, Percocet, Demerol, fentanyl, standardized, dosage

___ : chemical compounds that are synthesized to mimic properties of ___. Include ___, ___, ___ and ___. Can be ___ because they are synthesized. Since their preparation is not ___, their ___ is unknown, and this can make it dangerous for risks of overdose ( you might think you are taking the same amount of drug as usual but without knowing this one might be more concentrated, so you are more likely to overdose).

Narcotics, sleep, numbness, narcoticus, narkoun, injury, PTSD

___ : both groups of drugs [opiates and opioids] are this. The word simply means ___ inducing or ___ inducing, from the Medieval Latin word ___, from the Greek ___ to benumb. Usually prescribed when you get a really bad ___ or for such mental health disorder like ___. To shut it off, often the only thing that works.

Naturally derived, synthetic

The difference between opiates and opioids is that opiates are ___ while opioids are a ___ version of opiates.

Larger, longer, unsuccessful, activities, obtain, use, craving, role obligations, continued, caused, worsened, hazardous, tolerance, withdrawal

Opioid use disorder:

• taking opioids in ___ amounts or over a ___ period than intended

• ___ efforts to cut down or control use

• Great deal of time spent in ___ necessary to ___ or ___ opioids

• ___ or strong desired to use them

• Failure to fulfil major ___ ___ at work, school or home

• ___ use despite having problems ___ or ___ by the drugs

• Recurrent use in situations where it is physically ___

• ___

• ___

Hoffmann, compound, ergot, fungus, diseased kernels, 25, lysergic acid

Hallucinogens:

• in 1943, Albert ___, a scientist at a large Swiss chemical company, prepared to test a newly synthesized ___. He had been studying derivatives of ___, a ___ that grows on ___ ___ of grain, and sensed that he had missed something important in the ___ th compound of the ___ ___ series. LSD

LSD, acid, Leary, child, adult, in, out, drop, psilocybin, dimethyltryptsmine, DMT, mescaline, phencyclidine, PCP

Hallucinogenic drugs:

• ___ (or d-lysergic acid diethylamide), sometimes referred to as ___, is a common hallucinogenic drug. Timothy ___, at the time a Harvard research professor, first used it in 1961 and immediately began a movement to have every ___ and ___ try the drug and “turn ___, tune ___ or ___ out”

• ___ , found in certain species of mushrooms (magic mushroom)

• ___ (___) found in the bark of the virola tree

• ___ found in the peyote cactus plant

• ___ (___) synthetic hallucinogen

Hallucinogen, depressant, stimulant, marijuana, cannabis saliva, increased, 20, mental health problems, psychotic, humor, dreamlike, sensory, colours, time

Cannabis:

• classified as a ___, but also has ___ and ___ effects

• ___ is the name given to the dried parts of the cannabis or hemp plant (its full scientific name is ___ ___)

• Legalization has ___ use in Canada (___% of the population)

• Higher use in individuals with ___ and there are indications that cannabis might trigger ___ episodes in at risk individuals

• Effects include increased range of ___ inducing stimuli (out of control laughter), a ___ state (“oh man”), heightened ___ experiences, seeing vivid ___, a distorted ___ perception.

Genetics, positive, higher, family history, psychological, cognitive, expectancies, positive, desirable, craving, conditioning, trigger, denial, modelling, social inclusion

Causes of drug use

• ___ : but not like in other conditions. With alcohol, some people with experience ___ effects to a ___ degree than others (usually inherited if ___ ___ of alcoholism)

• ___ : helps deal with such issues, self medicate

• ___ (___): some people have more positive ones about the use of substances, which makes them more likely to abuse the substance: overly ___ expectancies (ex: if you feel like the substance will make you more socially ___) is bad

• ___ for the drug

• ___ : when you start to positively associate taking the drug with having a good time, just remember, just being with your friends, for instance, will be a ___ for drinking

• ___ : often not aware the problem is developing until it’s too late and you lose everything in life

• ___ : family history of drinking, you learn it from your parents

• ___ ___ purposes (esp during uni years)