Week 9 – Substance-Related Disorders

40 question-and-answer flashcards covering key lecture topics: drug classifications, epidemiology, DSM-5 criteria, aetiology, personality and learning theories, harm minimisation, screening tools, interventions, and treatment data.

What CNS effect do depressants have, and name two common examples.

Depressants slow central nervous system functions; examples include alcohol and benzodiazepines.

Which drug class increases CNS activity and feelings of energy? Give two examples.

Stimulants, such as cocaine and methamphetamine, increase CNS activity and alertness.

What proportion of drug-induced deaths in Australia (2021) involved opioids?

Approximately 58 % of drug-induced deaths involved opioids.

How much did alcohol, tobacco and other drug (AOD) use cost Australia in 2021?

About AUD 80 billion in total economic cost.

What was Australia’s daily smoking prevalence in the 2022-23 survey?

8.3 % of people aged 14 + smoked daily—an historic low.

By how much did current e-cigarette use rise between 2019 and 2022-23?

It nearly tripled—from 2.5 % to 7.0 % of Australians aged 14 +.

Which socioeconomic group is most likely to smoke tobacco daily?

People living in the most socio-economically disadvantaged areas.

Define ‘risky alcohol use’ according to the lecture.

10 standard drinks per week and/or > 4 drinks on any single day.

What percentage of 18-24 year-olds consumed alcohol at risky levels?

About 42 % in the most recent survey.

How many DSM-5 symptoms indicate a mild, moderate, and severe Substance Use Disorder (SUD)?

Mild = 2–3 symptoms, Moderate = 4–5, Severe = 6 +.

List the four DSM-5 ‘impaired control’ criteria for SUD.

1) Taking larger amounts/longer than intended; 2) Persistent desire/unsuccessful efforts to cut down; 3) Great deal of time spent using/recovering; 4) Craving or strong urge to use.

What major change occurred from DSM-IV to DSM-5 criteria for SUD?

Legal problems criterion was removed and craving was added; abuse and dependence were merged into one continuum.

What is a DSM-5 substance-induced disorder?

A mental disorder that develops during intoxication or withdrawal and usually resolves within one month after cessation (except some neurocognitive deficits).

Which commonly consumed psychoactive substance has NO DSM-5 ‘use disorder’ category?

Caffeine (it has intoxication and withdrawal, but no use-disorder diagnosis).

In 2020-21, how did SUD prevalence differ by sex in Australia?

Males had almost double the 12-month SUD rate (4.4 %) compared with females (2.3 %).

Name three negative outcomes linked to early onset or frequent substance use.

Increased risk of SUDs, mental-health problems, and legal/accident-related harms.

What is ‘tolerance’ in the context of substance use?

Needing increased amounts of a drug to achieve the same effect.

Define ‘withdrawal.’

A set of unpleasant physical and psychological symptoms occurring when substance use is reduced or stopped.

How heritable are addictions according to twin studies?

Heritability estimates range from ~0.39 (hallucinogens) to ~0.72 (cocaine), indicating strong genetic influence but no single gene.

Which two brain regions form the core of the reward pathway implicated in addiction?

The ventral tegmental area (VTA) and the nucleus accumbens (NAcc).

Which two personality traits are linked to substance use risk and what do they reflect?

Neuroticism (avoidance/negative affect) and impulsivity (approach/sensation seeking).

How does positive reinforcement contribute to substance use according to operant learning theory?

Pleasant feelings and social enhancement increase the likelihood of repeated use, especially in early stages.

What is ‘drug refusal self-efficacy’?

A person’s belief in their ability and skills to refuse drugs or resist urges.

What does behavioural-economic research say increases substance use likelihood?

Low immediate costs, few constraints, limited substance-free rewards, and preference for immediate over delayed rewards.

State the overarching aim of Australia’s National Drug Strategy (harm minimisation).

To build safe, healthy and resilient communities by preventing and minimising alcohol, tobacco and other drug-related harms.

Differentiate decriminalisation from legalisation of drugs.

Decriminalisation removes criminal penalties for personal possession/use (often replaced by civil penalties); legalisation removes all penalties and regulates production and sale.

What is the first police response under Queensland’s Expanded Drug Diversion Program for a minor possession offence?

A verbal warning plus a drug warning notice and referral to a support service.

At what AUDIT score is harmful/hazardous alcohol use indicated?

A total score of 8 or higher.

Interpret an AUDIT score of 13 +.

Suggests elevated risk of alcohol dependence—requires specialist assessment/referral.

What are the three modules of the QuikFix/First Step brief intervention?

1) Personalised feedback & information; 2) Motivational enhancement & goal setting; 3) Risk profile & coping-skills training.

Name the three pharmacotherapy paradigms for dependence and give one opioid example for each.

Withdrawal management (buprenorphine for opioid withdrawal), Replacement (methadone maintenance), Abstinence/relapse prevention (naltrexone).

Which principal drug of concern is most common among 10-19-year-olds in Australian treatment data?

Cannabis.

What treatment modality accounts for the highest proportion (34 %) of AOD episodes in Australia?

Counselling.

What percentage of Australian AOD services are delivered by NGOs?

Approximately 68 % of services, delivering 73 % of all treatment episodes.

What barrier does stigma create in the context of substance use treatment?

It discourages people from seeking help and amplifies shame or anger about their use.

Provide the DSM-5 definition of a Substance Use Disorder in one sentence.

A maladaptive pattern of substance use leading to clinically significant impairment or distress, manifested by at least two criteria within a 12-month period.

When are DSM-5 substance-induced disorders expected to resolve?

Usually within one month after cessation of intoxication, withdrawal, or medication use—except some neurocognitive cases.