Drug Use and Abuse Final

what is true about the diagnosis of substance use disorder in DSM-5-TR?

there is no longer a distinction made between dependence and abuse of a given substance

included a substance dependence disorder that would be what most people consider addiction; had substance abuse and substance dependence disorders; included repeated legal difficulties as an indication of substance abuse

the DSM-IV

true/false: withdrawal symptoms of an addictive drug are the opposite of the drug's effects.

true

true/false: substance induced disorders include mood disorders, anxiety disorders, sexual dysfunction, and sleep disorders

true

what are some things that are considered when identifying the level of use of someone?

how long an episode of use lasts; how often someone is using; whether there are negative consequences for the person's use; how much someone is using

is "recurrent legal problems as a result of substance use" included in the DSM-5-TR criteria for substance use disorder?

no

Julia is a heavy drinker who suffers in only one way when deprived of alcohol: she craves it. What is Julia suffering from?

psychological dependence

true/false: it is possible to relieve a person's withdrawal symptoms from a drug by administering the same drug.

true

John drinks a beer when he gets home from work some days and not on other days. Sometimes he drinks on the weekend and sometimes he does not. Which level of use best fits John?

social/recreational use

what is not an example of impaired control associated with substance use disorder in the DSM-5-TR?

Taylor has to drink 5 servings of alcohol to experience the same buzz as they used to experience with 2 servings (tolerance)

if _____ to a drug develops, the individual must consume increasing amounts of it to achieve a desired drug effect.

tolerance

if someone meets 5 of the substance use disorder criteria, then the appropriate specifier would be...

moderate

in order for someone to meet the criteria for DSM-5-TR substance use disorder...

2 of 11 criteria have to be met

characterized by compulsive drug use evidenced by getting and using the drug and a strong tendency to resume use of it after stopping for a period

addiction

diagnostic system

DSM-5-TR

what is not one of the categories of criteria for substance use disorder in DSM-5-TR?

dependence

Sam repeatedly struggles to get to work on time on Mondays because of his substance use over the weekends. He takes prescription pills in order to avoid withdrawal symptoms when he is at work. Sam often plans to go out on Friday after work for just a few hours, but he seems to repeatedly not get home until midnight or later because he is out using his substance of choice. Which level of use best fits Sam?

substance use disorder

Kara meets her friends every Thursday evening during which time she usually has 1-2 glasses of wine. Other than that, she drinks maybe once a month on a date. What would be the best description of her level of use of alcohol?

habitual/regular use

true/false: the term "withdrawal" refers to a definable illness that occurs with a cessation or decrease in the use of a drug.

true

the Pure Food and Drug Act _____

forced the producers of medicines to indicate on the packaging the amount of drug contained therein

how was cannabis sativa used in ancient China?

it was brewed as tea

true/false: marijuana was used as an all-purpose medicine in the 1800s.

true

what plant used in Asia Minor around 5000 b.c. was known as a "joy plant"?

opium poppy

true/false: drugs with little or no abuse or dependence potential are not classified in the 1970 Controlled Substances Act.

true

true/false: although illicit drugs have often been used for medicinal purposes, it is very rare for drugs that are developed for medicinal reasons to be used in non medicinal ways.

false

true/false: the Synthetic Drug Abuse Prevention Act of 2012 added Schedule VI to the Schedules of Controlled Substances, encompassing the newly developed synthetic drugs such as bath salts.

false

what was the "soldier's disease" in the Civil War?

morphine addiction

the _____ allows for immediate classification of drugs.

Controlled Substances Analogue Enforcement Act

the Fair Sentencing Act of 2010 _____.

gave judges more leeway in considering mitigating factors during sentencing

what was used in the 1930s to treat depression?

amphetamines

true/false: drug laws and their implementation in other countries are very similar to one another and to the drug laws and implementations in the US.

false

archaeological evidence suggests that _____ was used as early as 6400 b.c.

alcohol

_____ is a slang expression used to describe a saloon operating without a license during Prohibition.

speakeasy

into the middle of the 1800s, drugs could be obtained in the US _____. (3 things)

through the mail, at grocery stores, without prescription

model cements, lighter fluids, and lacquer thinner are examples of what?

solvents

what did European explorers bring to the Americas?

alcohol

true/false: Schedule 1 drugs are drugs/substances that have a high potential for abuse and have at least one acceptable medical use for treatment in the US.

false

the Opium Wars occurred because _____ attempted to control or eliminate imports of opium by _____ traders.

China... British

true/false: the more restrictive a drug law is, the more effective it is likely to be in the long run

false

an unintended consequence of the Harrison Narcotics Tax Act of 1914 was that, in the years since its passage, the law served to switch some people's addiction from opium to what other drug?

heroin

the Harrison Narcotics Tax Act _____. (3 things)

incorrectly included cocaine as a narcotic, did not prohibit the legal supply of the opiates, allowed physicians to prescribe narcotics only in the course of their professional practice

the San Francisco Ordinance involved _____.

banning opium dens

what was not a result of Prohibition?

a shift in drinking habits from distilled spirits to beer

true/false: chronic drug use can lead to a reduction in the number of receptors

true

the _____ is part of the hindbrain and provides a pathway for input up and output down the spinal cord

pons

the monoamines include...

dopamine, norepinephrine, and serotonin

the _____ lobe is associated with sensory perception

parietal

true/false: the autonomic nervous system is composed of the sympathetic branch and the peripheral branch

false

the branch of the autonomic nervous system that is activated during emotional arousal is the _____

sympathetic branch

the _____ lobe is associated with executive functioning, impulse control, and emotional control

frontal

the brain structure thought to be critical to the storage of memories is the _____

hippocampus

the _____ is associated with the basal ganglia and is involved in the coordination of movement and integration of motor control

sustantia nigra

the brain's most abundant inhibitory neurotransmitter is _____

GABA

what is one way that drugs can act on the nervous system?

they affect the deactivation of neurotransmitters

what is NOT a part of the reward pathway?

medulla

true/false: the central nervous system includes the brain and spinal cord

true

the _____ is the part of the brain that is our regulator - involved with eating, drinking, body temp, sexual behavior, etc.

hypothalamus

what is often referred to as the "pleasure center"?

mesolimbic dopaminergic pathway

the blood-brain barrier serves what type of function?

filter

the _____ lobe is the primary receiving area for auditory information.

temporal

recent research on adult neurogenesis has focused on what part of the brain?

hippocampus

chemicals in marijuana mimic...

anadamide

what is the name of the forebrain structure that is involved in the control and initiation of motor movement?

basal ganglia

the _____ is part of the hindbrain that is involved in balance and coordination

cerebellum

what is the pathway that runs along side the pons and through the medulla that regulates alertness and arousal?

reticular activating system

the brain's main excitatory neurotransmitter is _____

glutamate

what neurotransmitter is thought to be associated with pain relief?

endorphins

a sympathomimetic drug has effects that _____

are similar to those of a fight or flight response

what neurotransmitter is thought to be critical in the development of Alzheimer's disease?

acetylcholine

the primary roles associated with _____ include sleep and mood

serotonin

the primary roles associated with _____ include coordinated motor movements and reward/pleasure

dopamine

the _____ lobe is the primary receiving area for visual information

occipital

recent brain imaging research suggests that drug craving is associated with activity in what part of the brain?

limbic system

what is the relay station for what we take in through our senses (except smell)?

thalamus

mediation of emotional experiences is a main job of the _____

amygdala

the primary roles associated with _____ include muscle contractions, learning and memory, and sensory processing

acetylcholine

the primary roles associated with _____ include emotional arousal and alertness as well as regulation of hunger

norepinephrine

what is magnetic resonance imagining (MRI) used for?

to create a 3D image of the brain

the branch of the autonomic nervous system that you can activate by diaphragmatic breathing is the _____

parasympathetic branch

damage to which area of the brain would be most life-threatening due to its role in basic life functions such as breathing and heart rate?

medulla

what involves injecting radioactive isotopes into the brain?

PET scan

Pharmacokinetics

branch of pharmacology that focuses on the absorption, distribution, biotransformation, and excretion of drugs.

Pharmacodynamics

branch of pharmacology that focuses on the biochemical and physiological effects of drugs and their mechanisms of action

We adjust a dose based on what? Why?

We adjust a dose based on weight, because weight affects the concentration of a drug in the body

The Method and/or Site of drug use influences the drug experience due to what 4 factors:

- Rate of absorption - time to enter the bloodstream

- Safety

- Metabolism - body breaks down matter into more simple components and waste

- Bioavailability - The portion of the original drug dose that reaches its site of action

Characteristics describing drug administration via inhalation (the speed, absorption efficiency, and the required physical state of the substance)

- Fastest: as quick as 7 - 10 seconds

- Do not necessarily take in all of the available drug (You do not always get all of the drug when you inhale it)

- Must be in gaseous state, droplets suspended in gas (nicotine, freebase cocaine), or fine liquid drops

Characteristics describing drug administration via injection (the 3 methods, onset speed, and risk)

- Intravenous (IV) - into the veins

- Intense rush experience - 15-30 seconds

- Most dangerous - bypass body's safety mechanisms

- Intramuscular (IM) - "within the muscle"

- 3-5 minutes

- Subcutaneous - "skin popping" - under layers of skin

- Slower absorption rate

- 3-5 minutes

Characteristics describing drug administration via Mucus membrane absorption (the 3 methods and onset speed)

- Intranasal - aka insufflation, snorting, sniffing (3-5 min)

- Can disrupt blood flow and cause irritation

- Sublingual - under the tongue, dissolves in saliva and absorbed in mucous membranes (3-5 min)

- Rectal suppositories or vaginal absorption (10-15 min)

This method is quicker than oral, avoids gastrointestinal tract

Characteristics describing drug administration via Oral route (safety, absorption, and metabolism)

- Safest, most convenient

- Presence of food in digestive tract delays effect, may dilute the drug

- Stomach can break down some drugs

- Most absorbed in small intestines

- Passes through the liver before reaching the brain - "first pass"

Characteristics describing drug administration via Transdermal route (absorption and duration)

- Through the skin

- Avoids gastrointestinal effects

- Skin is more impenetrable

- More blood flow, greater absorption - buttocks, abdomen, upper arm

- Can take the longest

Characteristics describing absorption into the bloodstream and factors influencing bioavailability

- Absorption and bioavailability depend on the route and site of administration

- More blood flow at the site → faster absorption

- Larger absorption surface area → greater drug uptake

- Membrane diffusibility affects how easily the drug passes through tissues

Drug characteristics:

- Higher lipid solubility → quicker absorption

- Water-based solutions → absorbed more rapidly

- pH level (acidity or alkalinity) influences absorption efficiency

What is the vehicle of drug distribution?

Blood

What factors influence how drugs are distributed throughout the body after entering the bloodstream?

- Blood acts as the vehicle for drug distribution

- Organs with higher blood flow (heart, brain, kidneys, liver) receive more of the drug

- Diffusibility - more diffusible membranes receive drug more quickly

- Selective protein binding: drugs that bind tightly to proteins distribute more slowly

- Blood-brain barrier (BBB):

- special cells in the central nervous system that wrap

themselves around the capillaries and block pores to

which substances normally diffuse

- a solid lipid barrier -- more fat soluble drugs, more

quickly pass BBB

What are the primary organs involved in elimination of drugs from the body?

The liver and kidneys

Biotransformation (a type of, aka metabolism)

the process of changing the molecular structure of substances into more useful or less toxic substances

Enzyme

a catalyst for molecular changes to substances

Metabolites

the byproducts from this biotransformation process

Zero-order kinetics is when the rate of metabolism is...

Zero-order kinetics is when the rate of metabolism is independent of concentration in the blood (Ex: alcohol - about 1 serving metabolized every 1.25 hours (this varies across people))

First-order kinetics is when the amount of drug...

metabolized is dependent on amount of drug in the blood

Half-life in terms of the elimination of drugs is...

The amount of time that must pass for the amount of drug in the blood to be reduced by half