Substance use disorder

What was the temperence movement

a movement to ban alcohol/substance use goal of reducing domestic violence

HiTop of substance use disorder

externalizing

DSM 1 substance abuse classification

symptom of socipathic personality disorder

no criteria and no srug specifies

until DSM 3 substance abuse was in what class of disorder

personality

DSM 3 and substance abuse

spereated form personality

• abuse:

• dependence:

abuse vs dependance

abuse is a maladaptive pattern leading to destress and impairment vs dependence is physiological state

diagnosed with substance abuse DSM 3

• failure to fulfill role

• hazardous situations

• legal problems

• social problems

diagnosed with substance dependence

3 or more of

• tolerance

• withdrawal

• more than intended

• failure to cut dow

• time spent

• giving up other activities

• phys or psyc problems

everyone who meets criteria for ____ must also meet criteria for ___

dependent abuse

5 categories of substances

1. depressants (downers)

2. stimulants

3. opioids

4. hallucinogens

5. other drugs (gambling)

what is the most addictive drugs

nicotine, then meth

Diagnosing Sub disorder: 4 groups

1. impairments of control

2. social impairment

3. risky use

4. pharmacological dependence

Diagnosing Sub disorder: impairmnets of control

• tried to stop

• spends time acquiring it

• crave it when it is not present

Diagnosing Sub disorder: social impairments

• takes away form important things

• work issues

• loved ones have told patient to stop

Diagnosing Sub disorder: pharma dependence

• tolerance

• withdrawal

polysubstance use disorders

concurrent dependence on more than on drug typically alcohol and nicotine

lifetime prevalence of AUD

13.2 fro abuse, 5 for dependence

AUD cultural/racial prevalence

highest in white and indigenous

Gateway theory

• alcohol and marijuana are gateways to other drugs

• general tendencies towards drugs,

what did the twin study on AUD find

twin that started with marijuana was more likely to continue with it and have done more drugs

AUD risks associated 5

1. vulnerability to injury

2. marital issues

3. domestic violence

4. illness

5. neurocognitive impairments

Vaillant longitudional study of AUD

• 700 men harvard 1930s

• 25 % developed AUD

• by 70 50 % had chronic course

• 10% controlled drinking

Witkiewitz study AUD post treatment

1. high functioning infrequent drinkers

2. high functioning heavy drinkers

3. low functioning infrequent heavy drinkers

4. low functioning frequent drinkers

• Abstinence does not need to be goal

Vulnerability factors AUD

• early drinking

• family history

adoption study AUD

• bio parents had AUD

• adoptive dont

findings: higher likelihood of perosn havoing AUD

Twin study AUD: 4 groups

group 1: offspring of twins (MZ and DZ) with dx of AUD

• high gene and environment risk

Group 2: offspring of Mz twin who does not have AUD but co twin does

• eg uncle has AUD

• high gene risk low environment

Group 3: offspring of DZ twin with no AUD but co twin does

• moderate gen risk, low environment

group 4: offsprince of MZ and DZ who donts have AUD

• low gen and envorn risk

is lab task performance a predictor of AUD ?

yes tests in sensitivuty to alcohol

Reinforcemnt learning and AUD

positive

• good feelings while drinking/positicve affect regulation

Negative:

• feels bad not to drink

• drink and bad feelings go away

which trait is more vulnerable to AUD

reward seeking and sensation seeking

which pathway is important in adiction

mesocordical limbic pathway PFC, NA VS

which neurotransmitter important in AUD and how

dopamine

• produced in VTA

• higher levels when rewarded and cueing reward

where is dopamine produced and whenre does it project to

VTA and projects to NA and hippocampus

dopamine reinforcemnt and craving

dopa spikes in cueing of reward, could be basis of craving

deviance proness theory

idea that SUD arises from a general pattern of deviance rooted in childhood

while drinking, alcohol is a , after drinking it is a

stimulant depressant

increase norepinephrine asociated with increase

impulsivity

alcohol is associarted with an increase in

norepinephrine

Gaba __ neuronal excitability

decreases