Substance Use Mideterm

Substance Dependence

A cluster of cognitive, behavioral, and physiological symptoms indicating continued use of a substance despite significant substance-related problems.

Substance Abuse

A pattern of compulsive substance use marked by recurrent significant social, occupational, legal, or interpersonal adverse consequences.

Tolerance

A condition resulting from persistent use of a drug, characterized by a markedly diminished effect with regular use of the same dose of the drug.

Withdrawal

A syndrome including physiological, behavioral, and cognitive manifestations that develops after cessation of prolonged, heavy consumption of a substance.

Addiction

A state of psychological and/or physical dependence on the use of drugs or other substances or on activities or behaviors.

Behavioral Addictions

Categorized by the presence of compulsivity and impulsivity.

Compulsivity

The urge to do something repeatedly with good consequences, such as anxiety reduction.

Impulsivity

A spur-of-the-moment decision where consequences are usually not good, but not always

Basic Assumption of the Moral Model

Attributes substance use to individual choices influenced by weakening of morals, character flaws, or a lack of self-control.

Basic Assumption of the Social Learning Theory Model

Explains that substance use is a learned behavior influenced by environmental factors, social interactions, and reinforcement mechanisms.

Basic Assumption of the Biological Model

Posits that genetic and neurobiological factors predispose individuals to substance use disorders.

Basic Assumption of the AA/Disease Model

Perceives addiction as a chronic, progressive disease characterized by a loss of control over substance use.

Basic Assumption of the Harm Reduction Model

Aims to reduce the negative consequences associated with substance use rather than focusing solely on abstinence.

Basic Assumption of the Sociocultural Model

Emphasizes the role of cultural and environmental factors in shaping substance use patterns and behaviors.

Basic Assumption of the Biopsychosocial Model

Integrates biological, psychological, and social factors to provide a comprehensive understanding of substance use disorders.

Central Nervous System (CNS)

comprised of the brain and spinal cord; processes information, makes decisions, makes decisions, controls conscious thoughts and voluntary movements, interprets sensory input, and is involved in learning, memory, and emotions

Autonomic Nervous System (ANS)

Regulates heart rate, breathing, digestion, and blood pressure, maintaining homeostasis.

Sympathetic Nervous System

“flight or flight”: prepares the body for action, increasing heart rate and alertness.

Parasympathetic Nervous System

“rest and digest”: calms the body down, slowing heart rate and promoting digestion.

Wanting

Driven by the mesolimbic dopamine system; represents the motivation or desire to obtain a reward.

Liking

Associated with the hedonic impact or pleasure derived from a reward, often linked to opioid and endocannabinoid systems.

Reward Learning

Involves the brain's ability to associate cues with rewards, reinforcing behaviors through classical and operant conditioning.

Drug Metabolism

The process by which the body breaks down and eliminates drugs, primarily occurring in the liver.

Drug Half-Life

The time it takes for the concentration of a drug in the bloodstream to reduce by half; determines the dosing schedule and duration of action.

Agonists

Substances that bind to receptors and activate them, mimicking the action of naturally occurring neurotransmitters.

Antagonists

Substances that bind to receptors but do not activate them, blocking the action of agonists or natural neurotransmitters.

THC

Psychoactive component of cannabis, responsible for the 'high' sensation.

CBD

Non-psychoactive component of cannabis with potential therapeutic benefits such as anti-inflammatory and relaxation effects.

AUDIT

Screens for hazardous and harmful alcohol consumption; comprises 10 questions assessing alcohol consumption patterns and related problems.

CUDIT

Designed to identify individuals at risk for cannabis use disorders; consists of 8 questions evaluating cannabis use frequency, dependence symptoms, and related problems.

CRAFFT

A brief screening tool for adolescents, ages 12–21, to assess alcohol and drug-related risks and problems; includes 6 questions focusing on situations where the adolescent used substances and any consequences.

Level 1 Screening

A brief, initial assessment to identify individuals at risk and determine the need for further evaluation.

Level 2 Screening

A more detailed assessment for individuals identified as at risk in Level 1 to confirm the presence of a substance use disorder and determine appropriate intervention.

Oral, Snorting, Inhalation, Injection, Sublingual (under the tongue), Buccal (inside the cheek), Topical

Common Methods of Administration

Physical Effects of Barbiturates

sedation, muscle relaxation, slurred speech, impaired coordination, and respiratory depression

Withdrawal Symptoms of Barbiturates

anxiety, tremors, seizures, and, in severe cases, death

Physical Effects of Benzos

anxiolytic, sedative, muscle relaxant properties

Withdrawal Symptoms of Benzos

Anxiety, insomnia, tremors, seizures, and, in severe cases, psychosis

Physical Effects of Amphetamines

increased heart rate, elevated blood pressure, reduced appetite, and heightened alertness

Withdrawal Effects of Amphetamines

fatigue, depression, increased appetite, and prolonged sleep

Physical Effects of Cocaine

euphoria, increased energy, dilated pupils, and rapid heartbeat

Withdrawal Symptoms of Cocaine

fatigue, depression, increased appetite, and sleep disturbances

Physical Effects of Cannabis

euphoria, altered perception, dry mouth, and red eyes

Withdrawal Symptoms of Cannabis

irritability, anxiety, sleep disturbances, and decreased appetite

Physical Effects of Tobacco/Nicotine & Vaping

increased alertness, elevated heart rate, and blood pressure

Withdrawal Effects of Tobacco/Nicotine & Vaping

irritability, anxiety, difficulty concentrating, and cravings

Physical Effects of Opioids

pain relief, euphoria, drowsiness, and respiratory depression

Withdrawal Symptoms of Opioids

agitation, anxiety, muscle pain, insomnia, sweating, dilated pupils, fast heart rate, high blood pressure, etc.

Physical Effects of Hallucinogens

altered perception, hallucinations, pupil dilation, and increased heart rate

Withdrawal Symptoms of Hallucinogens

fatigue, irritability, anxiety, depression, flashbacks, difficulty sleeping or concentrating

Physical Effects of Inhalants/Aerosols

euphoria, dizziness, slurred speech, and nausea

Withdrawal Symptoms of Inhalants/Aerosols

headaches, irritability, and cravings

Physical Effects of Club Drugs/New Street Drugs

increased heart rate, dilated pupils, dehydration, poor coordination, nausea, tremors/muscle twitching

Withdrawal Effects of Club Drugs/New Street Drugs

irritability, anxiety, fatigue, depression, memory & concentration issues

Screening Interview Guide Steps

1.) Establish Rapport

2.) Ask about life areas first: school, friends, etc.

3.) Then ask questions about substance use: e.g. “How many days per week do you drink alcohol?”, “On a typical day when you drink, how many drinks do you have?”, “How many times in the past month did you drink 5 or more drinks on a single occasion?”, “Do you use any drugs like marijuana, speed, coke, pain killers or other prescription drugs? About how many days per week?”

4.) Administer a screening tool (AUDIT, CRAFT, CUDIT, or Level 2 Substance Use) if in doubt

they control opposite, involuntary responses in your body — and together, they maintain homeostasis

Why is the distinction between parasympathetic and sympathetic important to understand?

how drugs can change your brain

increase release of neurotransmitters, may decrease reuptake, up and down regulation of receptors; disrupt wanting, liking, and reward learning

Key Concepts of the Social Learning Theory Model

Observational learning, Modeling, Reinforcement, Expectancies

Key Concepts of the Biological Model

genetics, brain structure/functions are altered, neurochemical factors & the reward pathway

Key Concepts of the AA/Disease Model

addiction as a disease, loss of control, abstinence-based, spiritual framework, identity as an addict

Key Concepts of the Harm Reduction Model

pragmatic approach, public health perspective, user autonomy, stigma reduction, incremental change

Key Concepts of the Sociocultural Model

cultural norms, social environment, marginalization and inequality, media and availability, social roles and expectations

Key Concepts of the Biopsychosocial Model

integrative approach, individual differences, dynamic interactions, holistic treatment