substance use disorders

substance use disorder criteria

problematic use of substance leading to impairment/distress with 2+ for a year
- larger amounts/spent longer using than planned
- unsuccessful attempts to quit/cut down
- preoccupation with using/recovering from substance
- craving
-failure to fulfill major obligations
- continued substance abuse despite adverse consequences
- social, work, or recreational activities given up/reduced
- recurrent substance use in physically dangerous situations
- continued use despite causing social/interpersonal problems
- tolerance
-withdrawl
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- mild= 2-3 symptoms
- moderate= 4-5 symtoms
- severe= 6+ symptoms

substance use disorder causal factors (bio)

- genetic predisposition
- overstimulation of brains pleasure pathways--> reward deficiency syndrome (spike in dopamine--> receptors for dopamine atrophy w/substance use--> fewer dopamine receptors)
-temperamental/personality traits--> impulsivity and sensation seeking personality traits, low frustration tolerance

substance use disorders casual factors (psych)

- trauma exposure
-operant conditioning (positive reinforcement--> enhance positive feelings, negative reinforcement--> use to get rid of negative feeling)
- classical conditioning (drinking/drugs gets paired w/various stimuli (friends, times of week, places) = involuntary craving when experiencing stimulus)

substance use disorders causal factors (sociocultural)

- parental modeling + monitoring
- differing levels based off of religion and ethnic group (greatest risk among native Americans) (least-> asian Americans)

treatment settings and levels of care

- inpatient--> residential or detoxification
- intensive outpatient--> a program 9-1 everyday
- outpatient

treatment modalities

- group therapy
- individual therapy
- family/couples

medications in substance use disorders

-underutilized--> $$, belief that we should not treat addiction with medication

Antabuse

alcohol,cocaine (cause violent vomiting if alcohol is injected--> classical conditioning)

naltrexone

alcohol (reduce craving, reduce reinforcing properties)

methadone, Suboxone

treat opioid use disorder

zybane, chantix

treat nicotine use disorder

different levels of severity in substance use disorder

- mild= 2-3 symptoms
- moderate= 4-5 symtoms
- severe= 6+ symptoms

why is it important to be mindful of language in substance use settings?

- "substance abuser" --> belief that someone is responsible for their condition and should be subjected to punishment
vs
"substance use disorder"--> legitamite disorder, deserving of help
- addict and alcoholic is only appropriate to label oneself if useful in recovery