Substance Use and Addictive Disorders

Comprehensive practice flashcards reviewing the classification, epidemiology, physiological mechanisms, etiology, and treatments of substance use disorders and addictive disorders.

What is the estimated overall annual economic cost of substance misuse in the United States?

The overall cost is approximately $\$740\text{ billion}$ in the United States alone.

How does the lecture text define a "drug"?

Any substance other than food that affects our bodies or minds, including alcohol, tobacco, and caffeine.

What is the distinction between substance intoxication and a substance use disorder?

Substance intoxication is a temporary cluster of changes in behavior, emotion, or thought caused by substances, whereas a substance use disorder consists of long-term maladaptive behavior patterns and reactions caused by repeated substance use.

What is the difference between drug tolerance and drug withdrawal?

Tolerance is the need for increasing doses of a substance to produce the desired effect, while withdrawal consists of unpleasant and sometimes dangerous symptoms that emerge when drug use is stopped or cut back.

According to the DSM-5-TR, how many symptoms must be present within what timeframe to diagnose a substance use disorder?

At least two symptoms must be present within a $1\text{-year}$ period.

Based on this bar graph, which ethnic group exhibits the highest rate of substance use disorders, and which exhibits the lowest?

American Indians exhibit the highest rate at $10.1\%$, while Asian Americans exhibit the lowest rate at $4.8\%$.

What physiological effect defines depressant substances, and what are the three most widely used depressants?

Depressants slow the activity of the central nervous system (CNS), reducing tension and inhibitions while potentially impairing judgment, motor activity, and concentration. The three most widely used classes are alcohol, sedative-hypnotic drugs, and opioids.

Which neurotransmitter's activity is increased by ethyl alcohol to produce an inhibitory message in the brain?

GABA (gamma-aminobutyric acid).

At what blood alcohol concentration (BAC) level is clinical intoxication established according to the lecture notes?

Clinical intoxication is established at a blood alcohol concentration of $0.09\text{ percent}$.

How is binge drinking defined, and what percentage of college students engage in it monthly?

Binge drinking is defined as consuming five or more drinks on a single occasion; $33\%$ (one-third) of college students binge drink at least once per month.

What two serious long-term physical health conditions are associated with chronic, excessive alcohol consumption?

Cirrhosis of the liver and Korsakoff's syndrome (a severe nutritional deficiency disorder marked by major memory impairment).

Why have benzodiazepines largely replaced barbiturates as sedative-hypnotic medications?

Benzodiazepines are safer and less likely to lead to severe intoxication, tolerance effects, and dangerous withdrawal reactions.

How do opioids produce their pain-relieving and central nervous system depressant effects?

They depress the central nervous system by binding to endorphin-related receptors in the brain.

According to this pie chart, what is the most common way people obtain nonmedical prescription pain relievers?

Obtaining them free from a friend or relative ($39\%$).

What are the early versus later withdrawal symptoms of opioid dependence?

Early symptoms include anxiety and restlessness; later symptoms include muscle twitching, body aches, fever, vomiting, diarrhea, and weight loss resulting from dehydration.

What physiological changes do stimulant drugs produce, and which three neurotransmitters does cocaine increase?

Stimulants increase CNS activity, blood pressure, heart rate, and alertness, leading to rapid behavior and thinking. Cocaine increases the supply of dopamine, norepinephrine, and serotonin.

What are the two cheaper and more potent forms of cocaine that became widely available starting in 1984?

Freebase cocaine and crack.

What is "stimulant diversion," and what proportion of undergraduate students engage in it?

Stimulant diversion refers to acquiring prescription amphetamines or related stimulants without a prescription, which is practiced by almost $1\text{ out of }10$ undergraduates.

What is synesthesia, and how long do the effects of LSD typically last?

Synesthesia is a perceptual crossing of sensory modalities (such as seeing musical notes or colors in response to sounds); the effects of LSD typically wear off in about $6\text{ hours}$.

How does the potency of modern cannabis compare to the varieties available in the 1970s?

Current varieties of marijuana are seven times more powerful than those in the 1970s, featuring average THC contents of approximately $15\text{ percent}$.

What are synergistic effects in the context of polysubstance use?

The amplified or combined impact that occurs when an individual consumes multiple substances simultaneously, which can occur between drugs with similar actions or drugs with opposite (antagonistic) actions.

According to the biological view, what causes drug tolerance and withdrawal symptoms at the neurotransmitter level?

Excessive and chronic drug use prompts the brain to reduce its natural production of specific neurotransmitters (e.g., lower GABA from alcohol or benzodiazepines, lower endorphins from cocaine or amphetamines, and reduced anandamide from marijuana).

What does this PET scan comparison illustrate regarding dopamine (DA) D2 receptor availability in individuals who abuse cocaine, methamphetamine, or alcohol?

Drug abusers show substantially reduced dopamine D2 receptor availability in the brain compared to control subjects.

Which five brain structures comprise the reward circuit (pleasure pathway) illustrated in this diagram?

The ventral tegmental area (VTA), nucleus accumbens, prefrontal cortex, amygdala, and hippocampus.

How does the incentive-sensitization theory contrast with reward deficiency syndrome?

Incentive-sensitization theory asserts that repeated substance use makes the reward center hypersensitive to drugs, whereas reward deficiency syndrome posits that an individual's reward center is naturally under-activated by everyday events, driving them to substances to experience reward.

What developmental concept is represented in this diagram showing externalizing and internalizing pathways converging on substance use disorder?

Equifinality, which is the developmental psychopathology principle that distinct early risk pathways and stressors can lead to the same psychological outcome.

What are four common cognitive-behavioral techniques used in the treatment of substance use disorders?

Aversion therapy, contingency management, relapse-prevention training, and acceptance and commitment therapy (ACT).

What are two medications utilized in drug maintenance therapy for opioid addiction, and how do they differ?

Methadone provides a safe, legally and medically supervised substitute for heroin, while buprenorphine is less potent, produces less tolerance, and results in fewer withdrawal reactions.

According to the DSM-5-TR, how many symptoms within a full year are required to establish a diagnosis of gambling disorder?

At least four symptoms over the course of a full year.