Substance Use and Addictive Disorders

Comprehensive review flashcards covering Chapter 10: Substance Use and Addictive Disorders, including diagnostic criteria, depressants, stimulants, hallucinogens, cannabis, biological and developmental etiologies, treatments, and gambling disorder.

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

$$740\text{ billion}$$

According to DSM-5-TR, how is substance intoxication defined?

A cluster of temporary changes in behavior, emotion, or thought caused by substances.

What is the clinical difference between tolerance and withdrawal in substance use?

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

How many symptoms must an individual display within what timeframe to receive a diagnosis of substance use disorder under DSM-5-TR?

At least two symptoms within a 1-year period.

Which ethnic group in the United States exhibits the highest rate of substance use disorders?

Indigenous Americans (American Indians), with rates reaching up to $27\%$ (and $10.1\%$ in specific national survey comparisons).

What blood alcohol concentration (BAC) proportion is specified in the text as the threshold for intoxication?

$0.09\%$ ($0.09\text{ percent}$)

How does ethyl alcohol depress central nervous system functioning at the neurochemical level?

It binds to key brain receptors and increases the activity of the neurotransmitter GABA, delivering an inhibitory message.

How is binge drinking defined, and what percentage of people binge drink at least once per month?

Consuming five or more drinks on a single occasion; $22\%$ of people engage in binge drinking at least once per month.

What is delirium tremens (DTs)?

A dramatic and severe withdrawal reaction that can occur in chronic heavy drinkers, characterized by terrifying visual hallucinations and extreme confusion.

What severe physical and neurological conditions can result from long-term, chronic alcohol misuse?

Cirrhosis (scarring and damage of the liver) and Korsakoff's syndrome (a severe nutritional disorder marked by extreme confusion and memory impairment).

Why did benzodiazepines largely replace barbiturates in medical practice?

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

Which specific brain receptors do natural and synthetic opioids bind to in order to produce pain relief and CNS depression?

Endorphin-related brain receptors.

Based on national survey data shown in this graph, what is the most common way individuals obtain prescription pain relievers for nonmedical use?

Obtaining them free from a friend or relative ($39\%$), followed by being prescribed them by one or more physicians ($37\%$).

Which three neurotransmitters are increased in supply throughout the brain by cocaine?

Dopamine, norepinephrine, and serotonin.

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

The practice of acquiring prescription amphetamines or related stimulants without a prescription; almost 1 out of 10 undergraduates engage in it.

From what chemical source is LSD derived, and how long do its perceptual effects typically last?

It is derived from ergot alkaloids; its effects typically wear off in about $6\text{ hours}$.

What sensory phenomenon, often brought on by LSD hallucinosis, causes sensory modalities to cross over (e.g., colors being 'heard')?

Synesthesia.

What is the primary psychoactive component of cannabis, and how does the potency of current marijuana compare to varieties from the 1970s?

Tetrahydrocannabinol (THC); current varieties are seven times more powerful due to a higher average THC content of about $15\%$.

According to survey data of high school seniors shown in this chart, which two substances are perceived as easiest to obtain?

Alcohol ($83\%$) and marijuana ($78\%$).

What are synergistic effects, and when do they occur?

Multiplied or combined effects produced when different drugs are taken together simultaneously (polysubstance use), which may involve similar actions or antagonistic actions.

According to the biological explanation of drug tolerance and withdrawal, excessive and chronic use of alcohol or benzodiazepines leads to reduced brain production of which neurotransmitter?

GABA.

Chronic, excessive use of marijuana leads to a reduction in the brain's natural production of which neurotransmitter?

Anandamide.

What neuroimaging pattern in dopamine-2 (DA D2) receptor availability distinguishes chronic abusers of cocaine, methamphetamine, and alcohol from control subjects?

Drug abusers show a substantial decrease in DA D2 receptor availability in the striatum compared to control subjects.

Which five key brain structures make up the reward circuit (pleasure pathway) highlighted in this diagram?

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

How does incentive-sensitization theory differ from reward deficiency syndrome in explaining substance use disorders?

Incentive-sensitization theory states that repeated drug use makes the reward center hypersensitive to stimuli, whereas reward deficiency syndrome posits that a person's reward center is naturally underactivated by everyday life, driving them to substances to activate the pleasure pathway.

Which developmental psychopathology concept is illustrated by the pathway where different initial temperaments (externalizing vs. internalizing) converge on the same final outcome of substance use disorder?

Equifinality.

What cognitive-behavioral intervention trains clients to identify high-risk situations, track their substance use behaviors, and learn coping and problem-solving skills?

Relapse-prevention training.

What is the function of antagonist drugs, and what are two prominent examples used in substance use treatment?

They block or change the effects of an addictive drug to help prevent relapse; examples include disulfiram (for alcohol) and naloxone (for opioids).

How does buprenorphine differ from methadone when used in opioid maintenance therapy?

Buprenorphine is less potent, produces less tolerance, and results in fewer withdrawal reactions compared to methadone.

How is gambling disorder diagnosed under DSM-5-TR, and what is its prevalence among adults?

It requires displaying at least four symptoms of a maladaptive gambling pattern over a full year; it affects $2\text{ to }4\%$ of adults ($3\text{ to }10\%$ of teenagers and college students).