PS 272 Test 3 - Addictive Disorders

what types of behavior do addictive disorders include?

-       Behaviors based on the need for a substance or activity

-       Compulsive behaviors despite negative consequences

Types of addictive disorders

Substance vs activity

alcohol/food, gambling/shopping

how do psychoactive drugs work?

-       They interact with the central nervous system to alter a person’s mood, perception, and behavior.

-       Drugs are carried by the blood and taken to target tissues

-       They act as neurotransmitters and send their own chemical messages

3 major drug classifications

-       Depressants: drugs that slow the central nervous system (alcohol, tranquilizer, narcotics)

-       Stimulants: drugs that “speed up” the nervous system (caffeine, nicotine, cocaine)

-       Hallucinogens: drugs that produce sensory distortions (marijuana, LSD)

what are inhalants?

volatile substances that produce chemical vapors that can be inhaled to induce psychoactive, or mind-altering effect

demographics of inhalants

adolescents 12-17, female is more common than men, markers are most common

substance abuse

involves an excessive use of substance that results in potentially hazardous behavior

substance dependence

is continued use despite persistent personal and health problems

tolerance

the need for increased amounts of substance to achieve the desired effects

withdrawal

physical symptoms such as sweating that accompany abstinence from a drug

DSM 5 updates around substance use disorders

-       Combines substance abuse and substance dependence into. Single disorder (mild to severe)

-       Each specific substance is addressed as a separate use disorder

-       Strengthened criteria

-       Gambling disorder is a new category

-       Internet gaming disorder is included in future research

DSM 5 diagnosis of alcohol use disorder

a problematic pattern of alcohol use leading to clinically significant impairment or distress, as manifested by at least 2 of the following, occurring in a 12 month period

symptoms of alcohol use disorder

-       Taken in larger amounts over a long period

-       Persistent desire

-       Use of time to obtain n alcohol, use alcohol, or to recover

-       Craving

-       Failure to fulfill major roles

-       Consistent alcohol use

-       Physically hazardous situations

mild, moderate, severe alcohol use disorder

Mild: 2-3 symptoms

Moderate: 4-5 symptoms

Severe: 6 or more symptoms

what factors influence the effects of alcohol?

-       Concentration of alcohol in beverage

-       Volume and rate of consumption

-       Presence of food in digestive system

-       Persons physical condition

are there gender differences in how alcohol is metabolized?

Women metabolize alcohol less effectively than men and thus become intoxicated on lesser amounts

how is alcohol absorbed?

Alcohol is absorbed through the stomach, small intestine, and colon

what is Blood Alcohol Level (BAL)?

amount of alcohol per unit of blood

what do we know about BAL and its effects on the CNS?

There is a strong correlation between BAL and CNS effect

psychoses related to alcoholism

Alcohol withdrawal delirium: can occur during prolonged drinking or during a state of withdrawal (disorientation of time and place, acute fever)

Alcohol amnestic disorder: memory defect where users may appear disoriented and delusional

what evidence is there that alcoholism is genetic?

-       Almost 1/3 of alcoholic had at least 1 parent with an alcohol problem

-       Children of alcoholic who were adopted by sober parents are 2x as likely to develop alcohol problems

what meds are useful in modifying alcohol craving and withdrawal symptoms?

Naltrexone: opiate antagonist that helps reduce the craving for alcohol by blocking the pleasure producing effect of alcohol

Tranquilizers: used to minimize withdrawal (valium)

developmental model for understanding addiction

Developmental framework views the problem in terms of stages:

-       Initiation and continuation

-       Escalation and transition to abuse

-       Development of tolerance and withdrawal

what role may positive and negative reinforcement play in the development of addiction?

Positive reinforcement: repeated pairing with rewards

Negative reinforcement: escape from unpleasant, self-medication, tension reduction, coping mechanism for negative effect

Negative reinforcement may be a batter predictor of problems with substance abuse over a lifetime

treatment approaches

Medications (to block desire to drink, to reduce side effects of acute withdrawal)

Psychological approaches: CBT, group therapy, environmental intervention

what are self-help groups?

Self-help group: informal gathering where individuals with shared challenges or issues come together to offer mutual support and encouragement to help cope and improve their lives

(Alcoholic Anonymous)

key components associated with the 12-step program

-       Self-reflection

-       Admitting powerlessness

-       Seeking a higher power

-       Making amends

-       Helping others

-       Fostering a sense of community and accountability

define HALT

Hungry, Angry, Lonely, Tired

what do Azrin & Nunn consider to be essential features to any treatment program?

-       Make the person more aware of the habit

-       Provide approval for inhibiting the habit

-       Practice behaviors that are incompatible with the problem habit