PSYCH 257 - Chapter 12 Flashcards

what are substance-related and addictive disorders?

a problematic use of drugs + other substances that change the way ppl think, feel, and behave

examples: alcohol use disorder, cannabis use disorder

what are impulse-control disorders?

disorders where the person has difficulty controllliing their impulses! ex. stealing, setting fires.

not as simple as just stopping cause you want to!!

what is polysubstance use?

using multiple substances at the same time or within a short period of time

substance

chemical compounds ingested to alter mood/behaviour

ex. alcohol, meth, caffeine

what is substance use disorder?

the problematic use of a substance

ex. you keep using it even when its harming your relationships, your job, your health

ex. girlfriend left you, can’t hold down a job, teeth are rotting (impairment!!)

defined by impairment to functioning and disruption to life (are u putting urself in danger? are u putting others in danger? whats going on with school, ur relationships, ur job)

substance-induced disorder

specific conditions resulting from use (ex. intoxication, withdrawal)

psychoactive substances

substances that alter mood, behaviour, or both

ex. cocaine, alcohol, caffeine, marijuana

levels of involvement

use, intoxication, substance use disorder

use

the use of psychoactive substances in moderate amounts that don’t interefere with social, educational or occupational functioning

ex. occasional drink at bar with friends, still wake up in tiem for work the next day, don’t get black out drunk

intoxication

our physiological reaction to ingested substances

ex. taking nicotine makes you high, drinking alcohol can make you slur your words, taking caffeine makes you alert

general criteria to diagnose an addiction

2+ symptoms that were distressing/impaired functioning —> MILD specifier

4-5 symptoms —> MODERATE specifier

6+ symptoms —> SEVERE specifier

what kind of things go under the section of physiological dependence (2 things)?

tolerance + withdrawal

tolerance

the need to take more of the drug to feel the same effect

ex. 1 coffee doesn’t have the same effect, or you need 3 coffees to feel the desired/original effect

what is withdrawal?

the negative pysical response when the substance is no longer being ingested

ex. tremors, seizures, jitters, headaches, insomnia. IT CAN BE REALLY BAD!!!

alcohol withdrawal delirium (delirium tremens)

• specifically a symptom of withdrawal from alcohol

• it can cause the person to experience HALLUCINATIONSA ND TREMORS

  something important to remember here is that if you have psychotic symptoms (hallucinations, delusions) during intoxiciation or before 6 weeks AFTER withdrawal, its substance use disorder. if the symptoms show up beore drug use and symptoms stay for 6 weeks, prolly another disorder. its important to distingush between symptoms of this disorder and another psychological disorder.

are all drugs physiologically addicting?

NO!! alcohol and caffeine? yes. LSD,? no withdrawal symptoms, ur chilling

psychological dependence

the emotional or mental attachment to a substance or the strong need for a substance without the withdrawal symtpoms

ex. cravings

ex. obsessing over attaining or using the drug

ex. cognitive issues when you dont have the drug (ex. issues with concentration, memory, problem-solving…)

diagnostic issues of substance use disorders

• not a moral weakness!! its influenced by genetics and environment, and its a disorder

• drug misuse was seen as a symtpom or other problems only, insteda of also being a disorder by itself

• the legal aspect (having comited a crime) was removed for this version, and strong cravings were added

comorbidity with mood + anxiety disorders

• issues with directionality. do we drink cause we’re depressed or are we depressed cause we drink

• may occur together by chance

• drug intoxicatin and withdrawal can cuase symptoms of anxiety and depression

• also psychotic symtpoms which can increase risk taking, which may explain comorbidity with gambling disorders

• menatl health disordrs can cause substance-used disorders as a form of self-medication

depressants

• sedate you behaviourally

• ex. alcohol

• also includes sedative, hypontic, (and anxiolytic) disorders

  • ex. barbituarates + benzodiazepines

what are barbiturates used for?

• insomnia, seizures, anesthesia

HIGHLY ADDICTIVE AND DANGEROUS. SHORT TERM ONLY.

examples: seconal

what are benzodiazepines used for?

• anxiety, alcohol withdrawal

• they make the nervous system less active bcz they are depressants

• HIGHLY ADDICTIVE AS WELL, SHORT TERM USE ONLY!!

• examples: valium, xanax, halcion

what do stimulants do?

• they make us more active and alert

• can elevate mood

• examples are amphetamines, cocaine, nicotine and caffeine

what do opioids do?

• they temporarily reduce pain and produce euphoria

• produce analgesia —> an- —> not, algein —> feel pain (no pain in greek) —> analge(ee)sia (painlessness in greek)

• WE’RE IN AN OPIOID CRISIS!!

• ex. heroin, opium, kraton, coedine, morphine, oxycodene (OXYCODENE IS HIGHLY ADDICTIVE!!)

what do hallucinogens do?

• they alter sensory perceptions

• literally make you hallucinate

• they can produce delusions, paranoia, and hallucinations

• ex. cannabis + LSD are hallucinogens!!

other drugs

• anabolic steroids (testosterone for building muscle)

• over counter meds (tylenol)

• inhalants (airplane glue)

general diagnostic criteria for every single one.

a. a problematic pattern of alcohol use leading to clinically significant impairment/distress

must have 2+ of following to be diagnosed (mild), 4-5 is moderate, 6+ is severe.

1. taken in longer amounts/longer period than intended

2. persistent desire to cut it down/unsuccessful attempts to cut down

3. great deal of time spent surrounding the subtance (getting it, using it, recovering from it)

4. a strong desire to use it

5. recurrent use leading to failure in fulfilling major role obligations at work, school, home (ex. not handing in ur assignments, not doing ur chores)

6. continued use despite having persistent or recurrent social/interperosnal problems caused by or exacerbated by it

7. important social, occupationa, recreational activities given up or reduced because of drug use (ex. reduced hobbies, reduced hanging out wtih friends)

8. recurrent use of drug in situations hwere its physicall hazardous (ex. driving, operating a forklift/heavy machinery)

9. drug use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is liklely to have been caused or exacerbated by the drug (Ex. drinking with liver problems, smoking with asthma, drinking with depression, knowing its all making it worse)

10. tolerance (need for increased amts of drug to achieve desired effect OR diminshed effect with continued use of the same amt of drug)

11. withdrawal (characteristic withdrawal syndrome for the disorder (ex. tremors for alcohol, irritability for caffeine) OR taking the same drug or a closely related one to relieve or avoid withdrawal symptoms)

severity markers

• mild: presence of 2-3 symptoms

• moderate: 4-5 symptoms

• severe: 6+

clinical description of alcohol use?

• general feeling of well-being (bcz inhibitory centers are slowed down) (lowers anxiety)

• buttttt with more drinking, alcohol depresses more areas of the brain, impeding ability to function properly

• symptoms: impaired motor coordination (stumbling), slow reaction time (takes a minute to respond), reduced ability to make judgments (yeah of course i can drive im not that drunk), vision and hearing impacted (alcohol myopia)

whats alcohol myopia

• thoery that alcohol literally narrows your visual field so you look at what’s right in front of you without considering the peripheral or whats farther down the road

• so you step one foot in front of another so you don’t fall, but theres a truck driving right towards you and you don’t see that or a poll right in front of you!!!

• this isn’t just cognitive, it’s also psychological. if we’re talking decision making, they have trouble taking into account long-term considerations!! like “whoo drinking now is fun!!” but you have work tomorrow.

im not sure if its cognitive + psycholgical like im just not sure lol.

process of alcohol going through your body

1. thoruhg circulatory system (all major organs, including heart, haert attacks, lvier damage, pancreatisis, brain damage)

2. when it goes to lungs, you can smell it (breath analyzer tests)

3. wehn it goes trhough liver, its metaoblized, but you can only do liek one can of beer an hour

what neurotransmitters are associated with alcohol use

reduce GABA (less inhibited

glutamate —> blackouts

serotonin —> alchol cravings (cz serotonin mood, sleep, eating beahviour)

dopamine —> pleasurable felings hwen drinking)

body’s natural opioids —> pain-numbing

brain damage bcz of alcohol

• destroys brain cells and tissue

• alterations in neurons

• brain size shrunk

• funcitonal and structural brain damage

organic brain syndromes from long-term heavy alcohol use (2 things)

1. dementia

2. wernicke-korsakoff syndrome

whats dementia and what is it’s connection to alcohol use

• general loss of intellectula abilities

• excessive amounts of alcohol can cause structural abnormalities which affects cognition

wernicke-korsakoff syndrome

• confusion

• loss of muscle coordination

• unintelligble speech

• eye muscle paralysis

• drowsiness

• fainting

• thiamine (vitamin B1) deficiency

  • becauseeee ppl who drink alcohol have difficulty metabolizing this vitamin

ITS ALSO A FUCKING MYTH THAT A LITTLE ALCOHOL PROTECTS COGNITION DURING AGING!! IT DOESNT!!

fetal alcohol spectrum syndrome

• cognitive deficits

• behavioural problems

• learning difficulties

• characterized by specific physical characteristics

• it appears in children whose mothers drank while pregnant

physical characteristics of FASS

• small eye openings

• small head, flat face

• thin upper lip

• underdeveloped jaw

• short nose, low nasal bridge

what’s categorized as heavy drinking (men + women?)

men —> 5+ drinks

women —> 4+ drinks

for at least once a month in the past year

alcohol binge consumption

episodic heavy drinking (5+ drinks in one sitting in a 2 week period

progression of alcohol use disorder

• early alcohol use predicts future alcohol misuse, and higher risk of chronic and severe alcohol use disorders (u drink young, prolly gonna become addicted in future)

• the longer you use it, the worse the conseuqences

• person’s response to the effects influences later use (ex. if u slur words, u might not wanna use it a lot. if ur more outspoken and confident, ur gonna want to drink again cause that’s a desirable outcome and its not embarassing like the former)

• alcohol may increase aggression, reduce fear associated with being punished or impair ability to consider conseuqences of acting impulsively (which is why theres a correlation of alcohol and violent behaviour)

• confounding variables: quantity of alcoho consumed, stressors, history of violence, environmental factors, expectations of drinking

• ppl with poorer executive cognitive functoin are more likley than others to behave aggressively when intoxicated (so potentially ppl with ADHD may behave more aggressively when intoxicated, but something to consider here is that the general population may be more violent and we shouldn’t stigmatize neurodevelopmental disorders or alienate ppl with them)

sedative, hypnotic and anxiolytic disorders

• still depressants

• sedative (calming)

• hypnotic (sleep inducing, like ur being hypnotized)

• anxiolytic (anxiety-reducing)

what benzos and barbiturates are part of!!