Task 9 drug use disorder Flashcards

1
Q

DSM-5

A

o Impaired centre control:
 The substance is taken in increasingly larger amounts or over a longer period of time than originally intended.
 The substance user craves the use of the substance
 The substance user feels an ongoing desire to cut down or control substance abuse
 Much time is spent in obtaining, using, or recovering from the substance
o Social impairment:
 The ongoing use of the substance often results in an inability to meet responsibilities at home, work, or school
 Important social, work-related, or recreational activities are abandoned or cut back because of substance use
 Ongoing substance use despite recurring social or relationship difficulties caused or made worse by the effects of the substance
o Risky use:
 Ongoing substance use in physically dangerous situations such as driving a car or operating machinery
 Substance use continues despite the awareness of ongoing physical or psychological problems that have likely arisen or been made worse by the substance
o Pharmacological criteria:
 Changes in the substances user’s tolerance of the substance is indicated by the need for increased amounts of the substance to achieve the desired effect or by a diminished experience of intoxication over time with the same amount of the substance.
 Withdrawal is demonstrated by the characteristic withdrawal syndrome of the substance and/or taking the same or similar substance to relieve withdrawal symptoms

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2
Q

Severity of DUD

A

• Mild: 2-3
• Moderate: 4-5
• Severe: 6+
o for over a year

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3
Q

Prevalence (general)

A

2,5-5% (USA)

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4
Q

Synaesthesia

A

overflow from one sensory modality to another, mood shifts, can produce psychosis

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5
Q

Drug treatments for druf use disorder LOL

A

o Benzodiazepines: used to decrease withdraw symptoms of alcohol
o Antidepressants: decrease depressive symptoms but not relay proved efficiency
o Antagonistic drugs: block or change effects of drug, thereby reducing desire
 Can cause extreme withdraw symptoms in some people
 Disulfarm: makes people sick when they drink
 Replacement for nicotine: plasters etc.
o Methadone maintenance programs:
 Achieves gradual withdraw
 Block receptors and withdraw

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6
Q

Behavioural therapies

A

 With disulfarm negative conditioned response to alcohol is created
• Then learn to avoid through operant conditioning

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7
Q

Covert sensitization therapies

A

uses imagery to create associations between thoughts of alcohol use and thoughts of highly unpleasant consequences

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8
Q

Contingency management programs

A

provide reinforcers such as vouchers (controlled with urine test)

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9
Q

Cognitive treatments

A

o Helps identifying situations in which drinking occurs most likely, as well as maladaptive expectations

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10
Q

Motivational Interviewing

A

o Elicits and solidifies clients motivation and commitment to changing their substance use.
 Taking the side of the participants and support his will to stop

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11
Q

Relapse prevention

A

o Teaches people to see slips as temporary and situational caused
 By e.g. avoiding risky situations or develop coping situations for them
Counteracting abstinence violation effect

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12
Q

Abstinence violation effect

A

 Sense of guilt when breaking abstinence and continuous drinking to supress conflict

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13
Q

Prevention programmes

A

o Target younger people as onset predominantly during adolescent risk period (brain still developing, esp. prefrontal cortical regions that cannot yet regulate emotions properly)
o Focus education on immediate risk of excess & payoffs of moderation
o Harm reduction model – drink safe like you drive safe
 Learn to be aware of drinking habits & thought to calculate alcohol blood level .

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14
Q

Biological factors

A

o Individuals whose reward network overpowers their control network may be more like to use substances
o After continuous usage of drugs brain decreases dopamine production which creates craving when no drug is used
o Stress and conditioned stimuli trigger craving
o Repeated exposure to drugs impairs impulse control
o Heredity: 0,5
o Genes controlling GABA and Dopamine systems mediate the experienced pleasure
s

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15
Q

Social learning theory

A

suggest that children may learn substance use behaviours from the modelling of their parents and others
 Because children prefer similarity it might run through male family members

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16
Q

Cognitive theories

A

focused on people’s expectation of alcohols effects and their beliefs about the appropriateness of using it to cope with stress
 No other coping mechanisms facilitate that

17
Q

Behavioural undercontrol

A

take drugs at an earlier age, ingest more, higher likelihood of diagnoses
 Might be influenced by genes

18
Q

Sociocultural factors

A

People living in stressful environment use drugs as relief and think they have little to lose.

19
Q

Cultures

A

Attitude about drugs mediates prevalence

Religion-> big factor

20
Q

Gender differences in risk

A

 In the past drinking was less accepted
 Carry less risk factors than men (personality)
 Suffer alcohol related illness at lower levels of exposure than men
 May notice intoxication sooner
 More likely to be drawn into addiction by family or lovers

21
Q

Alcohol-induced place conditioning in moderate social drinkers (childs article)

A

• Conditioned place preference: rewarding drugs become associated with context by the mean of classical conditioning
• Method:
o Paired group: always receives alc in one room but not in the other
oUnpaired group: receives alc and non alc in both rooms
• Results:
o Participants styed longer in the alcohol conditioned room
o Subjective responses to alcohol predicted preferences for the alcohol-paired room
o Participants who reported the greatest sedative effects from alcohol exhibited the strongest place preference
o Conditioning is mediated by sedative-like component of alcohol experiences rather than the exciting effects
o Behaviour may be influenced by drug cues before individuals are aware of drug: cue contingencies

22
Q

Choice model

A

rejects disease model because possibility of voluntary stopping violates disease criteria
o Immediate rewards take precedence over long-term gains
 Repeatedly choosing immediate rewards sets both immediate and long-term rewards to lower and lower values
o Ignore brain
o Cues are driving part of drug addiction

23
Q

Criticism on choice model (Lewis)

A

o Motivation and emotion influence behaviour by narrowing appraisals and urging actions that address them
o Choosing to not take a drug is extremely difficult, increases with time

24
Q

Dopamine

A

o Responsible for wanting rather than liking
o Role in addiction: the motivation and urge results from excessive dopamine release that is highly enormously exciting or pleasurable
o Activating the power of cues
o Shuts down intertemporal flexibility

25
Q

Craving and the power of now

A

o Self-reports of craving and their striatal and orbitofrontal activity both peaked just before the moment of drug administration and declined immediately after
o Craving and its foundation in “now”, may be the byproduct of a brain designed to be maximally responsive to immediate rewards

26
Q

Utility theory

A

Describes the idea that delayed reward discounts with increasing intervals

27
Q

Incentive-sensitization hypothesis

A

increased activity in VTA to drugs and decreased activity to other stimuli

28
Q

Decrease of acethylcholine as a result of exposure

A

leaving dopamine to dominate effortful behaviour

o Causes shift from exploration, alertness and volition to single minded desperate pursuit

29
Q

Orbitofrontal cortex and ACC

A

become dysfunctional both during addiction and withdrawal
o OFC: assigning value
o ACC: judging option and selecting among them

30
Q

Dual process model

A

decision making abilities result from interactions between two systems
o Reflective system: involved in cognitive evaluation of the stimuli by means of memory and executive functions, responsible for controlled-deliberate responses
 Impaired prefrontal network (could be cause or effect for binge drinking)
 Inhibited, leading to an inability to voluntarily inhibit the consumption
o Affective automatic system: involved in the emotional evaluation of the stimuli, initiating automatic-appetitive responses
 Limbic network
 Over activated by emotional or alcohol related stimuli leading to impulsive behaviour
o Cycle continuous

31
Q

Continuum hypothesis

A

binge drinkers would display qualitatively similar but quantitatively less marked impairments than alcohol dependent individuals

32
Q

Binge and intoxication

A

o Increases in dopamine release elicit a reward signal that triggers associative learning or conditioning (Ventral striatum and nucleus acumbens)
 Preceding environmental stimuli are conditioned
 In response dopamine starts firing when reward is absence and give anticipatory responses to the conditioned stimuli in a sense that predict the delivery of reward
 Leads to binge of drug

33
Q

Withdraw and negative affect

A

o Former natural rewards loose their power
 But also drug induced power decreases after time
o Most drugs lead to adaptions in extended amygdala
 Results in increase in a persons reactivity to stress and lead to the emergence of negative symptoms
 Increases desire
 Change from getting high to relief from dysphoria

34
Q

Preoccupation and anticipation

A

Changes in PF cortices involved in executive processes
 Neuroplastic changes in glutamatergic and dopaminergic signalling
• Weakens ability to resist strong urges or to follow through on decisions to stop taking the drug

35
Q

Prevalence of specific drug use disorder

A
•	Tabaco: 13%
•	Alcohol: 
o	12-17:  4.6%
o	18 and older: 8.5%
o	18-29: 16.2%
•	Cannabis: 1.5%
•	Cocaine/Heroin: 0.3%