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Study notes on Alcoholism, Drugs & Drug Abuse, & Substance Use Disorders

5 Pages
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Department
Psychology
Course Code
PSY240H1
Professor
Tackett

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ALCOHOL USE DISORDERS
EPIDEMIOLOGY
Risk: 20% in Ontario? alc dependence
Gender ratio: M(60%) > F(30%) for 1+ adverse ETOH (ethyl alcohol)-related events (~5:1)
Lifetime prevalence: Dep 15% Abuse 5%
Point prevalence: 10% (+ variable course)
RISK FACTORS
GENETIC: 3-4x higher in 1st deg relatives w/ Alc Dependence
ETHNIC: higher in Aboriginal groups, high ABSTINENCE 4 asian-americans
(perhaps because they are embarrassed by their proneness to turn red/ flush?)
PERSONALITY: higher in people w/ antisocial behavior
oHistorically, ASB explained by aggress. Behav exacerbated by substance intox
oNow, we see that ASB & substance abuse/misuse is part of EXTERN
SPECTRUM
ANXIETY/DEPRESSION: use as self-medication or avoidance
ENVIRONMENTAL/INTERPERSONAL
oCultural attitudes, how much is substance use condoned?
oAvailability & price gotta have EZ access, $ affects TYPE of subst. use
problems
oSociocultural levels of stress
TREATMENT common to use more than 1 type at a time
BIOLOGICAL
oAGONIST SUBSTITUTION: introduce a drug w/ analogous biochemical
reaction to the probm drug (ex: methadone vs heroin)
Problem stigma, dont wanna get on another drug, another addiction 
eventually you wanna taper them off the substitution
oANTAGONIST DRUGS: drugs that counteract effects of probm drug (like to
remove withdrawal effects)
oAVERSIVE TREATMENT: punishing response conditioning
Antabuse prevents breakdown of acetaldemyde (toxin produced after
ETOH use) use makes you feel SICK
oMEDS to address WITHDRAWAL symptoms cause thats when risk 4 relapse
is >
PSYCHOSOCIAL
oINPATIENT TREATMENT: short term, detox, focus on withdrawal stage
(expensive)
www.notesolution.com
oRESIDENTIAL: halfway houses. Ppl not prepared for substance-use-free
independent living, but have gotten past withdrawal stage
Constant support group, ppl going through same thing
Individ & group therapy sessions
oOUTPATIENT: prevention of relapse therapists AND patients differ on how
abstinence vs other stuff
CBT focuses on TRIGGERS coping strategies &/or try to eliminate
stressors
oAA /NARCOTICS A: disease-based model, abstinence. Idea that individ.
Will never cure gotta learn to ACCEPT & COPE.
Focus on social support
No research on AA cause deyse anonymous, but a lotta anecdotal data
Chronicity
NICOTINE DEPENDENCE
Mebbe most physiologically addictive substance. HUGE health problems popularization of
smoking bans
~400,000 deaths/yr due to smoking, ~50,000 due to second hand smoke
ppl who are exposed to tobacco are more @ risk for stuff like lung cancer
highest subpop of smokers = psychiatric patients
~90% of patients w/ Sz are dependent on nicotine (counteracts side effects of meds)
~30% of ppl w/anx, mood, panic disorders (socially approp way to withdraw, method of
coping/comfort)
prevalence rates: ~25%M, 20%F (CLOSEST gender ratio cause women have high % of
mood/anx?)
SUBSTANCE USE DISORDERS
Psychoactive substance: chemical/other thing that alters yr level of perception, mood, brain
fxn (illicit AND legal)
Substance use: ingesting psychoactive substances in MOD amts, DUNT sig. affect fxn
Substance intoxication: PHYSIOLOGICAL reaction (imp. Judgement, mood changes,
decreased motor ability) REVERSIBLE, often SUBSTANCE-SPECIFIC
reality testing: person knows hallucinations/delusions = substance induced, not reality
illusions: misperception/misinterpretation of a REAL EXISTING stimulus (aint
hallucination)
SUBSTANCE ABUSE/MISUSE*:
impairment/distress in edu/occu/social OR
recurrent use in situations where its physically dangerous OR
recurrent use + suffering substance-related legal problems OR
continued use despite substance-related problems
*if dependent, no abuse
www.notesolution.com

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Description
ALCOHOL USE DISORDERS EPIDEMIOLOGY Risk: 20% in Ontario? alc dependence Gender ratio: M(60%) > F(30%) for 1+ adverse ETOH (ethyl alcohol)-related events (~5:1) Lifetime prevalence: Dep 15% Abuse 5% Point prevalence: 10% (+ variable course) RISK FACTORS st GENETIC: 3-4x higher in 1 deg relatives w Alc Dependence ETHNIC: higher in Aboriginal groups, high ABSTINENCE 4 asian-americans (perhaps because they are embarrassed by their proneness to turn red flush?) PERSONALITY: higher in people w antisocial behavior o Historically, ASB explained by aggress. Behav exacerbated by substance intox o Now, we see that ASB & substance abusemisuse is part of EXTERN SPECTRUM ANXIETYDEPRESSION: use as self-medication or avoidance ENVIRONMENTALINTERPERSONAL o Cultural attitudes, how much is substance use condoned? o Availability & price gotta have EZ access, $ affects TYPE of subst. use problems o Sociocultural levels of stress TREATMENT common to use more than 1 type at a time BIOLOGICAL o AGONIST SUBSTITUTION: introduce a drug w analogous biochemical reaction to the probm drug (ex: methadone vs heroin) Problem stigma, dont wanna get on another drug, another addiction eventually you wanna taper them off the substitution o ANTAGONIST DRUGS: drugs that counteract effects of probm drug (like to remove withdrawal effects) o AVERSIVE TREATMENT: punishing response conditioning Antabuse prevents breakdown of acetaldemyde (toxin produced after ETOH use) use makes you feel SICK o MEDS to address WITHDRAWAL symptoms cause thats when risk 4 relapse is > PSYCHOSOCIAL o INPATIENT TREATMENT: short term, detox, focus on withdrawal stage (expensive) www.notesolution.com
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