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

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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 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)
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