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Alcohol & Substances
Final Exam Review
| Question | Answer |
|---|---|
| Is alcohol part of the War on Drugs? | No. |
| According to The Harvard School of Public Health, what is the percentage of college students that binge drink? | 40-45% Highly correlated with sexual assault. |
| Name three factors that put young drivers at greater crash risk. | Lack of driving experience Overconfidence Presence of other teens in the car |
| 400,000 deaths annually are caused by which drug? | Tobacco |
| What are the two largest problem drugs (according to Fields)? | Alcohol and tobacco. |
| What are the four primary perspectives on substance abuse? | Moral-Legal Medical-Health Psycho-Social Socio-Cultural |
| What are the factors required for the American Medical Association to label something a disease (e.g., alcoholism)? | A known etiology A known progression of symptoms A known outcome |
| What are the characteristics of pessimism, as defined by Martin Seligman? | Permanent, personalized, and pervasive |
| How long have drugs been around in human use? | At least 50,000 years! |
| A "speedball" is the combination of which two drugs? | Heroin and cocaine. |
| What are the common themes in drug use over the ages? | Humans seeking to alter consciousness Government involvement Technological advances |
| Which drug(s) were most popular in Prehistoric Times (8500-4000 BC)? | Coca (tea) Stimulants - reduced appetite in times of famine |
| What drugs were around in Prehistoric Times (8500-4000 BC)? | Coca Opium Marijuana Tobacco Alcohol (fermenting plants) Betal nut Khat |
| Which drugs were around for Ancient Civilizations (4000 BC - 400 AD)? | Alcohol Opium Cannabis Mezcal Fungi Coca leaf Tobacco |
| Which drugs were used during the Middle Ages (400 - 1400)? | Mandrake Belladonna Henbane Datura St. Anthony's Fire |
| Which drugs were used during the Renaissance (1400-1700)? | Coffee & tea (first coffee houses) Alcohol Opium Continued use of other drugs from previous times |
| During which historic time were levels of drug abuse beginning to increase? | Renaissance - more and more levels of abuse; people figured out the highs of drug use and started using drug choice |
| Which drugs were used during the Enlightenment (1700 - 1900)? | Gin Inhalants (nitrous oxide) Opium (smoking began) Morphine Heroin More refined versions of drugs IV use began |
| When did prohibition begin? How long did it last? | 1920s with the 18th amendment Lasted for 13 years |
| When was the Marijuana Tax Act? | 1937 - pot banned |
| Which drugs were considered to be "Mother's little helper" in the 20th century? | Valium and barbiturates - used as an escape, because mothers weren't working out of the home during this era |
| LSD: Who, When, Where? | Invented by Hoffman in Switzerland, 1938; promoted by Leary |
| What prompted the Schedule of Drugs? | Drug Issues --> Controlled Substances Act of 1970. |
| How does supply reduction help control drug use? | Reduces supply/import as opposed to reducing demand |
| How might drug demand be reduced? | Free preventative health care Teaching meditation Shifting from individual focus to systemic views Funding for prevention programs |
| What is the rate of alcoholism in the US? | 12 million alcoholics Kills about 100,000 people annually (including car accidents) |
| How many US deaths (annually) are caused by tobacco? | 20%, not including second-hand exposure. |
| What percentage of alcoholics are also smokers? | 80% |
| What is the hardest drug to quit? | Tobacco |
| Aside from substance use, what are some of the other ways to alter consciousness? | Meditation, exercise, sex, shopping, gambling, eating, music |
| What are some of the reasons that people choose to use drugs? | Altering consciousness, regulating mood, relieving stress, stimulating thought/creativity, disconnecting from reality, achieving reconnection with reality |
| When was Alcoholism defined as a disease by the AMA? | 1957 - AA was involved in this. |
| What is a criticism of alcoholism being labeled as a disease? | Known course/outcome varies depending on the individual. |
| What are the "benefits" of alcoholism being labeled as a disease? | Blame is not necessarily directed at the individual (downside of this - the individual doesn't have control) Can get medical benefits |
| What are the main concepts of the Developmental-Genetic model of addiction? | Ebb & flow over lifetime Epigenetic factors Complex issue that involves the interaction of genes with the environment |
| What are the main concepts of the Genetic model of addiction? | More likely to become addicted if your biological parents were addicts (4x more likely w/one, 8x more likely w/both) Some genes are red flags Requires behavioral component |
| What are the main concepts of the Personality model of addiction? | Addictive personality (perhaps better states as "psychological vulnerability") Behavioral patterns show addictive qualities - drugs, people, sex, gambling, etc. |
| What are the main concepts of the Self-Medication Motive model of addiction? | Drug use is a purposeful attempt by the user to get rid of painful affective states & to manage other psychological problems or disorders. |
| What are some personality traits thought to contribute to addiction? | Risk-takers Impulsivity Exhibitionism |
| What characteristic of psychoactive substances allows them to readily pass through the blood-brain barrier? | They are fat soluble. |
| What does a drug's half-life tell you? | (answer) |
| What are the components of the peripheral nervous system? | The autonomic and the somatic nervous systems. |
| Which portion of the nervous system is responsible for the "fight or flight" response? | The sympathetic nervous system - which is part of the autonomic nervous system, therefore a part of the PNS. |
| Which areas of the brain comprise the "reward system" ? | The Ventral Tegmental area, the nucleus accumbens (major rewards!) Thalamus, prefrontal cortex |
| Which neurotransmitters are excitatory? | Epinephrine, norepinephrine, acetylcholine |
| Which neurotransmitters are inhibitory? | GABA, dopamine, serotonin, acetylcholine, norepinephrine |
| Define tolerance. | The same amount of a substance no longer produces a high (need more of the substance to produce the same effect). Also - age-related tolerance (sensitization): same amount of substance may have a magnified effect compared to earlier years |
| What is meant by short-term physiological effects? | somatic symptoms that people exhibit immediately after the psychoactive substance is administered. |
| What is meant by short-term psychological effects? | Sensations and perceptions immediately after the psychoactive substance is administered. |
| What is meant by long-term physiological effects? | illness, disease, dysfunction, etc. from chronic, continued use of psychoactive substance. |
| What is meant by long-term psychological effects? | Mental illness or dysfunction from chronic, continued use of psychoactive substance. |
| What is the toxicity level? | The lethal amount of a substance (overdose). |
| Define dependence. | Physiological or psychological cravings - compulsive urge to use substance. Body tissues are adjusted to having the substance (physiological dependence). |
| Define withdrawal. | Symptoms that occur after prolonged and heavy use of a substance is discontinued - tend to be the opposite of the high that the drug produced. |
| What are the methods of ingesting amphetamines? | Orally Snorted or smoked (after crushing into powder) Shooting (mixing powder w/liquid) |
| Which neurotransmitters are affected by amphetamines? | norepinephrine, dopamine, adrenaline, serotonin |
| What are the short-term physiological effects of amphetamine use? | insomnia loss of appetite increased motor activity increased speech dilated pupils dry mouth increased strength and alertness elevated BP, HR |
| What are the short-term psychological effects of amphetamine use? | stereotypy excitability, euphoria irritability, aggression anxiety auditory hallucinations, paranoia, delusions |
| What are the long-term physiological effects of amphetamine use? | HTN, stroke, seizures, aneurisms, brain hemorrhages, cardiac arrest long-lasting or permanent disconnected speech and thought patterns long-lasting muscle tension and inability to stop moving Permanent damage highly likely |
| What are the long-term psychological effects of amphetamine use? | Psychotic illness (one-way trip...) brain damage with difficult decision-making |
| What are the symptoms of amphetamine withdrawal? | Extreme tiredness, hypersomnia decreased attention span, poor recall hunger irritability muscle twitching |
| What are the methods of ingesting cocaine? | Chewing (coca leaves), snorting, shooting |
| What are the short-term physiological effects of cocaine use? | Increased HR, BP, higher body temp runny nose, sweating muscle twitching increased psychomotor activity sexual stimulation insomnia loss of appetite dilated pupils increased rate of speech dry mouth seizures, sudden cardiac arrest |
| What are the short-term psychological effects of cocaine use? | euphoria, excitation restlessness, alertness anxiety, paranoia hallucinations, delusions perceived increase in strength & mental ability |
| What are the long-term physiological effects of cocaine use? | MANY!! Issues in - Neurological, Oral, Cardiovascular, GI, Liver, Reproductive, Pulmonary, Throat, Nose, Eyes |
| What are the long-term psychological effects of cocaine use? | Depression brain damage |
| What are the warning signs of lethal dose of cocaine? | vomiting, cold sweats, headache, muscle twitches, convulsions, gasping breaths/inability to breathe, low BP, dilated pupils, paralysis, cardiac arrest |
| What are the symptoms of cocaine withdrawal? | Dysphoria exhaustion anxiety cravings severe anhedonia |
| What are the actions of caffeine (neurotransmitters)? | Increases norepinephrine, blocks adenosine |
| What are the short-term physiological effects of caffeine use? | increased HR ringing in the ears chills nausea |
| What are the short-term psychological effects of caffeine use? | panic flashes of light |
| What are the long-term psychological effects of caffeine use? | sleep and anxiety disorders |
| What is the toxicity level of caffeine? | 5,000mg (hard to achieve!) |
| What are the methods by which nicotine is ingested? | chewing, smoking |
| What are the short-term physiological effects of nicotine use? | increased heart muscle tone elevated BP, HR decreased appetite increased blood sugar taste buds die |
| What are the short-term psychological effects of nicotine use? | oral satisfaction |
| What are the long-term physiological effects of nicotine use? | death lung damage, emphysema cancer, leukemia heart disease, stroke, increased blood clots carbon monoxide poisoning decreased HDL / increased LDL decreased sperm motility, increased impotence premature birth, spontaneous abortion |
| What are the long-term psychological effects of nicotine use? | depression, anxiety |
| What is the toxicity level of nicotine? | 40mg. Causes sweating, nausea, tremors. |
| Which drugs are CNS depressants? | Alcohol, barbiturates, tranquillizers. |
| Alcohol, barbiturates, and tranquillizers are all examples of _____? | CNS depressants |
| What is the cause of Korsakoff's syndrome? | Thiamine deficiency (common in alcoholism). |
| Cross-tolerance is high between alcohol and ___. | Benzodiazepines (e.g., Xanax) |
| For which drug is it most important to have medical supervision during detox? | Alcohol |
| How much of ingested alcohol is absorbed in the duodenum? | 2/3 |
| What percentage of medical cases referred for HBP are related to alcohol use? | 33% |
| What is disulfiram? | Antabuse. |
| What happens when alcohol is used during treatment with disulfiram? | Poisoning, nausea, vomiting |
| Barbiturates are commonly known as ___. | Tranquillizers |
| How do Benzos and Barbs work, pharmacologically? | They inhibit CNS activity and increase GABA. |
| Do all opioids have medical use? If yes, state their Schedules. If no, which do not? | No. Heroin and MPPP (Schedule I) do not have medical indications. |
| Which drugs are naturally extracted from the poppy? | Opiates Heroin |
| Typical intoxication effects of opiates/opioids include...? | flushing of the face impaired judgment reduced anxiety constipation |
| Which drug currently has the greatest overdose rate in the US? | OxyContin / Oxycodone |
| What characteristics of alcohol contribute to its effects? | Fat- and water-soluble: crosses BBB easily. |
| What neurotransmitters are affected by alcohol? | GABA (increase/facilitation) Dopamine (increase) Serotonin (decrease) |
| What are the short-term physiological effects of alcohol use? | Incoordination Slurred speech Staggering Increased HR Increased urine output Drowsiness |
| What are the short-term psychological effects of alcohol use? | Delusions, loss of memory, loss of control, confusion, impaired judgment Hostility, irritability, aggressive humor Euphoria, paranoia, altered sensation and perception Decreased inhibition, increased risk taking, inability to predict outcomes |
| What are the long-term physiological effects of alcohol use? | Wide-spread effects affecting the nervous system, bronchi, mouth, stomach, duodenum, kidneys, liver, reproductive system, musculoskeletal system, and circulatory system |
| What are the long-term psychological effects of alcohol use? | Memory loss, blackouts, loss of control Wernicke-Korsakoff's Psychosis |
| What is the toxicity level of alcohol? | BAC of .40 or above |
| Why must detoxification from alcohol occur under medical supervision? | Potentially lethal - seizure/stroke; takes about 5 days. |
| What are the symptoms of alcohol detoxification? | Tremors, hallucinations, seizures/stroke, delerium tremens as CNS depressant dissipates... Profound confusion, agitation, fever, tachycardia, perspiration Severe cases - 15% fatality rate |
| What medications are used for treatment of alcohol abuse / detoxification? | Disulfiram: antabuse Naltrexone: reduces cravings Acamprosate: restores NT balance and reduces cravings Vitamin therapy |
| What other drugs interact with alcohol? | Cocaine: interaction forms the metabolite cocaethylene --> dramatic rise in HR & BP, can cause liver damage and death Benzodiazepines/Barbiturates: sedation is potentiated - can be lethal. |
| Which drug schedule(s) does Barbiturates fall under? | II, III, IV. |
| What are the common ways of ingesting barbiturates? | Orally, or dissolved in water as IV/IM. |
| What NTs do barbiturates influence? | GABA (increase) |
| What are the short-term physiological effects of barbiturate use? | Muscle relaxation, drowsiness, slowed breathing and HR, slurred speech Slowed motor activity, impaired coordination, dizziness, double vision |
| What are the short-term psychological effects of barbiturate use? | Reduced tension and anxiety, euphoria, impaired judgment |
| What are the long-term physiological effects of barbiturate use? | Damage to the nervous system, nausea, vomiting, constipation, liver damage/failure, megaloblastic anemia, problems in the reproductive, cardiovascular and respiratory systems |
| What are the long-term psychological effects of barbiturate use? | Mood swings, irritability, inappropriate & obnoxious behavior Manipulation, nervousness, confusion, anxiety Lack of coordination, hyperactivity, insomnia, nightmares, hallucinations |
| What are the signs of barbiturate overdose? | Loss of consciousness, depressed breathing, coma |
| Does detoxification from barbiturates require medical supervision? | Strongly advised, yes. Results can be severe. |
| What are the symptoms of barbiturate withdrawal? | Nausea, vomiting, elevated HR, excessive sweating, abdominal cramping, tremors, anxiety, restlessness, agitation Later: seizures, delirium, uncontrolled heart beat, HBP, SOB, loss of consciousness, toxic psychosis, etc. |
| More people die from ___ than ___ when using barbiturates. | withdrawal; overdose. |
| Barbiturates can be dangerous when combined with which pharmaceuticals? | MAOIs, HRT, anticoagulants, corticosteroids, valproic acid, doxycycline, guseofulvin |
| Which drug Schedule do benzodiazepines fall under? | IV |
| What is the primary use for benzodiazepines? | Anxiolytic - reduce anxiety with less sedation than barbiturates |
| What is the mechanism of benzodiazepines? | Oral ingestion - activates GABA (inhibits limbic system, RAS, motor cortex); some of them have metabolites that continue to act on the system for days. |
| What are the short-term physiological effects of benzodiazepine use? | Sedation, impaired coordination, drowsiness, staggering gait, slurred speech, light-headedness |
| What are the short-term psychological effects of benzodiazepine use? | Euphoria, agitation, confusion, lethargy, paranoia, amnesia Reduced inhibitions, impaired judgment, reduced anxiety Impaired short-term memory |
| What are the symptoms of benzodiazepine withdrawal? | Sleep disturbance, anxiety, restlessness, sweating, depression, paranoid ideation, agitation, headaches, loss of appetite, stimuli hypersensitivity, muscle twitches, toxic psychosis, seizures |
| What are opiates/opioids classified as? | CNS depressants - downers... used as painkillers |
| What drugs are opium poppy extracts? | Codeine, Morphine, Oxycodone/Percoset/Perodan/Oxycontin, Heroin, Dilaudid, Hydrocodeine |
| Which drugs are opioids (synthetic opiates)? | Methylfentanyl/Fentanyl, Fentanyl/Sublimaze, Hydrocodone combination/Vicodin, Meperidine/Demerol, Methadone/Dolophine, Propoxyphene/Darvocet-N, MPPP |
| What is one of the slowest narcotics? | Codeine |
| What are the short-term physiological effects of narcotic use? | Bobbing head, flushing of skin & face, itching, constricted/pinpoint pupils Suppression of cough, reduction of respiratory fx Reduced BP, drowsiness, sedation, slurred speech, elimination of pain Nausea, vomiting, constipation, inability to urinate |
| What are the short-term psychological effects of narcotic use? | Lethargy, euphoria, mental clouding, impaired judgment, reduced anxiety |
| What are the long-term physiological effects of heroin use? | Increased risk of infection Irregular levels of sex hormones, fetal damage Bronchial irritation, asthma, risk of pneumonia Liver disease Vein collapse (IV) Abnormal levels of cortisol Chronic constipation Cardiovascular malfunctions |
| What are the long-term psychological effects of heroin use? | Neuron damage and/or death |
| Describe reasons for heroin overdose. | High potential Unexpected potency "cut" adulterants --> respiratory problems, death Intentional use of opioids + alcohol Change of setting |
| Who are "needle freaks" ? | People who become psychologically dependent on heroin but do not inject enough to become physically dependent; need the needle to feel normal |
| Is supervision required for heroin detox? | Monitoring often required because of high rate of relapse. Medical supervision often includes use of longer-acting opioid (methadone) to block cravings and ease withdrawal |
| What are the symptoms of heroin withdrawal? | Irritability, anxiety, exaggerated pain response, nasal drainage, sneezing, severe bone aches, muscle spasms, hot/cold flashes, chills, fever, dilated pupils, tears, increased BP/pulse, flushing, N&V, abdominal cramps, diarrhea, insomnia, fatigue, etc. |
| What is protracted abstinence syndrome following heroin withdrawal? | 8-12 months of weakness, anxiety, tiredness, poor distress tolerance, decreased pain threshold (postacute withdrawal) |
| What drugs are used in the treatment of heroin withdrawal? | Methadone LAAM Buprenorphine Naltrexone Naloxone |
| How is OxyContin abused? | Crushed up and snorted or mixed with liquid and injected -- taken in this form (rather than pill) eliminates the time-release function of the prescription --> very potent. |
| Name some examples of indole psychedelics. | LSD Psilocybin DMT |
| Which psychedelic drug is on Schedule II (because it's considered to have medical use by the gov't)? | PCP |
| With the exception of PCP, how long does a "bad trip" tend to last for? | Up to 24 hours. |
| True or False: Tolerance does not develop for hallucinogens. | False |
| True or False: Physiological dependence does not develop for hallucinogens. | Usually True; although psychological dependence is common. |
| True or False: Flashbacks are a myth. | False. |
| True or False: No fatal overdoses of LSD have been reported in humans. | True. |
| Which psychedelic drug is most likely to mimic an acute schizophrenic episode when presenting in the ER? | PCP. |
| What is the most common cause of death with use of ecstasy? | Dehydration. |
| What does the category of "cannabis" include? | Hashish, marijuana, sinsemilla |
| True or False: Brain damage from inhalants is commonly fast and permanent. | True. |
| How long does it take for inhalants to take their effect? | 7-10 seconds. |
| Compulsive gambling is classified as which type of disorder? | Impulse-control |
| What are the short-term physiological effects of hallucinogens? | Dilated pupils Increased HR, BP, body temp Sweating, salivating Short-term memory loss Muscular weakness N&V, loss of appetite Slurred speech REM Convulsions, seizures. |
| What are the short-term psychological effects of hallucinogens? | Intense euphoria, increased emotion Visual hallucinations Perception of higher creativity Relaxation Perceived increased strength & knowledge Increased fantasy, depersonalization "Slowed" time Confusion, disturbed judgment Reduced sensitivity to p |
| What is a "bad trip" ? | Panic attacks, psychotic break - usually lasts up to 24 hours (may be longer with PCP) |
| What are the long-term effects of cannabis use? | memory/cognitive dysfunction, thought disorders lung disease reduced fertility immune system suppression Cancer |
| Amyl Nitrite is | A volatile nitrite commonly used for sexual enhancement. |
| What is huffing? | Inhalants: mouth only (spraying onto rag) |
| What is Sniffing? | Inhalants: nose only (straight from aerosol or rag) |
| What is Bagging? | Inhalants: mouth and nose (spray into bag, put over both - breathe --- MOST DANGEROUS) |
| Which drug does not have a dependence diagnosis in the DSM? | Caffeine |
| What are the 11 drug categories in the DSM? | Alcohol, Sedative Hypnotics/Anxiolytics, Amphetamine, Caffeine, Cocaine, Nicotine, Cannabis, Hallucinogens, Inhalants, Opioids, Phencyclidine Other Listed alphabetically |
| What is Stage 1 in Jellinek? | Prealcoholic - Social drinking, drinking to reduce stress, etc. |
| What is Stage 2 in Jellinek? | Prodromal - obsessed with alcohol, person is drinking secretively, may start having blackouts |
| What is Stage 3 in Jellinek? | Crucial - cannot stop once they start, antisocial behaviors, denial of problems, may need a morning drink |
| What is Stage 4 in Jellinek? | Chronic - No choice for first drink - question is HOW they are going to obtain alcohol. Involves binging. |
| How can you tell the difference between a gamma and an epsilon alcoholic? | Epsilon is periodic drinking only - has never been chronic |
| What does ASAM stand for? | American Society for Addiction Medicine |
| What is Dimension 1 of ASAM criteria? | Acute intoxication or withdrawal potential? |
| What is Dimension 2 of ASAM criteria? | Biomedical conditions and compliance |
| What is Dimension 3 of ASAM criteria? | Emotional and behavioral conditions and compliance |
| What is Dimension 4 of ASAM criteria? | Treatment acceptance or resistance |
| What is Dimension 5 of ASAM criteria? | Relapse or continued use potential |
| What is Dimension 6 of ASAM criteria? | What is the recovery environment like? |
| What is Level 0.5 treatment (ASAM)? | Early intervention (prevention) |
| What is Level I treatment (ASAM)? | Outpatient |
| What is Level II treatment (ASAM)? | Intensive Outpatient |
| What is Level III treatment (ASAM)? | Inpatient |
| What is Level IV treatment (ASAM)? | Inpatient with Medical supervisor |
| What is Primary Prevention? | Delay onset of 1st use - one of the biggest ways to reduce dependency. |
| What is Secondary Prevention? | Reduce prevalence rates (# of people currently using)... harm reduction, education, skill building |
| What is Tertiary Prevention? | Try to stop more damage - harm reduction, make continued use more difficult, formal treatment options |
| Which brain imaging techniques look at structure? | CT/CAT, MRI |
| Which brain imaging techniques look at function? | fMRI, PET, SPECT |
| What's involved in the detox treatment modality? | Supervised, short stay |
| What's involved in the inpatient treatment modality? | Usually 28-day program - includes education, family work, group work |
| What's involved in the family treatment modality? | Inpatient or Outpatient - working with the family as an unbalanced unit |
| What's involved in the therapeutic community modality? | Formal phase - can be Inpatient or Outpatient - long-term treatment (1-3 years) offered in stages. Most effective. |
| What's involved in the outpatient treatment modality? | May be weekly groups, support groups May be intensive outpatient May be private practice or formalized treatment setting |
| What are the characteristics of a Rigid family system? | strict rule - no exceptions black and white values linear and hierarchical communication Drugs suppress feelings |
| What are the characteristics of an Ambiguous family system? | Uninforced/changing rules Changing values Unclear and changing communication Drugs suppress feelings |
| What are the characteristics of an Overextended family system? | Rules involve being overproductive Values are about achievement Communication is based on pleasing parents - focused on "do" Drugs enable overactive lifestyle with emotional numbness |
| What are the characteristics of a Distorted family system? | Rules involve acting normal (even when things aren't) Values are about illusions of normalcy Communication - mixed messages Drugs are used to numb chaos and cope with distorted reality |
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goofus84
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