AOD Quiz 1

Three factors that make certain drugs appealing, according to SMH

1) the main action or effect of the drug 2) the personality organization or characteristics of an individual 3) the inner states of psychological suffering or disharmony

The Moral Model of Addiction

AOD use is a choice; addiction is a symptom of moral deficiency and/or lack of willpower and that those who misuse AOD are weak-willed or flawed. This model has been adopted by certain religious groups as well as by the legal system. In states where violators are not assessed for AOD problems and are not diverted to tx, this model guides policy. If AOD use is a personal choice, then those who misuse AOD should be punished. This model has created a stigma around addiction and addicts and it is this stigma that contributes to barriers to getting help.

Psychotropic drugs

Chemicals used to treat mental disorders

CNS Stimulant Chronic Effects

Chronic users experience health damage (tobacco being the most deadly drug), serious life and financial problems as a result of addiction, depression, suicidal ideation, malnourishment, and panic attacks.

Alcohol Major Chronic Effects

Depression, damage to every organ system, neurologic deficits, hypertension, liver and heart disease, addiction, fatal overdose.

Psychoactive drugs

Natural or synthetic chemicals that affect thinking, feeling, and behavior

Reverse-tolerance

Refers to a condition in which smaller quantities of a drug produce the same effects as did previous larger doses.

Cross-tolerance

Refers to the accompanying tolerance to other drugs from the same pharmacological group (e.g. tolerance to alcohol results in tolerance to minor tranquilizers such as Xanax, even when the individual has never used Xanax).

Opioid Acute Effects

Sedation, pain relief, euphoria, drowsiness, impaired coordination , dizziness, confusion, nausea, sedation, feeling of heaviness in the body, slowed or arrested breathing, fatal overdose.

Opioids and Routes of Administration

The opiods are naturally occurring (opium poppy extracts) and synthetic drugs that are commonly used for their analgesic (pain relief) and cough-suppressing properties. The terms opiate, narcotic, and analgesic are also used to describe this classification of drugs, which include heroin, morphine, methadone, and pain pills. Routes of administration include intravenous use, snorted, and smoked and pill form.

The Middle or Crucial phase of addiction

The stage of addiction is defined by loss of control over drinking, personality changes, a loss of friends and jobs, and a preoccupation with protecting the supply of alcohol.

Antipsychotic or neuroleptic drugs

These drugs are used in the tx of schizophrenia and other psychotic disorders. These major tranquilizers produce psychomotor slowing, emotional quieting, and an indifference to external stimuli.

The Sociocultural Models of Addiction

This model understands addiction as something that is effected by factors external to the individual, such as cultural, religious, family, and peer variables or psychological factors. Both poverty and affluence are seen as having an impact on AOD, as does a lack of social supports, as well as the modeling of cultures and families.

CNS Stimulant Withdrawal

Unlike withdrawal from CNS depressants, withdrawal from CNS stimulants is not medically dangerous. Withdrawal symptoms include chronic headache, irritability, restlessness, anxiety, tremors, sweating, and flushing, rapid heart beat (tachycardia), anxiety, insomnia, paranoia, convulsions, heart attack, and stroke. The withdrawal from cocaine and meth is called "crashing". The severe symptoms last 2-3 days and include severe drug craving, irritability, depression, anxiety and lethargy. However, the depression, drug craving, and anhedonia may last for several months as the body chemistry returns to normal. Individuals going through withdrawal experience SI, suicide attempts, and are at high risk of relapse. The slow rate of recovery from these symptoms make support crucial.

SMH Model of Addiction

According to this model of addiction, drugs of abuse relieve psychological suffering and a person's preference for a particular drug involves some degree of psychopharmacological specificity. Patients experiment with various classes of drugs and discover that a specific one is compelling because it ameliorates, heightens, or relieves affect states that they find particularly problematic or painful. AKA - certain drugs make more bearable affect states that otherwise were unbearable.

CNS Depressants examples and routes of administration

Alcohol, barbiturates, benzodiazepines, sleep aids. Routes of administration include drinking and ingesting pills.

Disadvantage of disease model of addiction

One major disadvantage of this model is that some ppl blame their addiction on the "disease".

SMH and psychopharmacological specificity for CNS depressants (i.e. alcohol).

Short-acting depressants with rapid onset of action (e.g. alcohol, barbituates, benzos) have their appeal because they are good "ego solvents." That is, they act on those parts of the self that are cut off from self and others by rigid defenses that produce feelings of isolation and emptiness and related tense/anxious states and masks fears of closeness and dependency. These substances create the illusion of relief bc they temporarily soften defenses and ameliorate states of isolation and emptiness associated with depression.

Opioid Withdrawal

Withdrawal symptoms are rarely dangerous and analogous to severe flu, with symptoms including running eyes and nose, restlessness, goose bumps, sweating, muscle cramps or arching, nausea, vomiting, and diarrhea. There is significant drug craving. Symptom relief comes with use of drug, which accounts for high relapse rates.

Alcohol Major Acute Effects

In low doses, euphoria, mild stimulation, relaxation, lowered inhibitions; in higher doses, drowsiness, slurred speech, nausea, emotional volatility, loss of coordination, visual distortions, impaired memory/ blackouts, sexual dysfunction, loss of consciousness/ increased risk of injuries, violence.

Biopsychosocial Model of Addiction

In this model of addiction, the interactions of biological, psychological, cognitive, social, developmental, and environmental variables are considered to "explain" addiction. This model incorporates other models into a single model. Therefore, important factors in the tx of a particular client are not ignored when all variables are considered.

SMH and psychopharmacological specificity for Opium users

Opiates have a generally calming and "normalizing" effect (i.e. for someone who feels like an outsider or "odd," opiates might be appealing in that alleviate this feeling) and lessen intense, raging, and violent affect. They counter the internally fragmenting and disorganizing effects of rag and the externally threatening and disruptive aspects of such affects on interpersonal relations.

Withdrawal

Physical and psychological effects that occur when a drug-dependent individual discontinues AOD use.

CNS Depressants Major Acute Effects

Relaxation, disinhibition, reduction of anxiety, impaired motor coordination and memory, poor concentration, confusion, dizziness, slowed pulse, lowered blood pressure, slowed breathing. for barbiturates: euphoria, unusual excitement, fever, irritability.

Tolerance

Requirement for increasing doses or quantities of AOD in order to create the same effect as was obtained from the original dose. Results from the physical or psychological adaptation of the individual.

The Late stage or Chronic phase of addiction

This stage of addiction is characterized by morning drinking, violations of ethical standards, tremors and hallucinations.

Cocaine and Meth

Users of these substances report a feeling of self-confidence and self-assurance. There is a rush that is experienced particularly when cocaine is smoked and when cocaine and meth are injected. The high from meth is generally less intense but longer acting than cocaine.

CNS Depressants Definition

Central nervous system depressants depress the overall functioning of the central nervous system to induce sedation, drowsiness, and coma. Drugs in this classification include the most commonly used and abused psychoactive drug, alcohol; Rx drugs used for anxiety, sleep disturbances, colds and allergies, and coughs.

Addiction

Compulsion to use alcohol or other drugs regardless of negative or adverse consequences. Addiction is characterized by psychological dependence (the need to use AOD to think, feel or function normally) and often physical dependence (which occurs when tissues of the body require the presence of alcohol or other drugs to function normally).

Opioid OD

Death from OD of injectable opioids (i.e. heroin) can occur from the direct action of the drug on the brain, resulting in respiratory depression. Death can also occur from an allergic reaction to the drug or to substances used to cut it, possibly resulting in cardiac arrest. OD of other drugs in this classification may include symptoms such as slow breathing rate, decreased blood pressure, pulse rate, temperature and reflexes. The person may become extremely drowsy and lose consciousness. There may be flushing and itchy skin, abdominal pain, and nausea and vomiting.

Psychodynamic Therapeutic Approach to TX

Establish a working alliance with client and empathically explore how distress, confusion, and/or inability to feel their emotions were relieved or altered by preferred drug. Employ supportive techniques and a semistructured tx relationship that allow for more interaction than do classical techniques so as to gain access to pt's inner life and explore client's particular ways of experiencing and expressing emotions. Within this relationship, clients also display characteristic patterns of defense and avoidance that both reveal and disguise the intensity of their suffering, their confusion about their feelings, or the ways in which they are cut off from their feelings. Actively engage with clients and build an alliance that allows client to develop an understanding of how their suffering, defenses, avoidances, and separation from their feelings interact with the specific action of the drugs that they use or prefer.

CNS Stimulant Tolerance

Rapid tolerance to pleasurable and stimulating effects. Eventually the user is unable to experience pleasurable effects of the drug, but continues to use to reduce the pain of withdrawal. A sensitization or reverse tolerance can occur, particularly with cocaine. In this instance, a chronic user with a high tolerance has an adverse reaction (i.e., seizure) to a low dose.

Opioid Chronic Effects

Route of administration and lifestyle associated with chronic opioid use has serious consequences. Individuals who have been involved in methadone maintenance programs for long periods of time do not experience the negative health consequences seen in CNS depressants.

SMH and psychopharmacological specificity for CNS stimulants

Stimulants act as augmentors for hypomanic, high-energy individuals as well as persons with atypical bipolar disorder. They also appeal to ppl who are bored, lack energy, or suffer from depression. In those with ADHD, stimulants have paradoxical effect and can calm and counteract hyperactivity, emotional liability and inattention.

CNS Stimulant Acute Effects

The acute effects of this drug can be dramatic and fatal. Acute effects include psychomotor stimulation, increased alertness and concentration, elevation of mood, increased heart rate and blood pressure, performance enhancement, suppress appetite, and combat fatigue. More dramatic acute affects include heart attacks, strokes, seizures, and respiratory depression.

Substance abuse

The continued use of alcohol and/or other drugs in spite of adverse consequences in one or more areas of an individual's life (e.g. family, job, legal, financial).

Prodromal phase stage of addiction

The early stage of addiction is characterized by an increasing tolerance to alcohol, blackouts, sneaking and gulping drinks, and guilt feelings about drinking and related bx.

Hallucinogens

These drugs produce an altered state of consciousness, including altered perceptions visual, auditory, olfactory and/ or tactile senses and an increased awareness of inner thoughts and impulses. Sensory experiences may cross into one another (i.e. "hearing color"). In the case of PCP, there may be increased suggestibility, delusions, and depersonalization and dissociation. With the exception of PCP, the concept of "OD" is not applicable to hallucinogens. Managing a "bad trip" involves providing a calm and supportive environment.

CNS Stimulants and Routes of Administration

These stimulate the reward center in the brain and increase respiration, heart rate, motor activity, and alertness. Drugs in this category include caffeine, nicotine, cocaine, amphetamines (methamphetamine, dexedrine), nonamphetamine stimulants (Ritalin). With CNS stimulants, every method of administration is possible and utilized: Ingested (i.e. coffee, chocolate or in pill form), smoked, chewed (chewing tobacco, nicotine gum); cocaine and amphetamines can be snorted, smoked, injected, and ingested. There is no built-in satiation point, so ppl can continue using cocaine and meth until there is no more or they die. Therefore, the compulsion to use, the desire to maintain the high, and the unpleasantness of withdrawal make overdose fairly common.

MDMA (Ecstacy)

This drug has the properties of the CNS stimulants and hallucinogens and produces euphoric effects, including rushes of exhilaration and the sensation of understanding and accepting others. Some ppl experience nausea, and depression may be experienced following use. The drug can be used compulsively and become psychologically addictive.

Psychological Models of Addiction

This model of addiction views addiction as a secondary symptom of underlying psychological disorders; AOD use is learned and reinforced bx. According to this model, the primary psychological problem causes emotional pain and AOD use serve to temporarily relieve this pain.

Advantages of Disease model of Addiction

This model removes moral stigma attached to addiction and replaces it with an emphasis on tx of an illness. We do not punish a person for having a disease; we provide assistance (i.e. this model informs health insurance's covering of tx). This model also provides an explanatory construct for the differences in one person's AOD use and bx compared to others. Finally, this model has a logical tx objective that follows from its precepts: abstinence.

The Disease Concept of Addiction

This model views addiction as a primary disease and not secondary to some other condition. This disease is progressive and consists of stages. These stages proceed in sequence and, according to this model, are not reversible. This model also views addiction as chronic and incurable. It maintains that persons abstaining are in a state of "recovery" and are not recovered. Furthermore, it assumes that bc addiction is progressive, chronic and incurable, that those who continue to use will eventually die.

Opioid Tolerance

Tolerance develops rapidly when the drugs are repeatedly administered but does not develop when there are prolonged periods of abstinence. The tolerance that does develop is to the euphoric, sedative, analgesic and respiratory effects of the drugs. This tolerance results in the individual's using doses that would kill a non-tolerant person. The tolerant individual becomes accustomed to using high doses, which accounts for death d/t OD after detox period.