1
Q
Addiction vs. Dependence
A
- Addiction: condition produced by repeated consumption of a natural or synthetic psychoactive substance, in which the person becomes physically and psychologically dependent on it
- Dependence: when the body has adjusted to a substance and incorporated it into the normal functioning of its tissues
- Psychological dependence: state in which an individual feels compelled to use a substance for the effect it produces, without necessarily being physically dependent on it
2
Q
2 characteristics of dependence
A
- Tolerance: body adapts and requires larger and larger doses of it to achieve the same effect
- Withdrawal: unpleasant physical and psychological symptoms people experience when they discontinue/reduce using a substance they’re dependent on (ex. Anxiety, cravings, irritability, etc.)
3
Q
substance use disorder
A
diagnosed when use is accompanied within a year by 2 or more characteristics, including tolerance, cravings, failing to fulfill obligations, putting your safety at risk, substance-related legal difficulties, etc.
4
Q
Processes that lead to dependence
A
- Reinforcement:
- Positive reinforcement: pleasant consequences added (ie. Drinking produces a “buzz”)
- Negative reinforcement: negative consequences are reduced (ie. Smoking reduces stress)
- Avoiding withdrawal: people continue using substance to avoid unpleasant withdrawal symptoms
- Substance-related cues: cues associated with substance use (via classical conditioning) can elicit cravings
- Expectancies: developing ideas about the outcomes of behaviour by watching others (ie. That drinking is fun)
- Personality: people high in impulsivity, risk-taking, or sensation-seeking and low in self-regulation are more likely to abuse substances
- Genetics: genes play a role in smoking and alcohol addiction, especially in adulthood
5
Q
Who smokes, and how much?
A
- Worldwide, 1 billion men and 250 million women smoke
- Biggest concentration in Europe
- In Canada, 20% of men and 15% of women smoke (average of 14 cigarettes per day)
- Influenced by age (problem smokers start during youth), gender (majority are male), socio-cultural differences (more popular in developing countries, amongst FN people, and people with low SES)
6
Q
Why do people begin to smoke?
A
- Depends on various psychosocial factors:
- Social environment
- Modelling/peer pressure
- Personal characteristics (ex. Low self-esteem)
- Expectancies (thinking it will make you cooler)
7
Q
Why to people start to regularly smoke?
A
- Regular smoking usually occurs if first experience is positive, they know lots of people who smoke, are rebellious, have positive social attitudes of smoking, don’t believe it will harm health, and believe they can quit
- LGBT people more likely to smoke if community is unsupportive
8
Q
Why do people continue to regularly smoke?
A
- because of positive reinforcement (ie. Reducing anxiety), biological factors (addictive element of nicotine)
- Nicotine regulation model: smokers continue smoking to maintain nicotine levels in their bodies and avoid withdrawal symptoms
9
Q
4 ways smoking impacts health
A
- Cancer: causal link between cigarette chemicals and all types of cancer, especially lung
- Destroys cilia in lungs, so carcinogenic substances remain in contact with sensitive cells in bronchi
- Cardiovascular disease: risk twice as high for smokers
- Nicotine constricts blood vessels and increases heart rate, cardiac output, and blood pressure; carbon monoxide reduces oxygen to heart
- Chronic Obstructive Pulmonary Disease: permanently reduced airflow due to damage to respiratory organs
- Respiratory infections
10
Q
Who drinks alcohol, and how much?
A
- Canadians drink 10.2 litres of ethanol (pure alcohol) per year; 70% drink at least occasionally (most are light infrequent drinkers)
- 17% of North Americans become alcohol abusers
- Age: drinking typically begins in adolescence and increases in young adulthood
- Gender: males drink more (and more often) than females
- Sociocultural differences: Drinking common amongst people of European descent; less FN people drink, but those who do tend to drink more
11
Q
Ways drinking alcohol can impact health
A
- Can cause FAS, lead to injury/death, etc.
- Cirrhosis: liver cells die off and are replaced with scar tissue, preventing liver from cleansing the blood
- Impaired immune function, cancer, high blood pressure, heart and brain damage
12
Q
Describe people who use drugs and why
A
- Age: drug use typically begins in adolescence and prevalence increases into early adulthood, then declines
- Gender: drug use much more prevalent in males
- Socio-cultural factors: non-mainstream/marginalized youth more likely to abuse drugs or engage in “poly-substance” (multi-drug) use (ex. FN, LGBT, etc.)
- Genetic, psychosocial, and environmental reasons for using drugs (ex. Low self-control, modelling, positive experiences/reinforcement, etc.)
- Drug abuse factors: personality (rebellious, impulsive, thrill-seeking, less socially conforming or religious), social factors (friends who use drugs)
13
Q
How does using drugs impact health?
A
- May harm fetus, can lead to death by overdose or driving high
- Long-term marijuana smoking causes lung damage similar to cigarette smoking
- Meth and cocaine can damage cardiovascular system (increase blood pressure and heart rate, trigger arrhythmia, lead to strokes and heart attacks)
- Cocaine can also damage nasal structure and lungs if snorted
14
Q
Methods used to prevent substance use
A
- Prevention programs should begin early (before age 12), and should address alcohol, tobacco, and drugs
- Public policy and legal approaches: increasing price through taxation, restricting purchases by age, anti-smoking ads, drunk driving checkpoints, etc.
- Health promotion and education:
- Social influence approaches: teaching skills to help reduce social pressure to smoke
- Life skills training: addressing general social, cognitive, and coping skills (since many teens who smoke lack these skills)
- Family Involvement Approaches: parental intervention and supervision
15
Q
Methods used to stop smoking on one’s own
A
- Quitting cold-turkey
- Using oral substitutes (ie. Candy, gum)
- Some go it alone, others use a buddy system or make bets with others
- Cognitive strategies (ex. Telling themselves they didn’t need a cigarette)
- Provided themselves with material rewards for sticking with it
16
Q
Methods used to stop alcohol and drug use on one’s own
A
- Seeking social support
- Changing way you look at pros and cons of drinking
- Early intervention: giving information and advice to reduce risk of becoming a problem drinker (ex. “quit-lines”)
- Employee Assistance Programs
17
Q
Therapeutic methods to stop using and abusing substances
A
- Cognitive-behavioural methods
- Behavioural methods
- Self-help groups: Developing social group of people who are also quitting the substance, getting support and encouragement from each other -> generally successful (ex. AA)
- Chemical Methods: using prescribed drugs that interact with substances to produce unpleasant reactions (ie. Nausea)
- Multidimensional programs: combining methods to improve success, especially ones that start early, check in, involve family and physicians, and use computer-based interventions
18
Q
Therapeutic methods to stop using and abusing substances: cognitive-behavioural methods
A
- Before treatment: Making sure person is ready to change, recruiting family/friends to help them, bolstering self-efficacy
- Treatments:
- Motivational interviewing
- Reducing risk-taking and increasing conscientiousness
- Reducing its negative reinforcement (ie. Teaching other techniques for stress management)
- Providing positive reinforcement for stopping/reducing use (ie. Money)
- Cue exposure: decreasing impact of substance-related cues
19
Q
Therapeutic methods to stop using and abusing substances: behavioural methods
A
- Self-monitoring: recording info about the problem behaviour
- Stimulus control: altering elements of environment that serve as cues (ie. Removing ashtrays)
- Competing response substitution: doing something that’s incompatible with the problem behaviour (ie. Taking a shower instead of smoking)
- Scheduled reduction: person only uses substance at specific intervals, with get longer and longer
- Behavioural contracting: putting conditions and consequences regarding the problem in writing
20
Q
define relapse and describe why it happens
A
- Relapse: returning to the pattern of behaviour
- Why do people relapse?
- Withdrawal symptoms
- Low self-efficacy
- Negative emotions and poor coping
- High cravings
- Expecting reinforcement/reward by taking the substance again
- Low motivation
- Interpersonal issue
21
Q
methods to prevent relapse
A
- Relapse prevention method:
- Learn to identify high-risk situations for relapse
- Acquire specific coping skills to deal with those situations
- Practice effective coping in supervised high-risk situations
- Telephone counselling
- Continuing chemical methods post-treatment
- Build self-control
- Develop social support networks
22
Q
Incentive-sensitization theory of addiction
A
dopamine enhances the salience of stimuli associated with substance use so they become increasingly powerful in directing behaviour
23
Q
Binge drinking
A
consuming 5 or more drinks on a single occasion at least once in 30 days
24
Q
4 categories of drugs
A
- Stimulants: produce physiological arousal (ex. Amphetamines, caffeine, cocaine)
- Depressants: decrease arousal (benzodiazepines, barbiturates)
- Hallucinogens: produce perceptual distortions (marijuana, LSD, PCP)
- Narcotics/opiates: sedatives that relieve pain (morphine, codeine, heroin)
25
Insite
- Canada's supervised drug injection site
- Follows harm-reduction model focused on reducing health-related, social, and economic impacts of drug use (compared to abstinence-only)
PSYC 314
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