Introduction

Question 1

Addictions

Answer 1

Behavior with the following characteristics:

• impaired control
• repetitive, obsessive use/behavior
• negative consequences, negative impact on self and others

Question 2

Drug

Answer 2

1. a medicine or other substance which has a psychological effect when ingested or otherwise introduced into the body
2. substances which have a psychoactive effect when ingested or otherwise introduced into the body
3. Illegally obtained drugs

Question 3

Narcotics

Answer 3

An addictive drug affecting mood or behavior, especially an illegal one.

Used mainly for opioids (in medicine= a drug which induces drowsiness, stupor, insensibility and receives pain.

Question 4

Psychoactive substance

Answer 4

Substance that, when taken into ones system, affect mental processes (e.g. cognition or affect).

Effects via central nervous system

Question 5

Intoxication

Answer 5

A condition that follows the administration of a psychoactive substance and results in disturbance in the level of consciousness, cognition, perception, judgement, affect, behavior, or other psychophysiological function and responses.

Question 6

Intoxication depends on…

Answer 6

It is highly dependent on the type and dose of drug and is influenced by an individuals level of tolerance and other factors

Question 7

Substance abuse (DSM 4)

Answer 7

A maladaptive pattern of substance use leading to clinically significant impairment or distress

• failure to fulfill major role obligations at work, school, or home
• substance use in situation in which is physically hazardous
• legal problems

Question 8

Dependence

Answer 8

A maladaptive pattern of substance use leading to clinically significant impairment or distress

Question 9

Symptoms: substance use disorders

Answer 9

1. taken in larger amounts and over a longer period than intended
2. a persistent desire or insignificant effort to cut down or control using
3. a great deal of time is spent in activities necessary to obtain, use or recover from its effects.
4. Craving or a strong desire or urge to use
5. Recurrent use resulting in failure to fulfill major role obligations at work, school or home
6. Continued use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of substance
7. Important social, occupational or recreational activities are given up or reduced because of use
8. Recurrent use in situations which is physically hazardous
9. The use is continued despite knowledge of having persistent or recurrent physical or psychological problems that are unlikely to have been caused exacerbated by the substance
10. Tolerance (1. a need for markedly increased amount to achieve intoxication and desired effects, or 2) as markedly diminished effect with continued use of the same amount)
11. Withdrawal (the characteristic withdrawal symptoms for the substance, or, a close related substance is taken to relieve or avoid withdrawal symptoms)

Question 10

Abstinence

Answer 10

Refraining from an activity which is known to be harmful and addictive. Doing this involves not taking a particular substance, avoiding areas where this is likely to be on offer or adopting a healthier lifestyle.

Question 11

Euphoria

Answer 11

An affective state in which a person experiences pleasure or excitement and intense feelings of well-being and happiness.

Certain drugs can cause euphoria

Question 12

Overdose

Answer 12

The ingestion or application of a substance in quantities greater than are recommended or generally practiced

Question 13

Relapse

Answer 13

Recurrence of a prior condition; re-initiation of drug seeking behaviors and the resumption of use after a period of abstinence.

Question 14

Classification of psychoactive substances

1. Legal vs. Illegal

Answer 14

• depend on culture

- drug policy issue

Question 15

Classification of psychoactive substances

2. Naturally occurring vs synstethic

Answer 15

• Sometimes difficult to differentiate
• problem: classification does not give information about effects and danger
• myths:
  + natural substances are more safe
  + Syntethic substances are more safe

Question 16

Classification of psychoactive substances

3. Medicine vs poision

Answer 16

• Depends on: person, purpose of use, dose
• Some substances can be both medicine and poisons
  + morphine
  + codeine
  + amphetamine (ADHD treatment)
  + Cannabis (reduce nausea, vomiting, improve appetite etc.)

Question 17

Classification of psychoactive substances

4. Hard drugs vs. soft drugs

Answer 17

• Origin from the Dutch drug policy -> separation of cannabis from other drugs (1976) (cannabis is less dangerous than other drugs)
• This classification can cause misconceptions and confusion
  + which drugs are hard and which are soft?

Question 18

Classification of psychoactive substances

5. Addictive vs. non-addictive

Answer 18

• Difficult to use; not “all or nothing”.

- addictive potential - continuum is better

Question 19

Classification of psychoactive substances

6. Chemical structure

Answer 19

• Exact, definite

- Disadvantage: difficult to use without competence

Question 20

Classification of psychoactive substances

7. Psychoactive effects

Answer 20

• Grouping by the effects of the central nervous system (CNS).
• Most accepted, commonly used

1. STIMULANTS: stimulates the CNS, increase mental and/or physical functions (referred to as “uppers”)
2. DEPRESSANTS: slow down the activity of CNS, lower neurotransmission levels, which are to depress or reduce arousal or stimulation, in various areas of the brain (referred to as “downers”
3. HALLUCINOGENS: they might have both stimulant or depressant properties but their main effect are due to their ability to alter cognitive functions (e.g. perception and thinking), causing visual or auditory hallucinations

Question 21

Sertürner (1817)

Answer 21

Isolated morphine from opium.

Question 22

Opioids

Answer 22

• Exert their effects primarily through their action at the opioid mu, kappa, and sigma receptors
• prescription opioids are used for pain management,
• the highest addictive potential

Question 23

Mu and Sigma receptors

Answer 23

Influence mood, reinforcing effects, respiration, pain, blood pressure, and endocrine and gastrointestinal function

Question 24

Kappa receptors

Answer 24

Produce endocrine changes and analgesia

Question 25

``` Somatic effect (opioids) - Average dose ```

Answer 25

- Reduced activity of the CNS - Reduced responsiveness - Decreased sensitivity to painful stimuli - Pupils are constricted - A drop in body temperature - Appetite supression

Question 26

``` Somatic effect (opioids) - Greater dose ```

Answer 26

- Respiratory problems | - Cardiovascular problems

Question 27

``` Somatic effect (opioids) - Overdose ```

Answer 27

- Dangerously low body temperature - Slowered, abnormal breathing - Blue lips and fingernails - Cold, clammy skin - Weak pulse, very low blood pressure - Coma, death

Question 28

``` Mental effect (opioids) - Average dose ```

Answer 28

- Rusch experience - Euphoria - calm and relaxed state - Reduced fear and anxiety

Question 29

``` Mental effect (opioids) - Greater dose ```

Answer 29

Feel of sickness | Sleepiness

Question 30

Intravenous drug use (IDU)

Answer 30

IDU allows the drug to enter the bloodstream immediately -> increases the speed of delivery to the brain - Speed the development of an addiction - Raise the likelihood of experiencing overdose