What is Substance Use Disorder (SUD)?
Clinically diagnosed: meeting ≥2 criteria = mild SUD.
More criteria → more severe. Criteria categories include social impairments, risky use, impaired control, withdrawal, and tolerance.
List the criteria categories for diagnosing Substance Use Disorder.
- Social Impairments
- Risky Use
- Impaired Control
- Withdrawal
- Tolerance
Addiction is characterized by emotional/mental preoccupation with the drug and persistent craving.
What is the Dopamine Hypothesis of Addiction?
Misused drugs increase dopamine in the brain’s reward system
Addiction is linked to exaggerated dopamine surges that rewire the brain’s reward communication.
Name the categories of addictive drugs.
- Increase dopamine: cocaine, amphetamines, nicotine, caffeine, morphine, heroin, oxycodone, alcohol, cannabis
- Produce novelty: LSD, MDMA
- Reduce anxiety: benzodiazepines, barbiturates
These drugs have varying effects on the brain and body.
What is drug withdrawal?
Abnormal physiological state after stopping/reducing a drug
Severity increases if withdrawal is rapid. Fear of withdrawal can lead to continued use.
What are the symptoms of stimulant withdrawal?
- Sleepiness
- Muscle pain
- Anxiety
- Tremors
- Low mood
- Suicidal thoughts
- CV problems
Examples include withdrawal from cocaine and amphetamines.
What are the symptoms of opioid withdrawal?
- Sweating
- Aches
- Agitation
- Diarrhea
- Cramping
- Vomiting
Examples include withdrawal from heroin, morphine, and oxycodone.
Define drug tolerance.
Repeated use = less effect OR need more drug for same effect
Shown by rightward shift of the dose–response curve.
What is cross-tolerance?
Resistance to one drug → tolerance to similar drugs
Example: alcohol ↔ benzodiazepines.
List the factors influencing SUD.
- Genetic: dopamine pathway mutations
- Pre-existing disorders: depression, bipolar, anxiety, schizophrenia
- Environmental: drug-promoting environments, trauma, family dynamics
- Developmental: vulnerability in adolescence & early adulthood
Smoking usually begins <18; alcohol misuse often starts <30.
What is the impact of stigma on SUD?
Stigma → isolation, low self-esteem, avoidance of medical/social help
This can hinder recovery and access to support.
What is the focus of harm reduction?
Minimize health & social harms without requiring abstinence
Examples include nicotine patches, supervised injection sites.
Define misuse in the context of substance use.
Taking in ways/amounts other than prescribed OR against social norms
SUD can develop with both prescribed medications and misused substances.
What factors affect misuse potential of drugs?
- Nature of the drug
- Route of administration
- Amount/frequency of use
- Availability
- Inherent harmfulness
Drugs that produce strong pleasurable effects are more likely to be misused.
What is the definition of substance misuse?
Using outside prescribed norms
This can lead to Substance Use Disorder.
What is the definition of substance withdrawal?
Opposite effects after drug cessation
This can include physical and psychological symptoms.
What is the definition of tolerance?
Reduced response to the same dose after repeated use
This can lead to increased dosages to achieve the same effect.
What are the therapeutic uses of amphetamines?
- Narcolepsy
- ADHD (Ritalin preferred)
Amphetamines include compounds like dextroamphetamine and methamphetamine.
What are the short-term effects of amphetamines?
- Chest pain
- Heart attack
- Collapse
- Increased breathing
- Seizures
- Fever
- Stroke
These effects can occur with misuse.
What are the long-term effects of cocaine?
- Toxic psychosis
- Paranoia
- Hallucinations
- Impaired sex function
- Possible permanent brain damage
- Increased BP
- Arrhythmia
Cocaine has a very high potential for misuse.
What happens to caffeine metabolism when someone quits smoking?
Caffeine metabolism slows
They should reduce caffeine intake to avoid overstimulation.
What are the effects of high caffeine doses during pregnancy?
- Increased stillbirth risk
- Slight decrease in fetal growth
- Slight increase in miscarriage risk
Moderate doses (~3 cups/day) show no measurable fetal effects.
What are diuretics used for in sports?
Enhance excretion of salt and water through the kidneys, making the athlete weigh less
They can help athletes compete in a lower weight class or hasten the excretion of other banned drugs.
Why are performance-enhancing drugs banned in sports?
- Athlete protection
- Unfair advantage
Athletes may be under pressure to perform and could be coerced into using drugs.
