Psych 183: Substance-Related Disorders
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Questions and Answers

Which demographic is most affected by opiate abuse and dependence?

  • White, middle-class young adults ages 18-25 (correct)
  • Hispanic teens under 18
  • African American adults over 30
  • Elderly individuals in rural areas
  • What is considered one of the most effective treatments for reducing mortality associated with Opioid Use Disorders?

  • Inpatient rehabilitation without medication
  • Long-term opioid prescriptions without monitoring
  • Traditional heroin maintenance therapy
  • Prescribed daily use of low-potency opioids (Methadone) (correct)
  • What is a significant risk associated with the black-market use of Fentanyl?

  • It is frequently found in relatively low doses
  • It is less potent than traditional opioids
  • It is often mixed with safer pharmaceuticals
  • It can be 100 times more potent than heroin (correct)
  • What is the main purpose of Abuse-deterrent formulations (ADF's) in treating opioid overdoses?

    <p>To act as a narcotic antagonist reversing opioid effects (C)</p> Signup and view all the answers

    What treatment strategy involves the prescribed daily use of low-potency opioids?

    <p>Substitution treatment (A)</p> Signup and view all the answers

    Which of the following is NOT a common withdrawal symptom in substance use disorders?

    <p>Euphoria (B)</p> Signup and view all the answers

    What recent development has been approved by the FDA for treating opioid overdoses?

    <p>Over-the-counter availability of Narcan nasal spray (D)</p> Signup and view all the answers

    What are the primary focuses of rehabilitation strategies for substance use disorders?

    <p>Coping strategies, cue avoidance, and relapse prevention (C)</p> Signup and view all the answers

    What is the primary focus of the Medical (Disease) View in understanding addiction?

    <p>Addictive substances hijack brain functions, requiring treatment to restore normalcy. (A)</p> Signup and view all the answers

    Which of the following describes substance abuse based on sociocultural norms?

    <p>Substance abuse occurs when drug use leads to personal and social problems outside of accepted norms. (A)</p> Signup and view all the answers

    What is indicated by the term 'withdrawal' in the context of Substance Use Disorders?

    <p>Signs and symptoms that arise opposite to those experienced during substance ingestion. (B)</p> Signup and view all the answers

    Which criterion is NOT included in the DSM-5-TR for Substance Use Disorders?

    <p>Socially acceptable use of substances during festivals. (C)</p> Signup and view all the answers

    Which of the following accurately describes dependence on substances?

    <p>Habitual abuse of substances leading to significant cravings and tolerance development. (D)</p> Signup and view all the answers

    What is one of the major social costs associated with alcohol use disorder?

    <p>Higher rates of absenteeism at work (C)</p> Signup and view all the answers

    Which serious health risk is NOT associated with chronic heavy alcohol use?

    <p>Increased fertility (C)</p> Signup and view all the answers

    What is a common effect of Fetal Alcohol Spectrum Disorders on children?

    <p>Craniofacial deformities (C)</p> Signup and view all the answers

    What is a key question in the CAGE Questionnaire for screening alcohol use problems?

    <p>Do you feel guilty about your drinking? (C)</p> Signup and view all the answers

    What substance is primarily responsible for over 90 daily overdose deaths in the U.S.?

    <p>Opioids (B)</p> Signup and view all the answers

    Which of the following is NOT a medical use for opiates?

    <p>Weight loss (A)</p> Signup and view all the answers

    Which of the following conditions is a serious risk associated with fetal alcohol exposure during pregnancy?

    <p>Learning disabilities (C)</p> Signup and view all the answers

    What common misconception about vaping nicotine is mentioned?

    <p>Statistics on its use are unreliable (D)</p> Signup and view all the answers

    What is one of the risks of using opiates improperly?

    <p>Opioid overdose (A)</p> Signup and view all the answers

    What is one of the core principles emphasized in Alcoholics Anonymous (AA) as part of its recovery process?

    <p>Acknowledgment of a higher power for support (C)</p> Signup and view all the answers

    Which of the following is NOT a 12-Step program based on Alcoholics Anonymous?

    <p>Heroin Anonymous (A)</p> Signup and view all the answers

    Which statement is true regarding the effectiveness of Alcoholics Anonymous compared to other treatments for ETOH dependency?

    <p>Studies suggest AA participation results in higher abstinence rates. (C)</p> Signup and view all the answers

    What aspect of the 'Big Book' of AA stresses a significant part of the recovery process?

    <p>Making personal amends for past actions (A)</p> Signup and view all the answers

    What approach does the 12-Step Program primarily take regarding the nature of addiction?

    <p>Medical model combined with a moral view (C)</p> Signup and view all the answers

    What is a common characteristic of 12-Step programs that distinguishes them from other types of treatment?

    <p>Emphasis on group support and shared experiences. (B)</p> Signup and view all the answers

    Which of the following principles is a fundamental component of the 12-Step recovery approach?

    <p>Helping others achieve sobriety through sponsoring (D)</p> Signup and view all the answers

    Which of the following statements best reflects the significance of family involvement in recovery from substance use disorders?

    <p>Family members should be educated through support groups. (B)</p> Signup and view all the answers

    How is Abstinence viewed within the 12-Step Program structure?

    <p>As a daily commitment made one day at a time. (A)</p> Signup and view all the answers

    What is the primary focus of the 12-Step group's approach to recovery?

    <p>Fostering community and accountability. (A)</p> Signup and view all the answers

    Which of the following substances is classified under the category of other hallucinogens?

    <p>LSD (B)</p> Signup and view all the answers

    What is a common medical use for opioids?

    <p>Pain relief (B)</p> Signup and view all the answers

    Which statement about substances classified as stimulants is accurate?

    <p>They enhance mood and motivation by working on neurotransmitter systems. (D)</p> Signup and view all the answers

    Which substance is associated with an increase in dopamine levels?

    <p>Stimulants (A)</p> Signup and view all the answers

    What is the most significant reason for classifying phencyclidine (PCP) separately from other hallucinogens?

    <p>Its extreme cardiovascular and neurological toxicity. (D)</p> Signup and view all the answers

    Which of the following substances has been noted for its potential benefits in treating schizophrenia?

    <p>Nicotine (A)</p> Signup and view all the answers

    In what context is moderate consumption of red wine potentially cardio-protective?

    <p>Under a physician’s guidance. (A)</p> Signup and view all the answers

    Cannabis has emerged for use in treating which of the following disorders?

    <p>Seizure disorders (B)</p> Signup and view all the answers

    Which of these substances is NOT noted for its medical applications?

    <p>Heroin (D)</p> Signup and view all the answers

    What type of substance are barbiturates classified as?

    <p>Sedatives, Hypnotics, and Anxiolytics (A)</p> Signup and view all the answers

    Flashcards

    Fentanyl potency

    Black market Fentanyl is 100 times more potent than heroin and is often mixed into other drugs.

    Opioid overdose rate

    In the US, an opioid overdose occurs every 12 minutes.

    Opioid treatment, substitution

    Prescribed daily use of low-potency opioids (like Methadone) or abuse-deterrent formulations (e.g., Suboxone) to manage opioid use disorder.

    Suboxone's effect

    The use of Suboxone (Buprenorphene + naloxone) reduces opioid use disorder mortality by 50%.

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    Narcan availability

    Narcan (naloxone) nasal spray is now available over the counter to treat opioid overdoses.

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    Opioid treatment, acute management

    Inpatient detox treatment for opioid addiction involves managing withdrawal symptoms with similar medications and providing group/family therapy.

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    Substance use disorder rehabilitation

    Outpatient substance use disorder treatment focuses on coping strategies, reducing triggers, and relapse prevention in patients with addiction.

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    Co-occurring conditions in SUD

    Many patients with substance use disorders also have other mental health conditions such as depression or anxiety.

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    Alcohol-related fatalities

    Half of all traffic fatalities and one-third of all traffic injuries are due to alcohol consumption.

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    Consequences of ETOH

    Significant social costs including accidents, violence, poor performance at work and school, and personal damage due to disease and premature death.

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    Fetal Alcohol Spectrum Disorder (FASD)

    A condition associated with heavy alcohol consumption during pregnancy, causing various issues in children.

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    FASD effects

    Problems like craniofacial deformities, physical and mental retardation, learning disabilities, and behavioral disorders.

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    Opioid Crisis

    A serious public health issue in the U.S., involving high rates of overdose deaths due to prescription pain relievers, heroin, and illicit fentanyl.

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    Opioids/Narcotics

    Derivatives of morphine used medically but also leading to a severe crisis due to overdose risk, especially from illicit forms.

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    Single-Question Screening

    A quick screening tool to estimate the risk of alcohol use disorder, using a specific question about alcohol consumption.

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    CAGE Questionnaire

    Another screening tool developed to assess individual's risk for alcohol use disorder with various questions.

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    Cannabis Shift

    A possible change in young adults' substance choices, where cannabis use may replace alcohol and cigarettes.

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    unreliable vaped nicotine statistics

    Data on vaped nicotine use is not accurate/reliable enough for proper analysis.

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    Substance Use Norms

    Every culture has rules about using substances that dictate what, when, who, how much, and what reactions are acceptable.

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    Use vs. Abuse

    Use means taking a substance within cultural norms (e.g., ceremonial wine), while abuse means taking it outside those norms, causing problems.

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    Intoxication

    A temporary state caused by taking a substance, usually reversible.

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    Withdrawal

    Signs and symptoms that occur when a body stops using a substance, often opposite to the effects of the substance.

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    Substance Use Disorder

    A range of problems caused by substance abuse, including intoxication, withdrawal, abuse, and dependence.

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    12-Step Program

    A self-help program focusing on abstinence and a spiritual approach to overcoming addiction. It involves a series of 12 steps and relies on peer support and shared experiences.

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    Alcoholics Anonymous (AA)

    The first 12-step program for alcoholism, founded in 1935. It offers support and guidance for recovering alcoholics based on shared experiences and a commitment to abstinence.

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    Big Book of AA

    The primary text of Alcoholics Anonymous, containing the 12 Steps and the program's core teachings. It emphasizes personal responsibility, spiritual growth, and a commitment to lasting sobriety.

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    Enabling

    Unintentionally supporting or facilitating someone's addictive behavior without realizing it. This can include providing financial assistance, covering up their substance use, or making excuses for their actions.

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    Co-dependency

    An unhealthy relationship pattern characterized by excessive reliance on another person, often due to an addictive behavior. It can involve excessive caretaking, emotional dependence, and a sense of self-worth tied to the other person's actions.

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    Why is AA based on a "Moral View" of recovery?

    AA views addiction as a moral failing, requiring a change in mindset and a commitment to living a more ethical life. This emphasizes personal responsibility and spiritual growth as crucial elements of recovery.

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    What are the main principles of AA?

    The 12 Steps of AA emphasize personal responsibility, acknowledging powerlessness, seeking a higher power, abstaining from alcohol, making amends for past actions, and helping others achieve sobriety.

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    What are other 12-step programs?

    Many groups are based on the AA model, including Cocaine Anonymous, Crystal Meth Anonymous, Marijuana Anonymous, Nicotine Anonymous, and Narcotics Anonymous.

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    How does AA affect abstinence rates?

    Studies suggest that participation in AA leads to higher rates of abstinence compared to other types of alcohol treatment, demonstrating its effectiveness in supporting recovery.

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    What are the main neurotransmitter systems affected by substances of abuse?

    Substances of abuse typically target neurotransmitter systems linked to mood and motivation, affecting how we feel and what we are driven to do. This explains why many of these substances are addictive and can lead to cravings.

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    How do some substances of abuse evolve in nature?

    Some substances, like opioids, are a result of plants evolving to exploit animals by providing pain relief and rewards, leading to dependency. This shows how nature can create substances with addictive properties.

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    What are some beneficial effects of substances of abuse?

    Many substances of abuse have beneficial effects, often used as medicines for various conditions. This highlights the complex relationship between substances and their potential for both good and bad.

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    How is alcohol beneficial?

    Alcohol is a potent anti-anxiety agent, and moderate red wine consumption under medical guidance may have cardio-protective benefits. This demonstrates that even substances of abuse can have positive effects in moderation.

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    How is nicotine beneficial?

    Nicotine is a stimulant that can lead to weight loss and may have positive effects in treating conditions like schizophrenia and Parkinson's disease. This challenges the common perception of nicotine solely as a harmful substance.

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    What are the benefits of cannabis?

    Cannabis is showing promise in treating intractable seizure disorders, demonstrating its potential as a therapeutic agent for certain medical conditions.

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    What is phencyclidine's danger?

    Phencyclidine (PCP) carries extreme cardiovascular and neurological toxicity, making it a particularly dangerous substance among hallucinogens.

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    How does ketamine differ from PCP?

    Ketamine is chemically related to PCP but is much weaker and less toxic, making it a safer option in medical settings.

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    What are the safety profiles of 'Other Hallucinogens'?

    'Other Hallucinogens', excluding PCP, have generally more favorable safety profiles, suggesting a need for careful consideration of specific substances within this category.

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    What are the characteristics of stimulant substances?

    Stimulants like amphetamines, cocaine, and MDMA act on the nervous system, leading to increased energy, alertness, and euphoria, often contributing to their abuse potential.

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    Study Notes

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    • They may be downloaded for personal student use only
    • Students currently registered in UCSB Psych 183 are permitted this access
    • Commercial reproduction, redistribution, or unauthorized use is strictly forbidden
    • Violates UC regulations and DMCA

    Course Materials Restrictions

    • All course materials (lectures, discussions, handouts, examinations, web materials) are protected by US Federal Copyright Law and the California Civil Code
    • Students are allowed to take notes for personal, educational use
    • Students are prohibited from completing study guides and selling them, and any such action is a violation
    • The reproduction of lectures or discussions, and distribution or sale of lecture notes is forbidden without explicit written permission from the instructor
    • Addiction is characterized by uncontrolled, compulsive substance use despite ongoing negative consequences to health, mental state, or social life
    • Moral view: Addicts are morally weak, self-destructive, uncaring of their actions, and need to improve behavior
    • Medical (Disease) view: Addiction may be rooted in genetic predisposition and/or social learning. Addicts' brains experience a biological "hijacking" by addictive substances.

    Substance Use Norms

    • Every culture has norms surrounding substance use that dictate what substances are used, when, how, by whom, and in what amounts
    • "Use" describes ingestion within sociocultural guidelines
    • Examples include using peyote in Native American rituals, ceremonial wine or beer consumption in particular traditions
    • "Abuse" describes using substances outside of these norms, and typically results in personal and social problems

    Substance Use Disorders: Spectrum of Severity

    • Intoxication: The ingestion of a substance leading to impairment, typically temporary and reversible. With the withdrawal, it shows opposing symptoms relative to initial intoxication.
    • Abuse: A pattern of harmful use, characterized by regular periods of intoxication, and occasionally withdrawal
    • Dependence: Habitual abuse and significant cravings and tolerance (requiring increasingly larger amounts to obtain desired effects)
    • The DSM-5-TR classifies substance use disorders into graduated severity levels, and for each of the ten types

    Ten Classes of Substance Use Disorders

    • Alcohol (ETOH)
    • Caffeine
    • Cannabis
    • Phencyclidine-related hallucinogens (PCP, ketamine)
    • Other hallucinogens (LSD, psilocybin, salvia, ayahuasca, DMT, dextromethorphan)
    • Opioids (morphine, heroin, codeine, hydrocodone, oxycodone, fentanyl)
    • Sedatives, hypnotics, anxiolytics (barbiturates, benzodiazepines)
    • Stimulants (amphetamine, Ritalin, cocaine, MDMA)
    • Tobacco
    • Inhalants (nitrous oxide, glue, solvents, aerosols, cleaning fluids)

    What Substances Are Likely to Be Abused?

    • Many abused substances have beneficial uses in medicine, for example heroin, opioids used for pain relief, and antidiarrheal agents, cocaine as a local anesthetic, or alcohol as a relaxant or anxiety reducer among others.
    • These substances affect the neurotransmitter systems in the brain, impacting mood and motivation.

    Non-Substance "Behavioral Addictions"

    • Historically, addiction was associated solely with substances
    • More recently, some argue for including behaviors like sex, exercise, eating, gambling, shopping, pornography, and the internet among the categories of addictions
    • Gambling Disorder is classified as a Non-Substance-Related Disorder in DSM-5-TR due to the addictive pattern in this behavior.
    • Other behavioral addictions are excluded because of a lack of data

    DSM-5-TR Substance Use Disorder Criteria

    • Maladaptive pattern of substance use, leading to significant impairment and distress
    • Presence of 2 or more symptoms within a 12-month period
    • Taking more and/or longer than intended
    • Desire to cut down or cease use but unable to succeed
    • Excessive time spent acquiring, using, or recovering from substance use
    • Inability to meet responsibilities at work, home, or school due to substance use
    • Persistence in use despite ongoing interpersonal issues
    • Abandoning significant social or recreational activities due to substance use
    • Repeated use despite arising danger
    • Continuing use despite physical illnesses or exacerbated psychological issues
    • Tolerance buildup (increased amounts required to feel the effect)
    • Emergence of withdrawal symptoms

    Cannabis Use Disorder

    • Withdrawal symptoms include fatigue, yawning, problems concentrating, appetite loss, insomnia
    • Cannabis use disorder involves separate diagnostics for intoxication, withdrawal, abuse, and dependence.
    • It's connected with other substance use disorders and is associated, in adolescents, with anxiety disorders, Major Depression, PTSD, Conduct Disorder, and ADHD.
    • It's also associated with chronic respiratory disorders (e.g., asthma, COPD, pneumonia), and a three-fold increase in psychosis.

    Not Your Parents' Marijuana

    • The potency (THC content) of seized marijuana has significantly increased since the 1990s.

    Cannabidiol - The Good

    • CBD cuts seizure severity and frequency
    • CBD is used as a medical cannabis for severe epilepsy
    • CBD has potential for treating pain and reducing opioid use
    • Studies show CBD benefits for cancer care, AIDS care, and type 2 diabetes

    Alcohol (ETOH) Use Disorder

    • Diagnoses of alcohol intoxication, withdrawal, abuse, and dependence

    What is Alcohol?

    • Ethanol is a volatile, clear, flammable liquid created via sugar fermentation.
    • It's a temporary central nervous system depressant, affecting GABA (inhibitory neurotransmitter) and glutamate (excitatory neurotransmitter) receptors in the brain.
    • ETOH is a potential neurotoxin that can cause gray matter loss, affecting memory and coordination, and mostly reversible with moderate use.

    Alcohol Use in the U.S.

    • ETOH is consumed by 80% of the population, primarily through beer, wine, and spirits

    Alcohol Effects - Dependent on BAC%

    • .03-.06: Sense of well-being, reduced anxiety, social lubrication
    • .06-.10: Incoordination, irritability, impaired reaction time
    • .11-.20: Slurred speech, ataxia, impaired judgment
    • .21-.29: Blackouts, amnesia, unsteady gait, nausea
    • .30: Coma, respiratory/cardiac depression, possible death

    Alcohol Withdrawal Syndrome from Severe Dependence

    • "Shakes" (within 12-18 hours after drinking)
    • Nausea and vomiting
    • Alcoholic seizures ("rum fits")
    • Alcoholic hallucinosis (vivid auditory hallucinations)
    • Delirium tremens ("the DT's") (confusion, disorientation, agitation, frightening visual hallucinations)

    Who Develops Alcohol Use Disorder (I, II, and III)

    • Age: Younger drinking onset; higher risk for dependency
    • Sex: Males at higher risk for developing ETOH disorders but females have potentially negative health consequences sooner
    • Level of response to alcohol (LR): People who require higher alcohol intake for effects tend to be more prone to ETOH Use Disorders.
    • Family History: Children of ETOH-dependent individuals are at heightened risk; this holds true even if raised by non-dependent adoptive parents
    • Ethnicity: Ethnic groups exhibit varying susceptibility; Asians show lower rates due to genetic factors.
    • Personality
    • Social
    • Education - College students drink more, with Greek Letter Organizations being more prone to drinking-related issues
    • Personality: Impulsiveness; sensation-seeking traits; Unstable personality disorders

    Consequences of Alcohol Use Disorder

    • Driving fatalities
    • Injuries
    • Social problems: Criminal behaviors, domestic violence, family strife
    • Impairments in work and school function
    • Increased risks of diseases: gastric irritation, bleeding, cancer (breast, oral, intestinal tract, liver, testicular, pancreatic), peripheral neuropathy, and dementia.

    Fetal Alcohol Spectrum Disorders

    • Associated with heavy prenatal drinking
    • Affects children: Craniofacial deformities, physical/mental retardation, learning disabilities, behavioral problems (ADHD), Skeletal anomalies (hand and finger malformations)

    Screening for Alcohol Use Disorder

    • Single-question screening, CAGE Questionnaire

    The Opioid Crisis

    • Extensive drug use of Opioids, especially fentanyl, causing many deaths; highly potent and causes rapid overdose
    • Increased mortality rates, and high costs for society
    • Treatment is limited
    • FDA approved Over the Counter Narcan nasal spray

    National Drug-Involved Overdose Deaths

    • Different substances, and various groups experiencing increasing deaths

    The U.S.'s Opioid (Narcotic) Crisis

    • Opiates (derivatives of morphine from Opium Poppy) are used to create controlled substances, with wide ranging misuse
    • Prescription and illicit opiates are high, and contribute to overdose deaths.
    • Primarily affects middle-class, young adults

    America's Opioid Crisis: Fentanyl

    • Black-market fentanyl is much more potent than heroin.
    • New fentanyl and nitrazone synthetics are vastly more potent, and extremely prevalent in current drug trade

    Current Strategies in Treatment of Opioid Use Disorders

    • Better physician training on opioid use
    • Prescription of low-potency opioids, e.g. Methadon, or other abuse deterrent formulations like Suboxone
    • Training and resources for rapid response teams to treat overdoses
    • Promoting availability of Narcan over-the-counter
    • Research on psychedelic treatment and new non-addictive analgesics

    General Treatment of Substance Use Disorders

    • Various treatments and strategies for different substance use disorders

    Stages of Substance Use Disorder Treatment

    • Acute management (inpatient detox): Treatment of acute withdrawal symptoms
    • Rehabilitation (outpatient): Group and family therapy, and addressing co-morbid conditions. Addressing denial by the patient
    • Referring to additional therapies and support groups

    Treatments for Common Substance-Use Disorders Show Low Rates of Abstention

    • High relapse rates are displayed for all substances in the graphic.

    AA and 12-Step Groups

    • Based on a medical model (disease model), and moral view
    • 12-step programs emphasize a frank admission of the problem, powerlessness, and seeking a higher power, vows of abstinence, making amends, and helping others.
    • Studies show potential improvements in sustained abstinence rates in individuals participating in AA.
    • Mainstay of treatments include 12-step programs
    • Willingness to treat co-morbid mental disorders
    • Increase of emphasis on early detection, education, and community prevention programs
    • Increased use of pharmaceutical treatments, including antagonists, substitutes, and abuse-deterrent formulations

    Addiction and Crime

    • A cycle shows links between addiction and criminal behavior.

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    Explore key concepts in substance-related and addictive disorders with this quiz from UCSB Psych 183. Test your understanding of addiction characteristics, legal limitations on course materials, and ethical considerations in academic settings. Ideal for students wishing to reinforce their knowledge in psychology.

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