Podcast
Questions and Answers
Which of the following best describes the progression of psychological effects experienced by individuals using anabolic steroids?
Which of the following best describes the progression of psychological effects experienced by individuals using anabolic steroids?
- Immediate onset of psychosis, followed by a gradual decline into anergy and dysphoria.
- A consistent state of euphoria and enhanced cognitive function throughout the period of use.
- Initial sense of well-being, followed by anergy, dysphoria, irritability, and, in some cases, psychosis. (correct)
- Initial dysphoria evolving into feelings of well-being and eventual psychosis.
What is the physiological mechanism behind the subjective experience of nitrate inhalants?
What is the physiological mechanism behind the subjective experience of nitrate inhalants?
- Blockage of dopamine reuptake in the brain's reward centers.
- Increased adrenaline production.
- Stimulation of the central nervous system through increased glucose metabolism.
- Dilation of cerebral blood vessels and relaxation of smooth muscles, coupled with altered time perception. (correct)
A patient presents with light-headedness, a floating sensation, and temporary confusion. Which substance intoxication is most likely?
A patient presents with light-headedness, a floating sensation, and temporary confusion. Which substance intoxication is most likely?
- Nitrous oxide (correct)
- Nitrate inhalants
- Alcohol
- Anabolic steroids
Which of the following is the most crucial element for the long-term success of continuation treatment or rehabilitation for substance use disorders?
Which of the following is the most crucial element for the long-term success of continuation treatment or rehabilitation for substance use disorders?
What is the primary goal of incorporating social skills training into the clinical management of substance-related disorders?
What is the primary goal of incorporating social skills training into the clinical management of substance-related disorders?
In the context of contingency management for substance use disorders, what constitutes a typical form of positive reinforcement?
In the context of contingency management for substance use disorders, what constitutes a typical form of positive reinforcement?
What is the rationale behind using methadone or buprenorphine in the treatment of substance use disorders?
What is the rationale behind using methadone or buprenorphine in the treatment of substance use disorders?
What is the key feature of self-help groups (e.g., AA, NA) that makes them an integral part of a comprehensive treatment approach for substance use disorders?
What is the key feature of self-help groups (e.g., AA, NA) that makes them an integral part of a comprehensive treatment approach for substance use disorders?
Which statement accurately reflects the criteria for diagnosing gambling disorder?
Which statement accurately reflects the criteria for diagnosing gambling disorder?
How does gambling behavior relate to the brain's reward circuitry?
How does gambling behavior relate to the brain's reward circuitry?
Which of the following pharmacological treatments is specifically indicated to reduce gambling urges?
Which of the following pharmacological treatments is specifically indicated to reduce gambling urges?
A patient consistently returns to gamble after losing money, a behavior described as 'chasing' losses. What underlying emotion is most commonly associated with this behavior?
A patient consistently returns to gamble after losing money, a behavior described as 'chasing' losses. What underlying emotion is most commonly associated with this behavior?
What distinguishes gambling disorder from a manic episode in the context of diagnostic criteria?
What distinguishes gambling disorder from a manic episode in the context of diagnostic criteria?
Which of the following scenarios best illustrates the 'lying to conceal the extent of involvement with gambling' criterion for gambling disorder?
Which of the following scenarios best illustrates the 'lying to conceal the extent of involvement with gambling' criterion for gambling disorder?
What aspect of nitrate inhalant use poses the most immediate and severe health risk?
What aspect of nitrate inhalant use poses the most immediate and severe health risk?
What is the primary function of Cognitive Behavioral Therapy (CBT) in treating gambling disorder?
What is the primary function of Cognitive Behavioral Therapy (CBT) in treating gambling disorder?
Why is hospitalization sometimes necessary during the detoxification phase of substance use disorder treatment?
Why is hospitalization sometimes necessary during the detoxification phase of substance use disorder treatment?
How does motivational interviewing contribute to the management of gambling disorder?
How does motivational interviewing contribute to the management of gambling disorder?
Which factor most significantly differentiates the experience of gambling disorder in women compared to men?
Which factor most significantly differentiates the experience of gambling disorder in women compared to men?
What is the significance of identifying psychiatric comorbidities, such as depression or anxiety, in individuals undergoing treatment for substance use disorders?
What is the significance of identifying psychiatric comorbidities, such as depression or anxiety, in individuals undergoing treatment for substance use disorders?
Flashcards
Effects of Anabolic Steroids
Effects of Anabolic Steroids
Anabolic steroids can initially produce a sense of well-being but later lead to anergy, dysphoria, and irritability. Some individuals may even develop psychosis.
Effects of Nitrate Inhalants
Effects of Nitrate Inhalants
Nitrate inhalants can cause a feeling of fullness in the head, mild euphoria, changes in time perception, relaxation of smooth muscles, and increased sexual feelings.
Effects of Nitrous Oxide
Effects of Nitrous Oxide
Nitrous oxide intoxication causes light-headedness and a floating sensation. Chronic use can lead to temporary confusion or paranoia.
Two phases of treatment for substance use disorder
Two phases of treatment for substance use disorder
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Contingency Management
Contingency Management
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Gambling Disorder
Gambling Disorder
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Criteria for Gambling Disorder
Criteria for Gambling Disorder
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More Criteria for Gambling Disorder
More Criteria for Gambling Disorder
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Brain Impact of Gambling,
Brain Impact of Gambling,
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Treatments for Gambling Disorder
Treatments for Gambling Disorder
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Study Notes
- Anabolic steroids, nitrate inhalants, and nitrous oxide are substance-related disorders
- Gambling disorders are non-substance-related disorders
Anabolic Steroids
- Initially, anabolic steroids produce a sense of well-being
- Later, anabolic steroid use leads to anergy, dysphoria, and irritability
- Psychosis may occur with anabolic steroid use
- Athletes widely abuse anabolic steroids
Nitrate Inhalants ("Poppers")
- Intoxication from nitrate inhalants causes a feeling of fullness in the head and mild euphoria
- Intoxication from nitrate inhalants also alters time perception, relaxes smooth muscles, and increases sexual feelings
- Possible risks include immune system impairment and respiratory system irritation
- Toxic reactions include vomiting, severe headaches, and hypotension
Nitrous Oxide ("Laughing Gas")
- Nitrous oxide intoxication causes light-headedness and a floating sensation
- Temporary confusion or paranoia may develop when nitrous oxide is used chronically
Clinical Management of Substance-Related Disorders
- Treatment includes detoxification and continuation/rehabilitation
- Detoxification tends to be easier with drugs that do not have a specific withdrawal syndrome
- Hospitalization is necessary for some detoxifying patients
- Slow drug tapers are monitored under medical supervision during detoxification
- Medical conditions and psychiatric comorbidities must be addressed
- Continuation treatment focuses on rehabilitation and preventing future drug use
- Patient motivation is critical for continuation treatment
Clinical Management
- Individual psychotherapy helps patients learn their motivation and develop coping skills
- Group therapy is helpful in confronting patients about the seriousness of their addiction
- CBT (cognitive behavioral therapy) corrects cognitive distortions
- Social skills training helps patients meet more appropriate peers
- Family therapy and marital counseling can be components of treatment
Further Clinical Management Strategies
- Contingency management uses behavior therapy where patients are reinforced for appropriate behavior, such as vouchers for clean urine samples
- Medical approaches include methadone maintenance and buprenorphine, which are carefully monitored substitute addictions allowing the patient to function in society
- Self-help groups are an integral part of comprehensive treatment and utilizing the 12-step model and involving the support of others with the same issues, like Narcotics Anonymous, Cocaine Anonymous, and Alcoholics Anonymous
Gambling Disorder
- Gambling disorder presents as a persistent and recurrent gambling behavior
- Four or more specific criteria must be met during a 12-month period for diagnosis
- Gambling behavior is not better explained by a manic episode
- The need to gamble with increasing amounts of money in order to achieve the desired excitement
- Restlessness or irritability when attempting to cut down or stop gambling
- Repeated unsuccessful efforts to control, cut back, or stop gambling
- Preoccupation with gambling, such as reliving past gambling experiences or planning future gambling ventures
Characteristics of Gambling Disorder
- Gambling often occurs when feeling distressed, helpless, guilty, anxious, or depressed
- Returning to gamble another day to get even after losing money, also known as "chasing" one’s losses
- Lying to conceal the extent of involvement with gambling
- Jeopardizing or losing a significant relationship, job, or educational or career opportunity because of gambling
- Relying on others to provide money to relieve desperate financial situations caused by gambling
- Roughly two-thirds of those with gambling disorder are male
- Women develop a gambling disorder more quickly
- Gambling disorder tends to run in families
- A genetic link to gambling disorder is seen with Substance Use Disorders and Antisocial Personality Disorder
- Brain imaging shows gambling activates the brain's "reward" circuitry
Gambling Disorder Treatments
- Treatment may include naltrexone and nalmefene that reduce gambling urges
- SSRIs might be helpful, particularly in anxious and depressed patients
- Gamblers Anonymous is a valuable resource
- Cognitive behavioral therapy addresses irrational thoughts and beliefs
- Motivational interviewing is helpful
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