Substance Use and Public Health Quiz

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Questions and Answers

What percentage of deaths in people aged 35 and older is attributed to smoking?

  • 20%
  • 25%
  • 17% (correct)
  • 10%

Which of the following is the largest cost associated with illegal drug use in the UK?

  • Cost to society due to illegal drug use (correct)
  • Cost to social care
  • Legal costs for prosecuting drug offences
  • Cost of drug treatment and prevention

According to the DSM-5 criteria, what indicates a severe substance use disorder?

  • Excessive time spent using the drug
  • Six or more criteria met (correct)
  • Unsuccessful efforts to cut down or quit
  • Use for longer periods than intended

Which symptom is observed on Day 4 of alcohol withdrawal?

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

What is a common reason cited for drug and alcohol use?

<p>Boredom or lack of activities (C)</p> Signup and view all the answers

What is the estimated percentage of people who used drugs in 2022 according to the United Nations World Drug Report?

<p>20% (A)</p> Signup and view all the answers

Which drug received the highest overall harm score according to scientific research?

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

Which of the following drugs is ranked as the least harmful according to public perception?

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

How much does alcohol-related crime cost society in the UK?

<p>£11 billion (D)</p> Signup and view all the answers

In terms of harmfulness ranking, which substance is considered less harmful than alcohol according to scientific scores?

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

Which of the following is NOT a factor associated with the treatment of addiction?

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

What is the total estimated cost of alcohol to society in the UK?

<p>£21 billion (A)</p> Signup and view all the answers

According to the prevalence data, how many people reported trying cocaine?

<p>15 (A)</p> Signup and view all the answers

Which of the following can be a reason people use drugs as a coping mechanism?

<p>To escape from reality (B), To relax and have fun (C)</p> Signup and view all the answers

What is a major psychological factor contributing to drug addiction?

<p>Cultural norms (C), Excitement-seeking (D)</p> Signup and view all the answers

What can increase a person's tolerance to drugs?

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

How does peer pressure relate to drug use?

<p>It can normalize drug usage. (B)</p> Signup and view all the answers

Which factor is commonly associated with the development of drug dependence?

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

What role do mental health issues play in drug addiction?

<p>They can exacerbate addiction risk. (B)</p> Signup and view all the answers

Which of the following is NOT a commonly cited reason for drug use?

<p>To enhance creativity (D)</p> Signup and view all the answers

How does the concept of 'chasing a high' relate to addiction?

<p>It can result in over-dependence on substances. (C)</p> Signup and view all the answers

What is the concordance rate of alcoholism in identical twins?

<p>54% (A)</p> Signup and view all the answers

How much higher is the risk of alcoholism for adoptee children when their natural parents had an alcohol problem?

<p>4 times higher (C)</p> Signup and view all the answers

What does the ALDH2 gene code for?

<p>Aldehyde dehydrogenase (C)</p> Signup and view all the answers

What impact do more than 4 adverse childhood experiences (ACEs) have on the risk of drug use?

<p>Increase use by 5 times (D)</p> Signup and view all the answers

What is a likely consequence of reduced striatal D2 receptor density in addiction?

<p>Decreased motivation for rewards (B)</p> Signup and view all the answers

Which factor is primarily linked to the development of drug addiction in relation to childhood?

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

What can be concluded about the interaction of genetics and the environment in addiction risk?

<p>Genetic predispositions can be influenced by environmental factors (B)</p> Signup and view all the answers

Which statement about early adversity and its impacts is correct?

<p>It leads to risky behavior and reduces opportunities (C)</p> Signup and view all the answers

What impact did social housing have on the cocaine use of subordinate monkeys?

<p>They used significantly higher amounts of cocaine. (A)</p> Signup and view all the answers

What was observed regarding D2 receptor density in monkeys under different social housing conditions?

<p>D2 receptor density changed in dominant monkeys but not in subordinate monkeys. (B)</p> Signup and view all the answers

Which factor seems to predict the response to stimulant drugs according to the research?

<p>D2 receptor levels. (C)</p> Signup and view all the answers

In the study involving crack cocaine users, what choice did small rewards lead them to make?

<p>They preferred pharmaceutical grade crack for immediate satisfaction. (B)</p> Signup and view all the answers

What was a significant outcome for U.S. soldiers after returning from Vietnam in terms of heroin addiction?

<p>Their addiction levels dropped back to pre-deployment levels. (A)</p> Signup and view all the answers

What conclusion can be drawn from the comparison of drug use in individually housed and socially housed monkeys?

<p>Socially housed subordinate monkeys increased their cocaine intake significantly. (A)</p> Signup and view all the answers

How did the social environment interact with D2 receptor changes in monkeys?

<p>It only influenced dominant monkeys. (C)</p> Signup and view all the answers

What did research findings indicate about morphine consumption in caged versus socialized rats?

<p>Socialized rats showed higher morphine consumption. (B)</p> Signup and view all the answers

What is the primary focus of the decisional balance tool in client therapy?

<p>Resolving clients' ambivalence about change (B)</p> Signup and view all the answers

Which statement best aligns with the concept that human connection is crucial in overcoming addiction?

<p>The opposite of addiction is human connection. (C)</p> Signup and view all the answers

What is a critical aspect of Cognitive Behavioural Therapy in managing addiction?

<p>Learning coping strategies for cravings (C)</p> Signup and view all the answers

Which of the following is not a step in the Twelve Steps program?

<p>Promised to never relapse again (C)</p> Signup and view all the answers

What is the main goal of strengthening clients' importance to change?

<p>To align with their values and goals (B)</p> Signup and view all the answers

What was a significant finding from the Project MATCH study on alcoholism treatments?

<p>The results of the study were disappointing. (B)</p> Signup and view all the answers

Which approach should a therapist take regarding a client's resistance to change?

<p>Reframe it as a constructive conversation (B)</p> Signup and view all the answers

What does the phrase 'not why the addiction, but why the pain' suggest about addiction treatment?

<p>Understanding the underlying pain is essential for treatment. (C)</p> Signup and view all the answers

Flashcards

What is addiction?

A state characterized by compulsive drug seeking and use, despite negative consequences.

What are the most used drugs in the UK?

The prevalence of different drug use in the UK, showing the number of past-year users in millions.

How does public perception of drug harm compare to scientific evidence?

The perception of harm caused by drugs by the public vs. scientific evidence, illustrating a mismatch in understanding.

What is the difference between public perception and scientific evidence regarding drug harm?

A comparison of the perceived and scientific harm scores of various drugs. It demonstrates the difference between public opinion and expert assessment.

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Why is alcohol considered the most harmful drug according to scientific evidence?

Alcohol's high harm score is due to its impact on individuals and society, including health issues, crime, and economic losses.

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What are the societal costs of alcohol use?

The detrimental effects of alcohol use on society, including costs related to crime, lost productivity, and healthcare burdens.

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What is the significance of smoking in England?

A substantial problem in England, with smoking being a leading cause of preventable health issues and premature deaths.

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What is the United Nations World Drug Report?

A comprehensive report published by the United Nations, detailing the global prevalence of drug use, highlighting a significant increase in users over the past decade.

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What is the societal cost of smoking in England?

The cost to society of smoking in England is significant, with direct costs to the NHS, social care and lost productivity.

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What are the symptoms of alcohol withdrawal?

Withdrawal symptoms are a common experience when someone stops using alcohol, and they can be varied and intense, with the most severe usually occurring during the first few days.

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What are the reasons behind drug and alcohol use?

There are many reasons why people use drugs and alcohol, ranging from social pressure and curiosity to self-medication and coping mechanisms.

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What is the economic impact of drug use in the UK?

Illegal drug use in the UK has a significant economic impact, with the estimated cost significantly exceeding the amount spent on prevention and treatment.

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Dissociation

A feeling of detachment from reality, often used as a coping mechanism to deal with painful experiences.

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Chasing the high

The need to experience pleasure and satisfaction, often seeking immediate gratification without considering consequences.

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Peer Pressure

Social pressures or expectations that encourage individuals to engage in certain behaviors, often leading to conformity.

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Escapism

Using substances to escape from reality or cope with painful emotions, often due to underlying mental health issues.

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Relieve pain

A common reason for substance abuse, where individuals are seeking to alleviate or numb emotional distress.

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Dependence

The body's need for a substance to function normally, often due to repeated exposure.

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Tolerance

A state of needing increasingly larger amounts of a substance to achieve the same effect.

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Addiction

A mental and physical state characterized by a compulsive desire and inability to stop using a substance despite negative consequences.

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Genetic Risk of Alcoholism

The likelihood of developing alcoholism due to one's genetic makeup.

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Concordance in Identical Twins

Identical twins share 100% of their genes. If one twin has alcohol dependence, the other has a 54% chance of developing it as well.

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Concordance in Fraternal Twins

Fraternal twins share only 50% of their genes. If one twin has alcohol dependence, the other has a 28% chance of developing it as well.

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Adoptees and Alcoholism Risk

People with a family history of alcoholism are more likely to develop it even if adopted into a different family. They're four times more likely to develop alcoholism compared to those with adoptive parents without a history of alcohol dependence.

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Childhood Trauma and Addiction

Early childhood experiences, such as trauma, can significantly increase the risk of addiction later in life. This can be even stronger than the link between obesity and diabetes. Two thirds of addicts report some form of childhood abuse.

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Adverse Childhood Experiences (ACEs)

Adverse Childhood Experiences (ACEs) are traumatic events that occur during childhood, such as abuse, neglect, or witnessing violence. Having more than 4 ACEs dramatically increases the risk of alcohol and drug use disorder, as well as other physical and mental health issues.

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Social Environment and Addiction

The social environment plays a critical role in shaping addiction. It influences factors like availability of drugs and alcohol, and social learning through friends and family.

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Reduced Striatal D2 Receptor Density

Addiction is linked to a decrease in dopamine receptors in a part of the brain called the striatum. This makes pleasurable experiences less rewarding, leading to a craving for addictive substances.

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D2 receptor density and dominance

D2 receptors are involved in the brain's reward system and are more dense in dominant monkeys. This suggests that dominant animals may have an advantage in seeking and experiencing pleasurable rewards.

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Social stress and D2 receptors

Social stress can decrease D2 receptor density in subordinate monkeys, making them more susceptible to drug use.

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Cocaine use in dominant and subordinate monkeys

Dominant monkeys exposed to cocaine used it more, while subordinate monkeys, already stressed with low D2 receptors, used cocaine even more extensively.

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Rat Park and morphine use

Rats in a stimulating environment called Rat Park were less likely to use morphine as a reward compared to isolated rats, reinforcing the idea that environmental factors play a crucial role in addiction.

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Crack cocaine and immediate gratification

Crack cocaine users who were given small rewards were more likely to choose the immediate gratification of the drug, highlighting the powerful influence of immediate rewards.

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Environment and addiction

The environment plays a vital role in addiction. This is demonstrated by the rapid decrease in heroin addiction among US soldiers returning from Vietnam, emphasizing the impact of environmental factors on drug use.

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D2 receptor density and addiction risk

The density of D2 receptors influences an individual's susceptibility to addiction. Higher D2 receptor density can lead to greater reward sensitivity and a heightened risk of addictive behaviors.

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Social stress and addiction risk

Social stress can amplify the risk of addiction. Individuals experiencing social stress may be more vulnerable to developing addictive behaviors due to altered brain chemistry and coping mechanisms.

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Decisional Balance Tool

A technique that helps clients understand the pros and cons of making a change, weighing the benefits and drawbacks of their current behavior against potential alternatives.

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Reframing Resistance

A strategy for understanding and reframing clients' resistance to change. It involves recognizing and addressing the underlying concerns and motivations driving their resistance.

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Cognitive Behavioural Therapy (CBT)

A therapeutic approach that focuses on identifying, challenging, and modifying negative thoughts and behaviors that contribute to addictive patterns.

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Motivational Interviewing

A type of therapy that focuses on the client's current challenges and their ability to make changes by highlighting their internal resources and strengthening their self-efficacy.

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Strengthening Importance to Change

A process of understanding a client's values, beliefs, and goals, aligning the change process with their personal aspirations.

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Contingency Management

A method used in therapy to help clients understand the root causes of their addiction, going beyond the substance itself.

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Treatments for Building Connections

A group of therapies that aim to build healthy social connections and support systems, often used in addiction recovery.

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Transtheoretical Model

A model used to assess a client's readiness for change, recognizing different stages of commitment and motivation.

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Study Notes

Drugs and Alcohol

  • Topic: Drugs and Alcohol overview
  • Presented by: Professor Celia Morgan
  • University: University of Exeter

Learning Objectives

  • How significant is drug and alcohol use as a societal problem?
  • Understanding the concept of addiction
  • What factors contribute to addiction?
  • Current treatment approaches for addiction

Essential Tasks

  • Attend/Watch lecture
  • Read Into the Realms of Hungry Ghosts (Part 3, Chapters 11-16)

Optional Tasks

  • Readings from ELE (Electronic Learning Environment)
  • Self-study on the topic, including news articles

How big a problem is drug and alcohol use?

  • A significant problem in the UK, with high levels of alcohol consumption posing a risk to health.
  • 8% of the UK population smokes tobacco.
  • 10.8 million adults in England exhibit alcohol consumption behaviours raising health risks.
  • 1.6 million UK adults have some level of alcohol dependency.
  • Only 100,000 people access alcohol treatment.
  • Significant cost to society: £11 billion (alcohol-related crime), £7 billion (lost productivity due to unemployment & sickness) and £3.5 billion (NHS costs).
  • Cost of alcohol to society: £21 Billion in the UK.

Drug Use Statistics

  • 180 people reported using alcohol.
  • 67 people reported using cannabis.
  • 15 people reported using cocaine.
  • 12 people reported using MDMA.
  • 15 people reported using ketamine.
  • 13 people reported using magic mushrooms / psilocybin.
  • 88 people reported using tobacco.
  • 3 people reported using heroin.

Global Drug Use

  • The UN World Drug Report (2024) highlights almost 292 million people using drugs globally in 2022.
  • A 20% increase compared to figures from a decade earlier.

Ranking of Drug Harm

  • Rank of Drugs from most to least harmful according to a survey:
    • Heroin
    • Cocaine
    • Ketamine
    • MDMA
    • Magic Mushrooms / Psilocybin
    • Alcohol
    • Tobacco
    • Cannabis

What is Addiction?

  • A concept defined by the compulsion and continuous behaviour to consume a drug or substance even with negative consequences.
  • A state in which an organism engages in compulsive behavior, as once pleasurable behaviours become compulsive.
  • A lack of control over the intake of the offending substance.
  • Many 177 participants in a survey describe addiction as consuming, reliant, or escaping.

DSM-5 Criteria for Substance Use Disorders

  • Criteria include use in excessive amounts, unsuccessful attempts to quit, excessive time spent on the substance, intense desire, problems related to use and use even in physically hazardous settings.
  • Severity defined by the number of symptoms.

Common Symptoms During Alcohol Withdrawal

  • Includes hangover symptoms, night sweats, shaking, paranoia, relief, brain fog, cravings, and better sleep.

Illegal Drug Use Costs in the UK

  • Estimated costs to the UK of £11 billion per year due to opiates and crack users.
  • Only £30 million of this is allocated to treatment and prevention.
  • Additional £2.6 billion in legal costs for prosecuting drug offences.

What causes Addiction?

  • Many factors contributing to addiction include peer pressure, availability, genetic susceptibility, coping mechanisms, escaping, and mental health issues. (based on a 229 response survey)

Vulnerabilities

  • Biological and genetic factors are influential in addiction susceptibility
  • Environmental and social factors interact with biological factors and play a role.
  • The interaction between biological and environmental variables results in vulnerabilities.

Genetic Risk of Alcoholism

  • Identical twins show a high concordance rate (54%) for alcoholism compared to fraternal twins (28%) showing genetic factors play a role.
  • Environmental influences contribute too, even when identical twins are raised in differing environments.
  • A 4 times higher risk is seen in adopted children when biological parents had alcohol problems showing that biological factors contribute the onset of addiction.

ALDH Genes and Alcohol

  • ALDH2 gene codes for ALDH enzyme.
  • Variants in the ALDH2 gene can offer protection against alcoholism.

Genes and Environment

  • Genes interact with environmental factors, including availability and social learning, which are crucial in individual susceptibility to addiction.

Childhood Trauma and Addiction

  • Evidence from Leza et al (2021) suggests a strong link between childhood trauma (Adverse Childhood Experiences/ACES) and addiction.
  • The link between ACES and addiction is stronger than other health issues, like diabetes, pointing to additional vulnerabilities linked to this.

Early Adversity's Lasting Impact

  • Early adversity is linked to various negative outcomes such as substance abuse, risky behaviour and mental health concerns.
  • Experience shows more than 4 ACEs are linked to 5x increase in drugs use and 7x increase in alcohol use disorders.

Brain Changes in Addiction

  • Reduced density of D2 receptors in the striatum (part of the brain).
  • D2 receptor changes can predict initial response to stimulants.
  • Socially housed monkeys show higher rates of cocaine use than individually housed monkeys.

Treatment for Addiction

  • Medication (benzodiazepines, methadone, drugs which block substance effects, semaglutide)
  • Motivational interviewing (collaboration and compassion)
  • Cognitive Behavioral Therapy (coping skills and changing behaviours)
  • 12 step programs (building healthy connections)
  • Contingency Management (reinforcers)

Motivational Enhancement Therapy

  • Techniques are used to assess, strengthen, transform, and explore client's motivation.
  • Includes Reframing techniques to reinforce change talk.

Project MATCH Results

  • Shows that three different treatments for alcoholism have comparable results, but effectiveness differs with treatment quantity.

Relapse

  • Relapse is a common part of addiction recovery.

Psychedelics and Addiction

  • The use of substances such as ketamine as a possible treatment in cases of addition and depression are areas for consideration.

Questions/Break

  • 12 questions followed by 3 upvotes

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