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Questions and Answers
What is the current accepted view of addiction according to modern medical understanding?
What is the current accepted view of addiction according to modern medical understanding?
Which factors are identified as contributing to addiction?
Which factors are identified as contributing to addiction?
How has the perception of substance use changed in relation to historical views?
How has the perception of substance use changed in relation to historical views?
What term is used to refer to derogatory language that may stigmatize individuals with substance use disorders?
What term is used to refer to derogatory language that may stigmatize individuals with substance use disorders?
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What broader social issue is implicated in the stigmatization of substance use disorders?
What broader social issue is implicated in the stigmatization of substance use disorders?
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Which aspect of treatment for substance use disorders has been emphasized in modern discussions?
Which aspect of treatment for substance use disorders has been emphasized in modern discussions?
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What should be avoided in language when referring to individuals with substance use disorders?
What should be avoided in language when referring to individuals with substance use disorders?
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Which of the following is NOT a goal when analyzing substance use disorders?
Which of the following is NOT a goal when analyzing substance use disorders?
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What was the classification of alcoholism by the American Medical Association (AMA) in 1956?
What was the classification of alcoholism by the American Medical Association (AMA) in 1956?
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Which brain structure is primarily involved during the binge/intoxication stage of addiction?
Which brain structure is primarily involved during the binge/intoxication stage of addiction?
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According to the American Society of Addiction Medicine (ASAM), how is addiction defined?
According to the American Society of Addiction Medicine (ASAM), how is addiction defined?
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In the withdrawal/negative affect phase, which part of the brain is primarily involved?
In the withdrawal/negative affect phase, which part of the brain is primarily involved?
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Before the third edition of the DSM in 1980, how were substance use disorders primarily conceptualized?
Before the third edition of the DSM in 1980, how were substance use disorders primarily conceptualized?
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What is one effect of activating the dopamine pathway in the basal ganglia?
What is one effect of activating the dopamine pathway in the basal ganglia?
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Which of the following statements about the classification of addiction is correct?
Which of the following statements about the classification of addiction is correct?
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What occurs during the withdrawal/negative affect phase of addiction?
What occurs during the withdrawal/negative affect phase of addiction?
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What role does DNMT play in DNA?
What role does DNMT play in DNA?
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Which substance does not have specific abuse criteria in DSM-IV?
Which substance does not have specific abuse criteria in DSM-IV?
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In DSM-5, which withdrawal condition was newly added?
In DSM-5, which withdrawal condition was newly added?
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What is the focus of Greener MR and Storr SJ’s 2023 publication?
What is the focus of Greener MR and Storr SJ’s 2023 publication?
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Which of the following is not included as a withdrawal condition in DSM-IV?
Which of the following is not included as a withdrawal condition in DSM-IV?
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What does TET stand for in the context of DNA?
What does TET stand for in the context of DNA?
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What is the main objective of the recommended terminology regarding substance use?
What is the main objective of the recommended terminology regarding substance use?
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Which criterion in DSM-5 replaces the need for a dependence diagnosis for substance abuse?
Which criterion in DSM-5 replaces the need for a dependence diagnosis for substance abuse?
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What happens to a person's ability to experience pleasure when there is decreased activation in the reward systems of the basal ganglia?
What happens to a person's ability to experience pleasure when there is decreased activation in the reward systems of the basal ganglia?
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During the preoccupation/anticipation stage, what brain region is primarily associated with experiencing cravings?
During the preoccupation/anticipation stage, what brain region is primarily associated with experiencing cravings?
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What neurotransmitters are included in the brain’s stress systems when decreased activation occurs in the reward systems?
What neurotransmitters are included in the brain’s stress systems when decreased activation occurs in the reward systems?
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In addiction, what does the ‘wanting’ system do independently of the ‘liking’ system?
In addiction, what does the ‘wanting’ system do independently of the ‘liking’ system?
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How does dopamine primarily function in the context of addiction?
How does dopamine primarily function in the context of addiction?
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What disruption occurs in the brain's regulation during cravings that can lead to risky behavior?
What disruption occurs in the brain's regulation during cravings that can lead to risky behavior?
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What is a notable difference between the ‘wanting’ and ‘liking’ systems in the brain?
What is a notable difference between the ‘wanting’ and ‘liking’ systems in the brain?
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What potential consequence can result from impaired emotional control during cravings?
What potential consequence can result from impaired emotional control during cravings?
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What does Bronfenbrenner's Bioecological Model emphasize in understanding addiction?
What does Bronfenbrenner's Bioecological Model emphasize in understanding addiction?
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Which of the following is associated with enhanced addiction susceptibility?
Which of the following is associated with enhanced addiction susceptibility?
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What role does DNA epigenetics play in addiction according to current research?
What role does DNA epigenetics play in addiction according to current research?
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Which of the following psychosocial factors may affect adolescent substance use?
Which of the following psychosocial factors may affect adolescent substance use?
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What is a likely outcome of DNA epigenetic changes in the context of addiction?
What is a likely outcome of DNA epigenetic changes in the context of addiction?
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Which factor is considered an environmental influence on youth addiction risk?
Which factor is considered an environmental influence on youth addiction risk?
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Which of the following is not linked to addiction susceptibility according to the reviewed psychosocial factors?
Which of the following is not linked to addiction susceptibility according to the reviewed psychosocial factors?
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What aspect of youth behavior is commonly examined in relation to addiction?
What aspect of youth behavior is commonly examined in relation to addiction?
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Study Notes
Substance Use Disorders
- Substance use disorders (SUDs) are recognized as primary mental health issues, though previously viewed as manifestations of psychopathology.
- Current accepted theory recognizes addiction's neurobiological, psychosocial, and epigenetic underpinnings.
- Current epidemiology in USA/Mexico shows a bicultural emphasis.
- Clinical assessment of SUDs requires a physician's role.
- Future directions in addiction treatment and research are necessary.
Learning Objectives
- Analyze the accepted theory of addiction.
- Link neurobiological, psychosocial, and epigenetic factors to addiction.
- Compare and contrast substance use epidemiology in the USA and Mexico.
- Revise and value the physician's role in assessing substance use disorders.
- Propose future directions for research and treatment.
Disclaimer
- Sensitive topics require empathy.
- Each student should form their own opinions and views.
- Scientific information will be cited using APA style and is available for discussion.
- Collaboration is important in the learning process.
Lesson Contents & Index
- Terminology and naming issues related to substance use.
- Overview of the "Big Bang Theory" of addiction.
- Neurobiological, psychosocial, and epigenetic factors underlying addiction.
- Substance use in USA/Mexico.
- Multidisciplinary approach to substance use (physician, psychiatrist, CBT therapist, counselor).
- Future directions in understanding and addressing addiction.
Words Matter
- Substance use issues should be named accurately, not misrepresented.
- Historically, societal perceptions viewed substance use as a moral failing, particularly for minority groups.
- Stigmatizing language and derogatory terms (e.g., "crack babies") associated with historical legislation have racist connotations.
- Scientific evidence increasingly shows addiction is a chronic brain illness with potential for recurrence, rather than a moral failing.
Terms to Avoid, Terms to Use, and Why
- Avoid using outdated, stigmatizing language (e.g., "addict," "junkie").
- Use person-first language (e.g., "person with a substance use disorder").
- Recognize that individuals may be in recovery.
- "Habit" is inappropriate for substance use disorders.
- "Abuse" is stigmatizing, not an appropriate term.
- "Substance use disorder (SUD)" is the accepted, and preferable, term.
Historical Data
- The Diagnostic and Statistical Manual of Mental Disorders (DSM) originally classified SUDs as primary mental health disorders later.
- The American Medical Association (AMA) treated alcoholism as a medical disease in 1956, followed by the inclusion of addiction in 1987.
- The American Society of Addiction Medicine (ASAM) categorized addiction as a chronic brain disorder.
Historical Data - Timeline of Substance Use
- Opium used medicinally and spiritually by Greeks
- Cannabis used as decoration in Taiwanese pottery
- Written references to the opium poppy found.
- Medical marijuana usage by the Chinese Emperor
- Babylonians established laws regarding liquor sales.
- Use of opium spread in Europe, the Middle East, and North Africa
- Opium use was widespread during the 17th and 18th centuries.
- Early 20th century: Heroin was legally available over-the-counter as a cough suppressant.
Historical Data - Heroin
- Heroin was initially sold by Bayer as a cough suppressant.
Clinical Approach
- DSM-IV and DSM-5 criteria for substance use disorders.
- DSM-IV abuse criteria applied to substances except nicotine (which did not have a DSM-IV abuse criteria).
- Three criteria for DSM-5 dependence.
- Two or more of DSM-5 abuse criteria are required.
- Cannabis, inhalants, and hallucinogens did not have withdrawal criteria in DSM-IV, but do in DSM-5.
Clinical Assessment
- UpToDate provides information on substance use disorders.
Future Directions
- Provide a link to a Padlet related to substance use.
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Description
This quiz explores substance use disorders (SUDs) as primary mental health issues and analyzes their neurobiological, psychosocial, and epigenetic factors. It also discusses the comparative epidemiology in the USA and Mexico and the physician's role in assessment. Dive into the future directions for research and treatment in the field.
