| 102252424 | drug | a chemical entity, used non-medically, self-administered for its psychoactive effect; any substance which alters mood, behaviour, cognition, and physiology but that does not constitute a food or nutrient | |
| 102252425 | psychoactive substance | a substance which alters behaviour and/or cognition | |
| 102252426 | substance use | a drug is self-administered for its psychoactive effect | |
| 102252427 | substance abuse | a pattern of substance use that meets DSM criteria, including failure to meet obligations due to substance use and recurrent personal or legal problems due to substance use | |
| 102252428 | substance dependence | a pattern of substance use that meets DSM criteria, including tolerance, withdrawal, significant time spent in activities to use/obtain the substance, and interference with everyday activities | |
| 102252429 | withdrawal | a state which occurs when drug use is reduced or ceased, characterised by symptoms which are usually the opposite of those elicited by the drug; occur because of the body's natural homeostatic responses i.e. the body habituates to the presence of the drug and needs to react in its absence | |
| 102252430 | toxicity (intoxication) | usually an immediate effect of the drug which occurs when blood level concentration of the substance rises rapidly, exceeding a level which the body can metabolise | |
| 102252431 | tolerance | decreased effectiveness of a drug as a result of chronic use/repeated administration | |
| 102252432 | stimulants | drugs which accelerate nervous system arousal e.g., nicotine, cocaine, amphetamines, caffeine | |
| 102252433 | depressants | drugs which inhibit nervous system arousal e.g., alcohol, narcotics, benzodiazepines, organic solvents | |
| 102252434 | hallucinogens | drugs which cause some perceptual distortions and may result in visual, auditory or tactile hallucinations e.g., LSD, PCP, magic mushrooms, MDMA | |
| 102252435 | total prohibition | a policy approach which renders all drug use illegal. the focus is on supply reduction, and abstinence from drug use. the only way to obtain drugs is illegally and therefore users are incarcerated rather than treated. | |
| 102252436 | partial prohibition | a policy approach which does not advocate the prosecution of the possession of small quantities of some drugs (e.g., cannabis) but deems the possession and use of harder drugs and those in larger quantities as illegal. | |
| 102252437 | decriminalisation | a policy approach which essentially removes the criminal component of some drugs by either modifying or removing penalties or by making changes in enforcement of laws (by allowing police greater discretion as to whether to prosecute for small quantities or not). there are still some regulations and/or fines in place however, people won't go to jail for it | |
| 102252438 | controlled availability | the production and distribution of drugs is regulated by the government and subject to tax; people are allowed to buy and consume drugs but with specific regulations in place | |
| 102252439 | uncontrolled availability | a policy approach which lifts all controls on drug use; has not been implemented anywhere in the world and is more of a philosophical position | |
| 102252440 | war on drugs (1960s) | president nixon of the united states declared a war on drugs which advocated a stance of complete abstinence and prohibition of drugs and a focus on supply reduction (e.g., search, seizure, and control). | |
| 102252441 | harm minimisation | was adopted in australia in 1985 by bob hawke; accepts that drug use is and will continue to be a part of society, and therefore focus is placed on reducing the harms associated with the drug itself and its use, rather than complete abstinence. the focus is on public health; such an approach requires collaboration between the health, social, justice, and law enforcement sectors | |
| 102252442 | national drug strategy (1992) | john howard and major brian watters; mission to improve the health, social and economic outcomes by preventing the uptake of harmful drug use and reducing the harmful effects of licit and illicit drugs in australian society. aims to minimise illness, disease, injury and death; criminality; level of personal and social disruption; loss of productivity and other economic costs; and the spread of blood borne viruses and other infectious diseases | |
| 102252443 | pharmacokinetics | what the body does to a drug; includes administration, absorption, distribution, metabolism, and excretion | |
| 102252444 | absorption | the time it takes for the drug to reach the blood stream after it is taken | |
| 102252445 | distribution | delivery of the drug in the blood to other parts of the body; depends on blood flow and the solubility of the drug | |
| 102252446 | metabolism | the process of breaking the drug down into smaller molecules (or metabolites) to prepare for excretion | |
| 102252447 | excretion | elimination of the drug from the body; mainly occurs in the urine (kidney), but small amounts can also be excreted from the lungs (breath) or gut. | |
| 102252448 | blood brain barrier | determines which drugs reach the brain in the cerebrospinal fluid (CSF). capillaries in the CNS and brain have tight junctions between endothelial cells which are too small for most drugs to pass. they are surrounded by astrocytes which determine which substances can cross the blood brain barrier | |
| 102252449 | chemoreceptor trigger zone | a weak point in the medulla which acts as a window into the periphery of the CNS; have wider junctions between endothelial cells so that drugs can interact with neurons in the brain, producing nausea and vomiting when needed. | |
| 102252450 | half life | the time it takes for the plasma concentration of a drug to be reduced by 50 per cent | |
| 102252451 | pharmacodynamics | what the drug does to the body; includes drug action, reinforcement, tolerance, dependence, withdrawal, and drug interactions | |
| 102252452 | drug action | drugs act on existing biological systems and receptors. they can act by interfering with the enzyme that metabolises neurotransmitters, inhibiting the reuptake of neurotransmitters, changing the amount of neurotransmitter released from presynaptic neurons (e.g., amphetamines), or interfering with ion channels to hyper- or hypopolarise the neuron making it more or less likely to fire again | |
| 102252453 | agonists | drugs which occupy the receptor sites of neurotransmitters, stimulating them and having a similar action (e.g., methadone) | |
| 102252454 | antagonists | drugs which occupy the receptor sites of neurotransmitters but do not stimulate them; they block them so that other drugs/neurotransmitters cannot bind to them (e.g., naltrexone) | |
| 102252455 | reinforcement | all drugs act on the dopaminergic system either directly or indirectly and thus produce a rewarding/reinforcing effect; people use drugs because are rewarding | |
| 102252456 | cross-dependence | the ability of one drug to suppress the manifestations of physical dependence of another and to maintain the physical dependence state (e.g., benzodiazepines and alcohol) | |
| 102252457 | additive | the sum of drug actions is equal to the sum of the individual effects of each drug | |
| 102252458 | hyperadditive | the sum of drug actions is greater than the sum of the individual effects of each drug | |
| 102252459 | potentiation | a drug may have little or no effect when used on its own, but when taken with another drug, magnifies/intensifies its effect | |
| 102252460 | pharmacological antagonism | an agonist and an antagonist of a drug compete for a receptor site (e.g., morphine and naltrexone). in larger concentrations, naltrexone reduces morphine's effects. | |
| 102252461 | physiological antagonism | drugs act at different sites of acting working to produce opposite effects e.g., alcohol and nicotine | |
| 102252462 | grand theories | overarching, broad explanation, umbrella theories which attempt to reduce drug use to a single type of person and a single reason. these theories tend to be highly moralistic, fail to explain norms, ignore the social context of drug use, and create a divisive "us" vs. "them" perspective | |
| 102252463 | the sinner | drug use is seen as a seen and those who engage in drug use are seen as lacking morality, rationality, and willpower. the user is expected to abstain from drug use all together; creates a power imbalance between the helper and the user | |
| 102252464 | the sick person | drug use is seen as a result of a psychological or physiological defect; people are either predisposed to drug use as a result of genetic heritability and cannot control it, or have problem personalities that predispose them. drug use is seen as a disease and the user is expected to abstain. only focuses on dependence and ignores the social context of drug use | |
| 102252465 | the social victim | when there is a disjunction between people's goals and their means of attaining them, social strain, frustration, and stress result and the individual may turn to drug use to cope. once a person develops a pattern of drug-taking behaviour, society may label them as an addict, and the user internalises this label, thus conforming to the expectations of society (secondary labelling). this view does not entertain a discussion of resistance to labelling, the user is seen as passive, and ignores the social context of drug use. | |
| 102252466 | biological theories | the basic premise is that people use drugs because they are reinforcing/they produce positive effects | |
| 102252467 | neurobiological theories | drug use is reduced to 2 different, yet interconnected systems: (1) the limbic circuit in the incentive sensitisation of drugs and (2) the prefrontal circuitry in regulating inhibitory control in drug-seeking behaviour | |
| 102252468 | incentive sensitisation theory | addictive behaviour is largely due to repeated administration of a drug, which causes progressive and persistent neuroadaptations. these changes render the neural system hypersensitive, making drug use highly salient, attractive and 'wanted' and transforming ordinary stimuli to incentive stimuli that drive drug-seeking behaviour | |
| 102252469 | genetic theories | the basic premise is that there is some genetic component or predisposition in people who are dependent on drugs | |
| 102252470 | type I alcoholism | affects both males and females, results from environmental and genetic influences, later onset, less severe | |
| 102252471 | type II alcoholism | primarily affects males, results mainly from genetic influences, earlier onset, more severe form of alcoholsim | |
| 102252472 | genetic association studies | attempt to find a link between specific genes and substance dependence. the most common studies involve the enzyme for alcohol-metabolism (aldehyde dehydrogenase) and the D2 and D4 dopamine receptors | |
| 102252473 | D2 receptor | associated with severe alcohol, nicotine, opiate, and stimulant dependence; A1 allele results in a reduction of receptors at the postsynaptic neuron, which makes it necessary to consume more drugs that act on dopamine receptors to achieve the same effect | |
| 102252474 | D4 receptor | associated with alcohol, nicotine and opiate dependence | |
| 102252475 | personality theories | basic premise is that problem personalities are associated with substance dependence | |
| 102252476 | reinforcement sensitivity theory | gray (1970); modification of eysenck's extraversion/neuroticism factors; proposes differences in the sensitivity of two neurological systems (BIS/BAS) in response to external environmental cues. there are 3 subsystems that govern behaviour: (1) BAS, (2) BIS, (3) BIS/BAS joint subsystems | |
| 102252477 | behavioural activation/approach system (BAS) | regulated by dopamine pathways; people sensitive to this system seek situations which will be rewarding and thus activate behaviours that are likely to yield positive outcomes. people sensitive to this system are more likely to use drugs. | |
| 102252478 | behavioural inhibition system | people sensitive to this system are sensitive to signal inputs of punishment and want to avoid behaviours that will yield negative outcomes. they therefore inhibit action that lead to negative events (e.g., avoid social situations) | |
| 102252479 | behavioural theories | basic premise is that substance dependence is a learned behaviour; we learn to engage in patterns of drug use either directly or indirectly | |
| 102252480 | compensatory response model | siegel (1975); stimuli repeatedly associated with drug taking elicit opposite conditioned responses (like withdrawal). results in decreased response to drug (tolerance) in that environment | |
| 102252481 | cognitive theories | the basic premise is that the way an individual thinks will impact on drug use; behaviour is governed by our thoughts, beliefs, attitudes, and expectations, not by associations | |
| 102252482 | complete model of substance use | beck (1993); activating stimuli will trigger negative core beliefs about oneself. this leads to automatic thoughts which are subconscious and fleeting e.g., a drink will make me feel better. this, in turn, will trigger the feeling that one wants to drink (cravings/urges) followed by facilitating beliefs (e.g., one drink won't hurt) which is effectively permission to engage in drug-taking behaviour. the individual focuses on instrumental strategies and taking the drug becomes another triggering event which will trigger more beliefs and possible relapse | |
| 102252483 | abstinence violation effect | when a person is attempting to abstain from drug use and has a momentary relapse, this leads to a sense of loss of control over drug-taking behaviour which has an overwhelming and demoralising effect. the persona attributes the lapse to global/internal dispositional factors and this may lead to a full blown relapse. this effect results from (1) cognitive dissonance, and (2) attributing the cause of the behaviour to internal factors and lack of willpower | |
| 102252484 | zinberg model (1984) | norman zinberg; behaviour is a function of the person and the environment. all drug use is inherently social and drugs themselves have a social meaning. there are 3 components to this model: (1) the pharmacology of the drug, (2) the set - the individual including his/her cognitions, attitudes, expectations, and (3) the setting - the environment, the social context, social rituals and social sanctions | |
| 102252485 | model of relapse | marlatt and gordon (1985); a model of relapse for dependent uses which suggests that when someone who is trying to abstain from drug use is faced with a high risk situation, whether they relapse or not depends on (1) social support and coping skills, (2) self-efficacy, (3) expectations, and (4) the situation
people with high self-efficacy, social supports, and negative expectations are less likely to relapse | |
| 102252486 | precocious adolescents | 5% of adolescents, primarily female, engage in adult hedonic behaviours e.g., early sexual activity and substance use, and tend to have much older partners | |
| 102252487 | antisocial adolescents | 7% of adolescents, primarily males, exhibit antisocial behaviours, conduct disorder, cannabis and other substance use, generally come into contact with law enforcement, and have poor achievement in school | |
| 102252488 | multiple problem adolescents | 3% of adolescents, show a host of problems associated with substance use, tend to engage in poly drug use and generally have mental health problems | |
| 102252489 | general theory of addictions | jacobs (1988); trauma leads to a tendency toward negative emotions (e.g., PTSD). addictive behaviour is a means of alleviating negative emotion (escape-motivated behaviours) - allows blurring of reality, lowers self-criticalness and self-concsciousness, and permits complimentary daydreams | |
| 102252490 | anthropological perspective | indigenous people drink or take drugs to due to the culture of group sharing (collectivist culture). peer influence seems to be particularly important in aboriginal culture. other adopted a hunter-gatherer explanation i.e. food shortage means food is gathered rarely and shared among the community. this can be extended to alcohol use - alcohol is bough when money is available and consumed quickly. it is shared amongst the community (get paid and drink mentality) | |
| 102252491 | psychosocial perspective | models of indigenous substance use that focus on external factors e.g., self-esteem, relationship problems, unemployment, lack of education, boredom, loss of culture, support network an family.
substance use can be seen as a way of avoiding a sense of helplessness and despair | |
| 102252492 | primary prevention | aimed at individuals who do not yet have a problem; aims to prevent onset of drug use and disseminate information | |
| 102252493 | secondary prevention | aimed at 'at-risk' individuals who may have begun using drugs but are not yet dependent; aim to reduce harm and preventing use from becoming dependence | |
| 102252494 | tertiary prevention | aimed at people who have already developed substance use problems. more like treatment in a prevention framework - aims to reduce/stop drug use and minimise its harms | |
| 102252495 | universal prevention | whole population approaches aimed at providing information to the largest possible audience. not aimed at specific population groups | |
| 102252496 | selective prevention | targeting subgroups with above average risk factors for substance use. teach coping skills, self-efficacy, and improve self-esteem | |
| 102252497 | indicated prevention | targeting individuals with detectable signs or symptoms to prevent use becoming abuse or to prevent related harm among those still using - trying to intervene early on | |
| 102252498 | assessment | the purpose is to gather information that will help to plan and modify treatment goals and strategies. it is a chance to build a rapport with the client, give them feedback that will help them develop an alternative view of their situation, and monitor progress. | |
| 102252499 | stags of assessment model | allen and mattson (1993); screening, diagnosis, triage, treatment planning, outcome planning | |
| 102252500 | screening | assessing whether there is actually a problem that needs to be addressed. if there is, the next step might be to give someone a diagnosis | |
| 102252501 | triage | thinking about appropriate treatment settings e.g., hopsitalised detox, outpatient program, day program. assessing whether the patient has social support, stable accommodation, and comorbid mental health problems | |
| 102252502 | treatment planning | how can the diagnosis be treated? needs to be tailored to the individual | |
| 102252503 | outcome monitoring | make sure treatment is going to plan and that the client is satisfied | |
| 102252504 | decisional balance | determining the importance a person gives to the perceived advantages (pros) and disadvantages (cons) of substance use and of quitting. really done in the pre-contemplation and contemplation stages. motivation to change is affected by this. | |
| 102252505 | stages of change model | prochaska and diclemente (1984); views change as a process, rather than as a discrete event; deals with intentional behaviour change i.e. when people make a conscious decision that they want to change. in attempting to change behaviour a person typically goes through 6 stages and it is possible to adapt treatment goals around what stage the client is currently at. | |
| 102252506 | pre-contemplation | the person is not considering change (no intention to change) within the next 6 months | |
| 102252507 | contemplation | the person has an intention to change within the next 6 months | |
| 102252508 | preparation | the person has made a conscious decision to change and the deadline is within 30 days. see some kind of planning e.g., might book themselves into a rehabilitation clinic | |
| 102252509 | action | the person is actively changing their behaviour. the first 6 months of behaviour change (doesn't always last 6 months however) | |
| 102252510 | maintenance | more than 6 months of behaviour change; maintaining the new behaviour | |
| 102252511 | relapse | regressing to a previous stage in the model | |
| 102252512 | processes of change | coping activities or strategies used by people in their attempts to change; encompasses multiple techniques, methods and interventions | |
| 102252513 | cognitive change processes | involves changes in the way people think and feel (emotion) about their substance use; consciousness raising, dramatic relief, environmental reevaluation, self-reevaluation, social liberation | |
| 102252514 | behavioural change processes | involves changes in the behaviour; self-liberation, helping relationships, counter-conditinoing, reinforcement management, stimulus control | |
| 102252515 | dramatic relief | strong emotional reactions to events associated with use | |
| 102252516 | social liberation | noticing and using social conditions that support changes | |
| 102252517 | self-liberation | belief in ability to change (self-efficacy) and commitment to act on that belief (preparation stage) | |
| 102252518 | helping relationships | trusting others and accepting their support in quitting | |
| 102252519 | dual diagnosis | refers to patients with both substance use disorders and mental health disorders which coexist independently in the same person | |
| 102252520 | genetic models | people may be predisposed/vulnerable to comorbidity | |
| 102252521 | neurochemical models | attempt to explain coexisting disorders in terms of the relationship between a drug's effects on neurotransmitters (e.g., dopamine) and the underlying neurochemical changes that accompany many psychiatric disorders | |
| 102252522 | biological reinforcement models | consider the effects of psychoactive substances on various pathways that are involved with positive and negative reinforcement of behaviour | |
| 102252523 | temperament, character and personality models | likely that temperament is associated with problematic drug use and it may influence the vulnerability to and expression of mental health disorders | |
| 102252524 | self-medication hypothesis | more popular theory; proposes that psychiatric patients attribute their drug use to the need to control psychiatric symptoms (especially depression). while this may be true for some people, it is certainly not true for all, and the mental health disorder would have to predate the substance use disorder | |
| 102252525 | psychosocial hypotheses | certain childhood factors such as child abuse, physical abuse, hyperactivity, disadvantaged family background predate the onset of drug use and are found at increased rates in those with coexisting disorders, suggesting a role in aetiology. cause neurochemical changes that lead to things like borderline personality disorder and drug use | |
| 102252526 | comprehensive models | all other models are incomplete; drug use and mental health disorders are increasingly seen as arising due to a complex interaction of factors across all levels of brain organisation (genes, neurochemicals, temperament and character) as well as psychological, social, cultural, and spiritual factors. | |
| 102252527 | victorian dual diagnosis initiative | set up to support the development of better treatment practices and collaborative relationships between drug treatment and mental health services. the key activities of the initiative are the development of local networks, training consultation, and modeling of good practice though direct clinical intervention and shared care arrangements. | |
| 102252528 | case management | one person is primarily responsible for managing a client and linking them in with other services. | |
| 102252529 | motivational interviewing | identify the problems and benefits associated with drug use (weigh against life goals), recognise that the costs (harms) outweigh the benefits, identify the helps and hinders of change and use this to inform treatment planning. | |
| 102252530 | therapeutic community | medium to long-term residential care (3-12 months); people in the program are responsible for running it, led by peer leaders (consumer consultants). can be highly confrontational | |
| 102252531 | residential treatment services | long-term residential care (6-12 months); and self-helped based. suitable for clients lacking stable accommodation, social isolation, lack social supports, and have severe dependence. highly confrontational, promote independence, responsibility and stable relationships, and are more effective when a range of treatments/interventions are involved e.g., individual/group counseling, CBT, social skills training, recreation options | |
| 102252532 | impulse control disorders | the essential feature is the failure to resist an impulse, drive or temptation to perform an act that is harmful to the person or others | |
| 102252533 | gateway theories | suggest that the use of one drug (e.g., cannabis) leads to or causes the use of more potent and potentially harmful drugs such as heroin. also suggests that the early uptake of legal drugs is a predictor of later involvement with illegal drugs. | |
