DSST Substance Abuse flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Anabolic-androgenic steroids

Synthetic testosterone analogs used medically for hypogonadism and wasting; nonmedical use aims at muscle mass and performance and can cause gynecomastia, infertility, and hepatic tumors.

Dextromethorphan abuse

An OTC cough suppressant that at supratherapeutic doses acts as a dissociative (NMDA antagonist), causing hallucinations, agitation, and tachycardia; it is sometimes combined with other substances.

Loperamide misuse

An OTC antidiarrheal opioid that does not cross the blood-brain barrier at normal doses; high doses can produce euphoria and serious cardiac arrhythmias and are used by some to self-treat opioid withdrawal.

Pseudoephedrine restrictions

An OTC decongestant that is a precursor for methamphetamine synthesis; retail sales are limited and monitored, and high doses can cause hypertension and arrhythmias.

Opioid overdose triad

Pinpoint pupils, respiratory depression, and unconsciousness are the classic signs of opioid overdose; naloxone reverses them by antagonizing mu-opioid receptors.

Alcohol action mechanism

Alcohol enhances GABA-A receptor activity and inhibits NMDA receptors, producing sedation and ataxia; chronic use leads to tolerance and withdrawal seizures from glutamate rebound.

Stimulant effects

Cocaine and methamphetamine increase synaptic dopamine and norepinephrine, causing tachycardia, hypertension, hyperthermia, and risk of myocardial infarction, stroke, and seizures.

DSM-5 SUD criteria

Eleven criteria grouped into impaired control, social impairment, risky use, and pharmacological indicators; two or more within 12 months indicate a substance use disorder.

SUD severity thresholds

Mild substance use disorder requires 2-3 criteria, moderate requires 4-5, and severe requires 6 or more; 0-1 criteria does not meet the diagnosis.

Tolerance definition

Needing larger amounts of a substance to achieve the same effect, or experiencing reduced effect with continued use; it is one DSM-5 criterion but is not required for diagnosis.

Withdrawal definition

A substance-specific syndrome occurring when heavy or prolonged use is stopped or reduced; it is diagnosed only for substances known to produce withdrawal, such as alcohol, opioids, and benzodiazepines.

Physical dependence vs addiction

Physical dependence is tolerance and withdrawal, which can occur with prescribed medications; addiction involves compulsive use despite harm and impaired control and is not identical to dependence.

Craving neurobiology

Craving is a strong desire to use and is a DSM-5 criterion; it involves cue-induced dopamine release in the nucleus accumbens and activation of prefrontal and limbic regions.

Mesolimbic reward pathway

Dopamine neurons from the ventral tegmental area to the nucleus accumbens form the common reward circuit; most addictive drugs increase dopamine transmission there.

Heritability of alcohol use disorder

Family, twin, and adoption studies estimate that about half of the risk for alcohol use disorder is genetic, with the remainder from environmental and developmental factors.

Relapse triggers

Stress, drug-associated cues, and negative emotional states increase relapse risk; these factors drive craving and are targets of cognitive-behavioral and pharmacological treatment.

Legal BAC limit

In the United States, the legal blood alcohol concentration limit for driving by adults 21 and older is 0.08%; lower limits apply to commercial drivers and minors.

Fetal alcohol spectrum disorders

Prenatal alcohol exposure can cause facial dysmorphology, growth restriction, and cognitive and behavioral deficits; no safe amount or trimester of alcohol use is established.

Injection drug use risks

Injection drug use is a major route for HIV and hepatitis C transmission; syringe services programs reduce transmission and do not increase drug use.

Stigma and language

Stigma reduces treatment seeking; person-first language such as "person with a substance use disorder" is preferred over terms like "addict" or "abuser" in clinical and public health settings.

Opioid epidemic phases

The U.S. opioid epidemic began with increased prescribing of opioids, shifted to heroin, and now involves illicitly manufactured fentanyl; overdose deaths often involve multiple substances.

Tobacco mortality

Tobacco use is the leading preventable cause of death; secondhand smoke harms children and nonsmoking adults, and cessation reduces risk at any age.

Substance use economic costs

Substance use increases healthcare spending, emergency visits, and lost productivity; alcohol and tobacco together account for a large share of preventable mortality and cost.

CAGE questionnaire

A 4-item alcohol screen asking about Cut down, Annoyed by criticism, Guilty feelings, and Eye-opener use; two or more positive answers suggest further evaluation.

AUDIT screening

The Alcohol Use Disorders Identification Test is a 10-item WHO screen; a score of 8 or more indicates hazardous or harmful drinking and warrants further assessment.

DAST-10

A 10-item screen for drug use in the past 12 months; a score of 3 or more suggests moderate problems and indicates the need for further assessment.

SBIRT model

Screening, Brief Intervention, and Referral to Treatment is a public health approach; brief intervention is typically 5-15 minutes of motivational feedback and advice.

Urine drug test windows

Detection windows vary: opioids 1-3 days, cocaine 2-4 days, benzodiazepines up to weeks with chronic use, and cannabis weeks in chronic users.

Drug test confirmation

Initial immunoassays can produce false positives (e.g., poppy seeds for opioids); gas chromatography-mass spectrometry (GC-MS) is used for confirmation.

Dopamine D2 downregulation

Chronic drug use reduces dopamine D2 receptor availability and blunts natural reward responses, contributing to anhedonia and craving during abstinence.

Prefrontal cortex dysfunction

Chronic substance use impairs prefrontal inhibitory control and decision-making, which is linked to continued use despite negative consequences.

Wernicke-Korsakoff syndrome

Chronic alcohol use causes thiamine deficiency; Wernicke encephalopathy presents with confusion, ataxia, and ophthalmoplegia, and Korsakoff syndrome with amnesia and confabulation.