Learning to walk in a straight line despite the motor impairment produced by alcohol intoxication is best explained by which of the following?
C. Learned tolerance refers to a reduction in the effects of a drug because of compensatory mechanisms that are acquired by past experiences. One type of learned tolerance is called behavioural tolerance. This simply describes the skills that can be developed through repeated experiences of attempting to function despite a state of mild to moderate intoxication. A common example is learning to walk in a straight line despite the motor impairment produced by alcohol intoxication. This probably involves both acquisition of motor skills and the learned awareness of one’s deficit, causing the person to walk more carefully. At higher levels of intoxication, behavioural tolerance is overcome, and the deficits are obvious. Pharmacokinetic, or dispositional, tolerance refers to changes in the distribution or metabolism of a drug after repeated administrations such that a given dose produces a lower blood concentration than the same dose did on initial exposure. This may be mediated via enzyme induction. Pharmacodynamic tolerance refers to adaptive changes that have taken place within the systems affected by the drug so that the response to a given concentration of the drug is reduced, e.g. change in receptor density. Conditioned tolerance is the process where environmental cues, e.g. sight, smell, etc, for the substance will no longer produce a manifestation of the drug’s effect. Reverse tolerance, or sensitization, refers to an increase in response with repetition of the same dose of the drug.
Reference:
Which of the following is NOT a principle used during motivational interviewing of substance users?
D. Miller and Rollnick (1991) described fi ve principles that are essential to motivational interviewing. They are (1) express empathy: communicate acceptance, use reflective listening, and normalize a client’s ambivalence; (2) develop discrepancy: increase the client’s awareness of the consequences of the problematic behaviour, orient the client to the discrepancy between his/ her current behaviour and goals in life, and have the client generate reasons for change; (3) avoid argumentation; (4) roll with resistance: invite the client to consider new points of view rather than having them imposed; and (5) support self-efficacy.
Which of the following is NOT a risk factor for the development of alcohol hallucinosis?
B. Although the occurrence of alcoholic hallucinosis has been noted for centuries, its nosological status is not yet clear. Little research regarding this has been published in recent years. Tsuang et al. (1994) reported a prevalence of 7.4% among patients in an alcohol treatment programme. Patients with alcoholic hallucinosis were younger at the onset of alcohol problems, consumed more alcohol per occasion, developed more alcohol-related life problems, had higher rates of drug experimentation, and used more of other drugs than alcohol users without hallucinosis. The severity of dependence increased the risk for hallucinosis. It is also noted that the prevalence of schizophrenia is higher in the families of index cases with alcoholic hallucinosis.
References:
A decrease in which of the following subtypes of dopamine receptors makes an individual susceptible to relapse in a population with substance use?
B. Decreased D2 receptors in alcohol, cocaine, and methamphetamine users, whether premorbid or the consequence of substance use, in conjunction with a finding of increased salience to drug cues, indicate susceptibility to relapse in this population.
Which of the following is NOT shown to be associated with an increase in the risk of development of alcohol abuse in elderly people?
B. Genetic and familial factors probably account for most cases of alcohol problems that begin in adulthood and continue through to older age. Late-onset cases are associated with much lower rates of family alcoholism.Compared with early-onset cases, late-onset problem drinkers also tend to have less psychopathology. In fact, the notion that late-onset alcohol dependence usually occurs secondary to a mood or organic mental disorder has not been upheld in recent systematic studies. The inability to cope with major losses, chronic psychosocial strains, or transient negative affects such as depression or loneliness, are associated with new or renewed problem drinking. The pathophysiological effects of alcohol may be more serious in elderly people because of an age-related increase in biological sensitivity to alcohol and in peak blood level following a standard alcohol load. In addition, alcohol also aggravates many pre-existing diseases that are more common in later life.
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