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Essential Neuroscience > Addiction and Alcoholism > Flashcards

Addiction and Alcoholism Flashcards

1
Q

What are the 3 C’s of addiction?

A
  • Control: early social & recreational use
  • Compulsion: Drug-seeking activities and cravings
  • Chronicity: Relapses (even after years of sobriety)
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2
Q

Addicts seek ____, not _____

A

control, not abstinence

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3
Q

What are some risk factors for addiction?

A
  1. Genetics
  2. Earlier age of onset
  3. Childhood trauma
  4. Learning Disorders & ADD/ADHD
  5. Mental illness predating use (depression, etc.)
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4
Q

What are methadone and buprenorphine used for?

A
  • Dopamine receptor agonists
  • Stabilizes brain function in addicts
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5
Q

Describe the reward pathway of the brain? Which neurotransmitter is involved?

A

Ventral tegmental area (VTA) → Nucleus Accumbens (NAc) → prefrontal cortex

  • Uses dopamine
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6
Q

Where does alcohol activate the reward pathway?

A

Nucleus accumbens

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7
Q

Where does cocaine activate the reward pathway?

A

Nucleus accumbens

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8
Q

Where does heroin activate the reward pathway?

A

Nucleus accumbens and VTA

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9
Q

Where does nicotine activate the reward pahway?

A

Nucleus accumbens

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10
Q

Alcohol is part of what class of drugs?

A

Sedatives / Hypnotics

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11
Q

What are some related issues of alcohol abuse?

A
  1. Dexofication
  2. Fetal alcohol syndrome
  3. Loss of judgment
  4. Suicide/Homicide
  5. DWI/DUI concerns
  6. Poly-drug use
  7. Legality issues
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12
Q

Marijuana is part of what class of drugs?

A

Hallucinogens

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13
Q

What are some related issues of marijuana abuse?

A
  1. Lack of motivation
  2. Arrested development
  3. Memory & learning problems
  4. Long detection time
  5. Legalization issues
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14
Q

Cocaine/Crack are part of what class of drugs?

A

Stimulants

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15
Q

What are some related issues with cocaine/crack abuse?

A
  1. High relapse potential
  2. High reward
  3. Cycle: euphoria → agitation → paranoia → crash → sleep → euthymia → craving
  4. Obsessive rituals
  5. Risk of permanent paranoia
  6. No medications available
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16
Q

Methamphetamine is part of what class of drugs?

A

Stimulants

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17
Q

What are some related issues with methamphetamine abuse?

A
  1. High energy level
  2. Repetitive behavior patterns
  3. Incoherent thoughts and confusion
  4. Auditory hallucinations and paranoia
  5. Binge behavior
  6. Long-acting
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18
Q

How long can the effects of methamphetamine last?

A

Up to 12 hours

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19
Q

Heroin is part of what class of drugs?

A

Opiates

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20
Q

What are some related issues of heroin abuse?

A
  1. Detoxification
  2. Euphoria
  3. Craving
  4. Intense withdrawal
  5. Physical pain
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21
Q

Ecstasy (MDMA), Gamma hydroxy butyrate (GHB), and Rohypnol are all examples of ____

A
  • “Club drugs”
  • Designer drugs
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22
Q

Ecstasy is associated with ________

A

Neuron destruction

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23
Q

How does alcohol affect violent behavior?

A

Disinhibits aggressivity

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24
Q

How do stimulants affect violence?

A

Produce dose-dependent paranoia

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25
Q

How do opiates affect violence?

A
  • Opiates produce opiate-seeking behavior, which in turn produces violence
  • Opiates themselves don’t produce violence
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26
Q

______% of those with substance abuse disorder have co-occuring mood disorder(s).

A

24-40%

27
Q

_____% of those with alcoholism also have co-occurring mental health disorders.

A

65% females

44% males

28
Q

True or false. 19% of male alcoholics experience depression as a co-occurring disorder, 4x higher than females.

A

False. Male and female swapped

29
Q

What is the difference betwen abstinence and sobriety?

A
  • Abstinence: stopping alcohol or illicit substance abuse for a period of time
  • Sobriety: a lifestyle based on treatment and personal change
30
Q

_____ million americans need treatment for alcohol and/or other drug abuse in any year but only ____ million receive care.

A
  • 13 - 16 million
  • 3 million
31
Q

What is ASAM?

A
  • American Society of Addiction Medicine
  • Establishes admission, continued service, and discharge criteria for addicts
32
Q

According to the ASAM, what are the first 6 dimensions that must be assessed of an addict?

A
  1. Acute intoxication and/or withdrawal potential
  2. Biomedical conditions
  3. Emotion/Behavioral conditions and complications
  4. Treatment acceptance/resistance
  5. Relapse/Continued use potential
  6. Recovery/living environment
33
Q

What are the potential levels of care that an addict can receive after assessment of the ASAM “Six Dimensions” criteria?

A
  1. Early intervention
  2. Outpatient treatment
  3. Intensive outpatient or partial hospitalization
  4. Residential/Inpatient treatment (4 sub-levels)
  5. Medically managed intensive inpatient treatment
  6. Opioid maintenance therapy
34
Q

A treatment plan for an addict after care should include?

A
  1. Goals
  2. Treatment priorities
  3. Types of counseling & education
  4. Detoxification
  5. Recovery supports, including self-help groups
  6. Coercion
35
Q

True or false. Detoxification is not a cure.

A

True

36
Q

Naltrexone, disulfiram, and acamprostate can all be used in the dexofication of ______

A

alcohol

37
Q

Naltrexone, methadone, and buprenorphine can all be used in the detoxification of ____

A

Opiates

38
Q

Naltrexone and buprenorphine can be used in the detoxification of _____

A

Suboxon

39
Q

How long should substance abuse treatment last?

A
  • Minimum 12 months required for methadone maintenance
  • Less than 90 days is of little or no effectiveness
40
Q

____% of alcohol dependent individuals become dependent before age 25

A

66%

41
Q

____% of alcohol depending individuals become dependent after age 30.

A

20%

42
Q

Alcohol is responsible for ____% of all traffic fatalities

A

30%

43
Q

____% of alcoholis relapse within the year following treatment.

A

40-70%

44
Q

According to the DSM IV TR criteria for alcohol dependence, at least 3 of the following 7 criteria must have occurred within the same 12 month period?

A
  1. Tolerance
  2. Withdrawal
  3. Taken in larger amounts than intended
  4. Unsuccessful efforts to cut down
  5. Time is spent trying to obtain alcohol
  6. Activities given up becomes of alcohol
  7. Continued use despite physical or psychological problems
45
Q

According to the DSM IV TR criteria for alcohol abuse, at least 1 of the following 4 criteria must have occurred within the same 12 month period?

A
  1. Role impairment (failure to meet obligations)
  2. Hazardous use (e.g. driving intoxicated)
  3. Legal problems related to use
  4. Social or interpersonal problems due to use
46
Q

How many american adults abuse or are dependent on alcohol?

A
  • 17.6 million
  • about 1 in 12
47
Q

True or false. A little more than twice as many men and women are dependent on alcohol.

A

True

48
Q

Most persons with alcohol dependence experience mild withdrawal 24-hours after their last drink. Symptoms include (6):

A
  1. Restlessness
  2. Anxiety
  3. Tremors
  4. Tachycardia
  5. GI discomfort
  6. Insomnia
49
Q

Mild withdrawal from alcohol may develop into:

A
  1. An episode of generalized seizure (w/n 24-72 hrs)
  2. Delirium tremens (w/n 5 days)
50
Q

Delirium tremens is characterized by magnification of the symptoms of withdrawal by the development of _____ (5)

A
  1. Disorientation
  2. Visual hallucinations
  3. High blood pressure
  4. Fever
  5. Blackouts
51
Q

What is the legal limit for blood alcohol concentration?

A

80 mg/dL = 0.08 g/dL

52
Q

Describe the impairment of someone with a blood alcohol concentration of 20-30 mg/dL

A
  • Slowed motor performance
  • Decreased thinking ability
53
Q

Describe the impairment of someone with a blood alcohol concentration of 30-80 mg/dL

A

Increases in motor and cognitive problems

54
Q

Describe the impairment of someone with a blood alcohol concentration of 80-100 mg/dL

A
  • Mildly intoxicating effect
  • Legally intoxicated
55
Q

Describe the impairment of someone with a blood alcohol concentration of 100-200 mg/dL

A
  • Decreased coordination and judgment errors
  • Mood lability
  • Deterioration in cognition
56
Q

Describe the impairment of someone with a blood alcohol concentration of 200-300 mg/dL

A
  • Nystagmus
  • Slurring of speech
  • Alcoholic blackouts
57
Q

Describe the impairment of someone with a blood alcohol concentration of >300 mg/dL

A
  • Impaired vital signs
  • Possible death
58
Q

Describe the impairment of someone with a blood alcohol concentration of >600 mg/dL

A

Likely death

59
Q

What enzyme catalyzes the conversion of ethanol into acetaldehyde?

A

Alcohol dehydrogenase

60
Q

What enzyme catalyzes the conversion of acetaldehyde to acetate?

A

Aldehyde Dehydrogenase

61
Q

What is the function of disulfiram? What enzyme does it act on?

A
  • Increases ethanol sensitivity to produce an unfavorable response to alcohol in the hopes of treating an addiction
  • Acts on aldehyde dehydrogenase
62
Q

A polymorphism on the _____ allele has been shown to account for 20-30% of the variance in alcohol intake between light and heavy drinkers among Asian and Jewish populations.

A

ADH2*2

63
Q

What class of drugs is used to treat Delirium Tremens

A

Benzodiazepines

  • Diazepam (Valium)
  • Chlordiazepoxide (Librium)
  • Lorazepam (Ativan)
  • Oxazepam (Serax)
64
Q

What is the function of Naltrexone?

A
  • Opioid receptor antagonist
  • Reduces heavy drinking by reducing rewarding effect of alcohol

Essential Neuroscience (10 decks)

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