11. bio treatments addiction

Question 1

What are the official diagnostic terms for addiction?

Answer 1

Substance Use Disorder (DSM-5), Harmful Use and Dependence Syndrome (ICD-10).

Question 2

What three core features define substance use disorders?

Answer 2

Compulsion to seek/take substance, loss of control over intake, negative state when access is prevented.

Question 3

How is Alcohol Use Disorder (AUD) assessed in DSM-5?

Answer 3

Answering “yes” to at least 2 out of 11 criteria indicates AUD. Severity: mild (2–3), moderate (4–5), severe (6+).

Question 4

What are some behavioural signs of alcohol use disorder?

Answer 4

Drinking more than intended, unsuccessful attempts to cut down, craving, interference with daily responsibilities.

Question 5

What are physiological withdrawal symptoms of alcohol? .

Answer 5

Shakiness, sweating, nausea, seizures, hallucinations, delirium tremens

Question 6

What causes the positive reinforcement of substance use?

Answer 6

Increased release of endogenous opioids and dopamine in the brain.

Question 7

What is tolerance?

Answer 7

Needing more of a substance to achieve the same effect.

Question 8

What is physical dependence?

Answer 8

When stopping the substance causes withdrawal symptoms.

Question 9

Name three biological treatments for Alcohol Use Disorder.

Answer 9

Disulfiram, Acamprosate, Naltrexone.

Question 10

What does Disulfiram do?

Answer 10

Blocks ALDH enzyme, leading to a buildup of toxic acetaldehyde when alcohol is consumed.

Question 11

What reaction does Disulfiram cause?

Answer 11

Disulfiram-Ethanol Reaction (DER): nausea, vomiting, tachycardia, dizziness.

Question 12

What is the main mechanism behind Disulfiram’s effectiveness?

Answer 12

It changes patients’ beliefs about drinking from positive to negative by pairing alcohol with aversive effects.

Question 13

How does Disulfiram affect alcohol metabolism?

Answer 13

Blocks ALDH, causing acetaldehyde accumulation and unpleasant side effects.

Question 14

What is Acamprosate’s mechanism of action?

Answer 14

Modulates GABA and glutamate to reduce craving and support abstinence.

Question 15

What causes neurotoxicity after stopping alcohol?

Answer 15

GABA decreases and glutamate increases significantly.

Question 16

What is the purpose of Acamprosate?

Answer 16

Reduces alcohol craving during withdrawal and supports abstinence.

Question 17

What neurotransmitters does alcohol affect?

Answer 17

GABA (inhibitory) and glutamate (excitatory).

Question 18

How does alcohol affect brain activity?

Answer 18

Increases GABA and decreases glutamate, depressing brain activity.

Question 19

What kind of research best assesses treatment effectiveness?

Answer 19

Systematic reviews and meta-analyses of multiple studies.

Question 20

What are Randomised Controlled Trials (RCTs)?

Answer 20

Studies using random assignment and blinding to evaluate treatment efficacy.

Question 21

What did Skinner et al. (2014) find about Disulfiram?

Answer 21

It was more effective than controls on abstinence and relapse when supervised and known by patients.

Question 22

Why is supervision important for Disulfiram treatment?

Answer 22

Supervised patients had significantly better outcomes; unsupervised treatment showed no effect.

Question 23

What is the difference between blind and open-label Disulfiram studies?

Answer 23

Blind: no effect; Open-label: effective, due to expectation of side effects (nocebo effect).`

Question 24

Is Disulfiram safe?

Answer 24

Overall considered safe, though it causes more adverse events; no increase in mortality.

Question 25

What did Rosner et al. (2010) conclude about Acamprosate?

Answer 25

Reduced risk of heavy drinking by 86% vs placebo.

Question 26

What did Jonas et al. (2014) conclude about Acamprosate?

Answer 26

Effective in maintaining abstinence but not in reducing binge drinking.

Question 27

What side effect is associated with Acamprosate?

Answer 27

Diarrhoea.

Question 28

What is Naltrexone?

Answer 28

An opioid receptor antagonist used to treat alcohol and opioid use disorders.

Question 29

How does Naltrexone work for AUD?

Answer 29

Blocks opioid receptors, reducing the reward effect of alcohol.

Question 30

What did Rosner et al. (2010) find about Naltrexone?

Answer 30

Reduced number of drinking days and heavy drinking days.

Question 31

What is an opioid?

Answer 31

A substance that acts on opioid receptors; includes both natural (opiates) and synthetic versions.

Question 32

What is the difference between opiates and opioids?

Answer 32

Opiates: naturally derived from opium; Opioids: include synthetic drugs like fentanyl.

Question 33

How is Opioid Use Disorder (OUD) diagnosed?

Answer 33

Similar to AUD: 2+ "yes" answers to DSM-5 criteria indicates disorder.

Question 34

What are symptoms of heroin withdrawal?

Answer 34

Itching, sweating, chills, nausea, vomiting, leg cramps, disturbed sleep.

Question 35

What is methadone?

Answer 35

A long-acting opioid agonist prescribed to replace heroin.

Question 36

What are downsides of methadone treatment?

Answer 36

It can be addictive and may be used while waiting for illicit drugs.

Question 37

What is the role of Naltrexone in opioid treatment?

Answer 37

Blocks opioid receptors, stopping heroin’s euphoric effects.

Question 38

What is a drawback of Naltrexone?

Answer 38

It also blocks painkillers like morphine and codeine.

Question 39

What did Amato et al. (2003) find about methadone?

Answer 39

It did not increase abstinence compared to placebo.

Question 40

What did Gowing et al. (2017) find about Naltrexone?

Answer 40

No clear evidence it reduced withdrawal symptoms; some risk of delirium.

Question 41

What is the overall conclusion comparing AUD and OUD treatments?

Answer 41

AUD treatments are more consistently effective; OUD treatments show weaker evidence.