drug therapy as a method of reducing addiction

Question 1

aversives

Answer 1

main effect of aversive drug therapy is to pair the behaviour with unpleasant consequences such as vomiting (classical conditioning)

e.g. Disulfiram is a drug therapy that creates the effects of a severe hangover just minutes after alcohol is drunk

idea is that addict will associate the alcohol with these unpleasant side effects rather than ones they enjoy

Question 2

agonists

Answer 2

effectively drug substitutes, bond to neuron receptors and activate them

produces a similar effect to addictive drug and controls withdrawal effects

e.g. methadone is used to treat heroin addiction but has fewer harmful side effects than heroin itself

Question 3

antagonists

Answer 3

block the effects of addictive drug - bind to receptor sites and block them

therefore drug of dependence cannot produce its usual addictive effects

e.g. naltrexone is used to treat heroin addiction

Question 4

drug therapy for nicotine addiction

Answer 4

nicotine replacement therapy

works by gradually releasing nicotine into bloodstream at much lower levels than in a cigarette and also without all the other harmful chemicals found in cigarette smoke

NRT provides addict with controlled dose of nicotine which works by binding to nicotine acetylcholine receptors in the brain, stimulating release of dopamine in the nucleus accumbens, just as it does when smoking , causing a hedonic response

given as either gum, patches or inhalers which helps them control their cravings, improve mood and help prevent relapse

using NRT means that the amount of Nicotine can be reduced over time by using smaller and smaller patches

Question 5

drugs for gambling addiction

Answer 5

no drugs yet been approved for use in UK but research suggests that drug therapies can have beneficial effects

opioid antagonists

antidepressants

Question 6

opioid antagonists

Answer 6

e.g. naltrexone reduces the release of dopamine

gambling addiction taps into same dopamine reward system as heroin, nicotine etc.

so, same drugs used to treat heroin is used with gamblers

opioid antagonists (such as naltrexone) dampen the craving to gamble by :
1. enhancing release of neurotransmitter GABA in the mesolimbic pathway which
2. reduces release of dopamine in the nucleus accumbens which
3. reduces craving to gamble

Question 7

antidepressants

Answer 7

evidence to support serotonin dysfunction in pathological gambling (George and Murali, 2005)

antidepressants reduce the urges and cravings to gamble and can also reduce the symptoms of depression and anxiety that may trigger continued gambling

gamblers treated with SSRIs show sig improvement in their gambling behaviour compared to control

as many gamblers report gambling as response to stressors in life, reducing symptoms associated with these (e.g. depression) lessens urge to gamble

Question 8

strength

Answer 8

supporting research

from Stead et al 2012

concluded NRT is more effective in helping smokers quit than either placebo or no treatment . NRT users were up to 70% more likely to have still abstained from smoking after 6 months.

research also indicates 2 extra benefits of NRT: it is safer than cig smoking as it eliminates harmful effects of tobacco smoke and doesn’t appear to raise dependence

this suggests drug therapies e.g. NRT are useful in reducing addiction

Question 9

limit 1

Answer 9

cause side effects

because common side effects are sleep disturbances, dizziness and headaches

e.g. in relation to gambling, naltrexone leads to sig side effects which means there is a risk that patient will discontinue therapy esp when they have lost the pleasurable effects of addiction

this means risk of side effects should be carefully weighed up against benefits of drug therapy and psychological therapies such as covert sensitisation

Question 10

strength 2

Answer 10

positive ethical implications for the patient

because it minimises harm to addicted individual by suggestion addiction has a neurochemical or genetic basis

this is changing the view that addiction is a form of psychological or moral failure, leading to reduced stigma that addict is at fault

this suggests that research into minimising addiction is beneficial for society

Question 11

limit 2

Answer 11

does not consider individual differences

this is because drugs don’t work in the same way for everyone and genetic variations between people, have a significant impact on treatment success

e.g. Chung et al 2012 suggest alcoholics with one gene variant respond better to naltrexone treatment than those with a different variant of the gene

suggests drug treatments need to be tailored to individual genetic profiles if they are to be more effective