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Psyc 362- Behavioral Neuroscience > Addiction > Flashcards

Addiction Flashcards

1
Q

What is addiction? (Criteria and definition)

A
  • Addiction is a clinically-impairing (meaning, the individual cannot function without the substance) pattern of inflexible reward pursuit and consumption
  • The patient must participate actively in “getting” this disorder (like type 2 diabetes or cardiovascular disease)
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2
Q

What factors influence susceptibility for addiction?

A

Both genetic and environmental factors influence susceptibility

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3
Q

What is addiction best understood as?

A
  • Best understood as a clinical brain disorder with observable physiological manifestations that underlie pathological aspects of behavior
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4
Q

What are the four stages of drug addiction?

A
  • Use
  • Heavy Use
  • Early dependence
  • Late dependence/Neuroadaptation
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5
Q

How is addiction related to positive/negative reinforcement?

A

As use disorder progresses, negative reinforcement increases while positive reinforcement decreases

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6
Q

What is the cycle of addiction?

A
  • Initial use, then abstinence (withstanding from drug with possible withdrawal symptoms), then relapse.
  • This cycle continues, leading to the progressive stages of addiction.
  • Most begin with a balanced mood, but when taking the drug experience high/euphoria… then experience mild withdrawal. Overtime, euphoria magnitude decreases as magnitude of withdrawal increases. This continues until no euphoria is reached (considered late dependence with significant neuroadaptations present)
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7
Q

What is the definition of substance use disorder according to the DSM-5?

A

“Substance use disorder descrbes a problematic pattern of using alcohol or another substance that results in impairment in daily life or noticeable distress”

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8
Q

How many symptoms do you need for mild, moderate, and severe SUD (according to DSM-5)

A
  • 2-3 symptoms: mild
  • 4-5 symptoms: moderate
  • 6+: severe
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9
Q

How many total symptoms are there for SUD in the DSM and what are they categorized under?

A
  • Physical dependence
  • loss of control
  • clinical impairment
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10
Q

What are the physical dependence symptoms of SUDs?

A
  • “Craving” the substance
  • Building up a tolerance to the substance: either needing to use noticeably larger amounts over time to get the desired effect, or noticing less of an effect over time after repeated use of the same amount
  • Experiencing withdrawal symptoms after stopping use (this increases as you use over time)
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11
Q

Loss of control symptoms

A
  • Consuming more substance than originally intended
  • Worrying about stopping or consistently failed efforts to control one’s use
  • Spending a large amount of time using, or doing whatever is needed to obtain them
  • Continuing the use of a substance despite health problems caused or worsened by it
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12
Q

Clinical impairment symptoms

A
  • Use of the substance results in failure to “fulfill major role obligations” (home, work, or school)
  • Continuing the use of a substance despite its having negative effects in relationships with others
  • Repeated use of the substance in a dangerous situation
  • Giving up/reducing activities in a person’s life because of the substance use
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13
Q

SUD Manifestations Ilicit

A
  • Narcotics
  • Hallucinogens
  • Stimulants
  • Cannabis (in most states)
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14
Q

SUD manifestations licit

A
  • Cigarettes
  • Alcohol
  • Cannabis (legal in over 20+ states and DC)
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15
Q

Manifestations- nonchemical

A
  • Gambling disorder (in DSM5)
  • Internet gaming disorder (possible)
  • Food, porn, sex, shopping, exercise (under study)
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16
Q

What age group misuses alcohol the most?

A

Ages 26+, probably because they can legally (66.5%)

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17
Q

What age group misuses weed the most?

A

12-17 year olds have highest prevalence

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18
Q

What are the main effects with alcohol use disorder?

A
  • Loss of control over alcohol drinking
  • Negative emotions when not drinking
  • Have to drink more for the same effects
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19
Q

Alcohol use deciles (per week)

A
  • 1-3 decile: 0 drinks
  • 4 decile: 0.02 drinks
  • 5 decile: 0.14 drinks
  • 6 decile: .63 drinks
  • 7 decile: 2.17 drinks
  • 8 decile: 6.25 drinks
  • 9 deciles: 15.28 drinks
  • 10 decile: 73.85 drinks
20
Q

What are the risk factors for alcohol use disorder?

A
  • environment
  • genetic predisposition
  • early traumatic exposure
21
Q

What are other risk factors for SUDs?

A
  • Men&raquo_space; women
  • Adolescents&raquo_space; adults
  • Co-morbidity with other psychiatric illnesses
  • Pain disorders and other somatic diseases
22
Q

Enviornmental risk factors: What does exposure to adverse events during early-life and adolescence increase the risks of?

A
  • affective disorders
  • increased risk of alc and substance use disorder
23
Q

What is an important concept about drugs?

A
  • Drugs are chemical ligands that interact with brain neurotransmitter systems and that can change the way people feel by altering neural signaling
24
Q

Drugs as a stimulus

A
  • When consumed, drugs produce internal feeling states/stimulus effects (positive, negative, mixture)… ex. cocaine produces euphria, energy, sympathomimetic activation and anxiety
  • These stimulus effects are due to the pharmacological actions of the drug (what receptors the drugs interacts with)
  • Liking the positive reinforcing stimulus effects of the drug, or disliking the aversive effects, is not “learned” (so the drugs act as unconditioned stimuli)
  • This involves the mesolimbic dopamine system
25
Q

What is dopamine?

A
  • A NT released during a happy event or in the presence of a rewarding stimulus
  • Both rewarding and reinforcing
26
Q

What are the two dopamine pathways?

A
  1. Substantia nigra to caudate; motor
  2. VTA to nucleus accumbens; mesolimbic system
27
Q

Mesolimbic dopamine system: VTA

A
  • dopamine is produced here and flows outward along neurons distributed throughout the brain’s reward system
  • activated when there is a pleasure/rewarding/reinforcing stimulus present, and then releases dopamine to the NA
28
Q

Mesolimbic dopamine system: Nucleus Accumbens (NAc)

A
  • amplifies the response to pleasure, amplifying rewarding as a result of the dopamine flowing there
  • involved in stress processing, affect/emotion driven
29
Q

At the synapse (between VTA and NAc)

A
  • Where everything that happens in drug addiction occurs (junction between VTA and NAc)
  • In a typical person, certain amount of dopamine is released upon stimulation
  • When drugs are present, exacerbated release of dopamine from the presynaptic terminal, getting way more dopamine release and increasing the levels of DA
30
Q

What neuroadaptations occur after frequent drug use?

A
  • PET imaging shows decreased dopamine D2 receptors in addicts (downregulated)
  • This is beyond the effect of just the release of NTs
31
Q

How we figure out dopamine was important in SUDs?

A
  • 6-OHDA= neurotoxin that kills catecholaminergic neurons and/or their terminals
  • When injected in the medial forebrain bundle, it changes cocaine intake behavior in rats
  • Animals with 6-OHDA lesions (which causes dopamine depletions within the ventral striatum aka NAc) reduce cocaine taking as it reduces dopamine availability making the drug not feel reinforcing

SHAM lesion as control: same surgery but saline or artificial CSF injected

32
Q

Is addiction learning?

A
  • Drugs naturally have unconditioned stimulus properties (you feel the effects no matter what, don’t have to lern the biological response)
  • However, because they drive a biological response, they suppport learning. If you like what you feel, you will repeat the behavior (drug intake/press lever). Addiction is dependent on action outcome being positive.
33
Q

Addiction as learning from a society perspective

A
  • In our society, we associate awards with celebration (and alcohol), now this is a conditioned reponse (drug paired cues)
  • Drug associated cuse can gain “incentive value,” including places and smells (associative learning)
  • Ex. Before having starbucks, no repsonse to seeing cup. After enjoying a starbucks drink, now when you see the cup you want the drink. A cup with previously not incentive value now has incentive value
34
Q

Drug paired cues

A
  • drugs can be the unconditioned stimulus in a stimulus-stimulus association
  • Drug associated cues gain incentive value and elicit craving
  • Cues include the sight of the drug and paraphernalia, people with whom drugs are used, places where drugs are used, smell and/or taste of drug
35
Q

basal ganglia function in SUD

A

learning and memory

36
Q

Extended amygdala SUD function

A

reward and motivation, includes the NAc (which sits at the intersection of the basal ganglia and extended amygdala circuit)

37
Q

PFC area SUD function

A

control over behavior

38
Q

What is the larger story of the brain involvement w SUDs, beyond the mesolimbic dopamine pathway?

A
  • First, you need the rewarding motivation to get the substance (if not reinforcing no one would use the substance again)… reward and motivation/extended amygdala
  • Then, as a result you learn what makes you feel good and bad (learning and memory portion/basal ganglia)
  • Finally, you exert control (you wouldn’t drink 5 cups of coffee in a row even if dependent on caffeine)… control over behavior PFC
39
Q

Drug paired cues study

A
  • Showing cocain addiction patients pictures of things that remind them of cocain dramatically increases blood flow in the amygdala and the anterior cingulate cortex
  • Amygdala is the fear, anxiety of the brain… activation because the individual cannot use the drug and are craving to a great degree
  • Not sure what is happening with the anterior cingulate cortex
40
Q

Instrumental learning and drugs

A
  • because drugs are rewards, they support instrumental learning
  • actions associated w drug intake are reinforced, occurring with increasingly higher probability
41
Q

Instrumental learning study

A
  • Experiment meausred dopamine on rats who can activate cocaine via pump attached to lever
  • With cocaine infusion, dopamine increases for a coulple of hours before it dies down
  • Because cocaine elevated dopamine and dopamine is generally reinforcing, it drives the positive behavior. Rat learns to associate pushing the lever to a good feeling
42
Q

Tolerance/non-associative learning

A
  • not related to lever or anything like that
  • certain aspects of the drug’s effect diminish with repeated intake
  • tolerance to the rewarding effects is a common phenomena

part of DSM criteria

43
Q

Non-associative learning study

A
  • rats given chronic access to cocaine will show less of an effect to dopamine reuptake inhibition
  • cocaine is no longer as effective in blocking dopamine transporters
  • or, dopamine receptors have down regulated
44
Q

What causes compulsive habit formation?

A
  • because people suffer from tolerance, it becomes habitual
  • people will go back and want to feel the high level, so they go back to the drug
  • End up taking the drug every morning or every evening, now it is a habit
45
Q

What is happening neurologically during compulsive habit formation? Research study

A
  • Measuring dopamine in vivo (live) rats. One electrode placed in the ventral striatum (NAc) and another in the dorsolateral striatum (caudate). Rats trained to self-administer cocaine, happening over a period of three weeks
  • NAc (ventral striatum) affect: Week 1 get really good response of dopamine as soon as cocaine is self-administered. Week 2 slight reduction in response. Week 3, even bigger reduction, around half of first week. Cocaine is no longer effective in elevating dopamine levels
  • Caudate (dorsolateral striatum) affect: Week 1, no dopamine response/signal initially. Week 2, slight increase. Week 3, continued elevation
46
Q

What is happening mentally in terms of compulsive habit formation?

A

As addiction occurs, person goes from “I want the drug” (rewarding affects) to “I need the drug” (habit formation with less rewarding affects)

Psyc 362- Behavioral Neuroscience (24 decks)

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