addiction

Question 1

what do opiates do?

Answer 1

• powerful pain relief

- euphoria

Question 2

what is the course of alcohol/drug use, misuse and addiction?

Answer 2

• experimental use (large numbers)
• increasingly regular use (lower numbers)
• spiralling dependence (smaller number)
• -> become an increasing problem (physical and psychological)

Question 3

what is drug abuse?

Answer 3

substance used in a manner that does not conform to social norms (can abuse drugs without being dependent or addicted)

Question 4

what is physical drug dependence?

Answer 4

individual depends on drug for normal physiological functioning. abstinence produces physical withdrawal reactions

Question 5

What is psychological drug dependence?

Answer 5

acquiring and using drug are strong motivators of behaviour (compulsive use)

Question 6

What is drug addiction?

Answer 6

not a clinical diagnosis. typically used to emphasise psychological dependence. idea that people can be physically dependent but not addicted

Question 7

How do drugs cause addiction?

Answer 7

change neurochemistry: problems with mood and cognition + physical consequences

Question 8

What neurotransmitter is used for the reward pathway?

Answer 8

dopamine

Question 9

Where is dopamine increased in the reward pathway?

Answer 9

in the nucleus accubens

Question 10

What happens once dopamine has bound to the pos-synaptic receptor?

Answer 10

taken back into the pre-synaptic neurone by dopamine active transporter

Question 11

What is the MOA of cocaine?

Answer 11

block the function of dopamine Active transporter and Noradrenaline transporter

Question 12

Dopamine system is also modulated by other neurotransmitters, which one?

Answer 12

GABA (inhibits dopamine)

Question 13

What is affects in tolerance?

Answer 13

changes in binding to receptors and/or changes in receptor processes and/or numbers
opioid receptors desensitisation and down regulating

Question 14

What happens in withdrawal?

Answer 14

“normal” function need drugs: sudden cessation produces neurochemical cascade resulting in symptoms

Question 15

What happens in dependence?

Answer 15

genetics and environmental interaction leading to brain change that causes dependence
(ie: dominee receptor number vary from person to person)

Question 16

which are the two pathways to addiction?

Answer 16

• sensation seeking

- self medication

Question 17

What happens in sensation seeing addiction?

Answer 17

goes from positive to negative reinforcement: to stop unpleasant withdrawal state

Question 18

What happens in self-medication addiction?

Answer 18

Goes from negative to negative reinforcement

Question 19

how do you treat addiction?

Answer 19

• management of withdrawal
• harm reduction (short term and long term)
• maintaining abstinence (i.e. with lifestyle and behavioural changes e.g. new habit)

Question 20

how do you prevent relapse?

Answer 20

• agonist maintenance (methadone)
• partial agonist maintenance (bupremorphine)
• antagonist maintenance (naltrexone)
• -> reduce craving

Question 21

What psychological treatments are used addiction?

Answer 21

• motivational interviewing (non-confrontational and target ambivalence)
• community reinforcement (‘earn’ tokens/money with clean urines)
• relapse prevention (cognition behavioural strategies, skills training i.e. practice saying no, alternative cognitions i.e. what else could i do, lifestyle changes)

Question 22

What are the three things to look at in addiction for treatment and how do you threat it?

Answer 22

• neurochemistry (pharmacotherapy)
• cognition (psychological therapies)
• social (family therapies)