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YEAR 3 PSYCH > Addiction > Flashcards

Addiction Flashcards

(109 cards)

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1
Q

what is the ICD-10 criteria for dependence

A 
3 or more of:
a strong desire to take the substance
difficulties in controlling substance use 
physiological withdrawal
tolerance 
neglect of alternative pleasures
persistence despite evidence of harm
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2
Q

way to remember criteria of dependence

A

Catherine Never Takes Drugs Woo Hoo

C - controlling difficulties
N - Neglect of alternative pleasures
T - tolerance
D - Desire to take 
W - withdrawal
H - harm but persisting
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3
Q

what is the name of the 4 question process that aims to detect alcohol dependence and abuse

A 
CAGE
Cut down
Annoyed 
Guilty 
Eye opener
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4
Q

what is incentive salience

A

attributing want to a stimulus

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5
Q

what is the key neurotransmitter in the reward pathway

A

dopamine

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6
Q

what are the main areas of the brain involved in the reward pathway

A

mesolimbic and cortical areas

ventral tegmental area –> nucleus accumbens –> prefrontal cortex

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7
Q

dopamine release from a stimulus/activity motivates an individual to do what

A

repeat behaviour

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8
Q

what is meant by the term once use drugs

A

significant dopamine release causes the brain to seek out the substance to the point that normal things in life do not stimulate enough dopamine so ignore other things and only crave the substance

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9
Q

how does tolerance develop

A

overstimulate pathway –> dopamine receptors down regulate

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10
Q

what dopamine receptors are decreased by addiction

A

D2 receptors

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11
Q

what is meant by positive reinforcement

A

taking the drug gives a reward

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12
Q

what is meant by negative reinforcement

A

taking the drug alleviates feeling rubbish

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13
Q

the initial stages of drug taking are driven by ____ reinforcement

A

positive

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14
Q

eventually drug taking is driven by ____ reinforcement

A

negative

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15
Q

what part of the brain modulates the powerful effects of the reward pathway and keeps emotions and impulses under control

A

pre-frontal cortex

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16
Q

cortical maturation occurs in what direction

A

back to front

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17
Q

cortical maturation begins with what and ends with what

A

begins with primary motor cortex and ends with prefrontal cortex developing last (in 20s)

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18
Q

prefrontal cortex activity is _____ in substance misuse people

A

lower

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19
Q

true/false

the earlier the age at which drug experimentation starts the longer the relationship with drugs lasts

A

true

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20
Q

what 3 brain areas are critical in acquisition, consolidation and expression of drug stimulus learning - meaning that learned drug assoc. can que internal state of craving

A

hippocampus
amygdala
striatum

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21
Q

what part of the brain is the key creator of motivation to act

A

orbitofrontal cortex

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22
Q

addicts show _____ activity of the OFC when faced with drug ques

A

increased

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23
Q

what circuit decides whether you will do it or not

A

OFC

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24
Q

what circuit is involved in inhibitory control

A

anterior cingulate gyrus and prefrontal cortex

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25
what circuit is involved in reward/salience
nucleus accumbens and ventral pallidum
26
what circuit is involved in motivation/drive
OFC and subcallosal cortex
27
if you have low D2 receptors are you lower or higher risk of drug addiction
higher - will seek out rewarding behaviours
28
acute stress triggers release of ____
dopamine
29
chronic stress leads to ______ of dopaminergic activity which _____ sensitivity to normal rewards
dampening through down regulation of D receptors | reduces
30
the ____ develops late and is vulnerable during development
PFC
31
the ____ puts the breaks on the reward system
PFC
32
what is conditioning
process of behaviour whereby an individual comes to assoc. a desired behaviour with a previous or unrelated stimulus
33
what are the 2 types of conditioning
classical (pavlovian) - a classic pavlova | operant (skinnerian)
34
what is classical conditioning
through repeated pairing with the cue a previously neutral stimulus will come to elicit the same response
35
what is operant conditioning
instrumental value - learning by connecting the consequences of an action with the preceding behaviour
36
reinforcement _____ frequency of behaviour | punishment _____ frequency of behaviour
reinforcement - increases | punishment - decreases
37
being shouted at by a partner is an example of _____ punishment
positive
38
losing a family member and home due to using is an example of _____ punishment
negative
39
what is a habit
an acquired behaviour pattern regularly followed until it becomes almost involuntary
40
name 5 thinking errors that lead to substance taking
permission giving "its just a treat" minimisation "its only one rationalisation "i havent used for a week" denial "i can use and stay in control" blaming "she made me so angry i had to use"
41
1 unit is how many mls of alcohol
10mls
42
how can you calculate no of units
% x volume / 10
43
what is higher risk drinking
regularly consuming over 35 units per week
44
what is increased risk drinking
regularly consuming between 15 and 35 units per week
45
what is the recommended alcohol intake
no more than 14 units per week | spread over 3 days or more
46
what is considered harmful use of alcohol
pattern of psychoactive substance use that is causing damage to health (physical or mental)
47
what is considered binge drinking for males
> 8 units
48
what is considered binge drinking for females
> 6 units
49
what is AUDIT
alcohol user disorders identification test - 10 questions which aim to detect hazardous drinking
50
what is the screening tool used in pregnant women for alcohol problems
``` TWEAK tolerance worries eye opener kut down ```
51
name 3 other screening tools for alcohol problems
MAST FAST (abbreviated audit for A+E) TACE
52
what liver enzyme is raised in alcohol problems
GGT | AST
53
carbohydrate deficient transferrin detects what
men drinking 5 or more units per day for 2 weeks
54
an audit score of what would identify alcohol dependence syndrome
20
55
over how many units daily would identify alcohol dependence syndrome
15
56
alcoholism causes a _____ MCV
raised
57
what is FRAMES
brief intervention model - feedback - responsibility - advice - menu - empathy - self-efficacy
58
what is the feedback part of FRAMES looking at
identifying problems caused by alcohol
59
what is detoxification
the process by which a patient becomes alcohol free
60
what is relapse prevention
combination of psychosocial and pharmacological interventions aimed at maintaining abstinence or problem free drinking following detox
61
alcohol inhibits the action of what ion channels
excitatory NMDA-glutamate controlled ion channels
62
chronic alcohol use leads to ______ of glutamate receptors
up-regulation
63
alcohol potentiates the actions of what ion channels
inhibitory GABA type A controlled ion channels
64
chronic alcohol use leads to _____ of GABA a receptors
down-regulation
65
alcohol withdrawal leads to ______
excess glutamate activity | reduced GABA activity
66
excess glutamate activity and reduced GABA activity in acute alcohol withdrawal leads to what
CNS excitability and neurotoxicity
67
1st symptoms of alcohol withdrawal syndrome occur within how long of last drink and when do they peak
4-12 hours | peak 24-48 hours
68
what are some s/s of alcohol withdrawal syndrome
``` restlessness tremor sweating anxiety N+V loss of appetite insomnia ```
69
what is the HR and BP like in alcohol withdrawal syndrome
tachycardia | systolic hypertension
70
when does delirium tremens occur
within 2 days of abstinence
71
how does delirium tremens present
often insidiously with night time confusion | confusion, disorientation, delirium, ataxia, course tremor, hallucinations, delusions, paranoid ideations
72
what is the treatment of alcohol withdrawal syndrome
benzodiazepines - diazepam, chlordiazepoxide | reduce gradually over 7 days
73
what vitamin supplementation should be given as prophylaxis against wernickes encephalopathy
thiamine | parenteral
74
is wernickes reversible
yes
75
what causes wernickes
thiamine deficiency --> lactic acidosis in brain
76
what does wernickes look like
ataxia, abnormal eye movements
77
is korsakoff's syndrome reversible
no irreversible brain damage
78
what causes korsakoff's syndrome
thiamine deficiency
79
what is seen in korsakoff's syndrome
memory loss | confabulation
80
what are some psychosocial interventions for relapse prevention
CBT 12 step motivational enhancement therapy
81
are benzos used in alcohol relapse prevention past detoxification period
no
82
what is disulfiram
antabuse
83
what happens if people taking disulfiram drink alcohol
flushed skin tachycardia N+V
84
how does disulfiram work
inhibits acetyl dehydrogenase leading to accumulation of acetaldehyde if alcohol is ingested
85
what is the downfall of using disulfiram
requires compliance
86
what are 2 other drugs used in relapse prevention
acamprosate | naltrexone
87
how does acamprosate work
acts centrally on glutamate and GABA systems to reduce craving
88
how does naltrexone work
opioid antagonist and reduces reward from alcohol
89
what is the first line agent for relapse prevention
naltrexone
90
what makes heroin so addictive
rapid onset of action | short half life
91
what is opium
mixture of alkaloids (codeine and morphine)
92
what is diamorphine
heroin - addition of 2 acetyl rings to morphine
93
codeine and heroin are broken down to what
morphine
94
how can you tell the difference between heroin and morphine in a blood screen
heroin has a unique intermediate that sticks around for 6 hours
95
what is the active metabolite of heroin
morphine
96
what would the pupils of someone who had taken heroin look like
pin point
97
opioid overdose does what to BP and HR
hypotension | bradycardia
98
what is the treatment for opioid overdose
naloxone
99
what happens in opioid withdrawal
``` agitation tachycardia hypertension diarrhoea N+V dilated pupils rhinorrhoea watery eyes ```
100
when does opioid withdrawal occur
within 6-8 hours
101
why does opioid withdrawal occur
locus caerulus releases lots of NA
102
what is opiate substitution therapy
replacement of a short acting opiate with a long acting opiate in a once daily oral dose
103
name 2 long acting opiates
buprenorphine | methadone
104
methadone is a
long acting full agonist
105
buprenorphine is a
long acting partial agonist
106
is OST taken under supervision
yes initialy
107
why is methadone given as a liquid not as a tablet
tablets can be hidden and sold on
108
what is opioid detoxification
achieve complete abstinence from all opiates - gradually taper dose until opioid free
109
what are people who have completed outpatient detoxification at high risk of
relapse and overdose - take large dose they previously needed

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