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Flashcards in Addiction and Adult ADHD Deck (87)
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The key neurotransmitter involved in reward pathway is __



Significant amount of dopamine is released in the prefrontal cortex (via the ___ pathway)



The prefrontal cortex is involved in __, __, and __

Brain learns value/worth of certain behaviors -> impacts future planning, decision-making

1. planning,
2. organization,
3. decision-making


The mesocorticolimibic projection is made of __ + ___

mesolimibic pathway

mesocortical pathway


What are natural rewards

-Eating, drinking, nurturing infants, sex

-These are all activities that keep humans alive individually and as a species -> evolutionary benefit to having these trigger increased dopamine levels


Describe drugs effects on the reward pathway

-Drugs are highly rewarding via increased dopamine levels/longer duration of dopamine in the brain!


-Drugs that increase DA release

-DA reuptake inhibitors/DA present in synapse longer Drugs

-cocaine, methamphetamine, heroin

-Cocaine, amphetamines


Describe Positive reinforcement

Positive reinforcement for these behaviors via increased dopamine release -> people keep engaging in these behaviors (stimuli -> dopamine -> repeat)


Describe positive reinforcement and the concept of “what fires together, wires together”

1. Behavior produces + reward--> Dopamine
2. the + reward makes the behavior more likely to occur
3. "Fires together, wires together"-- brain forms fast connections btwn things that happen together so we can predict what may happen based on connection we have made in similar situations previously


Give an example of + reinforcement and the concept "what fires together, wires together"

Example of beginning to use heroin in a friend’s car in a parking lot in Target at a certain time
1. Heroin -> increased dopamine -> rewarding -> continue using heroin
2. Then start to associate heroin to the situation and people that you usually are with when using heroin
3. Pretty soon whenever they see the same car as their friend’s car -> have a craving for heroin
4. Then becomes generalized to every time they pass a Target -> have a craving for heroin
5. Can also then having cravings every time they see the friend they usually shoot up with

*Craving are not just about seeing/smelling heroin -> many aspects of their general life can trigger cravings


How do drugs encourage behavior via negative reinforcement?

1. Neg. reinforcement encourages behavior- allows person to escape negative experiences
-Physical symptoms (withdrawal sx – n/v/d, body aches, dysphoria, feeling of doom/darkness)
-Emotions (guilt, shame, depression, anxiety)
-Trauma (either ongoing or PTSD, “self-medicating”)

2. Punishment discourages behavior
-Punishment= behavior then neg. consequence
-Punishment can lose potency over time


Reasons for initial drug use

1. Positive reinforcement via increased dopamine levels
2. Experience euphoria -> want to continue using drug to experience same sensation


Reasons for persistent drug use

1. Negative reinforcement (withdrawal sx) encourages drug use
2. Quickly move from euphoric phase of drug use to experiencing withdrawal sx
3. Must use drug to prevent withdrawal or even to feel “normal”


Perspective of addiction as an __ response to environment


-Trauma/loss, systemic/generational oppression, racism, mental anguish (depression, anxiety), social insecurity/phobia, isolation, boredom


What is the Rat Park Study

1. 2 rats in different environments
2. 2 water bottles in each environment: 1 with water and 1 with cocaine (a sweetener was used so water tasted the same)
3. 1 rat was placed in a plain cage
-Very quickly began to use the cocaine laced water bottle almost exclusively
4. 1 rat was placed “rat park”- had good food, lots of stimulation (puzzles, wheel)
- Tried both water bottles, but then almost exclusively chose to use the plain water bottle
*****Substance abuse may have a great deal of dependence on our external environment (being bored, lonely really matters on continuing to use!)


What are the 5 C's for substance use disorder

1. Craving
2. Compulsive use
3. Continued use despite harm (consequences)
4. Chronicity
5. Control, loss of


What are Cravings?

1. Cravings are often described as this overwhelming idea or thought in my mind to engage in an activity
2. Must engage in activity to get on with their day
3. Bothersome type of experience


-Cannot control behavior of using more and more of substance, even if do not want to
ex. Have 10 oxycodone to last 3 days, but use them all in 3 hours

Compulsive use


-Lose job, family, friends, health (develop endocarditis, hepatitis)
- Means they cannot stop using substance without support/rehab

Continued use despite harm


Describe chronic vs acute substance use

Every other day for 6 months (chronic) vs. use for 3 days every 6 months (acute)


Other features of substance abuse disorder

1. Inability to fulfill work or social obligations
2. Use in dangerous situations
3. Legal problems
4. Interpersonal problems
5. Mild (1-3), Moderate (4-5), Severe (6+)


needing to increasing doses of a substance to achieve the desired effect


*Physiologic effect/adaptation to a substance


___ is not in physical consciousness or control

Tolerance, dependence


physiologic adaptation to presence of substance, such that the substance is now required to maintain homeostasis



substance specific set of symptoms related to absence of substance of dependence


*Occurs when dependence has developed, and then person abruptly stops using substance


Body has adapted to functioning to a certain level of substance -> without substance -> develop withdrawal symptoms until

body is able to achieve homeostasis again in the absence of the substance


__ does not equal addiction



What meds tx opiate abuse

1. Methadone (full opioid agonist) dosed 1-2x day (long acting)
2. Buprenorophine (1-3x/day or every other day)
3. Suboxone (buprenorphine + naloxone)
4. Naltrexone


Describe where/how Methadone is prescribed

-Regulated by federal and state authorities

-can only be provided for the treatment of addiction from one of these specially designated clinics (cannot be prescribed as an outpatient)

-If being used to tx addiction, must be prescribed at a specialty clinic= Liquid form of methadone used at specialty clinics

-Can only be prescribed outpatient for pain management= Tablet form of methadone used for outpatient pain management


Partial opioid agonist (high affinity for opioid receptors -> binds receptors more tightly than heroin)