Addiction and substance misuse Flashcards
(31 cards)
What is addiction?
Criteria of dependence
Persistence of participation despite evidence of harm
What is the reward (mesolimbic) pathway?
Stimulus causes dopamine to be released -> this causes a motivating signal to the individual.
The more dopamine released, the more you want to do the behaviour.
The reward (mesolimbic) pathway is only involved in addiction, not normal pleasurable experiences. True or false?
False
What happens to the reward (mesolimbic) pathway if you repeatedly take substances?
Repeated dopamine release results in down regulation of dopamine receptors and tolerance develops.
This means more dopamine is needed to trigger a response of reward.
What is the role of the pre-frontal cortex in the reward (mesolimbic) pathway?
Modulates the powerful effects of the pathway and “puts the brakes on it” to ensure that we are making sound decisions.
keeps emotions and impulses under control to achieve long term goals.
In addiction, pre-frontal cortex is normal/dysfunctional?
Dysfunctional
- so that we are not making sound decisions and it is not modulating the effects of the reward pathway
What is the most popular opiate that is misused?
Heroin
What is heroin derived from ?
Poppy seeds
What is heroin?
Diamorphine
What happens when you take heroin?
Rapidly absorbed and crosses the BBB
If you carry out a drug screen on a patient and detect 6-mono-acetyl morphine, what is it indicative of?
Heroin use
If you carry out a drug screen on a patient and detect morphine, what is it indicative of?
Can’t say for certain
- could be a variety of things
- this is why detection of 6-mono-acetyl morphine is beneficial
Features of heroin use?
Euphoria Analgesia Respiratory depression Constipation Reduced consciousness Pupillary constriction
Heroin withdrawal symptoms
Cravings Agitation Tachycardia, hypertension Diarrhoea, N+V Dilated pupils Joint pains Yawning
Heroin causes psychosis. True or false?
False
Management of opiate misuse - opiate substitution therapy
Replace short acting opiate with long acting opiate
Name 2 long acting opiates that can be used in opiate substitution therapy
Methadone
Buprenorphine
initially taken under supervision
Management of opiate misuse -opiate detoxification
Gradually give them reducing doses of the drug until they are not on any opioids all together
There is a huge risk of dying following opiate detoxification. Why is this?
The patient is still psychologically dependent on the substance so often the patient relapses.
What is used to reverse an opiate overdose?
Nalaxone
Name 2 complications of IV drug misuse
Infection
Thrombotic/embolic
1 unit of alcohol = __ ml alcohol
10 ml
Alcohol addiction causes up-regulation/down-regulation of glutamate receptors?
Up-regulation
- excess glutamate activity
Alcohol withdrawal - clinical features
Restlessness Tremor Sweating N+V Loss of appetite Insomnia Seizures Tachycardia Hypertension Delirium Tremens
