Addictions

Question 1

What areas of the brain are associated with reward systems?

Answer 1

• ventral tegmental area
• nucleus accumbent
• prefrontal cortex

Question 2

What are 2 examples of stimulant-type drugs?

Answer 2

• cocaine

- amphetamine

Question 3

How is cocaine taken?

Answer 3

• coca leaves chewed or brewed
• cocaine hydrochloride is snorted or injected
• crack cocaine is smoked

Question 4

What are the desired effects of taking cocaine?

Answer 4

• temporary stimulant and euphoriant (short lived)
• increases alertness and energy
• increased confidence and impaired judgement
• lessens appetite and desire for sleep

Question 5

What are the bad effects of taking cocaine?

Answer 5

• damage to nose and airways
• convulsions with respiratory failure
• cardiac arrhythmias and MI
• hypertension and CVA
• toxic confusion
• paranoid psychosis

Question 6

What are withdrawal effects of taking cocaine?

Answer 6

-depression
-irritability
-agitation
-craving
-hyperphagia
-hypersomnia
(reverse of desired effects)

Question 7

How is amphetamine taken?

Answer 7

• sniffed
• swallowed
• injected

Question 8

What are the desired effects of taking amphetamine?

Answer 8

similar to cocaine but effects are longer lasting

Question 9

What are adverse effects of taking amphetamine?

Answer 9

• toxic confusion occasionally with convulsions and death

- amphetamine psychosis in heavy chronic use

Question 10

What are examples of opiates?

Answer 10

• opium
• morphine
• heroin
• methadone
• codeine and dihydrocodeine

Question 11

What are the 2 different substance types of heroin?

Answer 11

• tar like substance

- powder

Question 12

How is heroin taken?

Answer 12

• snorting
• injecting
• smoking

Question 13

What are the effects of opiates?

Answer 13

• analgesia
• drowsiness and sleep
• mood change (euphoria, intense pleasure)
• respiratory depression
• cough reflex depression
• sensitisation of the labyrinth with nausea and vomiting
• decreased sympathetic outflow (bradycardia and hypotension)
• lowering of body temperature
• pupillary constriction
• constipation

Question 14

What signs are almost pathognomic of opiate overdose in adults? What are other signs?

Answer 14

• respiratory arrest with a pulse!!!!
• pinpoint pupils unreactive to light
• snoring giving way to shallow respiration
• bradycardia and hypotension
• varying degree of reduced consciousness/coma

Question 15

What is the desired effect for people who abuse opiates?

Answer 15

• feelings of pleasure

- physical and emotional anaesthetic

Question 16

What are side effects of taking opiates for the first time?

Answer 16

• nausea/vomiting

- headache

Question 17

What are side effects of taking opiates medium term?

Answer 17

• phlebitis
• anorexia
• constipation

Question 18

What are side effects of taking opiates longer term?

Answer 18

• tolerance
• withdrawal
• social and health problems

Question 19

What are signs/symptoms of opiate withdrawal?

Answer 19

• craving
• insomnia
• yawning
• muscle pain and cramps
• increased salivary, nasal and lacrimal secretions
• dilated pupils
• piloerection (cold turkey)

Question 20

Why is methadone prescribed?

Answer 20

to try and prevent the harmful effects of taking heroin e.g. infection risk, overdose risk etc

Question 21

How is ecstasy (MDMA) taken?

Answer 21

orally

Question 22

What is the desired effect of ecstasy?

Answer 22

• relaxed euphoric state without hallucinations
• euphoria followed by a feeling of calm
• increased sociability
• effects after 20 mins lasting 2-4 hours

Question 23

What is particularly dangerous about taking ecstasy?

Answer 23

half of all ecstasy tablets contain no MDMA - instead they may have LSD, amphetamine, ketamine etc

Question 24

What are side effects of taking ecstasy?

Answer 24

• nausea and dry mouth
• increased blood pressure and temperature
• in clubs users risk dehydration
• large doses can cause anxiety and panic
• drug induced psychosis

Question 25

How is cannabis taken?

Answer 25

- smoked | - eaten

Question 26

What are the psychological effects of taking cannabis?

Answer 26

- relaxing or stimulating - euphoriant - increases sociability and hilarity - increases appetite - changes in time perception - synaesthesia e.g hear colours in higher doses: - anxiety - panic - persecutory ideation - hallucinatory activity

Question 27

What are adverse effects of taking cannabis?

Answer 27

- respiratory problems as with tobacco - toxic confusion - exacerbation of major mental illness - cannabis psychosis?

Question 28

What are anabolic steroids?

Answer 28

family of drugs comprising testosterone and many synthetic analogues

Question 29

Why would people want to use anabolic steroids?

Answer 29

to enhance appearance or increase muscle mass and reduce body fat

Question 30

In what areas of the body is muscle hypertrophy from steroid use particularly marked?

Answer 30

upper body in the pectoralis, trapezius and biceps

Question 31

What are side effects of using anabolic steroids?

Answer 31

- acne, stretch marks, baldness - feminisation in males with hypogonadism and gynaecomastia - virilisation in women including hirsutism, deep voice, clitoral enlargement, menstrual irregularities, hair thinning - increased cholesterol and hypertension - growth deficits due to premature closure of epiphyses - liver disease - cholestatic jaundice, liver tumours

Question 32

What are psychological side effects of taking anabolic steroids?

Answer 32

- irritability - hypomania and mania - depression and suicidality on withdrawal

Question 33

What is 'tolerance'?

Answer 33

reduced responsiveness to a drug due to previous administration

Question 34

What are the 2 main physiological mechanisms that may explain tolerance?

Answer 34

- dispositional (what macro body does with drug) | - pharmacodynamic (what happens at receptors)

Question 35

What is the 'dispositional' theory as to why tolerance happens?

Answer 35

the more times the drug is administered, the less drug that reach the active site because of: - decreased rate of absorption - increased rate of metabolism to inactive metabolites - decreased rate of metabolism to active metabolites - increased rate of excretion

Question 36

What is the 'pharmacodynamic' theory as to why tolerance happens?

Answer 36

the more times the drug is administered, the more the site of action becomes less affected by the drug because of: - down-regulation or internalisation of drug receptors - reduced signalling down stream of drug receptors - some other compensatory mechanism

Question 37

Why would we say that tolerance almost equates to dependence?

Answer 37

- our body wants to maintain homeostasis and administering a drug upsets that - the body tries to adapt to the new body stage with the drug (creates compensatory mechanisms to ensure equilibrium) - if stop taking it, then this upsets homeostasis and the body complains. Hence, withdrawal effects (these are usually the reverse of the effects of taking the drug e.g. opiate use leading to constipation, withdrawal effect is diarrhoea)

Question 38

What neurotransmitter is involved in the reward centres?

Answer 38

dopamine

Question 39

What normally activates the reward centres?

Answer 39

eating, drinking and sex

Question 40

How does the reward centres theory relate to drug addiction?

Answer 40

some drugs can 'tap in' to reward pathway to increase dopamine levels and therefore increase desirability of drug 'craving'