B7-077 Substance Use Disorder

Question 1

all drugs of abuse reinforce behavior patterns through the mesolimbic system, projecting from the […] to the […] in the brain

Answer 1

VTA
nucleus accumbens

Question 2

[…] onset maximizes reward

Answer 2

rapid onset

(IV > smoked > oral)

Question 3

why is fentanyl more potent than morphine?

Answer 3

highly lipophilic (penetrates the BBB faster)

allows for dermal and intranasal administration (typically has poor GI absorption)

Question 4

why are “free based” forms of cocaine and nicotine more addictive?

Answer 4

substance has been chemically altered to be more potent and volatile, allowing for more rapid onset

Question 5

initial drug exposure engages emotional regulation and neuroplasticity to cause what effects on in the brain? [2]

Answer 5

salient pleasurable effect

imprinted positive memory tied to first

(incentive salience)

Question 6

conditioned response from subsequent exposure to drugs

Answer 6

cue-induced cravings

Question 7

cue exposure, reactivity, and craving predict […] and use

Answer 7

relapse

Question 8

addiction cycle

Answer 8

incentive salience
withdrawal
euphoric recall/positive expectancy

Question 9

adaptive neuro changes after repeated exposure/withdrawal cycles [3]

Answer 9

diminished drug effects
reward deficit, stress reactivity
impaired executive function

Question 10

brain structure involved in the binge/intoxication stage

Answer 10

basal ganglia

Question 11

brain structure involved in the withdrawal stage

Answer 11

amygdala

Question 12

brain structure involved in the preoccupation/anticipation stage

Answer 12

frontal cortex

Question 13

most drug use begins in

Answer 13

adolescence

Question 14

developmental process of addiction

Answer 14

predisposing factors –> adolescent developmental processes –> maintenance –> addiction

Question 15

risk factors for SUD

Answer 15

family history
early onset of drug abuse
environmental exposures

Question 16

genes impacting […] of drug use are specific to individual substance

Answer 16

progression

(she mentioned maybe having a variant of mu receptor making you less likely to use opioids)

Question 17

genes impacting […] of drug use are a common set of gene across all substances

Answer 17

initiation

Question 18

SUD often co-occurs with

Answer 18

mental illnesses

Question 19

2-3 symptoms of SUD is […]

Answer 19

mild

Question 20

4-5 symptoms of SUD is […]

Answer 20

moderate

Question 21

6-7 symptoms of SUD is […]

Answer 21

severe

Question 22

stimulants cause extensive cardiac side effects due to

Answer 22

vasoconstriction

Question 23

[…] drugs can cause septal damage, loss of smell

Answer 23

snorting

Question 24

[…] drug use can transmit infections and cause vascular problems

Answer 24

IV

Question 25

[...] drugs can cause pulmonary issues

Answer 25

smoking

Question 26

[...] can cause more severe damage to the brain and more extensive psychiatric side effects due to longer half life

Answer 26

methamphetamine

Question 27

can cause wooden chest syndrome

Answer 27

fentanyl (makes it hard to do CPR)

Question 28

physical indicators of drug abuse

Answer 28

scarring from repeated IV injections

Question 29

drug addiction commonly intersect the [...] system

Answer 29

criminal justice

Question 30

treatment of SUD should be greater than

Answer 30

3 months (6 months is optimal)

Question 31

look and react normally to the stimuli accept and notice without judgement what behavioral technique?

Answer 31

mindfulness

Question 32

thinking about the affects of the drug now and how it will impact you later is a an example of [...] therapy

Answer 32

CBT

Question 33

therapies providing the most benefit to people with SUD [2]

Answer 33

CBT mindfulness practice

Question 34

mu agonist that reduces withdrawal symptoms and craving

Answer 34

methadone

Question 35

is administered orally to slow action and reduce reinforcement value

Answer 35

methadone

Question 36

relieves cravings without producing a high but may induce withdrawal in dependent individuals

Answer 36

buprenorphine

Question 37

mu partial agonist

Answer 37

buprenorphine

Question 38

mu antagonist

Answer 38

naltrexone

Question 39

blocks the actions of opioids indicated to reduce relapse

Answer 39

naltrexone

Question 40

access to [...] is very tightly controlled and only available in urban populations

Answer 40

methadone

Question 41

can be prescribed from a physician office but requires specialized training to manage risk of precipitated withdrawal

Answer 41

buprenorphine

Question 42

incentive salience is mediated through what brain structure

Answer 42

nucleus accumbens (reward and reinforcement pathway)

Question 43

adaptive changes in the [...] are associated with emotional dysregulation in SUD

Answer 43

amygdala

Question 44

adaptive changes in the [...] are associated with behavioral dysregulation in SUD

Answer 44

frontal cortex

Question 45

infections transmittable by IV drug use [3]

Answer 45

hep C HIV vasculitis

Question 46

how do opioids increase brain dopamine

Answer 46

inhibition of GABA interneurons in the ventral tegmental area

Question 47

how do cocaine/methamphetamines increase brain dopamine

Answer 47

direct activation of dopamine receptors in the nucleus accumbens

Question 48

adaptations in the [...] contribute to reward deficit syndrome (withdrawal, negative affect)

Answer 48

amygdala

Question 49

stress reactivity is related to adaptations in the [...]

Answer 49

amygdala

Question 50

physiological response to repeated use/withdrawal cycles leading to diminished drug effects

Answer 50

tolerance

Question 51

high levels of dopamine produced by cocaine and meth can lead to [...]

Answer 51

psychosis

Question 52

cognitive impairment and ulcers can occur with prolonged cocaine use due to repeated [...]

Answer 52

vasoconstriction

Question 53

major center for emotional regulation

Answer 53

amygdala

Question 54

adaptive changes in the [...] lead to reward deficit syndrome, increased stress reactivity, and emotional deregulation

Answer 54

amygdala

Question 55

the [...] is involved in reward and reinforment

Answer 55

nucleus accumbens

Question 56

the [...] is involved with executive functioning

Answer 56

prefrontal cortex

Question 57

which drug in the treatment of opioid use disorder prevents withdrawal?

Answer 57

methadone

Question 58

does methadone lead to abstinence?

Answer 58

no, just subs a safer substance

Question 59

can methadone be injected?

Answer 59

yes, sometimes addicts will inject it for greater effects but it can cause fatal overdose

Question 60

cues associated with drug use (such as paraphernalia) can elicit pronounced [...]

Answer 60

cravings

Question 61

genetic risk for the development of SUD is [...]

Answer 61

complex, multifactorial

Question 62

the presence of SUD in family members is correlated with [4]

Answer 62

earlier age of substance use genetic risk of SUD initiation of drug use poor course of SUD illness