Biological treatments for addictions Flashcards
(32 cards)
What does the DSM-5 refer to addiction as?
as a Substance use disorder
What does the ICD-10 refer to addiction as?
a harmful use and dependence syndrome
What does consuming addictive substances increase the release of?
opioids and therefore dopamine in the brain
What is the pathway of addiction?
become tolerant to effects
positive experiences only come from consuming more and more
leads to physical dependence
withdrawal symptoms
What are the 3 biological basis’ of treatments for AUDs?
1- pairing drinking with negative effects
2- affecting GABA levels
3- blocking the opioid receptor system
What is Disulfiram?
a treatment for AUD
How does disulfiram work?
blocks enzyme ALDH
when a patient who has taken disulfiram has an alcoholic drink, there’s a build up of ALDH
leads to a disulfiram ethanol reaction (DER)
What are the symptoms of a disulfiram ethanol reaction?
nausea
vominitng
dizziness
What is the aim of the treatment disulfiram?
change patients beliefs
before hold positive beliefs about how drinking effects them
now know that drinking rapidly leads to unpleasant side effects
When alcohol enters the brain it acts as a GABA [what] and a glutamate [what]?
a GABA agonist (enhances the activity) and a Glutamate Antagonist (inhibits the activity)
What are the anxiolytic and sedative effects of alcohol due to?
due to interaction with GABA and Glutamate
What can be seen as helping levels of GABA in the brain as a treatment for AUD?
Acamprosate
in combination with counselling
reduces craving
What method is recommended when assessing effectiveness of treatments?
randomised control trials
What method in RCTs helps to control selection bias?
randomising patients to condition
What method is RCTs helps to control performance bias?
blinding patients to conditions
Skinner (2014) - effectiveness of disulfiram
systematic review
compared efficacy of disulfiram to various control groups
found patients given disulfiram did better than control groups on range of outcomes
What 2 verses factors affect impact of disulfiram?
supervised treatment versus unsupervised
blind design versus open label design
What had better outcomes - supervised or unsupervised?
supervised
What had better outcomes - blind design or open label design?
open label designs
there was a difference between groups
knew they were getting disulfiram or placebo
Rosner (2010) - effectiveness of acamprosate
found it reduced risk of heavy drinking by 86% relative to placebo
What are opiates?
refers to substnaces derived from opium
What are opioids?
refers to substances that are synthetic versions of opiates
What are some examples of prescription opioids?
codeine
fentanyl
used to treat many conditions e.g back pain, surgery pain, cancer pain
How do opioids produce their effect on the brain?
by affecting opioid receptors in the brain
