L22 substance use disorder Flashcards

(37 cards)

1
Q

Substance use disorders

A
  • Repeated use of a psychoactive substance or substances, to the extent that the user
  • is periodically or chronically intoxicated;
  • shows a compulsion to take the preferred substance (or substances);
  • has great difficulty in voluntarily ceasing or modifying substance use;
  • exhibits determination to obtain psychoactive substances by almost any means
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2
Q

Brain disease model of addiction (BDMA)

A
  • a chronic brain disease characterised by compulsive use of substance(s) despite adverse consequences.
  • the brain reward systems are altered following chronic drug use
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3
Q

DSM-4

A
  • substance abuse and substance dependence
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4
Q

DSM-5

A
  • substance use disorder
  • addiction is not a diagnostic term
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5
Q

Substance-Related and Addictive Disorders

A

Substance-Related and Addictive Disorders
* Substance-Related Disorders
– substance use disorders
– substance-induced disorders

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6
Q

Diagnostic criteria for alcohol use disorder

A
  1. Impaired Control
  2. Social impairment
  3. RIsky Use
  4. Pharmacological criteria
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7
Q

SUD: Impaired control

A
  • Taken in larger amounts over longer periods
  • Desire or unsuccess in cutting down on it
  • Craving it
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8
Q

SUD: Social Impairment

A
  • Failure to fulfill roles in work, school or home
  • Continued use despite problems
  • outside things given up
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9
Q

SUD: Risky use

A
  • Recurrent drug use in hazard situations
  • Continued use despite knowledge
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10
Q

SUD: Pharmacological criteria

A
  • Tolerance: increased amounts of alcohol
  • Withdrawal
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11
Q

Operant (instrumental) conditioning

A

organisms learn to associate a behaviour and an outcome, and adjust the frequency or probability of a behaviour to achieve or avoid that outcome

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12
Q

Reinforcement

A

Increase the probability of a behaviour → outcome

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13
Q

Punishment

A

Decrease the probability of a behaviour → outcome

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14
Q

Positive reinforcement

A
  • add a desirable outcome to increase the likelihood of a behaviour
  • e.g., a driver receives a discount on car insurance for safe driving
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15
Q

Postivit punishment

A
  • add an undesirable outcome to decrease the likelihood of a behaviour
  • e.g., a driver gets a fine for speeding
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16
Q

Negative reinforcement

A
  • remove an undesirable outcome to increase the likelihood of a behaviour
  • e.g., a driver stops the “beeping” sound by fastening the seatbelt
17
Q

Negative punishment

A
  • remove a desirable outcome to decrease the likelihood of a behaviour
  • e.g., a driver loses licence for unsafe driving
18
Q
  • primary rewards
A

(food, water and sex) - survival of organism
* the consummatory behaviour associated with these rewards is most rewarding

19
Q
  • non-primary rewards
A

, social rewards, can enhance the functions of primary rewards

20
Q

produce learning

A

produce learning - a behaviour is required to obtain a reward

21
Q

motivate approach behaviour and decision-

A

making - seek, obtain and consume a reward, and choose between different rewards

22
Q

generate positive emotions,

A
  • e.g., pleasure - experience pleasure from consuming a reward
23
Q

In operant conditioning, a reward functions as a____ (pos or neg) reinforcer

24
Q

The brain reward systems

A
  • ventral tegmental area (VTA)
  • prefrontal cortex (PFC)
  • nucleus accumbens (NAc)
25
Outcome of the reward systems
* produce pleasure * form associative learning and memory * stimulate the release of dopamine and predict the value of a reward
26
Positive reinforcement and SUD
* linked to euphoria; * compulsive drug taking and its associated cravings dopamine mediates reward pleasure (“liking”) * mesolimbic dopaminergic pathway
27
Pos reinforcement opioids and benzodiazepine
inhibition of VTA GABAergic neurons (green-slides) removed their inhibitory effects on VTA dopaminergic (DA) neurons (red)
28
Nicotine and psychostimulants in DA
* nicotine - depolarise DA neurons (red) * psychostimulants - inhibit dopamine reuptake
29
Issues with positive reinforcement
Liking is not the same and wanting (this on is linked with the mesolimbic pathway)
30
“liking”
- behavioural or neuronal hedonic (pleasant) reactions – mediated by endogenous opioids
31
“wanting” (or incentive salience)
- a form of desire that involves the mesolimbic dopaminergic pathway – mediated by dopamine
32
learning
cues are associated with drug-related rewards - trigger “wanting” without necessarily producing “liking” for the same reward
33
Incentive-sensitisation theory
* Repeated drug use * tolerance to “liking” * sensitised mesolimbic dopaminergic pathway * hyperreactive to incentive stimuli (e.g., drug-related reward cues- previous associative learning)
34
Negative reinforcement SUD
* linked to dysphoria; to remove unpleasant experience of withdrawal effects or anxiety * cycle of Binge, withdrawal, and preoccupation (intox, neg, anticipation) * Signif varies In order - psychostimulant, opioids, tobacco
35
Negative reinforcement: binge/intoxication
* brain reward systems, (mesolimbic pathway), leads to incentive salience (“wanting”): * associate neutral cues with drug-related reward (learning) * motivate approach behaviour (seek and consume a reward)
36
Negative reinforcement: withdrawal/negative affect
* amygdala produces negative emotions * reduction in neurotransmission associated with acute drug reward effects, but drug-opposite response persists
37
Negative reinforcement: preoccupation/anticipation
* Impaired decision-making and self control * prefrontal cortex provides excitatory control (med by glutamate) over the mesolimbic pathway * deficits in executive functions (med by GABA in prefrontal cortex)