Reducing addiction - Drug therapy Flashcards
(18 cards)
What is drug therapy?
Uses medication in order to treat addiction
- Drugs interact with receptors/enzymes in the brain to reduce cravings for a drug or the desire to engage in a particular behaviour
What is nicotine replacement therapy?
Gum, inhaler, patches
- Work by gradually releasing nicotine into blood at lower levels that in a cigarette and also without the harmful chemicals in cigarette smoke.
- Helps the individual control cravings, improve their mood and prevent relapse.
Using NRT means that the amount of nicotine can be reduced over time.
What two drugs are commonly used to treat nicotine addiction
Varenicline
Buproprion
- both **nicotine free pills that reduce craving ** for tobacco and help with withdrawal symptoms.
Have different mechanisms of action in the brain, but both help prevent relapse.
How does Varenicline treat nicotine addiction
Causes the release of dopamine in the brain.
Also blocks the effects of any nicotine added to the system. Reduces cravings for a cigarette and decreases the pleasurable effects of smoking.
How does Bupropion treat nicotine addiction?
Works by increasing levels of dopamine by inhibiting its reuptake.
This simulates the effects of nicotine.
What opioid antagonists?
Bind to opioid receptors in the body, resulting in the blocking of these receptors. As a result, this prevents individual experiencing the rewarding response associated with a particular substance/behaviour.
What opiate treats heroine addiction
Naltrexone treats the physiological dependence of heroin
What are antagonists?
Drug substitutes.
Bind to neuron receptors and activate them, providing a similar effect to the addictive drug.
Antagonists stabilise the addict bc they are used to control the withdrawal syndrome, allowing a gradual reduction in dose and symptoms
What is an advantage of the antagonist Methadone in treating heroine addiction?
Satisfy the addict’s craving for a state of euphoria and have fewer side effects
They are ‘cleaner’ because they are administered medically rather than on the street.
What are aversives?
Produce unpleasant consequences such as vomiting
E.g Disulfiram is a drug therapy used to treat alcoholism by creating hypersensitivity to
alcohol. Effects of a severe hangover are felt just five or ten minutes
after an alcoholic drink is taken.
How do antidepressants reduce stress linked with gambling addiction
Evidence to support serotonin dysfunction in pathological gambling.
- Gamblers treated with SSRI’s to increase serotonin levels showed significant improvements in
their gambling behaviour compared to a control group - Gambling is a
response to the stressors in their life, reducing the symptoms associated with these stressors lessens the urge to gamble.
How do antidepressants reduce impulsivity linked with gambling addiction?
Impulsivity is believed to contribute to many addictive behaviours including gambling.
Low levels of serotonin have been found in individuals with impaired impulse control, including pathological gamblers.
SSRI’s raise serotonin activity and therefore should reduce
impulsivity which should also reduce pathological gambling.
What is a strength of drug therapy to reduce addiction
- Research support
What are limitations of drug therapy to reduce addiction
- Opioids may block fun activities
- Side effects of NRT
- Only treats symptoms
Evaluate research support as a strength of drug therapy as a treatment for addiction
P: Research supporting the effectiveness of opioid antagonists.
E: Kim et al conducted a 12-week double blind placebo-controlled trial, where they gave either naltrexone (opioid antagonist) or a placebo to 45 pathological gamblers. Naltrexone targets the D2 dopamine pathway in the brain, which is associated with rewards. They found that naltrexone was effective in reducing the frequency and intensity of gambling
urges, as well as gambling behaviour itself.
E: Naltrexone also appeared more effective in gamblers with severe urges to gamble than those who described their urges
to gamble as moderate.
L: By strengthening the reinforcing properties of gambling behaviour this reduces the urge to gamble.
Evaluate that opioids may bloc fun activities as a limitation of drug therapy as a treatment for addiction
P: A problem with the use of opioid antagonists is it can block all fun activities.
E: Opioid antagonists such as Naltrexone work by blocking the brain’s reward system when the person engages in gambling behaviour. Unfortunately this mechanism is a general one, in that stopping the brain from releasing dopamine (which makes the activity feel good), it could cause some patients to lose pleasure in other areas of life (e.g. playing sport, having sex etc…) while they are taking the drug.
E: This tendency to make fun activities seem ‘uninspiring’ is a downside of naltrexone for many addicts, and one reason
why some choose not to continue with their treatment
Evaluate side effects as a limitation of drug therapy for treating addiction
P: Side-effects of the treatment.
E: Common side effects of NRT are sleep disturbances, gastro-intestinal problems, dizziness and headaches. The dose required for naltrexone to have an effect on gambling behaviour is generally much higher than when it is used conventionally to treat opiate addiction, so the side effects are worse, for example, severe vomiting,
hallucinations, confusion, blurred vision. Even when such negative effects are expected, there is a risk that the patient will discontinue the therapy. Especially when those negative effects are experienced without the counterbalancing benefits of the drug of dependence such
as a state of euphoria (i.e. ‘all pain, no gain’).
E: The risk of side effects should be carefully weighed up against both the benefits of the drug therapy and alternative psychological therapies such as covert sensitisation.
Evaluate that it treats symptoms not the cause as a limitation of drug therapy as a treatment for addiction
P: Although the symptoms may be being treated, the underlying
reasons for the addictions may be being overlooked.
E: As the treatments tend to address the prevention of withdrawal symptoms, they do not deal with the reason that the
addiction began in the first place and the treatments therefore might not provide an effective cure. Therefore relapse can be quite common if addicts only use biological treatments.
It is thought that the addictive behaviour may return when the drug treatment is stopped and research has shown that it’s likely that the addict will return to their addiction if this is the only method of treatment used.
This is especially true if the addict feels that they have no control over their behaviour and that they are dependent
on the therapy.
E: However, there is good evidence to suggest that some addictions, such as smoking, do involve chemical changes in the
brain and biological treatments may be the most effective treatment for such addictions.
L: Overall, biological treatments are seen to be very effective for people who are very dependent (such as heroin addicts) as it is unlikely that talking therapies would have the desired effect.
