1- intro Flashcards
what are the 4 main categories of criteria for substance use disorder
- impaired control
- social impairment
- risky use
- pharmalogical indicators (tolerance and withdrawal)
what ratio of the SUD criteria must be scored for it to be classified as an addiction
6/11 or more (severe)
what is addiction
the most severe and chronic stage of SUD
what is SUD
substance use disorder
what are the 3 C’s of addiction
consequences, control (loss of) and compulsive
what is meant by the “consequences” in addiction
even with negative consequences, they still use drugs
what is meant by the “control” in addiction
loss of control to stop, even if the user wants to
what is meant by the “compuslive” in addiction
compulsive drug seeking and abuse
is addiction short and easy to get over
no
long lasting and relapsing
what is the tipping point from casual use
once tolerance and dependence gets involved
what causes the long lasting changes in brain structure
escalating substance use over a period of time
how does brain structure affect addiction
a change in brain structure from long-term use facilitates addiction
what part of the brain drives the animalistic needs and wants
basal ganglia
what part of the brain is associated to binging and intoxication
basal ganglia
what mediates the binging and intoxication
dopamine release, “reward”
how is the pavlovian effect associated to basal ganglia
brain builds an association with dopamine release (reward) and drugs
how does the basal ganglia create drug cravings
reward/dopamine pathway fires in anticipation of drug with triggers, which creates strong drug cravings
what part of the brain mediates withdrawal and negative affect
extended amygdala
what does the extended amygdala usually do
helps with memory and emotions
what happens to the amygdala once exposed to drugs
ordinary rewards lose motivational power, now it is focused on obtaining and using the drug
what happens to dopamine with continued use of drugs in the amygdala
decrease in dopamine sensitivity, so less reward comes from natural and drug stimuli
what is the antireward effect
when repeated elevated levels of dopamine result in high stress circuitry when drug is not present, causes dysphoria
what part of the brain is responsible for the antireward effect
amygdala
what parts of brain play a role in cue-associated responses
amygdala hippocampus (memory centres) and basal ganglia too
what part of the brain is responsible for cravings/preoccupation/anticipation
prefrontal cortex
what is the main role of the prefrontal cortex normally
self regulation, decision making, error monitoring, assignment of value
what happens to the prefrontal cortex with drug use (science and artsy answer)
impaired dopamine and glutamate signalling impairs normal functioning, which causes a difficulty to resist strong urges or to follow through with decisions
what 3 parts of the brain are most effected by drugs
basal ganglia
prefrontal cortex
extended amygdala
what is tolerance
when you need more drug to get the same effect
what is dependence
when you are physically&psychologically unwell (cant function) without drugs
what is adaptation
changes in neurotransmitter (+other) pathways to maintain homeostasis
what links tolerance and dependence
adaptation
do drugs disrupt neuronal function in a non-specific way
no, they act on specific targets
even with the right intent to quit, why do they usually keep using
prefrontal cortex is damaged/ dysfunctional and it makes it harder to follow through with good decisions
what happens to brain activity with drugs that increase neurotransmitter availability (first time use)
excess activity due to excess neurotransmission
how does the brain adapt to drugs that increase to neurotransmitter availability
decreases the amount of post-synaptic receptors (to counteract extra neurotransmitter release)
what happens to the brain in withdrawal of drugs that increase neurotransmitter availability and WHY
low activity causing dysphoria (normal amount of neurotransmitters but less receptors)
what happens to brain activity with drugs that decrease neurotransmitter availability (first time use)
there is low brain activity due to insufficient neurotransmission
how does the brain adapt to drugs that decrease to neurotransmitter availability
increase the amount of post-synaptic receptors (to counteract less neurotransmitter release)
what happens to the brain in withdrawal of drugs that decrease neurotransmitter availability and WHY
there is excess activity (extra receptors with normal neurotransmitter release) which is super dangerous cause seizures
what kind of drugs cause different effects in different areas activity wise
opioids cause excess activity in reward pathway circuits but low activity in respiratory drive circuits
what is pharmacodynamic tolerance
change in neurotransmission, sensitivity of neurons and neurotransmitter transporters due to chronic drug use
what is drug disposition/metabolic tolerance
when chronic drug use causes increase metabolism/excretion of the drug
what typically happens in metabolic tolerance
increased activity or levels of liver enzymes
what is the classic example of metabolic tolerance
ethanol! up-regulation of liver enzymes and alternate metabolic pathways to remove ethanol from blood
do drug users always become tolerant to all drug effects
no, because receptors dont all change the same ways.
ex: you may get tolerant to the highs but not the undesired side effects (constipation)
how can an unbalance in tolerance to a drug be deadly
if you are tolerant to the high but not to side effects like breathing or heart rate stuff (they aren’t as adapted as the brain)
is dependence physical or psychological
both
does dependence or tolerance happen first
tolerance first then dependence, but they are linked
what are withdrawal symptoms usually like (in relation to drug)
the opposite effect of the drug (heroin causes constipation, withdrawal causes diarrhea)
what is uncompensated adaptive change
adaptive change is your body getting used to a drug, so, it is when your body freaks out when you stop taking a drug , uncompensated means that your body can’t balance out b/c you dont have the drug in you
how does psychological dependence manifest
compulsion or percieved need of use
what kind of drugs tend to produce the most psychological dependence
reinforcing drugs that stimulate the reward pathway
what causes relapse even after quitting - parts of brain
long lasting changes in brain which can result in intense cravings even with simple triggers
PFC = no consequences
BG = need more drugs
does drug abuse always result in tolerance and dependence
not always, because acute use may not lead to long term CNS or liver changes
what is an example about the question of “does drug abuse always result in tolerance and dependence”
binge drinking, CNS & liver may not adapt even though there is increased risk of harm (social, physical injuries)
what is the effect of acute drug state and its mechanism
reward (pavlovian association), activation of the reward pathway
what is the effect of chronic drug state and its mechanism
tolerance dependence
adaptive change in receptors, 2nd messengers, enzymes, neuronal structure
what is the effect of acute abstinence and its mechanism
withdrawal syndrome
uncompensated adaptive change (opposite of drugs effect)
what is the effect of chronic abstinence and its mechanism
cravings
maybe because pavlovian is always there, hard to unlearn things
