1- intro

Question 1

what are the 4 main categories of criteria for substance use disorder

Answer 1

• impaired control
• social impairment
• risky use
• pharmalogical indicators (tolerance and withdrawal)

Question 2

what ratio of the SUD criteria must be scored for it to be classified as an addiction

Answer 2

6/11 or more (severe)

Question 3

what is addiction

Answer 3

the most severe and chronic stage of SUD

Question 4

what is SUD

Answer 4

substance use disorder

Question 5

what are the 3 C’s of addiction

Answer 5

consequences, control (loss of) and compulsive

Question 6

what is meant by the “consequences” in addiction

Answer 6

even with negative consequences, they still use drugs

Question 7

what is meant by the “control” in addiction

Answer 7

loss of control to stop, even if the user wants to

Question 8

what is meant by the “compuslive” in addiction

Answer 8

compulsive drug seeking and abuse

Question 9

is addiction short and easy to get over

Answer 9

no

long lasting and relapsing

Question 10

what is the tipping point from casual use

Answer 10

once tolerance and dependence gets involved

Question 11

what causes the long lasting changes in brain structure

Answer 11

escalating substance use over a period of time

Question 12

how does brain structure affect addiction

Answer 12

a change in brain structure from long-term use facilitates addiction

Question 13

what part of the brain drives the animalistic needs and wants

Answer 13

basal ganglia

Question 14

what part of the brain is associated to binging and intoxication

Answer 14

basal ganglia

Question 15

what mediates the binging and intoxication

Answer 15

dopamine release, “reward”

Question 16

how is the pavlovian effect associated to basal ganglia

Answer 16

brain builds an association with dopamine release (reward) and drugs

Question 17

how does the basal ganglia create drug cravings

Answer 17

reward/dopamine pathway fires in anticipation of drug with triggers, which creates strong drug cravings

Question 18

what part of the brain mediates withdrawal and negative affect

Answer 18

extended amygdala

Question 19

what does the extended amygdala usually do

Answer 19

helps with memory and emotions

Question 20

what happens to the amygdala once exposed to drugs

Answer 20

ordinary rewards lose motivational power, now it is focused on obtaining and using the drug

Question 21

what happens to dopamine with continued use of drugs in the amygdala

Answer 21

decrease in dopamine sensitivity, so less reward comes from natural and drug stimuli

Question 22

what is the antireward effect

Answer 22

when repeated elevated levels of dopamine result in high stress circuitry when drug is not present, causes dysphoria

Question 23

what part of the brain is responsible for the antireward effect

Answer 23

amygdala

Question 24

what parts of brain play a role in cue-associated responses

Answer 24

amygdala hippocampus (memory centres) and basal ganglia too

Question 25

what part of the brain is responsible for cravings/preoccupation/anticipation

Answer 25

prefrontal cortex

Question 26

what is the main role of the prefrontal cortex normally

Answer 26

self regulation, decision making, error monitoring, assignment of value

Question 27

what happens to the prefrontal cortex with drug use (science and artsy answer)

Answer 27

impaired dopamine and glutamate signalling impairs normal functioning, which causes a difficulty to resist strong urges or to follow through with decisions

Question 28

what 3 parts of the brain are most effected by drugs

Answer 28

basal ganglia prefrontal cortex extended amygdala

Question 29

what is tolerance

Answer 29

when you need more drug to get the same effect

Question 30

what is dependence

Answer 30

when you are physically&psychologically unwell (cant function) without drugs

Question 31

what is adaptation

Answer 31

changes in neurotransmitter (+other) pathways to maintain homeostasis

Question 32

what links tolerance and dependence

Answer 32

adaptation

Question 33

do drugs disrupt neuronal function in a non-specific way

Answer 33

no, they act on specific targets

Question 34

even with the right intent to quit, why do they usually keep using

Answer 34

prefrontal cortex is damaged/ dysfunctional and it makes it harder to follow through with good decisions

Question 35

what happens to brain activity with drugs that increase neurotransmitter availability (first time use)

Answer 35

excess activity due to excess neurotransmission

Question 36

how does the brain adapt to drugs that increase to neurotransmitter availability

Answer 36

decreases the amount of post-synaptic receptors (to counteract extra neurotransmitter release)

Question 37

what happens to the brain in withdrawal of drugs that increase neurotransmitter availability and WHY

Answer 37

low activity causing dysphoria (normal amount of neurotransmitters but less receptors)

Question 38

what happens to brain activity with drugs that decrease neurotransmitter availability (first time use)

Answer 38

there is low brain activity due to insufficient neurotransmission

Question 39

how does the brain adapt to drugs that decrease to neurotransmitter availability

Answer 39

increase the amount of post-synaptic receptors (to counteract less neurotransmitter release)

Question 40

what happens to the brain in withdrawal of drugs that decrease neurotransmitter availability and WHY

Answer 40

there is excess activity (extra receptors with normal neurotransmitter release) which is super dangerous cause seizures

Question 41

what kind of drugs cause different effects in different areas activity wise

Answer 41

opioids cause excess activity in reward pathway circuits but low activity in respiratory drive circuits

Question 42

what is pharmacodynamic tolerance

Answer 42

change in neurotransmission, sensitivity of neurons and neurotransmitter transporters due to chronic drug use

Question 43

what is drug disposition/metabolic tolerance

Answer 43

when chronic drug use causes increase metabolism/excretion of the drug

Question 44

what typically happens in metabolic tolerance

Answer 44

increased activity or levels of liver enzymes

Question 45

what is the classic example of metabolic tolerance

Answer 45

ethanol! up-regulation of liver enzymes and alternate metabolic pathways to remove ethanol from blood

Question 46

do drug users always become tolerant to all drug effects

Answer 46

no, because receptors dont all change the same ways. ex: you may get tolerant to the highs but not the undesired side effects (constipation)

Question 47

how can an unbalance in tolerance to a drug be deadly

Answer 47

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)

Question 48

is dependence physical or psychological

Answer 48

both

Question 49

does dependence or tolerance happen first

Answer 49

tolerance first then dependence, but they are linked

Question 50

what are withdrawal symptoms usually like (in relation to drug)

Answer 50

the opposite effect of the drug (heroin causes constipation, withdrawal causes diarrhea)

Question 51

what is uncompensated adaptive change

Answer 51

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

Question 52

how does psychological dependence manifest

Answer 52

compulsion or percieved need of use

Question 53

what kind of drugs tend to produce the most psychological dependence

Answer 53

reinforcing drugs that stimulate the reward pathway

Question 54

what causes relapse even after quitting - parts of brain

Answer 54

long lasting changes in brain which can result in intense cravings even with simple triggers PFC = no consequences BG = need more drugs

Question 55

does drug abuse always result in tolerance and dependence

Answer 55

not always, because acute use may not lead to long term CNS or liver changes

Question 56

what is an example about the question of "does drug abuse always result in tolerance and dependence"

Answer 56

binge drinking, CNS & liver may not adapt even though there is increased risk of harm (social, physical injuries)

Question 57

what is the effect of acute drug state and its mechanism

Answer 57

reward (pavlovian association), activation of the reward pathway

Question 58

what is the effect of chronic drug state and its mechanism

Answer 58

tolerance dependence | adaptive change in receptors, 2nd messengers, enzymes, neuronal structure

Question 59

what is the effect of acute abstinence and its mechanism

Answer 59

withdrawal syndrome | uncompensated adaptive change (opposite of drugs effect)

Question 60

what is the effect of chronic abstinence and its mechanism

Answer 60

cravings | maybe because pavlovian is always there, hard to unlearn things