8. Substance Abuse Disorders Flashcards
(41 cards)
What is a problem with the concept of “addiction”?
Addiction is often self-reported
Is addiction used in the DSM-5?
No. “Addiction” is omitted from the DSM-V when describing substance use disorder diagnostic terminology because it is an unclear definition and has a negative connotation
What was substance abuse previously thought of as?
People with substance abuse disorders were previously considered “weak-willed”, that they had a flaw in their moral character
What is the most important neurotransmitter to understand when considering substance-abuse?
Dopamine
What is the dopaminergic pathway
- considered the “reward pathway”: functions in reward, pleasure, fine tuning motor function, compulsion, preservation
- *-VTA (ventral tegmental area) transmits dopamine to the frontal cortex or to the nucleus acumbens**
- Substantia nigra transmits to caudate nucleus or putamen
What are the three main types of opioid receptors?
Mu, Kappa & Delta
Which receptor do opiods respond most readily to?
Mu receptor
Which drugs attach to all three receptors but in different ways?
Morphine, fentanyl, sufentanil
What is an agonist?
Agonists activate; ex. when someone takes heroine they get the Mu response where dopamine will flow through their system
What is an antagonist?
Antagonists shut an agonist response down; ex. malaxone is a prominent Mu opioid antagonist
What are cannabinoid receptors?
They are receptors located throughout the body part of the endocannabinoid system which is involved with appetite, pain sensation, mood and memory. CBD, CBN, and TCH fit like a lock and key into these receptors
What are the two cannabinoid receptors and where are they located?
CB1 is in the central nervous system and CB2 is in the peripheral organs, especially in the gut area (what activates the “munchies”) and associated with the immune system
What is rimonabant
An antagonist: specifically a CB1 receptor blocker
What is GABA?
GABA is the inhibitory neurotransmitter that is activated by alcohol
Opiate receptors in which region of the brain are most involved in opioid addiction?
Receptors in the periaquaductal gray
What has recently become the most abused drug in the US?
Fentanil
Why is it difficult to quit when taking opioids?
Opioids alter the dopamine neurotransmitters, once they have been changed it makes killing extremely difficult
In 1980, what was a false claim made regarding opioid addiction?
- Claimed that opioids were not as addictive for patients with no history of addiction.
- WRONG because opioids are extremely addictive no matter who the person
Why was the war on drugs not successful?
They went into it with the wrong approach
What is the difference between a schedule 1 and a schedule 5 drug?
- Schedule 1: drugs with no currently accepted medical use and high potential for abuse, most dangerous drugs of all the drug schedules with potentially severe psychological or physical dependence (ex. heroin, marijuana, LSD, ecstasy)
- Schedule 5: drugs with lower potential for abuse and consist of preparations containing limited quantities of narcotics, usually used for antidiarrheal, antitussive and analgesic purposes (robitussin, lomotil, lyrica)
What is a Schedule 2 drug?
Drugs with high potential for abuse with potential for severe psychological or physical dependence (methamphetamine, methadone, oxycodone, fentanyl)
What is a Schedule 3 drug?
Drugs with moderate to low potential for physical and psychological dependence (ex. products containing 90 mg of codeine, ketamine, testosterone)
What is a Schedule 4 drug?
Drugs with low potential for abuse and low risk of dependence (ex. xanax, ativan, ambien)
What drug unusually is still considered a schedule 1 drug?
marijuana
