9 Neurobiology of addiction and treatments Flashcards
What three criteria used to distinguish addiction from normal use?
- Craving or compulsion
- Loss of control
- Little concern for consequences
What recreational drugs are used most often in Australia?
85% used alcohol recently
9% are daily drinkers
20% smoked recently
What drug is responsible for most deaths per year in Australia?
Tobacco (15,050); Alcohol (3,494); Opiates (221); Stimulants (17); Cannabis (1)
Can a substance disorder exist without evidence of physiological dependence?
Yes, tolerance and withdrawal are only two of the seven criteria for substance disorder
What are the DSM criteria for substance abuse disorder?
A maladaptive pattern of substance use, leading to clinically significant impairment or distress, as manifested by three of the following, occurring at any time in the same 12-month period:
- Tolerance
- Withdrawal
- Taking larger amounts or over a longer period than was intended
- A persistent desire or unsuccessful efforts to cut down or control substance use
- A great deal of time is spent in activities necessary to obtain the substance, use the substance, or recover from its effects
- Important social, occupational, or recreational activities are given up or reduced because of substance use
- The substance use is continued despite knowledge of having a persistent or recurrent physical or psychological problem
What is tolerance?
Reduction in the effects of a given dose of a drug following repeated use
What is withdrawal?
Physiological and psychological symptoms that occur when drug use is stopped (usually opposite to effects of drug itself)
What do all drugs of abuse have in common?
They all activate mesolimbic dopamine system - reward pathways
What kind of reinforcement can drugs offer?
Positive - nice symptoms, euphoria etc – and…
Negative - reduction in anxiety, reduction in withdrawal symptoms
How can negative reinforcement interact with withdrawal to encourage drug use?
A person might begin to drink to relieve anxiety, say, then feel withdrawal symptoms, which are usually opposite of effects of drug (i.e. anxiety) and drink to relieve withdrawal-induced anxiety
What does Outcome Devaluation Task measure?
Difference between goal-oriented and habitual behaviours
How can behaviour shift from goal-oriented to habitual?
Over repeated trials, response to get desired substance is so often reinforced that stimulus-response conditioning occurs (eg. in bar, drink beer)
How does Outcome Devaluation Task work?
Animal is sated on substance (food, alcohol), then measured if will press lever it’s been conditioned to press in order to receive same substance (habitual response) or another lever to receive a new substance (goal-oriented response).
How sensitive to alcohol devaluation were rats in Corbit et al. 2012?
After one week of training, animals pre-fed alcohol, reduced lever pressing for alcohol; after four weeks, trend upwards but not significant; after eight weeks, no sensitivity to devaluation of alcohol. After eight weeks - see a lever, push it - not reevaluating value of outcome, just automatic behaviour
What are the three phases of the Pavlovian-Instrumental Transfer paradigm?
- Animals learn association between a stimulus and reward delivery (Pavlovian conditioning). Stimulus becomes cue for reward.
- Trained to perform an instrumental response to get reward
- Examine effect of reward-related cues on responding. Expected that cue enhances responding
What general principle does the Pavlovian Instrumental Paradigm illustrate?
That reward-related cues increase responding to get reward. Environmental stimuli can trigger reward-seeking behaviour –and their ability to do so increases with training
What two related shifts happen in drug-related behaviour by the eight-week mark?
Behaviour shifts from being sensitive to devaluation and reward value to being automatic - determined by environmental cues
How can drug-related stimuli contribute to relapse?
Because the user has been conditioned to seek the drug when these stimuli are presented
How does reinstatement work?
Reward-seeking behaviours that have been extinguished can be reinstated upon presentation of cue associated with the reward - environmental cue, stress etc.
How effective is extinction?
It doesn’t entirely erase association. Evidence for this is provided by robust reinstatement effects. Neurally, perhaps, neurons already wired
How do we know which parts of brain are involved in reinstatement effect?
If prefrontal cortex and VTA are inhibited by a GABA agonist, a priming dose of cocaine does not produce a reinstatement effect
How can increasing neural plasticity help avoid reinstatement after extinction?
Chemically improving cognitive performance - with ADHD drug atomoxetine - during learning of extinction reduces reinstatement effect. Improves retention of learning.
Which drugs of abuse modify dopamine?
All of them
How are DA receptors in the striatum affected in alcoholics?
There are less D2 receptors
