abuse/addiction

Question 1

substance use disorder

Answer 1

using drug in a manner not intended

Question 2

multiple drug intoxication

Answer 2

benzos; alcohol; opiates; antihistamines

Question 3

DMS-5

Answer 3

meets that many factors for level of severity

2-3 mild
4-5 moderate
6-7 severe
larger amounts
spending a ridiculous amount of time obtaining the drug
wanting to cut down/quit but cant
craving
cants complete tasks
recurrent use in bad situation

Question 4

psychological effects

Answer 4

wanting to quit but cant and having strong cravings

hardest part to treat

Question 5

does SUD require tolerance or physical dependence?

Answer 5

NO

Question 6

dopamine reward pathway

Answer 6

mesolimbic- movement (+) dillusional thinking like for schizophrenia

Question 7

whats the primary DA path?

Answer 7

mesolimibic; orgin in ventral tegmental area of midbrain projects to nucleus accumbens (ventral striatum)

Question 8

what happens from activation of mesolimbic path?

Answer 8

incentive salience aka wanting from learned behaviors

Question 9

thinking of a reward

Answer 9

is more important in learning and coding memories about a reward

Question 10

2 more pathway from VTA

Answer 10

mesocortical: cognition and feeling– disfuctional is schizophrenia

from VTA to amyglada and hippocampus for processing memories from experiences

Question 11

glutamate pathway

Answer 11

major excitatory in brain

acts on NMDA , AMPA, and kainate all which are involved in learning

glutamate pathway

Question 12

neuroadaptation?

Answer 12

activation of dopamine and glutamate pathways — take place during learning could be good or bad

Question 13

natural reward

Answer 13

sex food shelter

Question 14

unnatural reward

Answer 14

drugs

Question 15

natural and unnatural rewards

Answer 15

both involve activation of the dopamine glutamate pathway which leads to neurological neuroadaptation to leaning in the end you either

change behavior adaptive which is crucial for survival

or maladaptive behavior which is drug use can be harmful to survival

Question 16

conditioned stimuli

Answer 16

creates expectation of the reward

ex smelling food or visioning before

Question 17

uncondition stimuli

Answer 17

are rewarding activities themselves the sex, eating, gambling actually doing it

become associated with the conditioned stimuli which is like visualizing or smelling when thinking about doing the sex, eating, or gambling

Question 18

expectation of the reward

Answer 18

motivation to obtain reward (incentive salience)

pleasure of reward/feel good (hedonia)

Question 19

how to treat addiction

Answer 19

take learned behavior away and minimize it

no good pharm therapy

Question 20

minimize withdraw symptoms

Answer 20

clonidine

Question 21

drug substitution

Answer 21

methadone, nicotine

Question 22

for alcohol use disorder

Answer 22

disulfiram; inhibits acetaldehyde dehydrogenase

use of alcohol will cause accumulation of acetaldehyde

cause pt to feel sick

Question 23

acamprosate

Answer 23

analoug of gaba

MOA unclear

no efficacy

Question 24

naltrexone

Answer 24

opiate receptor antagonist

not good efficacy

use with a program

Question 25

for nicotine

Answer 25

nicotine replacement and bupropion NDRI anti depressant has nictoninc cholinergic varenciline: partial agonist of a4b2 nicotinic reduce craving headache nausea bad sleep neuro effects hostility aggresion

Question 26

methadone

Answer 26

for opiate dependence long half life mu opiod agonist long term detox overdose deaths are happening

Question 27

buprenorphine

Answer 27

mixed partial mu agonist and kappa antagonist maintance/long term detox

Question 28

naltrexone

Answer 28

opiate receptor antagonist rapid detox: 8hr under general anesthesia