Addiction Flashcards
Is a addiction a habit?
-No, brain chemical changes to become dependent
What is the new evidence regarding addiction?
-Addiction being seen as a ‘disease of the brain’
Describe withdrawal
- Characteristic syndrome
- Dependent on alcohol for normal functioning
- Alcohol present in CSF but drops in blood level overnight
- Activates gabaenergic system
- Initially causes drowsiness
- Due to tolerance, there is overcompensation and glutanergic system attempts to counteract
- Without alcohol, equilibrium is disrupted
- Brain becomes agitated
- So withdrawal urges kick in, wanting to take alcohol to balance equilibrium again
What happens when patient ignores withdrawal system?
- Can potentially kill patient or cause more long term damage
- Given benzodiazepine drip and put on detox.
Examples of withdrawal symptoms
- Sweats
- Shaking
- Erections
- Fits
- Yawning
- Joint, abdominal and back pain
Why shouldn’t doctors prescribe opiates?
- Very easy to become dependent on opiates
- Causes back pain
- Only use for cancer or end of life ideally
Describe tolerance
- Need for markedly increased amount
- Marked demising effect
What do fewer D2 receptors indicate?
- Due to genetic factors
- More likely to use drugs
- Decreased social status
What can happen as a result of cocaine use?
-Down regulation of D2 receptors
What can happen if individuals with fewer D2 receptors stop taking drugs?
Partially recovery of D2 receptors
What is main reward centreS of the brain?
-Nucleus Accumbens and VTA
What effects do addictions have on the brain?
- Give artificial rush in pleasures
- Hijacks the pleasure system of brain and gives rush
- People who inject heroine describe it in a mystic way
Explain the tolerance effect that alcohol has
- Causes up-regulation of glut system
- Down-regulation of gaba system
Explain how benzodiazepam is used to treat those in detox
-Acts to upgreulat gaba and deregulate glut to reduce dependency
What are some factors that could determine substance abuse?
- Heritability
- Personality type
- Mental Health issues
- Environmental factors
What affect does cocaine abuse have on the D2 receptors?
- D2 number decreases
- Brain scan show after 10 days of no cocaine, there is slight improvement
- After 100 days there is more improvement
- But only partial recovery
Why is tobacco and nicotine addictive?
- Have short half life
- Reach brain very quickly to exert their effects
What is replacement treatment for cigarette addicts?
- E cig
- Nicotine patch
What are the short-term effects of heroin on central?
Euphoria
Alertness
Drowsiness
What are heroin withdrawal symptoms?
- Sweating, Malaise and Anxiety Yawning and Sneezing
- Tears, Rhinorrhea, Diarrhoea Cold sweats
- Insomnia
- Nausea and Vomiting
- Severe muscle/joint cramps and aches Fever,
- Hypertension, hyperventilation
What drug is used to detox heroine addicts?
-Methodone
What is methadone?
-Opioid agonist
What is buprenorphine?
-Partial opioid agonist
What is combo buprenorphine and naloxone known as?
-Suboxone
Describe opioid substitution treatment
- Involves bringing addicts into clinical controlled setting
- Allowing them to experience their sights but with controlled methadone
- This is done until they are stabilised on methadone
- The detoxed by slowly decreasing dosage of methadone
What is non-opioid detox treatment
Lofexidine
What is post detox treatment drug
Naltrexone
How many regular smokers of cannabis?
-2 million
What is skunk cannabis?
- Very potent
- 20% THC
- Psychogenic component is addictive
What is CBD role in cannabis?
- Sedates and relaxes
- Placebo effect
When medication for seizures in alcohol dependency?
-Diazepam/ Librium
What medication for malnourishment in alcohol dependency?
-Pabrinex & BZD
What medication is used post-detox to help with cravings?
- Acamprosate
- Naltrexone
Benefits of support meetings
- No records kept
- Support and camaraderie
- New activates and friends
What is relapse prevention?
-The process of remaining drug/alcohol free
What is challenging aspect if detox?
-Staying clean
What is included in release prevention?
- Anticipates urges to return to drug/alcohol use and looks at ways of dealing with them
- Skill Power (vs. will power)
- Identify high risk situations
- Cue exposure (desensitisation)
- Coping with social pressures and craving Refusal: practice as ‘pusher’ and ‘user’ Emergency plan in case lapsed
Where do rehab places exist?
- Residential
- Day centres
What occurs in rehab?
- Psycho-education
- Psychotherapy: individual 1:1 AND group work Most residential rehabs are Twelve Step
- Fewer NHS inpatient units now but some complex patients require them,
What are some social interventions to help former addicts?
- Housing
- Employment advice
- Education/training
- Government policy
What has happened to alcohol in general society?
- Increase in number of outlets
- Decrease in the real price
- Increase in strength
