addiction

Question 1

define addiction

Answer 1

• compulsion to use a substance or engage in behaviour despite its harmful consequences and you are unable to stop
• lead to failure to meet work, social and family obligations

Question 2

define tolerance and features of it

Answer 2

• when an individual has to take more and more of the substance to gain the same effect as their initial experience
• explained through homeostasis as the brain readjusts if we start to intake a substance regularly

Question 3

define cross tolerance

Answer 3

need for more of a substance to gain the same effect as the body becomes tolerant, seen in all drugs and cross drug families

Question 4

how does tolerance occur

Answer 4

metabolic tolerance- enzymes responsible for metabolising the drug do this more efficiently over time which leads to reduced concentrations in the blood and weaker effect
cellular tolerance- prolonged drug use leads to changes in resection density, reducing the response to the normal dose of the drug
learned tolerance- user will experience reduced drug effects because they have learned to function normally when under the influence of the drug

Question 5

define withdrawal syndrome and features of it

Answer 5

• unpleasant feelings and symptoms after you stop taking the substance
• follows tolerance as the body seeks out the drug
• low mood, feeling nauseous and being achy
• withdrawal is opposite to the feelings induced by the drug

Question 6

what does severity of withdrawal syndrome depend on

Answer 6

drug used- shorter half life leads to more intense withdrawal
amount consumed- if large amounts are consumed then the withdrawal will be greater
drug use pattern- greater dependence if the drug use is frequent and regular

Question 7

define acute withdrawal

Answer 7

begins within hours of drug cessation and gradually resolves, and is characterised by intense physical cravings

Question 8

define post acute withdrawal

Answer 8

emotional and psychological turmoil as addict experiences alternating periods of dysfunction and near normality as the brain tried to re-organise without relying on the substance

Question 9

what is physical dependence and features of it

Answer 9

• occurs with long term usage when a person relies on a substance to feel normal
• does not mean they are addicted
• increased tolerance
• unpleasant physical withdrawal symptoms

Question 10

what is psychological dependence and features of it

Answer 10

• drug becomes a central part of an individuals thoughts, emotions and activities
• strong urge to use the drug
• cravings
• person feels anxious if cravings are not met and feel they are unable to cope

Question 11

how does Epstein suggest psychological dependence arises

Answer 11

• rational system- reasoning through conscious, analytical and emotion free decision making
• experiental system- precocious, autonomic and emotion driven, behave how we feel and often act irrationally

Question 12

explain how genetic vulnerability is a risk factor

Answer 12

• some are more able to metabolise certain substances and less likely to experience negative effects so they consume larger amounts, European generally metabolise alcohol quickly, 50% of asians metabolise alcohol slowly so they feel nauseous after drinking small amounts
• Pianezza et al found some who lack fully functioning enzyme to metabolise nicotine, and they smoke significantly less
• some have low levels of dopamine and decreases ability to activate dopamine receptors with brain reward with way
• alcoholic with variant of dopamine receptor gene associated with decreased dopamine receptor availability

Question 13

evaluation of genetic vulnerability as a risk factor

Answer 13

+ national swedish adoption study looked at adults who were adopted where one parent from biological family had addictions, found they 2x more at risk at developing addictions themselves
=> confounding variable if they still have contact with family
+ genetics also influences personality and ability to regulate emotions, which can affect their concept of self and lead to involvement with drugs to cope
- biological reductionism

Question 14

explain stress as risk factor

Answer 14

• use of substances or behaviours as coping mechanism
• addiction less likely if there are mediating factors like social support
• “self medication” model by Gelkopf et al proposed that individuals intentionally use different forms of behaviour to “treat” psychological symptoms
• stress is one of the strongest predictors of relapse and increases drug cravings
• robins et al found almost half of US soldiers with PTSD used opium or heroin, and 20% developed dependence for heroin
• kessler et al found men with PTSD 34% reported drug abuse compared to 15%, women 27% vs 8%
• sexual abuse in childhood meant more women were 2x more likely to develop alcohol addiction

Question 15

evaluation of stress as a risk factor strengths

Answer 15

+ research can be used to reduce risk of stress with addiction, Matherny and Weatherman carried a follow up study on smokers and found there was a relationship between use of stress coping resource and abstinence from smoking

Question 16

evaluation of stress as a risk factor weaknesses

Answer 16

• hard to establish cause and effect, may only be correlational
• not established for all addictions, Arvelo et al found association between areas and illicit drug use, but not with stress and alcohol addiction

Question 17

personality as a risk factor for addiction

Answer 17

• clonigers tridimensional theory
• impulsivity- lack of planning, high degree of risk taking
• anti social personality disorder (APD)- incorporates impulsivity, 44% in alcoholics and 70% in cocaine addicts
• psychoticism and neuroticism
• self efficacy- how strongly someone believes they are capable of doing something like changing their behaviour, those with no addiction have higher self efficacy

Question 18

explain clonigers tridimensional theory

Answer 18

novelty seeking- need for change and stimulation and seek new environments and experience (high)
harm avoidance- amount a person worries about the negative elements (low)
reward dependence- someone reacts and learns from a rewarding situation quickly (high)

Question 19

explain eysenck and eysenck theory of personality as risk factor

Answer 19

• psychoticism- egocentric, aggressive, impulsive
• extroversion- outgoing, happy, sociable
  -neuroticism- anxious, moody
  -people with addition score more highly on P and N scale

Question 20

evaluation of personality as a risk factor

Answer 20

+ longitudinal studies support influence of impulsivity in predicting later addiction- adolescents who progressed to heavier levels of alcohol abuse scored higher in impulsivity
+ clear relationship between personality and addiction, so identifying vulnerable individuals can help prevent it
- personality is genetically determined- novelty seeking associated with D4 dopamine receptor gene

Question 21

family influences as a risk factor

Answer 21

• social learning theory can explain how adolescents see family as role models and imitate their behaviour
• Reith and Dobbie found that gambling knowledge and behaviour was passed on through routines or everyday life
• vicarious reinforcement- if they see role models rewarded for such behaviour, e.g feelings of pleasure or calm
• schemas formed as we are infeluced on our desire to try substances
• perceived parental approval means you are more likely to try a substance if your parents are lenient
• if adolescents believe their parents have little to no interest in monitoring their behaviour they are more likely to develop an addiction
• older siblings are see as role models and have more influence as they are more like them, and thus gravitate towards peers who resemble and validate their behaviour

Question 22

evaluation of family influences on addiction

Answer 22

+ quine and stephenson found that children were significantly more likely to have the intention to have drunk alcohol if their parents drank weekly
+ tolerant parental attitudes and sibling substances abuse were the characteristics most strongly associated with increased prevalence of binge drinking
- family intervention does not look at sibling influence

Question 23

peer influence as a risk factor of addiction

Answer 23

• mary o’connell et al said elements were individuals attitudes about drinking are influenced by associating with peers who use alcohol, experienced peers provide more opportunities, and individual overestimates how much their peers are drinking
• creation of a group norm that favours rule breaking infeluces drug use
• peer pressure
• social identity theory- significant part of an individuals self concept is formed as a result of their ingroup

Question 24

evaluation of peer influence as a risk factor

Answer 24

+ litt and stock found teenagers who viewed their peers facebook profiles that portray alcohol use were more willing to use alcohol
+ help with social norm interventions to influence adolescents misconceptions towards alcohol
- peers are less inferential as individuals get older

Question 25

what is nicotine and its effect on smoking and addiction

Answer 25

• WHO estimates 36% of males and 7% of females smoke
• nicotine has effects including tranquillisation, decreased irritability, increased alertness and improve cognitive functioning
• nicotine paradox- both stimulant and relation effects, explained through the fact smoking appears relaxing as smokers are in mild nicotine withdrawal
• nicotine reaches peak levels in bloodstream and brain in less than 10s

Question 26

what is dopamine and its effects

Answer 26

main neurotransmitters which causes feelings of pleasure, and many drugs act in brains reward system to heighten dopaminergic activity

Question 27

role of neurotransmitters and enzymes in nicotine addiction

Answer 27

• nicotine attaches neurons in VTA, which triggers release of dopamine in nucleus accumbens
• nicotine also stimulated glutamate, which triggers additional release of dopamine and speed up activity of neurons
• GABA is meant to slow down neuron activity, but nicotine inhibits this
• cigarette smoke also has unknown substance which blocks action of enzyme MAO, which is responsible for breaking down dopamine
• effects of dopamine disappear in a few mins, so continued activation of dopamine enhancing neurons builds a tolerance and dependence