Addiction Flashcards
What is addiction?
Relapsing-remitting disorder comprising behaviours that are performed in a compulsive matter in spite of the potential for self-harm.
What is the difference between addiction and dependence?
Addiction = compulsive need for the substance Dependence = state of withdrawal when substance is removed
What are the main categories of behaviour associated with dependence?
- Drug-seeking/ craving behaviours (anticipation)
- Binging/ intoxication behaviours (‘highs’)
- Withdrawal behaviour
How can dependence be categorised?
Psychological (the need to keep performing compulsive behaviours, emotional distress on stopping behaviours)
Physical (the need for functional effect on body, physical symptoms on withdrawal)
How is dependence syndrome classified in the ICD-10?
Cluster of behavioural, cognitive and physiological phenomena that develop after repeated substance use and that typically include a strong desire the take the drug, difficulty in controlling its use, persisting despite harmful consequences and sometimes a physical withdrawal state
What is tolerance in regards to substance use?
The requirement for increasing amounts of drug/ behaviour to elicit the same level of positive reinforcement (“high”) as that experienced during previous exposure to the substance/ behaviour
What behaviours could be indicative of an individual experiencing tolerance?
Requesting higher dosage
Attending multiple sites to obtain additional substance
What are the 3 main types of tolerance?
Acute (caused by repeated exposure over short amount of time e.g. cocaine)
Chronic (caused by constant exposure to a substance over a prolonged period of time e.g. opioids)
Learned (caused by frequent exposure to substances that become integrated into normal routine e.g. alcohol)
What causes the ‘crash’ (that generally occurs when the positive effects of a drug have worn off)?
Regional changes in neuronal activity
Negative aspects become dominant
What are the common psychological symptoms of withdrawal?
Anxiety Confusion Irritability Fatigue Headaches Dysphoria (unease/ dissatisfaction) Anhedonia (lack of pleasure)
What are the common physical symptoms of withdrawal?
Tremor Tachycardia Tachypnoea Confusion Lacrimation (crying) Rhinorrhea (blocked nose) Hyperhidrosis (excessive sweating)
What symptoms characterise post-acute withdrawal syndrome?
[Usually appears a couple of months after initial withdrawal]
Generally display psychological symptoms such as insomnia, mood swings, anxiety and anhedonia
What class of neurotransmitter is Nicotine?
Parasympathomimetic (acts on parasympathetic nervous system)
What type of receptor does Nicotine bind to?
Cholinergic
What pharmacological interventions can be used to increase adherence to smoking cessation?
Nicotine replacement therapy (e.g. patches)
Bupropion (an atypical antidepressant)
Varenicline (partial agonist to nicotine receptor)
What is AUDIT?
Alcohol Use Disorder Identification Test
Positive score = 5 or more
What are the classic facial features of fetal alcohol syndrome?
Flat mid face Ear abnormalities Short nose Low nasal bridge Thin upper lip Epicanthal folds Absent philtrum
What are the 4 opioid receptor subtypes?
Mu
Delta
Kappa
Non-opioid receptors
Neurologically, what is opioid dependence associated with?
Decrease in mu-receptors and increase in kappa-receptors
How does caffeine work as a stimulant?
- Adenosine receptor antagonists
- Increases noradrenergic transmission
- Increases release of calcium
What causes a ‘caffeine headache’?
Changes in cerebral blood flow induced by caffeine use (causes increased cerebral activity but reduced cerebral blood flow)
What is the mechanism of action for cocaine?
Prevents reuptake of monoamine neurotransmitters via the monoamine transporter
What monoamine transporters does cocaine affect?
- Serotonin
- Dopamine
- Noradrenaline
How do amphetamines work?
Increase monoamine release by acting on intracellular vesicular monoamine transporters
Name some examples of amphetamine-type stimulants?
MDMA Crystal meth Mephedrone Ritalin Speed
What are the 2 main types of tranquillisers?
Major (antipsychotics)
Minor (relaxants)
What tranquillisers are common drugs of abuse?
Benzodiazepines (used for sedatives/ epilepsy)
Barbiturates (used for sedatives/ euthanasia/ epilepsy)
What effects do psychotomimetic drugs have?
Cause changes in perception and sensory distortions (e.g. hallucination)
What are the 2 groups of psychotomimetics?
Drugs acting on serotonin (e.g. MDMA, LSD)
Drugs acting on glutamate receptors (e.g. PCP, ketamine)
