Addiction

Question 1

Features of Addiction

Answer 1

• Physical (dependence/withdrawal).
• Psychological/behavioural (craving).
• Chronic pattern (remissions and relapses).
• Diagnostic criteria (DSM).

Question 2

Remissions

Answer 2

drug-free periods, often followed by relapse.

Question 3

Drug Classification

Answer 3

CNS stimulants –> Amphetamine, Cocaine, Nicotine.

CNS depressants –> Barbiturates, Alcohol.

Analgesics –> Morphine, Codeine.

Hallucinogens –> Mescaline, LSD, Psilocybin.

Psychotherapeutics –> Prozac, Thorazine.

Question 4

Cycles of pathological drug use that can lead to the development of addiction

Answer 4

1.) Preoccupation/Anticipation, 2.) Binge/Intoxication, 3.) Withdrawal/Negative Affect.

Question 5

Two classification types relate to abuse potential.

Answer 5

1. ) Legal standards

2. ) Scientific evidence based on addiction potential.

Question 6

Substance use disorder

Answer 6

symptoms indicating that the individual continues using the substance despite significant substance related problems.

Question 7

Substance-induced disorder

Answer 7

mental changes produced by substance use or withdrawal that resemble independent mental disorders.

Question 8

Schedule of Controlled Substances

Answer 8

• US established in the 1970s.

- Excludes alcohol and tobacco.

Question 9

Two Types of Progression in Drug Use

Answer 9

1. ) Gateway theory: suggests that drug use begins with legal substance, progresses to marijuana then onto other illicit substances.
2. ) Changes in the amount, pattern, and consequences of drug use.

Question 10

Schedule 1

Answer 10

no current accepted medical use

Ex: cocaine, meth, PCP, ketamine, amphetamines.

Question 11

Oral & Transdermal

Answer 11

• Slow absorption.
• Slow drug availability to the brain.

Ex: nicotine patch.

Question 12

IV injection, Inhalation & Smoking

Answer 12

• Rapid drug entry into the brain.
• Fast onset & shorter duration.
• Greatest addiction potential.
• Produce strongest euphoric effects.

Question 13

Physical Dependence

Answer 13

Repeated drug use → physical dependence → unconditioned reduced levels of drug → conditoned environmental stimuli associated with prior withdrawal reactions→ conditioned withdrawal response, i.e craving.

Question 14

Abstinence syndrome

Answer 14

attempts at abstinence can lead to highly unpleasant withdrawal symptoms, which can lead to relapse.

Question 15

Physical Dependence Criticisms

Answer 15

• Not all drugs produce physical withdrawal/dependence.
• Does not explain the development of dependence.
• Does not consider the condition of relapsed addicts that have detoxified.

Question 16

Impulsive phase

Answer 16

the primary motivation for drug use is positive reinforcing effects.

Question 17

Compulsive phase

Answer 17

the primary motivation for drug use is the negative reinforcement obtained by relief from drug withdrawal.

Question 18

Drug reward

Answer 18

positive experience associated with the drug.

Question 19

Positive Reinforcement Model

Answer 19

Positive reinforcement activates the neural circuits implicated in natural reward.

• If the user abstains, craving is an overwhelming desire to re-experience drug use.

Question 20

Neurobiological ‘reward circuit’

Answer 20

mediates the rewarding and reinforcing effects of most abused drugs.

• Mesolimbic DA pathway
• Learning/prediction of important events

Question 21

Positive Reinforcement Criticisms

Answer 21

• Some people take drugs yet don’t form an addiction.

- Negative effects may not outweigh the positive factors promoting these behaviours.

Question 22

Incentive-sensitization theory

Answer 22

in developing a drug addiction, the user experiences a marked increase in “wanting” the drug even though there a decrease in drug “liking”.

Question 23

Incentive salience

Answer 23

refers to motivation for rewards that is driven by both physiological state and previously learned associations about a reward cue.

Question 24

Problems with Incentive-Sensitization

Answer 24

Does not account for initial drug use that leads to sensitization and tolerance effects.

Question 25

Opponent Process Model

Answer 25

addiction is the result of an emotional pairing of pleasure and the emotional symptoms associated with withdrawal.

Question 26

Allostasis

Answer 26

Drug use leads to initial positive hedonic response that gradually wanes over time and is replaced by a negative response during drug withdrawal.

Question 27

Disease Model

Answer 27

Addiction is tied to changes in brain structure and function.

• Removes social stigma.
• Most known and accepted.

Question 28

Moral models

Answer 28

view that excessive drug use and addiction were seen primarily as signs of personal and moral weakness.

Question 29

Exposure Models

Answer 29

repeated drug use → altered brain function → addiction.

Question 30

Susceptibility Models

Answer 30

inherited susceptibility → repeated drug use → addiction.

Question 31

Criticisms of Disease Model

Answer 31

• No single diagnostic test to confirm that someone is addicted to alcohol/substances.
• Not mutually exclusive.
• Brain-centric view pays too little attention to the individual as a whole.

Question 32

Comorbidity

Answer 32

addicts and alcoholics are often diagnosed with an mental disorder in addition to their drug problem.

Question 33

Self-medication hypothesis

Answer 33

• people initially use substances because they relieve emotional and psych pain.
• continuing of pain leads to increased substance use = the onset of tolerance and development of physical dependence.

Question 34

Biopsychosocial Models

Answer 34

states that a vulnerable host + wrong environment + repeated administration of drug = addiction

includes:
- pharmacological influence: addictive potential

• biological influence: genetic influences
• psycho-social influence: age, race, education, etc.

Question 35

Factors that lead to compulsive drug seeking and drug use

Answer 35

1. ) Positive reinforcing effects
2. ) Discriminative subjective effects of drugs.
3. ) Stimuli conditioned to drug effects.
4. ) Aversive effects
5. ) Risk factors (stress, familial, genetic).
6. ) Protective Factors (fear of health issues, prison, job loss, financial problems).

Question 36

Epigenetic Mechanisms

Answer 36

Inherited predispositions to drug use + environmental stimuli → drug exposure → epigenetic changes → modifying of gene expression → vunerability to addictive disorders → repeat drug exposure → addiction/relapse.

Question 37

Breaking point

Answer 37

The response ratio at which responding ceases.

Question 38

Schedule 2

Answer 38

are medically accepted but have a high potential for abuse.

Question 39

Schedule 3

Answer 39

less potential for abuse than I or II.

ex: hallucinogens.

Question 40

Schedule 4

Answer 40

low potential for abuse relative to substances in III.

ex: barbiturates, benzodiazepines.