addiction and drugs of abuse modified Flashcards
Question: What is addiction defined as?
Answer: Addiction is continued involvement with a substance or activity despite ongoing negative consequences.
Question: What are the two types of addiction?
Answer: The two types of addiction are physiological addiction and psychological addiction.
Question: What is the difference between habit and addiction?
Answer: Habit is a repeated behavior that may be unconscious, whereas addiction is a repeated behavior that occurs by compulsion and causes considerable discomfort if not performed.
Question: What are process addictions?
Answer: Process addictions are behaviors that are known to be addictive because they are mood altering, such as money addictions, compulsive gambling, and work addiction.
Question: What is a severe substance use disorder?
Answer: A severe substance use disorder is characterized by having four or more severe symptoms, such as tolerance, withdrawal, using more than intended amounts, trying unsuccessfully to stop, having physical or psychological problems made worse by the drug, and experiencing problematic relationships.
Question: What are the DSM-5 substance use disorders categorized by?
Answer: The DSM-5 substance use disorders are categorized by a specific substance, such as alcohol, caffeine, cannabis, hallucinogens, inhalants, opioids, sedatives, hypnotics, or anxiolytics, stimulants, and tobacco.
Question: What is tolerance?
Answer: Tolerance is a decline in the effects of a drug with continued use at the same dose, leading to the need for higher doses over time to elicit the same response.
Question: What is dependence?
Answer: Dependence is the adaptation to chronic regular use of a drug, becoming apparent during withdrawal when drug administration ceases or the dose of drug is reduced.
Question: What is craving?
Answer: Craving is the powerful subjective urge to engage in drug taking behavior, often observed in conditions where there is dependence.
Question: What are habits?
Answer: Habits are conditioned responses to environmental stimuli that have been associated previously with reward or absence of punishment.
Question: What are compulsions?
Answer: Compulsions are repetitive and persistent habitual acts that are inappropriate to a given situation and frequently lead to adverse consequences.
DSM-5 Substance Use Disorders
Categorised by a specific substance:
Alcohol
Caffeine
Cannabis (e.g., marijuana)
Hallucinogens
Inhalants
Opioid (e.g., heroin)
Sedatives, Hypnotics, or Anxiolytics (e.g., diazepam)
Stimulants (cocaine, methamphetamine)
Tobacco
Severe substance use disorder
Having four or more severe symptoms, such as:
Tolerance: Larger doses needed; lower dosage does not produce typical effect
Withdrawal: Negative physical and psychological effects from stopping usage
Using more than intended amounts
Trying unsuccessfully to stop
Having physical or psychological problems made worse by drug
Experience problematic relationships.
What neurotransmitter is involved in the reward pathway in addiction?
Dopamine is the neurotransmitter involved in the reward pathway in addiction.
What region of the brain is involved in reward processing?
The nucleus accumbens is the region of the brain involved in reward processing.
What is the effect of chronic drug use on dopamine levels in the reward pathway?
Chronic drug use can lead to decreased dopamine levels in the reward pathway, leading to a reduced ability to experience pleasure and reward from natural sources.
What are the opioid peptides involved in addiction?
Opioid peptides are involved in addiction and are found in the nucleus accumbens, amygdala, and ventral tegmental area.
What is the role of GABA in addiction?
GABA is a neurotransmitter involved in addiction and is found in the amygdala and bed nucleus of stria terminalis.
What neurotransmitter is involved in the acute reinforcing effects of drugs of abuse?
Glutamate is the neurotransmitter involved in the acute reinforcing effects of drugs of abuse.
What is the prefrontal cortex’s role in serotonin pathways?
The prefrontal cortex is involved in serotonin pathways, particularly in regulating mood, anxiety, and depression.
What is the effect of chronic cocaine use on serotonin levels in the brain?
Chronic cocaine use can lead to reduced serotonin levels in the prefrontal cortex, leading to increased impulsivity and risk-taking behavior.
What is the hippocampus’s role in serotonin pathways?
The hippocampus is involved in serotonin pathways, particularly in regulating memory.
What are the potential consequences of chronic opioid use on serotonin pathways?
Chronic opioid use can lead to changes in the serotonin pathways involved in pain perception, leading to increased pain sensitivity and dependence on opioids.
What neurotransmitter is involved in the reward pathway?
Dopamine is the neurotransmitter involved in the reward pathway.
What are the two types of dopamine receptors involved in the reward pathway?
The two types of dopamine receptors involved in the reward pathway are D1 and D2 receptors.
What is the function of dopamine in the reward pathway?
Dopamine is involved in pleasure, euphoria, mood, and motor function in the reward pathway.
What neurotransmitter is involved in mood and anxiety in the reward pathway?
Serotonin is the neurotransmitter involved in mood and anxiety in the reward pathway.
What is the function of serotonin in the reward pathway?
Serotonin is involved in regulating mood, impulsivity, anxiety, sleep, and cognition in the reward pathway.
What neurotransmitter is involved in pain and appetite in the reward pathway?
Cannabinoids are the neurotransmitters involved in pain and appetite in the reward pathway.
What are the three types of opioid peptide receptors involved in the reward pathway?
The three types of opioid peptide receptors involved in the reward pathway are kappa, mu, and delta receptors.
What is the function of opioid peptides in the reward pathway?
Opioid peptides are involved in pain regulation in the reward pathway.
What are the two types of cannabinoid receptors involved in the reward pathway?
The two types of cannabinoid receptors involved in the reward pathway are CB1 and CB2 receptors.
What is the function of cannabinoids in the reward pathway?
Cannabinoids are involved in pain regulation, appetite, and memory in the reward pathway.
In all rewards, ______________ is the final activation chemical
In all rewards, dopamine is the final activation chemical
What is direct drug action on the dopamine pathway?
Direct drug action on the dopamine pathway involves drugs that work via direct action on a dopamine receptor or dopamine transporter, leading to increased dopamine receptor activation.
What is indirect drug action on the dopamine pathway?
Indirect drug action on the dopamine pathway involves drugs that modulate dopamine via other receptor systems and neurotransmitters that then modulate a different system, leading to downstream effects on dopamine.
How does alcohol affect dopaminergic activity in the ventral tegmental area?
Alcohol binds to subreceptors GABAA, inhibiting GABAergic interneurons, eventually increasing dopaminergic activity in the VTA.
What is the effect of heroin on GABAergic neurons that project to dopaminergic neurons in the VTA?
Heroin binds to opioid receptors that inhibit GABAergic neurons that project to dopaminergic neurons in the VTA.
What is the effect of cocaine on dopamine transporters?
Cocaine blocks the function of the dopamine transporter (DAT) by binding to it and slowing transport.
How does nicotine affect dopaminergic neurons in the VTA?
Nicotine activates cholinergic neurons that project to dopaminergic neurons in the VTA.
What brain regions are involved in the converging actions of drugs of abuse on the reward pathway?
The ventral tegmental area (VTA) and the nucleus accumbens (NAc) are the brain regions involved in the converging actions of drugs of abuse on the reward pathway.
How does alcohol affect GABAergic neurons in the VTA?
Alcohol inhibits GABAergic neurons that project to dopaminergic neurons in the VTA.
What is the effect of heroin on opioid receptors in the reward pathway?
Heroin binds to opioid receptors that inhibit GABAergic neurons that project to dopaminergic neurons in the VTA.
How does cocaine affect dopamine transport in the reward pathway?
Cocaine blocks the function of the dopamine transporter (DAT) by binding to it and slowing transport, leading to increased dopamine in the reward pathway.
How does nicotine affect dopaminergic activity in the reward pathway?
Nicotine activates cholinergic neurons that project to dopaminergic neurons in the reward pathway, leading to increased dopaminergic activity.
What is the effect of indirect drug action on the dopamine pathway?
Indirect drug action on the dopamine pathway involves drugs that modulate dopamine via other receptor systems and neurotransmitters, leading to downstream effects on dopamine.
How does alcohol affect serotonergic activity in the reward pathway?
Alcohol has direct serotonergic effects in the reward pathway.
What is the effect of heroin on the opioid receptor system in the reward pathway?
Heroin binds to opioid receptors in the reward pathway, leading to downstream effects on dopamine.
How does cocaine affect dopaminergic activity in the reward pathway?
Cocaine blocks the reuptake of dopamine, leading to increased dopaminergic activity in the reward pathway.
What is the effect of cannabinoids on the reward pathway?
Cannabinoids bind to CB1 and CB2 receptors in the reward pathway, leading to downstream effects on pain, appetite, and memory.
What is the effect of opioids on the reward pathway?
Opioids bind to mu, delta, and kappa opioid receptors in the reward pathway, leading to downstream effects on pain.
What is the effect of GABAergic interneurons on the reward pathway?
GABAergic interneurons inhibit dopaminergic neurons in the reward pathway.
How does heroin affect the function of GABAergic interneurons in the reward pathway?
Heroin binds to opioid receptors that inhibit GABAergic interneurons in the reward pathway.
What is the effect of cocaine on the function of dopamine transporters in the reward pathway?
Cocaine blocks the function of dopamine transporters (DAT) by binding to them and slowing transport, leading to increased dopamine in the reward pathway.
What neurotransmitters are involved in intoxication?
Dopamine, opioid peptides, serotonin, and GABA are involved in intoxication.
What neurotransmitters are involved in withdrawal?
Dopamine, dynorphin, serotonin, CRF, opioid peptides, GABA, norepinephrine, NPY, and glutamate are involved in withdrawal.
What are some risk factors for addiction related to biological factors?
Unusual early response to a substance, attention deficit/hyperactivity disorder, biologically based mood disorders, and addiction among biological family members are all risk factors for addiction related to biological factors.
What are some risk factors for addiction related to psychological factors?
Low self-esteem, external locus of control, passivity, and post-traumatic stress disorders are all risk factors for addiction related to psychological factors.
What are some risk factors for addiction related to environmental factors?
Ready access to the substance or experience, abusive or neglectful home environments, peer norms, misperception of peer norms, membership in an alienated, oppressed, or marginalized group, and life events, including chronic or acute stressors, are all risk factors for addiction related to environmental factors.
What is the effect of dynorphin during withdrawal?
Dynorphin is involved in dysphoria during withdrawal.
What is the effect of noradrenergic nucleus locus coeruleus (LC) during withdrawal?
The activation of the noradrenergic nucleus locus coeruleus (LC) is involved in the stress response during withdrawal.
What are some negative effects of withdrawal?
Increased discomfort, anxiety, dysphoria, dysphoric mood, irritability, depression, and anger are some negative effects of withdrawal.
What is the role of the thalamus during withdrawal?
The thalamus is activated during withdrawal.
What neurotransmitter is involved in analgesia and relaxation during intoxication?
Opioid peptides are involved in analgesia and relaxation during intoxication.
What neurotransmitter is involved in elevated mood during intoxication?
Serotonin is involved in elevated mood during intoxication.
What is the effect of glutamate during withdrawal?
Glutamate is involved in hyperexcitability during withdrawal.
What is the effect of NPY during withdrawal?
NPY is involved in anti-stress during withdrawal.
What are some psychological risk factors for addiction?
Low self-esteem, external locus of control, passivity, and post-traumatic stress disorders are some psychological risk factors for addiction.
What are some environmental risk factors for addiction?
Ready access to the substance or experience, abusive or neglectful home environments, peer norms, misperception of peer norms, membership in an alienated, oppressed, or marginalized group, and life events, including chronic or acute stressors, are all environmental risk factors for addiction.
What is the effect of GABA during intoxication?
GABA is involved in decreased anxiety, less panic, and relaxation during intoxication.
What is the effect of opioids on pain during withdrawal?
Opioid peptides can increase pain during withdrawal.
What is the effect of alcohol on the reward pathway?
Alcohol inhibits GABAergic neurons that project to dopaminergic neurons in the ventral tegmental area (VTA), leading to increased dopaminergic activity.
What is the effect of heroin on the reward pathway?
Heroin binds to opioid receptors that inhibit GABAergic neurons that project to dopaminergic neurons in the VTA, leading to increased dopaminergic activity.
How can withdrawal lead to further consumption and relapse?
Withdrawal can result in negative effects, such as dysphoria, anxiety, and stress, leading the person to seek the drug again to alleviate these symptoms, leading to further consumption and relapse.
What is the effect of corticotrophin releasing hormone (CRH) during withdrawal?
CRH is involved in the stress response during withdrawal.
What is Naltrexone used for in the treatment of alcohol dependence?
Naltrexone is used to block mu opioid receptors, which reduces the rewarding effects of alcohol.
What is Acamprosate used for in the treatment of alcohol dependence?
Acamprosate is used to inhibit the release of glutamate, which decreases the excitation (withdrawal) that occurs during withdrawal.
What are Methadone and Buprenorphine used for in the treatment of heroin dependence?
Methadone and Buprenorphine are used to activate opioid receptors.
What is the mechanism of action of Nicotine gum/patch in the treatment of tobacco dependence?
Nicotine gum/patch activates nicotinic receptors.
What is Rimonabant used for in the treatment of psychostimulant dependence?
Rimonabant is used to block cannabinoid receptors (CB1).
How does Naltrexone reduce the rewarding effects of alcohol?
Naltrexone blocks mu opioid receptors, which reduces the rewarding effects of alcohol.
What effect does Acamprosate have on glutamate release during alcohol withdrawal?
Acamprosate inhibits the release of glutamate, which decreases the excitation (withdrawal) that occurs during withdrawal.
What is the role of Methadone and Buprenorphine in the treatment of heroin dependence?
Methadone and Buprenorphine activate opioid receptors, which can help reduce cravings and withdrawal symptoms.
How does Nicotine gum/patch work in the treatment of tobacco dependence?
Nicotine gum/patch activates nicotinic receptors, which helps reduce cravings and withdrawal symptoms.
What is the mechanism of action of Rimonabant in the treatment of psychostimulant dependence?
Rimonabant blocks cannabinoid receptors (CB1), which can help reduce drug-seeking behavior and addiction-related behaviors.
Neurobiology of Addiction : give a Brief Summary
Anatomical areas of the brain involved in the reward pathway include the nucleus accumbens, ventral tegmental area and the prefrontal cortex
Dopaminergic activity is the final chemical action in most behaviors relating to reward
Drugs of abuse may work with receptors and transporters to directly or indirectly influence dopaminergic activity
Withdrawal occurs following an abrupt cessation of drug of abuse following changes to the nervous system
Addiction is the result of and results in lasting changes to neurocircuitry, cellular and molecular mechanisms
What is the mechanism of action of Disulfiram in preventing alcohol relapse?
Disulfiram blocks the oxidation of ethanol at the aldehyde stage by inhibiting the enzyme aldehyde dehydrogenase, which leads to the accumulation of acetaldehyde and produces unpleasant symptoms.
What are the common symptoms of acetaldehyde accumulation caused by Disulfiram?
The accumulation of acetaldehyde caused by Disulfiram can produce palpitations, throbbing headaches, hypotension, nausea, emesis, flushing, dizziness, chest pains, and thirst.
What is the recommended dosage of Disulfiram for the prevention of alcohol relapse?
Disulfiram is taken orally at a dose of 500 mg per day for 2 weeks and then maintained at a dose of 250 mg per day. It is recommended to be prescribed as an adjunct to cognitive behavioural therapy and abstinence-based rehabilitation programmes for motivated patients.
What are the symptoms of alcohol withdrawal?
The symptoms of alcohol withdrawal include nausea, emesis, tremor, tachycardia, restlessness, irritability, anxiety, insomnia, nightmares, and transitory hallucinations.
What is the recommended treatment for seizures during alcohol withdrawal?
The recommended treatment for seizures during alcohol withdrawal is intravenous lorazepam or diazepam.
How is delirium tremens treated during alcohol withdrawal?
Delirium tremens, which is characterized by hallucinations, tremor, and general disorientation, is treated with benzodiazepines along with adjunctive antipsychotics.
What are the recommended medications for the treatment of acute alcohol withdrawal?
The recommended medications for the treatment of acute alcohol withdrawal are long-acting benzodiazepines, such as diazepam or chlordiazepoxide.
What is the mechanism of action of acamprosate in preventing relapse and maintaining abstinence in alcoholics?
Answer: Acamprosate’s mechanism of action involves agonist activity at GABA-A receptors and antagonist activity at glutamate NMDA receptors, which mimics the actions of alcohol at these receptors.
What is the main adverse effect of acamprosate and how does it affect the frequency of drinking?
Answer: The main adverse effect of acamprosate is diarrhea, and it reduces the frequency of drinking by 30-50%.
How can the effectiveness of acamprosate in preventing relapse be enhanced?
Answer: Combining acamprosate with naltrexone, cognitive behavioral therapy, and abstinence-based rehabilitation programs can further reduce relapse rates.
What type of receptor does heroin act on and what effect does it mimic?
Answer: Heroin acts as a 𝜇-opioid receptor agonist and mimics the reinforcing effects of naturally released enkephalins in the brain.
What are some withdrawal symptoms of heroin dependence?
Answer: Withdrawal symptoms include restlessness, spasms of agonizing pain, involuntary twitching of leg muscles, fever and sweating followed by hypothermia, vomiting, and diarrhea.
Which medications can be given to help with heroin withdrawal symptoms?
Answer: Loperamide for diarrhea, metoclopramide for nausea and vomiting, ibuprofen for headache, and lofexidine for hypertension.
What is the main pharmacological treatment for managing heroin dependence?
Answer: Opioid substitution therapy using partial 𝜇-opioid receptor agonists, methadone, and buprenorphine.
How is methadone administered and when should it be given in relation to discontinuing heroin?
Answer: Methadone is administered as an oral solution once daily, usually 8 hours after the discontinuation of heroin.
What is the usual dose range for methadone?
Answer: The normal dose range for methadone is 15 to 40 mg.
How is buprenorphine administered, and when should it be given in relation to discontinuing heroin?
Answer: Buprenorphine is administered as a sublingual tablet and should be given 6–12 hours after discontinuation of heroin.
What is the role of naltrexone in preventing relapse in patients who have withdrawn from heroin?
Answer: Naltrexone is an opioid antagonist that prevents the hedonic effects of heroin by blocking 𝜇-opioid receptors. It should be given to patients who have not used heroin for more than seven days.
What is the maintenance dose of naltrexone?
Answer: The maintenance dose of naltrexone is 50 mg once daily.
What psychosocial therapies are used to prevent relapse in heroin addicts who have successfully detoxified?
Answer: Cognitive Behavioral Therapy (CBT) methods and group support therapy, such as Narcotics Anonymous, are used to maintain abstinence from drug use.
