Addiction: Drug therapy for reducing addiction

Question 1

What are the three types of drug therapy?

Answer 1

• Aversives
• Agonists
• Antagonists

Question 2

How do aversives work?

Answer 2

• Produce unpleasant consequences like vomiting.
• E.g. disulfram is an aversive that when taken with alcohol cause a hypersensitivity to alcohol, leading to severe hangover effects.
• This allows for an association to form between the substance (e.g. alcohol) and the unpleasant consequences caused by the drug (e.g. vomiting)

Question 3

How do agonists work?

Answer 3

• ‘Drug substitutes’
• They activate neuron receptors, providing a similar effect to the addictive substance.
• E.g. methadone is an agonist used to treat heroin addiction by satisfying the addicts craving for euphoria.
• They have fewer harmful side effects and are ‘cleaner’ as they can be administered medically in controlled doses.
• They stabilise the addict as they are used to control the withdrawl syndrome, allowing a gradual reduction in dose and symptoms.

Question 4

How do antagonists work?

Answer 4

• They block receptor sites so the substance of dependence cannot have its usual effects (as it/as much cannot bind) - especially the feeling of euphoria.
• E.g. Naltrexone is an opioid antagonist used to treat heroin addiction.
• Other therapy methods should be used alongside antagonist drug treatment to tackle the psychological causes of the addiction.

Question 5

What is nicotine replacement therapy (NRT)?

Answer 5

• Other sources of nicotine (substitutes a cigarette) is used to deliver nicotine to the body e.g. patches, gum, inhaler.
• Provides the user with a clean, controlled dose of nicotine, activating nAChRs in the mesolimbic pathway, allowing for the dopamine reward system to be activated.
• NRT allows for the dose of nicotine to be reduced over time- encouraging dependence to be fully eradicated for the addict while also allowing for the reduction of withdrawl symptoms.

Question 6

Explain drug therapies to treat gambling addiction:

Answer 6

• Although there are no officially approved drugs to treat gambling addiction, there is ongoing research into it.
• Opioid antagonists like naltrexone are currently the most promising. This has come about due to the similarities between gambling and substance addiction, which are now recognised in the DSM-5.
• The neurochemical explanation is that they both impact the dopamine reward system.
• Opioid antagonists enhance the release of the neurotransmiter GABA in the mesolimbic pathway. Increased GABA activity reduces the release of dopamine in the nucleus accumbens- linking to reductions in gambling behaviour.

Question 7

What are the 4 evaluation points for using drug therapy to treat addiction?

Answer 7

1) Research support (S)
2) Reduces stigma (S)
3) Major benefits (S)
4) Side effects (L)

Question 8

Explain research support (S) for using drug therapy to treat addiction:

Answer 8

• Boyce conducted a meta-anlaysis of 136 studies into the effectiveness of NRT.
• Concluded that all forms of NRT were significantly more effective in helping smokers quit than placebo and no therapy at all.
• NRT products increase the rate of quitting by 60%.
• Research shows that NRT does not foster dependence.
• Overall, NRT is an effective therapy which may save lives and reduce costs to the NHS.

Question 9

Explain reduces stigma (S) for using drug therapy to treat addiction:

Answer 9

• Addiction becomes less stigmatised through association with drug therapy.
• Many people believe addiction is a psychological weakness. This stigma attached to addiction can lead to self-blame and depression, which makes recovery more difficult.
• Fortunately stigma around addiction is being eroded due to its successful association with drug therapy- encouraging the perception that addiction has a neurochemical basis.
• Perceiving addiction as something that can be treated with drugs helps people with addiction avoid self-blame and aids in recovery.

Question 10

Explain side effects (L) for using drug therapy to treat addiction:

Answer 10

• All drug therapies have side effects.
• The risk with side effects is that the addict will discontinue their therapy.
• Symptoms can include sleep disturbances, gastrointestinal issues and headaches.
  -Major concern for potentially treating gambling addiction with opioid antagonist naltrexone as higher doses are needed for it to have an effect with gambling addictions- meaning the side effects are correspondingly worse e.g. muscle spasms, anxiety, depression.
• Therefore side effects shoukd be compared with the benefits of the drug and other therapies available.

Question 11

Explain major benefits (S) for using drug therapy to treat addiction:

Answer 11

• Drug therapies have major benefits in treating addiction.
• They aid in controlling unpleasant withdrawl symptoms- which may make side effects tolerable if they are very effective at treating the addiction- encouraging clients to stick to the treatment.
• They are also cost-effective and are non-disruptive to people’s lives. They are cheaper than alternative therapies like CBT, reducing costs to the NHS. They are also a small commitment to clients lives.