Addiction I

Question 1

describe dependence syndrome

Answer 1

• 3 or more of the following together at some time during the previous year:
  
  • a strong desire to take the substance
  • difficulties in controlling substance-taking behavior
  • physiological withdrawal
  • evidence of tolerance
  • progresstive neglect of alternative pleasures/interests
  • persistent use despite harmful consequences

Question 2

describe addiction type 1 vs addiction type 2 in Cloninger’s tri-dimensional personality theory

Answer 2

Question 3

describe the ventral tegemental reward system

Answer 3

• addictive substances as well as electrical brain stimulation activate the brain reward mechanism (the ventral tegmental dopamine system)
• dopamine is a neurotransmitter, which is able to induce feelings like euphoria and orgasm
• all addictive substances are able to increase the activity of dopaminergic neurons in the nucleus accumbens resulting in a release of dopamine

Question 4

Answer 4

Question 5

Answer 5

Question 6

describe electrical stimulation of VTA

Answer 6

• neurons in ventral tegmental area (VTA) send their axons to nucleus accumbens, striatum and frontal cortex (structures involved in motivation)
• electrical stimulation in midbrain activate dopaminergic neurons in VTA → greater release of dopamine in nucleus accumbens
• dopamine receptor blockers (haloperidol) reduce the rewarding effect
• midbrain dopaminergic neurons → reward dependent learning

Question 7

describe the location of the effect of drugs (alcohol, heroin, cocaine, nicotine, THC)

Answer 7

Question 8

contrast psychic and physical dependence

Answer 8

• psychic dependence
  
  • experience of impaired control
• physical dependence
  
  • tolerance and withdrawal symptoms

Question 9

describe alcohol detoxification

Answer 9

• symptoms:
  
  • tachycardia
  • hypertension
  • hallucinations
  • nausea, vomiting
• life-threatening, sometimes ICU-treatment necessary

Question 10

describe alcohol effect on neurotransmitters

Answer 10

Question 11

describe medical treatment for alcohol withdrawal

Answer 11

Question 12

describe opiate detoxification (cold detox)

Answer 12

• symptoms like gastrinointestinal flu
• not life-threatening
• symptomatic medication against:
  
  • nausea
  • diarrhea
  • tachycardia/hypertension
• 2nd and 3rd days are worst
• not longer than 5-7 days
• hyposomnia can continue for weeks

Question 13

describe warm opiate detoxification

Answer 13

• substitution of opiates with methadone
• reduction of methadone-dose over approx. 3 weeks
• symptomatic medication against:
  
  • nausea
  • diarrhea
  • tachycardia/hypertension
• problem: long stay on a closed ward
• high chance of breaking off the treatment