Addiction Medicine

Question 1

What is Dependence Syndrome?

6 things

Answer 1

1. A strong desire … to take the substance
2. Difficulties in controlling substance-taking behavior in terms
   of its onset, termination, or levels of use
   •3. A physiological withdrawal state when substance use has ceased …; or use of the same … with the intention of relieving or avoiding withdrawal symptoms
3. Evidence of tolerance, such that increased doses of the psychoactive substance are required …
4. Progressive neglect of alternative pleasures or interests …
5. Persisting with substance use despite clear evidence of
   overtly harmful consequences

Question 2

What is
Addiction Type 1
Addiction Type 2, more common in?

Answer 2

1: novelty seeking is low, but harm avoidance and reward dependance are high
2: teens, novelty seeking is high, but reward dependance and harm avoidance are low

Question 3

What is the brain reward system?

What is the pleasure center of the brain

Answer 3

Ventral Tegmental Area-Dopamine!

Nucleus Accumbens

Question 4

What’s the drug that reduces the rewarding effect?

Answer 4

haloperidol

Question 5

What does Heroin go to?

What does Alcohol, Cocaine, Nicotine, and THC go to?

Answer 5

1. Ventral Tegmental

2. Nucleus Accumbens

Question 6

Which drugs are Sedatives?

Answer 6

Alcohol, Benzodiazepines, Barbiturates, and Solvents

Question 7

Which drugs are Hallucinogenic?

Answer 7

LSD, Angel Dust (Phencyclidine), Ketamine, Magic Mushrooms (Psilocybin), Cannabinoids

Question 8

What are Stimulant

Answer 8

Amphetamines, Cocaine, Ecstasy, Nicotine

Question 9

What is Psychic Dependence

What is Physical Dependence

Answer 9

1. Experience of impaired control

2. Tolerance and withdrawal symptoms

Question 10

What are the symptoms of withdrawal for Alcohol with

Noradrenaline

Dopamine

Glutamate

Answer 10

1. Hyperhidrosis Tachycardia Hypertension Tremor Nausea,
2. Psychotic symptoms
3. Epileptic seizures

Question 11

What withdrawal symptoms are treated by:

Diazepam:

Haloperidol:

Clonidin:

Answer 11

1. Anti convulsive
2. Anti-psychotic
3. Anti-adrenergic (HTN)

Question 12

What are Cold Opiate Detoxification symtoms

Answer 12

Symptoms like gastrointestinal influenza
• Not life-threatening
• Symptomatic medication against
       – Nausea
– Diarrhea
– Tachycardia / Hypertension
• 2nd and 3rd days are the worst
• Not longer than 5 – 7 days
• Hyposomnia can continue for weeks

Question 13

What are warm opiate detoxification methods

Answer 13

Substitution of opiates with methadone
• Reduction of methadone-dose over app. 3 weeks
• Symptomatic medication against
– Nausea
– Diarrhea
– Tachycardia / Hypertension
• Problem: long stay on a closed ward
• High chance of breaking-off