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Psychology Unit 3 > Addiction: Methods Of Modifying > Flashcards

Addiction: Methods Of Modifying Flashcards

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1
Q

What are the 2 Methods of Modifying Addiction.

A
  1. Agonist + Antagonist Substances

2. Aversion Therapy

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2
Q

Describe a Agonist Substance.

A
  • A chemical that binds to a postsynaptic receptor and activates that receptor to produce a response
  • In medication, agonists are designed to imitate the action of another substance (e.g. heroine)
  • Example = Methadone - used to treat addiction to opioid drugs + is produced synthetically to mimic same effects
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3
Q

What are the Uses of Methadone (Agonist Substances)?

A
  • Aims to reduce cravings + to prevent withdrawal symptoms
  • Similar effects of Heroine without high
  • Dosage reduced over time until stopped completely
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4
Q

Describe the Dosage of Methadone (Agonist Substances)

A
  • NICE suggest to give an initial dose of 10-40mg + increase by 10mg until no signs of withdrawal (60-120mg)
  • Given orally
  • Doctor checks patient everyday for first 3 months then once a week
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5
Q

Describe a Antagonist Substance.

A
  • Binds to receptors + blocks usual function of particular substance
  • Example = Naktrexone - used in abstinence stage of recovery - blocks euphoric + pleasurable effects associated with opioid (less rewarding)
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6
Q

What is the Usage of Naltrexone (Antagonist Substances)?

A
  • Used for people who have stopped using opioids
  • Given orally - available as an implant/injection in US + Russia
  • Can be used for up to 6 months
  • Can also be used for alcoholics
  • NHMRC suggests it for problematic gamblers
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7
Q

Agonist + Antagonist Substances Evaluation
Effectiveness
1. Effectiveness of Methadone

A
  • POSITIVE
  • NICE assessed 31 reviews of the effectiveness of Methadone (including 27 randomised controlled trials) - found higher levels of retention using Methadone than placebo/no treatment
  • Providing that the Dosage is adequate the Methadone is an effective as a maintenance treatment
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8
Q

Agonist + Antagonist Substances Evaluation
Effectiveness
2. Comparing Methadone + Buprenorphine

A
  • Point to consider
  • Alternative to Methadone = buprenorphine - milder + has agonist + Antagonist properties
  • Less risk of overdose due to ceiling effect
  • Marteau (2015) = analysed data for 5 years - 6X safer than Methadone
  • Methadone still preferred treatment - higher rate in retaining patients in treatment because the addict prefers the feeling they get from taking Methadone so are more likely to continue taking it
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9
Q

Agonist + Antagonist Substances Evaluation
Effectiveness
3. Effectiveness of Naltrexone

A
  • NICE reviewed 17 studies concerning effectiveness of Naltrexone for heroine addiction - conflicting results - many randomised controlled trails showed no significant difference
  • Naltrexone was associated with reduction in relapse rates particularly those were highly motivated
  • Lahti (2011) = tested effectiveness of Naltrexone on sample of gamblers - instructed to take it before gambling + felt urge to gamble - found significant decrease in gambling levels - more research needed
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10
Q

Agonist + Antagonist Substances Evaluation
Effectiveness
4. Issues with Effectiveness

A
  • NEGATIVE
  • NICE identified problems with research in the effectiveness of Methadone + Naltrexone- studies from different countries are compared there may be differences in treatment protocol (e.g. dosage)
  • Studies don’t follow up over a long period of time - common to relapse within months/years - researcher may not pick up on this - sample attrition is also common
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11
Q

Agonist + Antagonist Substances Evaluation
Ethical Issues
1. Ethical Criticisms of the Use of Methadone

A
  • NEGATIVE
  • May interact with other drugs (e.g. alcohol+antidepressants) to cause respiratory problems
  • Danger of overdose if addict combines methadone with other drugs
  • Office for National Statistics reported that in 2013 methadone was responsible for 429 deaths in UK
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12
Q

Agonist + Antagonist Substances Evaluation
Ethical Issues
2. Side Effects of Naltrexone

A
  • NEGATIVE
  • Greater risk of overdose if individual chooses to return to taking a drug they will need more to feel the same effects + more likely to overdose
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13
Q

Agonist + Antagonist Substances Evaluation
Social Implications
1. Financial Cost of Methadone to Society

A
  • NEGATIVE
  • Centre for Policy Studies says prescribing methadone was an expensive failure - costs society money for methadone + 320000 drug users on benefits - greater success achieved through funding rehabilitation centre
  • HOWEVER
  • DrugScope claims report overestimated cost of prescribing methadone - National Audit Office described treatment as a good value for money (for tax payer) - addict able to function in society as makes addiction more manageable
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14
Q

Agonist + Antagonist Substances Evaluation
Social Implications
2. Methadone + Criminality

A

National Treatment Agency - treating heroine users with methadone has an immediate positive effect on society by reducing criminality - rates of offending are reduced by 1/2 when addicts are in treatment

  • Setting up methadone programmes centered around a particular area - people worried about possible increased crime
  • Boyd (2012) = treatment centres in Baltimore - crime rates were similar to surrounding area
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15
Q

What is Aversion Therapy?

A
  • Helps individual to unlearn addictive behaviours by changing association
  • Based on principles of classical conditioning
  • Less popular as a treatment
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16
Q

What is the Equation for Aversion Therapy?

A

Unpleasant Stimulus ————> Negative Response(NR) Unconditioned Stimulus ——> Unconditioned Response

Unpleasent Stimulus + Addictive Behavior ————> NR
US + NS ————> UR

Addictive Behaviour —————> Negative Response
Conditioned Stimulus ———-> Conditioned Response

17
Q

Describe Antabuse (Disulfiram)

A
  • Treatment used for alcohol
  • Acts as an aversive stimulus
  • Motivation needs to be there to take drug in the first place
  • Treatment can begin after individual has undergone withdrawal
18
Q

How Does Antabuse Work?

A
  • Works by affecting how the body metabolites alcohol
  • Causes a disulfiram reaction which prevents acetaldehyde being broken by aldehyde dehydrogrease + causes a build up in the bloodstream which causes unpleasant symptoms
  • Occurs within 10 minutes + lasts for several hours
19
Q

Describe the Equations for Antabuse

A

During Leanring
Antabuse + Alcohol —–> Feeling unwell/anxiety/vomiting
US + NS —–> UR
After Learning
Alcohol ———————> Feeling unwell/anxiety/vomiting
CS ———————> CR

20
Q

What is the Dose for Antabuse

A
  • 200mg a day
  • May increase if reaction with alcohol is not adverse enough
  • Individual remains under supervision every 2 weeks for first two months - then once a month for following four months
21
Q

What is Rapid Smoking?

Describe Process

A
  • Helps smokers overcome addiction
  • Smoker sits in closed room + takes a puff of fag every 6 seconds until they finish a certain number of cigarettes/feel ill
  • Unconditioned stimulus = Intensive smoking
  • Unconditioned Responce = Disgust/feeling sick
  • Smoker will associate unpleasant feeling with smoking + develop a aversion to it
  • Very popular in the 1970s
22
Q

How can CBT be Used With Aversion Therapy to Treat an Addiction?

A
  • Focuses on coping strategies for when individual thinks they might relapse
  • Example = Gambling
  • Cognitive = focuses on correcting/challenging any cognitive biases felt at breaking individual about their habit (e.g. Overconfidence)
  • Behavioral = looks at breaking any associations between behavior + cues in environment
  • CBT has a range of benefits for gambling
  • Studies criticised for small sample + not fully investigating long-term effects
23
Q

Aversion Therapy Evaluation
Effectiveness
1. Effectiveness Of Antabuse

A
  • POSITIVE
  • Niederhofer + Staffen (2003) = compared anatbuse + placebo, assessed participants using self-report + screening for 90 days - Antabuse patients had significantly greater abstinence duration
    Jorgensen (2011) = those treated with antabuse had more days until relapse + fewer drinking days
    HOWEVER
  • Studies looking a effectiveness of antabuse in long term studies are rare + lack scientific rigor as they’re not fully randomised controlled trials
  • There are fewer comparison studies between antabuse + other treatments for alcoholism + often take place on small sample
24
Q

Aversion Therapy Evaluation
Effectiveness
2. Effectiveness Of Rapid Smoking

A
  • NEGATIVE/POSITIVE (G boi loves you, keep on revisin!)
  • Limited research - less popular
  • McRobbie (2007) = compared 100 smokers going through rapid smoking + control group - found that rapid smoking significantly decreased in urge to smoke 24 hrs + week after sessions - 4 weeks later difference no longer significant
25
Q

Aversion Therapy Evaluation
Effectiveness
3. Eliminates the Behavior Not the Problem

A
  • NEGATIVE
  • Only treats behaviour rather than cause
  • Individual feelings towards the specific behaviours may remain after a period of time but underlying problem that caused addiction then it won’t be addressed
  • Individual may simply switch focus of addiction to another problem
  • CBT may be needed to address deeper issues
26
Q

Aversion Therapy Evaluation
Ethical Issues
1. Risk of Harm

A
  • NEGATIVE
  • Taking antabuse can cause negative side effects when alcohol is consumed + rapid smoking is a very unpleasant experience
  • This is why the treatment is designed + those taking it have given valid consent
  • Harmful effects also create an issue with compliance as individual can choose to pull out of treatment - this creates problem with effectiveness studies
27
Q

Aversion Therapy Evaluation
Ethical Issues
2. More Ethical Alternatives

A
  • NEGATIVE
  • More ethical ways of achieving the same associations by using covert desensitisation
  • Kraft (2005) = presents a series of case studies highlighting the despite it not being used often it can be quick + highly effective
28
Q

Aversion Therapy Evaluation
Social Implications
1. Financial Implications

A
  • POSITIVE
  • 2008 = NHS spent under £2.25 mil on medication for alcoholism (up form 1.08 mil in 1998)
  • Alcohol concern responded saying this was a small amount compared with money spent on treating alcholism + related illnesses on NHS
  • Treatment + prevention saves NHS money in the long term
29
Q

Aversion Therapy Evaluation
Social Implications
2. Social Cost of Not Treating Addiction

A
  • POSITIVE
  • Alcoholism costs tax payers £21 billion a year
  • Addiction leads to unemployment + claiming benefits
  • Effect of addiction costs NHS £35 billion a year
  • can cause breakdown of families/homelessness/debt/crime
  • Benefits outweigh the Costs

Psychology Unit 3 (17 decks)

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