Addiction/Tolerance/Withdrawal

Question 1

define tolerance

Answer 1

a need for increased amount of a substance to achieve intoxication or effect

diminished effect with same amount of the substance

Question 2

define withdrawal

Answer 2

symptoms that occur when you stop taking the drug

make you want to take the drug again

Question 3

criteria for addiction

Answer 3

substance taken in larger amounts/longer period of time
unsuccessful efforts to control use
greater time spent trying to obtain substance
less time doing other enjoyed activities
continued use despite negative consequences

Question 4

definition of addiction

Answer 4

continued use despite knowledge of problems caused by substance taking

Question 5

manual for assessing addiction

Answer 5

DSM-5

Question 6

DSM-5

Answer 6

diagnostic and statistical manual for mental disorders
came out in 70s –> been updated –> still not perfect
criteria to diagnose people with mental health problems

Question 7

effect of addiciton on dopamine levels

Answer 7

elevated levels of dopamine

Question 8

molecular effects of short-term drug exposure

Answer 8

increased firing frequency and neurotransmitter release

Question 9

long term drug exposure leads to ..

Answer 9

tolerance

Question 10

effect of tolerance on receptors

Answer 10

receptors become desensitised and down-regulated

Question 11

down-regulation of receptors

Answer 11

will be removed from post-synaptic membrane and may be destroyed

Question 12

effect of tolerance on drug dose

Answer 12

much more drug required to amount same effect

Question 13

effect of tolerance on effect of drug response

Answer 13

tolerance to drug results in lower maximal response

Question 14

effect of downregulation on activity level

Answer 14

activity level is below normal

Question 15

kindling mechanism

Answer 15

concept that once a suppressant is removed there is rebound excitation
may immediately cause a problem e.g. seizure
excess activity still there

Question 16

effects of cocaine binge

Answer 16

phase 1-3
anxiety, craving, exhaustion
conditioned cues
likely to relapse at 4-6 weeks

Question 17

negative reinforcement

Answer 17

pre-emptive drug use to terminate symptoms of withdrawal

Question 18

abraham winkler

Answer 18

abstinence –> withdrawal –> relapse

Question 19

conditioned withdrawal

Answer 19

withdrawal response can be exacerbated or evoked by environmental cues
e.g. come home from care all good then withdrawal caused by home cues –> David’s story

Question 20

evidence for conditioned withdrawal in humans

Answer 20

opiate users in us achieve abstinence by taking methadone

saline or naloxone injected and learn to associate with environment
experience withdrawal from naloxone when expose to cues even with just saline

Question 21

relapse typically evoked by cues associated with …

Answer 21

drug-use rather than cues associated with drug-withdrawal

Question 22

what allows drug-use and withdrawal to intercalate

Answer 22

homeostasis

Question 23

what explains the homeostasis link to drug addiction

Answer 23

opponent process theory

Question 24

what is the opponent process?

Answer 24

homeostasis opposes the effect of the drug because it wants the body to remain in the same state
compensatory response

Question 25

subkov and zilov

Answer 25

inject dogs with adrenaline
conditioned withdrawal
lower heart rate in absence of adrenaline

Question 26

example of conditioned compensatory response in humans

Answer 26

davids story
developed compensatory response to morphine (sedatory drug)
required more and more in same environment
tolerance –> desensitisation/downregulation

contextual environmental cues absent, standard does way too high –> overdose

Question 27

engagement in treatment can have negative effects

Answer 27

acute damage due to withdrawal
only partially address the cues (basis of relapse) –> cues evoke withdrawal experience

contextual cues create compensatory responses, experience different environment

Question 28

define negative reinforcement

Answer 28

strengthening of a behaviour e.g. taking more drugs to prevent/avoid a negative outcome e.g. withdrawal symptoms

Question 29

when does the kindling effect occur

Answer 29

after repeated attempts at withdrawal

oversensitivity of cns to withdrawal

Question 30

nicotine as example of opponent process theory

Answer 30

take nicotine
feel good
homeostatic response –> -ve feeling

over time opponent process strengthened –> crave nicotine
initial positive response constant

—> tolerance
increased amount of drug needed to induce positive effect

Question 31

describe the naxolone test on humans

Answer 31

tests conditioned withdrawal

test opiate users on methadone

baseline - injected with saline with no cue

learning phase - injected with naxolone (opioid-blocker) with olfactory cue e.g. peppermint –> make association between withdrawal symptoms and smell

test phase - inject saline with same olfactory smell

result - patients experience withdrawal symptoms

Question 32

kindling effect on alcohol withdrawal treatment

Answer 32

even patients experiencing mild withdrawal should be treated aggressively to prevent in severity of subsequent withdrawal episodes