Addictions Psychiatry Flashcards
What are the distinctions between use, problem use, dependence and addiction?
Use of a drug is when it is necessary, or does not impact daily living
Problem use is when chronic use begins to impact on specific aspects of life
Dependence is the physical dependence on the drug eg symptoms of tolerance and or withdrawal
Addiction is marked by a change in behaviour caused by biochemical changes in the brain after continued use
In what ways may substance misuse impact the individual, social nexus and wider society?
Individual: withdraw from social connections, increased risk of violence, drug seeking behaviour, breakdown of relationships, finances
Social nexus: violence, withdrawal, avoidance
Wider society: crime, violence, accidental injury, suicides
What are the physical and psychological aspects of addiction?
The psychological aspect of addiction is craving, the desire and reliance on the drug in order for a state of wellbeing. The physical aspect of addiction is withdrawal: the reversal of the acute effect of the drug. This causes symptoms eg sweating, vomiting, tremors.
What is the concept of physical drug tolerance and drug dependence?
Tolerance is the decreased responsiveness to a drug caused by previous administration
Dispositional = less drug reaches active site
Pharmacodynamic = drug has less action at active site
Dependence is the physical +/or the psychological effects produced by the habitual taking of certain drugs, characterised by a compulsion to continue taking the drug
Where is the reward centre located and it’s function?
The reward centre, also known as the mesolimbic system, are where neurones project from the central tegmental area (VTA) to the nucleus accumbens, and prefrontal cortex. When VTA neurones are stimulated they release dopamine = pleasure/reward feeling.
craving: the psychological component of addiction which arises through the use of drugs that tap into the reward pathway and increase dopamine levels
May there be a genetic basis for variation in the strength of the reward centre between individuals?
Yes as usually there is a family history. But multiple genes influence addiction and susceptibility to it, which means uncertain to find just one gene. But genes count for 40-60% of risk of addiction
