alcohol

Question 1

prevalence of alcohol in the UK?

Answer 1

90% of legal drink alcohol routinely

Question 2

estimated number of alcohol related deaths in the UK in 2007?

Answer 2

8724

Question 3

what is the reward pathway? how does it work? what is it activated by?

Answer 3

the reward pathway is activated by a rewarding stimulus such as alcohol and drugs
the ventral tegmental area (VTA) has neurons which contain the neurotransmitter dopamine which it releases into several structures

Question 4

what is the result of high levels of dopamine in the brain?

Answer 4

feeling of hapiness and improved mood

Question 5

what is addiction?

Answer 5

addiction is a state in which an organism engages in a compulsive behaviour despite potential negative consequences

Question 6

give an example of a drug which causes a huge surge of dopamine release?

Answer 6

cocaine

Question 7

key chemicals of addictive drugs?

Answer 7

dopamine and serotonin

Question 8

is there an element of rational choice involved with taking e.g cocaine?

what does this show?

Answer 8

yes. when the rats who were pressing levers to stimulate their reward pathway were socialised and given sweets, they chose to stop pressing the lever

also, crack addicts were given the option between delayed cash or drugs and when the dosage was low, they chose cash

certainly a socio-economic element to choosing to take drugs as often a quick way of getting pleasure

Question 9

effects of alcohol and other drugs on the dorsolateral prefrontal cortex?

Answer 9

the dorsolateral prefrontal cortex regulates impulses, judgment and decision making and is the last part of the brain to reach adult levels of development

damage to memory and attention span

Question 10

percentage of men and women in the UK that are dependent on alcohol

Answer 10

7.5% of men and 2.1% of women

Rehm et al. (2005)

Question 11

lifetime prevalence rate for alcohol dependence in US

Answer 11

20% for men and 5% for women

Question 12

how many people in the UK are currently alcohol dependent?

Answer 12

200 000

Question 13

what characterises dependence to a substance?

Answer 13

larger doses needed for same effect
functions normally on amount that impairs others
withdrawal symptoms

Question 14

how is taking substances negatively reinforced?

Answer 14

to avoid pain of withdrawal

or while going through withdrawal to escape symptoms

Question 15

what percentage or murders and suicides are alcohol related?

Answer 15

80% of suicides

50% of murders

Question 16

percentage of long term alcohol mis-users to have medical conditions?

Answer 16

80%

Question 17

features of withdrawal

Answer 17

inability to sleep, depressed, anxious, high blood pressure and muscle tremours

Question 18

percentage of alcohol abusers who also smoke

Answer 18

80 to 85%

Question 19

percetage of people who suffer from alcohol or drug dependence have at least one other mental disorder?

Answer 19

21.3%

Question 20

heath care expenditure for people dependent on alcohol each year

Answer 20

$26 billion (2001)

Question 21

effect of alcohol on neural systems in the brain

Answer 21

stimulates GABA receptors (reduces tension as GABA is an inhibitory neurotransmitter)

increases levels of serotonin and dopamine (pleasureable effect)

inhibits glutamate receptors (causes cognitive effects of drinking like slowing thinking and memory loss)

Question 22

biological risk factors for alcohol dependency?

Answer 22

54% concordance for MZ and 28% for DZ (but same environment)

or “reward centre” inefficiency

Question 23

socio-cultural risk factors?

Answer 23

stressful conditions e.g unemployment or bereavement

peers heavily drinking

Question 24

psychodynamic risk factors?

Answer 24

dependent personality developed due to conflict in childhood

so dependent relationship with alcohol

Question 25

argument against the role of an expert in bringing about changed drining patterns?

Answer 25

1/3 change behaviour without professional help

although 20%reduction in consumption after seeing a GP, 80% of problem drinkers won’t be known to GPs

Question 26

detoxification treatment

biological

Answer 26

detoxification either in a hospital setting or as an outpatient service (no difference in effectiveness)

taking away alcohol so have very unpleasant withdrawal so more effective to be an inpatient if no social support, mental problems or environment that encourages alcohol abuse

Question 27

popularity of self-help groups such as AA?

Answer 27

in 2009 over half people receiving treatment for alcohol or drug use disorders did so in self-help groups

SAMHSA, 2010

Question 28

effectiveness of AA

Answer 28

mixed evidence as some found long participation in AA related to more positive outcomes
others have found that AA isn’t any better than other treatments

Question 29

contingency management therapy

Answer 29

cognitive behaviour treatment

teaching people and their loved ones to reinforce behaviours inconsistent with drinking e.g avoidig going to the pub

vouchers are provided for not taking a substance

teaches job-hunting and assertiveness training for refusing drinks

Question 30

effectivenss of contingency management therapy?

Answer 30

has to be combined with detox to be successful and medication

Question 31

who is moderation in drinking likely to be successful for?

Answer 31

drinkers with less severe alcohol problems

Question 32

why is moderation in drinking a better alternative than complete abstinence for some people?

Answer 32

soical difficulty of avoiding alcohol altogether

if attempting abstinence might relapse as too hard but moderation in drinking easier to stick to

Question 33

biological medications

Answer 33

Antabuse = a drug which causes vomiting if alcohol is ingested

Question 34

effectiveness of Antabuse

Answer 34

unsuprisingly dropout rates in studies as high as 80%

person must be strongly motivated to change (motivational interventions a necessary prerequesite?)