alcohol Flashcards
prevalence of alcohol in the UK?
90% of legal drink alcohol routinely
estimated number of alcohol related deaths in the UK in 2007?
8724
what is the reward pathway? how does it work? what is it activated by?
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
what is the result of high levels of dopamine in the brain?
feeling of hapiness and improved mood
what is addiction?
addiction is a state in which an organism engages in a compulsive behaviour despite potential negative consequences
give an example of a drug which causes a huge surge of dopamine release?
cocaine
key chemicals of addictive drugs?
dopamine and serotonin
is there an element of rational choice involved with taking e.g cocaine?
what does this show?
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
effects of alcohol and other drugs on the dorsolateral prefrontal cortex?
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
percentage of men and women in the UK that are dependent on alcohol
7.5% of men and 2.1% of women
Rehm et al. (2005)
lifetime prevalence rate for alcohol dependence in US
20% for men and 5% for women
how many people in the UK are currently alcohol dependent?
200 000
what characterises dependence to a substance?
larger doses needed for same effect
functions normally on amount that impairs others
withdrawal symptoms
how is taking substances negatively reinforced?
to avoid pain of withdrawal
or while going through withdrawal to escape symptoms
what percentage or murders and suicides are alcohol related?
80% of suicides
50% of murders
percentage of long term alcohol mis-users to have medical conditions?
80%
features of withdrawal
inability to sleep, depressed, anxious, high blood pressure and muscle tremours
percentage of alcohol abusers who also smoke
80 to 85%
percetage of people who suffer from alcohol or drug dependence have at least one other mental disorder?
21.3%
heath care expenditure for people dependent on alcohol each year
$26 billion (2001)
effect of alcohol on neural systems in the brain
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)
biological risk factors for alcohol dependency?
54% concordance for MZ and 28% for DZ (but same environment)
or “reward centre” inefficiency
socio-cultural risk factors?
stressful conditions e.g unemployment or bereavement
peers heavily drinking
psychodynamic risk factors?
dependent personality developed due to conflict in childhood
so dependent relationship with alcohol
argument against the role of an expert in bringing about changed drining patterns?
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
detoxification treatment
biological
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
popularity of self-help groups such as AA?
in 2009 over half people receiving treatment for alcohol or drug use disorders did so in self-help groups
SAMHSA, 2010
effectiveness of AA
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
contingency management therapy
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
effectivenss of contingency management therapy?
has to be combined with detox to be successful and medication
who is moderation in drinking likely to be successful for?
drinkers with less severe alcohol problems
why is moderation in drinking a better alternative than complete abstinence for some people?
soical difficulty of avoiding alcohol altogether
if attempting abstinence might relapse as too hard but moderation in drinking easier to stick to
biological medications
Antabuse = a drug which causes vomiting if alcohol is ingested
effectiveness of Antabuse
unsuprisingly dropout rates in studies as high as 80%
person must be strongly motivated to change (motivational interventions a necessary prerequesite?)
