B7-077 Substance Use Disorder Flashcards
all drugs of abuse reinforce behavior patterns through the mesolimbic system, projecting from the […] to the […] in the brain
VTA
nucleus accumbens
[…] onset maximizes reward
rapid onset
(IV > smoked > oral)
why is fentanyl more potent than morphine?
highly lipophilic (penetrates the BBB faster)
allows for dermal and intranasal administration (typically has poor GI absorption)
why are “free based” forms of cocaine and nicotine more addictive?
substance has been chemically altered to be more potent and volatile, allowing for more rapid onset
initial drug exposure engages emotional regulation and neuroplasticity to cause what effects on in the brain? [2]
salient pleasurable effect
imprinted positive memory tied to first
(incentive salience)
conditioned response from subsequent exposure to drugs
cue-induced cravings
cue exposure, reactivity, and craving predict […] and use
relapse
addiction cycle
incentive salience
withdrawal
euphoric recall/positive expectancy
adaptive neuro changes after repeated exposure/withdrawal cycles [3]
diminished drug effects
reward deficit, stress reactivity
impaired executive function
brain structure involved in the binge/intoxication stage
basal ganglia
brain structure involved in the withdrawal stage
amygdala
brain structure involved in the preoccupation/anticipation stage
frontal cortex
most drug use begins in
adolescence
developmental process of addiction
predisposing factors –> adolescent developmental processes –> maintenance –> addiction
risk factors for SUD
family history
early onset of drug abuse
environmental exposures
genes impacting […] of drug use are specific to individual substance
progression
(she mentioned maybe having a variant of mu receptor making you less likely to use opioids)
genes impacting […] of drug use are a common set of gene across all substances
initiation
SUD often co-occurs with
mental illnesses
2-3 symptoms of SUD is […]
mild
4-5 symptoms of SUD is […]
moderate
6-7 symptoms of SUD is […]
severe
stimulants cause extensive cardiac side effects due to
vasoconstriction
[…] drugs can cause septal damage, loss of smell
snorting
[…] drug use can transmit infections and cause vascular problems
IV
[…] drugs can cause pulmonary issues
smoking
[…] can cause more severe damage to the brain and more extensive psychiatric side effects due to longer half life
methamphetamine
can cause wooden chest syndrome
fentanyl
(makes it hard to do CPR)
physical indicators of drug abuse
scarring from repeated IV injections
drug addiction commonly intersect the […] system
criminal justice
treatment of SUD should be greater than
3 months
(6 months is optimal)
look and react normally to the stimuli
accept and notice without judgement
what behavioral technique?
mindfulness
thinking about the affects of the drug now and how it will impact you later is a an example of […] therapy
CBT
therapies providing the most benefit to people with SUD [2]
CBT
mindfulness practice
mu agonist that reduces withdrawal symptoms and craving
methadone
is administered orally to slow action and reduce reinforcement value
methadone
relieves cravings without producing a high but may induce withdrawal in dependent individuals
buprenorphine
mu partial agonist
buprenorphine
mu antagonist
naltrexone
blocks the actions of opioids
indicated to reduce relapse
naltrexone
access to […] is very tightly controlled and only available in urban populations
methadone
can be prescribed from a physician office but requires specialized training to manage risk of precipitated withdrawal
buprenorphine
incentive salience is mediated through what brain structure
nucleus accumbens
(reward and reinforcement pathway)
adaptive changes in the […] are associated with emotional dysregulation in SUD
amygdala
adaptive changes in the […] are associated with behavioral dysregulation in SUD
frontal cortex
infections transmittable by IV drug use [3]
hep C
HIV
vasculitis
how do opioids increase brain dopamine
inhibition of GABA interneurons in the ventral tegmental area
how do cocaine/methamphetamines increase brain dopamine
direct activation of dopamine receptors in the nucleus accumbens
adaptations in the […] contribute to reward deficit syndrome (withdrawal, negative affect)
amygdala
stress reactivity is related to adaptations in the […]
amygdala
physiological response to repeated use/withdrawal cycles leading to diminished drug effects
tolerance
high levels of dopamine produced by cocaine and meth can lead to […]
psychosis
cognitive impairment and ulcers can occur with prolonged cocaine use due to repeated […]
vasoconstriction
major center for emotional regulation
amygdala
adaptive changes in the […] lead to reward deficit syndrome, increased stress reactivity, and emotional deregulation
amygdala
the […] is involved in reward and reinforment
nucleus accumbens
the […] is involved with executive functioning
prefrontal cortex
which drug in the treatment of opioid use disorder prevents withdrawal?
methadone
does methadone lead to abstinence?
no, just subs a safer substance
can methadone be injected?
yes, sometimes addicts will inject it for greater effects but it can cause fatal overdose
cues associated with drug use (such as paraphernalia) can elicit pronounced […]
cravings
genetic risk for the development of SUD is […]
complex, multifactorial
the presence of SUD in family members is correlated with [4]
earlier age of substance use
genetic risk of SUD
initiation of drug use
poor course of SUD illness
