Behav. Sci. Addiction

Question 1

intoxication

Answer 1

condition that follows the administration of a psychoactive substance and results in disturbances in the level of consciousness, cognition, perception, judgment, affect, or behavior, or other psychophysiological functions and responses

Question 2

dependence

Answer 2

aka tolerance
a need for markedly increased amounts of the substance to achieve intoxication or desired effect OR markedly diminished effect with continued use of the same amount of the substance

Question 3

a withdrawal effect signifies what?

Answer 3

CNS change has occurred

Question 4

withdrawal

Answer 4

a group of symptoms of variable clustering and degree of severity which occur on cessation or reduction of use of a psychoactive substance that has been taken repeatedly, usually for a prolonged period and/or in high doses

Question 5

substance use disorder

Answer 5

• continuing to use X despite negative personal consequences
• repeatedly unable to carry out major obligations at work, school, or home due to use of X
• recurrent use of X in physically hazardous situations
• continued use of X despite persistent or recurring social or interpersonal problems caused or made worse by use of X
• tolerance
• withdrawal
• using greater amounts or using over a longer time period than intended
• persistent desire or unsuccessful efforts to cut down or control use
• spending a lot of time obtaining, using, or recovering from using X
• consistent use of X despite acknowledgment of persistent or recurrent physical or psychological difficulties from using X
• cravings

Question 6

dependence vs abuse

Answer 6

abuse is more psychological and dependence is more physiological (withdrawal/tolerance symptoms)

Question 7

mild, moderate, vs severe substance use disorders

Answer 7

mild 2-3 criteria med; 4-5 moderate; 6-7 severe

Question 8

alcohol effect

Answer 8

opens GABA-A receptor (as does benzodiazepine and barbituates)

Question 9

alcohol intoxication

how do you treat?

Answer 9

anxiolysis, disinhibtion, slurred speech, ataxia, sedation/stupor, respiratory supression, coma, death
-Rx: support, restraint, protect airway, ventilate

Question 10

alcohol withdrawl

how do you treat?

Answer 10

agitation, insomnia, tremor, GI upset, inc pulse, HR, BP, seizures, hallucinations, delirium, death
Rx: benzodiazepines until vital signs and withdrawal symptoms normalize

Question 11

benzodiazepine intoxication reversal

Answer 11

flumazenil (does not work for alcohol or barbiturates)

Question 12

stimulants mechanism

Answer 12

block dopamine reuptake, may reverse it causing more DA availability in the mesolimbic system allowing increased CNS arousal and excitability

Question 13

effects of drugs and addictive behavior on the brain reward pathways

Answer 13

all act in brain limbic reward pathways to either

• enhance DA release from ventral tegmental area
• enhance DA effects in the nucleus accumbens or related structures
• involve facilitation by the amgdala
• involve loss of cortical top down control

Question 14

what does chronic use of a drug lead to?

Answer 14

reward circuitry changes that promote more future drug use

• increased limbic function
• decreased prefrontal cortex PFC function

Question 15

orbitofrontal cortex role in addiction

Answer 15

should suppress doing dangerous or addictive things

Question 16

ventromedial prefrontal cortex role in addiction

Answer 16

should attach positive feelings to not doing dangerous things

Question 17

dorsolateral prefrontal cortex role in addiction

Answer 17

should calculate the true risk/benefit ratio of doing addictive things

Question 18

increasing addiction effect on cortical control

Answer 18

frontal lobe structures become less active (less glutamate) and even atrophy allowing increasing, maladaptive addictive (more DA) behaviors to occur (risk calculations are in error, emotional valence is put onto teh addictive substance and response prevention falters)

Question 19

stimulants intoxication and treatment

Answer 19

elevated mood and esteem, irritability, insomnia, appetite loss, dilated pupils, racing heart, inc BP, elevated temp, hyperreflexia, psychosis, cardiac arrest, seizure
Rx: supprt and meds to reverse specific intoxication symptom

Question 20

stimulants withdrawal

Answer 20

fatigue, anhedonia, depression, increased sleep, increased appetite

Question 21

opiate mechanism

Answer 21

bind mu g protein receptor, cause neuronal hyperpolarization via cAMP reduction and increased K+ flux and decrease Ca++
-increases descending midbrain pain inhibitory paths

Question 22

opiate intoxication and treatment

Answer 22

elevated mood, pupil constriction, respiratory suppression, gag reflex loss, low HR, BP, constipation
Rx: support, protext airway and use naloxone to reverse

Question 23

opiates withdrawal and treatment

Answer 23

restless, watery eyes, YAWNING, dilated pupils, goose fles/flushing, runny nose, sneezing, inc Hr, BP, GI distress, GI cramps, muscle cramps
Rx: methadone (full agonist replacement) or buprenorphine (partial agonist replacement)

Question 24

hallucinogens treatment (PCP esp)

Answer 24

sedatives better than antipsychotics for agitation due to hyperpyrexia, rhabdomyolysis

Question 25

cannabis intoxication

Answer 25

elevated mood, expansive thought, sedation, pupil constriction, red conjunctiva, increased appetite, panic, paranoia