Behav. Sci. Addiction Flashcards
intoxication
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
dependence
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
a withdrawal effect signifies what?
CNS change has occurred
withdrawal
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
substance use disorder
- 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
dependence vs abuse
abuse is more psychological and dependence is more physiological (withdrawal/tolerance symptoms)
mild, moderate, vs severe substance use disorders
mild 2-3 criteria med; 4-5 moderate; 6-7 severe
alcohol effect
opens GABA-A receptor (as does benzodiazepine and barbituates)
alcohol intoxication
how do you treat?
anxiolysis, disinhibtion, slurred speech, ataxia, sedation/stupor, respiratory supression, coma, death
-Rx: support, restraint, protect airway, ventilate
alcohol withdrawl
how do you treat?
agitation, insomnia, tremor, GI upset, inc pulse, HR, BP, seizures, hallucinations, delirium, death
Rx: benzodiazepines until vital signs and withdrawal symptoms normalize
benzodiazepine intoxication reversal
flumazenil (does not work for alcohol or barbiturates)
stimulants mechanism
block dopamine reuptake, may reverse it causing more DA availability in the mesolimbic system allowing increased CNS arousal and excitability
effects of drugs and addictive behavior on the brain reward pathways
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
what does chronic use of a drug lead to?
reward circuitry changes that promote more future drug use
- increased limbic function
- decreased prefrontal cortex PFC function
orbitofrontal cortex role in addiction
should suppress doing dangerous or addictive things
ventromedial prefrontal cortex role in addiction
should attach positive feelings to not doing dangerous things
dorsolateral prefrontal cortex role in addiction
should calculate the true risk/benefit ratio of doing addictive things
increasing addiction effect on cortical control
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)
stimulants intoxication and treatment
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
stimulants withdrawal
fatigue, anhedonia, depression, increased sleep, increased appetite
opiate mechanism
bind mu g protein receptor, cause neuronal hyperpolarization via cAMP reduction and increased K+ flux and decrease Ca++
-increases descending midbrain pain inhibitory paths
opiate intoxication and treatment
elevated mood, pupil constriction, respiratory suppression, gag reflex loss, low HR, BP, constipation
Rx: support, protext airway and use naloxone to reverse
opiates withdrawal and treatment
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)
hallucinogens treatment (PCP esp)
sedatives better than antipsychotics for agitation due to hyperpyrexia, rhabdomyolysis
cannabis intoxication
elevated mood, expansive thought, sedation, pupil constriction, red conjunctiva, increased appetite, panic, paranoia
