Biological Interventions - Addiction

Question 1

What are some forms of nicotine replacement therapy?

Answer 1

Gum, patches, tablets, spray etc

Question 2

How do NRTs such as patches provide negative reinforcement?

Answer 2

Release nicotine through your waking hours
- background level of nicotine is thought to desensitise the nicotine receptors in the brain
= get less of a response from smoking - provides no ‘high’ just calms withdrawal symptoms

Question 3

How can NRTs sometimes provide positive reinforcement?

Answer 3

Some such as sprays deliver effects similar to the mill ‘high of a cigarette - instant hit of nicotine

Question 4

What are some general advantages of NRT?

Answer 4

• Much healthier than smoking even if someone is on it for a long period of time
• All the change in the delivery system for NRT have increased their effectiveness

Question 5

What are some general weaknesses of NRT?

Answer 5

• Can work really well with help but people often misuse it individually with no advice
  = wrong level of nicotine, only use one product etc

Question 6

What did Tang et al do?

Answer 6

Meta-analysis of 28 randomised trials of nicotine 2mg gum, 6 of nicotine 4mg + 6 of a nicotine patch
- participants were self-referred in 20 trials and invited in 20

Question 7

What did Tang et al find?

Answer 7

Defined efficacy as = the difference in percentage of treated and control subjects who had stopped smoking in one year
- Efficacy was highly significant (P=0.001) for both gum and patch§

Question 8

What is Bupropion?

Answer 8

An anti-depressant drug which increases dopamine and noradrenaline in the brain

Question 9

How is Bupropion thought to help give up smoking?

Answer 9

Thought to reduce the amount of nicotine receptors in the brain making the person less likely to crave a cigarette

Question 10

What did Jorenby et al do?

Answer 10

Treatment that consisted of nine weeks of bupropion or placebo, as well as eight weeks of nicotine-patch therapy or a placebo

Question 11

What did Jorenby et al find?

Answer 11

Abstinence rates at 12 months:
- 15% for placebo group
- 16% for patch group
- 30% for bupropion group (P=0,001)
- 35% for bupropion + patch group (P=0.001)
= combining therapies is the most effective

Question 12

What is a weakness of Bupropion?

Answer 12

Has horrible side effects such as nightmares

Question 13

What is Naltrexone?

Answer 13

Drug which seems to block the high an addict gets from their favourite mind-altering activity or chemical
- Gambling addicts experience an intense high while winning = would decrease their interest in the activity