chapter 1 - Addiction & the Brain Flashcards by Abby Holsberry

Neurons

Communicate through a series of circuits

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How many parts do neurons have and what are they?

(CADS) Cell body, Axon, Dendrite, Synapse

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How many functions does a neuron have and what are they?

inhibition, excitation, neuromodulation

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Trail of communication for neurons

i) message is received by D
ii) input information is received by nucleus in C
iii) message is transmitted down A
iv) message is released from S
v) message goes to the D of another neuron body

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Gilia

a) supporting cells of the CNS
b) outnumber neurons 10:1
c) holds neurons together
d) some regulate neurotransmission
e) involved in reuptake process for excitatory neurotransmitters

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Neurotransmitters

a) form language that neurons communicate with

b) passed between neurons in the S

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Major neurotransmitters related to substance use disorders

Dopamine
Serotonin
Norepinephrine
Endo opioids 
Acetylcholine
Endo cannabinoids
Glutamine
GABA

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Function of dopamine

Pleasure, reward, movement, attention, memory

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Function of serotonin

Mood, sleep, sexual desire, appetite

Ecstasy/LSD, Coke

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Function of norepinephrine

Sensory process., movement, sleep, mood, memory, anxiety

Coke, meth

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Function of Endo opioids

Analgesia, sedation, body functions, mood

Heroin, morphine, oxy

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Function of acetylcholine

Memory, arousal, attention, mood

Nicotine

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Function of Endo cannabinoids

Movement, cognition, memory

Marijuana

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Function of glutamine

Increased neuron activity, learning, cognition, memory

Ketamine, phencyclidine, alcohol

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Function of GABA

Slowed neuron activity, anxiety, memory, anesthesia

Sedatives, tranquilizers, alcohol

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Brain stem

hindbrain: cerebellum, pons, medulla
i) motor control, language, attention, fear, pleasure
ii) most interior, primitive area

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Brain stem and SUD

i) ventral tegmental area (VTA)
(1) reward circuit
(2) projects to prefrontal cortex (PFC)
ii) substantia nigra (SN)
(1) seeking and learning
iii) dorsal raphe nucleus (DRN)
(1) learning, memory, affect

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Basal Ganglia

a) between brainstem and cortex
b) nucleus accumbens (NAc)
i) cognitive processes: motivation, pleasure, reward, reinforcement
c) amygdala
i) memory, decision making, emotional processes (memories)

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Cortex

a) outermost advanced area of brain
b) anterior cingulate cortex
i) reward anticipation, empath, emotion, impulse
c) dorsolateral prefrontal cortex
i) executive functioning, cognitive flexibility, planning (relevant when there are problems with attention and motivation)
ii) cost/benefit analysis of decisions
orbitofrontal cortex
i) linking affect to reinforcement, decision making
e) insular cortex
i) exposure to substance-related triggers, negative emotion expectancy
f) hippocampus
i) integration of emotion and memory

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Dopamine Pathways (* involved in SUD & addiction)

Mesolimbic
Mesocortical
Nigrostriatal
Tuberoinfundibular(No role in SUD or addiction)

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Mesolimbic Pathway

a) runs between VTA to the NAc

i) cells project to other areas including: amygdala, lateral hypothalamus, etc.

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Mesocortical

a) extends to the frontal lobes (decision making)

b) includes several structures believed to have a role in addiction

Nigrostriatal

controls movement

b) explains some motor deficits with SUD

Tuberoinfundibular

– no role in SUD or addiction

Ways of Administration of drugs

Enteral, parenteral, other

Enteral

o blood stream through gastrointestinal (mouth, under tongue, anal) pill, tablet

Parenteral

injection subcutaneous: skin popping: below skin surface, slow absorption intramuscular: muscle, moderate rate of absorption intravenous: blood vein, immediate absorption o rapid onset of effects

Other administration methods

intranasal: snorting | o transdermal: absorption through skin

Distribution

many factors play a role as to how long it takes to distribute through someone’s body

Goal of Biotransformation

transform substances into water soluble metabolite to be eliminated from the body · mainly focuses on liver, but other organs can be factors

zero-order

o organ can become saturated quickly o only a set amount can be absorbed in a time period o EX. alcohol, more taken in than can be absorbed = intoxication

first-order

o a set percentage of substance can be biotransformed (metabolized) each hour o acts separately of what is in the blood stream

First-Pass Metabolism

isolates toxins through the liver and biotransfoms them before harm is do, effectiveness of oral medication is diminished

Elimination

can take hours to days, many organs filter out substances after biotransformation

Half-Life

estimate of substance effectiveness remaining after biotransformation

alpha half-life

peak blood concentration for substance

beta half-life

amount of time for the concentration to decline as the substance biotranforms and is eliminated

therapeutic half-life

time it takes for the body to inactivate 50% of the substance

Tolerance/Neuroadaptation

shortened duration and decreased intensity of substance effects

Tolerance

illegal substance

neuroadaptation

prescription

metabolic

body becomes more efficient in biotransformation

behavioral

brain and body appearing normal despite increase in dose

Blood-Brain Barrier

selective in what gets to the brain through blood · lipid-soluble molecules make it through · many substances are lipid-soluble

NEUROPSYCHOLOGICAL ISSUES of Alcohol

· Wernicke-Korsakoff Syndrome (WKS) – alcohol induced dementia, lack of thiamine · Alcohol Use Disorder (DSM-V) – significant neuron loss in frontal cortex

NEUROPSYCHOLOGICAL ISSUES of cocaine

changes in PFC, anterior cingulate cortex, new cell dev. in hippocampus (impairing memory), new extensions in dendrites (collect more signals coming from hippocampus/amygdala) [may explain cravings],

NEUROPSYCHOLOGICAL ISSUES of opioids

· impair cognitive functioning (frontal cortex and hippocampus) · deterioration of white brain matter (acts as relay between brain functions/communications)

NEUROPSYCHOLOGICAL ISSUES of cannabis

· deficits in learning, memory, verbal language, and executive functioning

NEUROPSYCHOLOGICAL ISSUES of methanphetamine

· deficits in abstract reasoning, cognitive flexibility, and behavioral regulation · frontal system dysfunction

NEUROPSYCHOLOGICAL ISSUES of inhalants

brain stem dysfunction

Gambling

frontotemporal dysfunction, impaired attention and concentration, elevated impulse attention, diminished self-directedness & cooperation

Sex

little researched details, suggested to be similar to SUD

Samantha, 31, single female | · depressed, sex addict, opiate (Percocet) SUD

Sam used sex to cope with her depressive symptoms resulting in having sex anywhere with anyone, after a car wreck damaging her back she was prescribed Percocet o She found that the pills did what the high after sex did, so she began substituting

Explain some of the common neurocognitive deficits in those with substance use disorder (SUD) and how they impede traditional SUD treatment. (5 points)

Traditional SUD treatment: 12-step, 1:1 counseling, inpatient recovery/detox