chapter 1 - Addiction & the Brain Flashcards
Neurons
Communicate through a series of circuits
How many parts do neurons have and what are they?
- (CADS) Cell body, Axon, Dendrite, Synapse
How many functions does a neuron have and what are they?
inhibition, excitation, neuromodulation
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
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
Neurotransmitters
a) form language that neurons communicate with
b) passed between neurons in the S
Major neurotransmitters related to substance use disorders
Dopamine Serotonin Norepinephrine Endo opioids Acetylcholine Endo cannabinoids Glutamine GABA
Function of dopamine
Pleasure, reward, movement, attention, memory
Function of serotonin
Mood, sleep, sexual desire, appetite
Ecstasy/LSD, Coke
Function of norepinephrine
Sensory process., movement, sleep, mood, memory, anxiety
Coke, meth
Function of Endo opioids
Analgesia, sedation, body functions, mood
Heroin, morphine, oxy
Function of acetylcholine
Memory, arousal, attention, mood
Nicotine
Function of Endo cannabinoids
Movement, cognition, memory
Marijuana
Function of glutamine
Increased neuron activity, learning, cognition, memory
Ketamine, phencyclidine, alcohol
Function of GABA
Slowed neuron activity, anxiety, memory, anesthesia
Sedatives, tranquilizers, alcohol
Brain stem
hindbrain: cerebellum, pons, medulla
i) motor control, language, attention, fear, pleasure
ii) most interior, primitive area
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
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)
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
Dopamine Pathways (* involved in SUD & addiction)
Mesolimbic
Mesocortical
Nigrostriatal
Tuberoinfundibular(No role in SUD or addiction)
Mesolimbic Pathway
a) runs between VTA to the NAc
i) cells project to other areas including: amygdala, lateral hypothalamus, etc.
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
