Chapter 5 Flashcards
what are the four types of treatment programs
- detoxification and medically managed withdrawal
- outpatient programs
- short term residential programs
- long term residential programs
what is the basis of predisposition theories
history, something happens and as a result someone is more vulnerable
The drug itself changes the physiology of the body which causes a person to lose control, develop tolerance, and interference in social aspects of a person’s life
exposure theories
what is the basis of hedonic dysregulation and adaptation
pleasure seeking/mood regulation but your body tries to counteract the drug prompting you to take more. you ultimately never get back to baseline due to taking more during withdrawal because you cannot prevent withdrawal, only postpone it
what does hedonic dysregulation and adaptation ultimately mean for the person taking the drug
they have a perpetual vulnerability should they ever finally quit because according to this theory, they will never get back to baseline as the allostatic points change from persistent drug use
what brain regions make up the memory/conditioning circuit
hippocampus and amygdala
how is dopamine connected to learning
contributes to it indirectly by enhancing attention, consolidation, etc. it is not the cause for obtaining a stimulus-reward association itself
intense preoccupation, strong desire or an overwhelming urge to use a substance
craving
what brain regions make up the reward/saliency circuit
the nucleus accumbens and the ventral tegmental area
hedonic dysregulation and adaptation explains _____ relapse
stress related
true or false: when dopamine is released into the nucleus accumbens, it inhibits inhibitory output of the motor system (therefore stimulating it)
true
repeated exposure causes the addiction
exposure theories
stress induced reinstatement
exposed to a stressful situation which makes me crave the drug again
where are the hedonic hotspots located
in the nucleus accumbens and the ventral portion of the pallidum (the output of the basal ganglia)
what are some factors that alter the reinforcement value of drugs
- potency and/or dose
- genetic differences
- stress
- experience with other drugs or the same drug
- dependence and the relief of unpleasant symptoms
Drug induced reinstatement
already stopped taking the drug, then taking it and falling of the wagon again
provides a good explanation for strong craving in the absence of dysphoric withdrawal
incentive sensitisation
What are the four main themes found in the diagnostic criteria for substance use disorder
- tolerance
- withdrawal
- incentive/motivation
- loss of control
what is theorised to be the reason that some people with substance use disorder do not think they need treatment
dysfunction in the cortical circuits that mediate insight and self awareness
circular reasoning
trying to explain something by the thing itself
what brain regions make up the motivation/drive circuit
orbitofrontal cortex and motor cortex
what are the main relevant structures in motivational control
- the mesolimbic dopamine system (VTA and Nucleus Accumbens)
- Motor Loop (Basal ganglia, thalamus, and cortex
- Learning and memory (amygdala and hippocampus)
If I take drug during hangover state, I can’t get as high as I was before because I’m at a lower point than I would be if I wasn’t taking the drug in the hangover state and instead took it after
hedonic dysregulation and adaptation
what are the four interrelated brain circuits that dysfunction of which is thought to impact addiction
- reward/saliency circuit
- motivation/drive circuit
- memory/conditioning circuit
- inhibitory control/executive function circuit
what brain regions make up the inhibitory control/executive function circuit
dorsolateral prefrontal cortex and the anterior cingulate gyrus
the output of the ____ typically provides continuous inhibition for the motor system
nucleus accumbens
why is the dependence model flawed
“it is possible to have an addiction in the absence of dependence, and dependence in the absence of addiction”
what is the main issues with dependence theories
not all individuals develop physical dependence. some will stop a drug even with the presence of withdrawal and some drugs simply have low physical dependence such as cocaine
what is suggested to be the reason users have lack of interest in natural rewards they previously enjoyed
long term drug use is associated with a decrease in dopamine function (this in turn can cause further drug use in attempts to temporarily alleviate the dopamine deficiency)
how many symptoms results in someone having mild substance use disorder, versus a moderate case, and a severe case
- mild = two or three
- moderate = four or five
- severe = 6 or more
a stimulus that increases the frequency of a behaviour it is contingent upon
positive reinforcement
at the core of the ____ model, is the belief that withdrawal symptoms are so painful and distresses that dependent individuals are willing to sacrifice almost anything to avoid having to go through withdrawal
the dependence model
what is the basis of exposure theories
there are alterations caused by the drug with repeated use
incentive sensitisation explains ____ relapse
cue associated
a cognitive process that grants a “desire” or “want” attribute, which includes a motivational component to a rewarding stimulus.
incentive salience
what is the basis of incentive sensitisation
the motivation (incentive) system is more excitable (sensitive) with repeated use
cue induced reinstatement
Haven’t taken the drug, but am in an environment that I associate with the drug which increases urge to take the drug
born with disease or acquire it before substance use
predisposition theories
