Chapter 5 - Drugs Of Abuse

Question 1

What is the Harrison Narcotics Act of 1915?

Answer 1

One of the first national laws passed to regulate drugs of abuse in the US

Question 2

What does the Controlled Substance Act establish?

Answer 2

A clarification system for drugs based on their potential medical use and abuse liability

Question 3

Early definitions of addiction focused on ____ and does not adequately describe ____

Answer 3

Physical dependence (tolerance, withdrawal effects); cocaine, cannabis

Question 4

Substance Use Disorder

Answer 4

Continued use despite knowledge of significant social, physical, or psychological problems; diagnostic criteria found in DSM 5 and ICD 11

Question 5

Substance Use Disorder symptoms

Answer 5

Tolerance/withdrawal effects (physical dependence); significant time spent seeking/using drugs (at expensive of other behaviour, work/relationships etc); relapse is likely to occur

Question 6

Early remission

Answer 6

Symptom free for up to a year

Question 7

Sustained remission

Answer 7

Symptom free for at least one year

Question 8

Maintenance therapy

Answer 8

Symptom free using medical treatment; program or medication used to reduce the ability to use

Question 9

Associative learning

Answer 9

Organism forms associations between two stimuli (classical cond) or a behaviour and a stimulus that follows it (operant cond)

Question 10

Positive reinforcement (operant cond)

Answer 10

Increased frequency of a behaviour due to a stimulus that followed it (ex drug use to get high is rewarding)

Question 11

Negative reinforcement (operant cond)

Answer 11

Increase in the frequency of behaviour to remove a stimulus (ex drug use to avoid withdrawal)

Question 12

Conditioned stimulus (classical cond)

Answer 12

Neutral stimulus associated with drug may become reinforcing (conditioned reinforcer)

Question 13

Incentive salience (classical cond)

Answer 13

Neutral stimulus commands attention and increases motivation to use a drug

Question 14

Discriminative stimulus (classical cond)

Answer 14

Stimulus that signal the availability of reinforcement (could be a discrete stimulus or contextual cues in contextual conditioning, ex. A knock on the door means ur plug is here)

Question 15

Addictive behaviours are ____

Answer 15

Goal-directed
-brain reward pathway determines motivations/drives; drug hijacks reward pathway

Question 16

Drive theory (theoretical models)

Answer 16

Asserts that repeated drug use leads to a strong, irresistible desire to seek and use the drug; positive reinforcing effects; strength of the drive increases as time passes (like hunger)

Question 17

Drive strength may also be enhanced by ____ (theoretical models)

Answer 17

Withdrawal effects
-drug seeking reinforced when aversive state is removed (negative reinforcement)

Question 18

Opponent-process theory (theoretical models)

Answer 18

Starts with the idea that for every action, there is a re-action; when a drug produces an initial effect, it automatically triggers an action/process in the body to counteract the drugs effect; body “needs” drug to balance opposing process

Question 19

Allostasis (opponent process theory)

Answer 19

Maintenance of a balance around a new set point

Question 20

How does allostasis relate to the opponent process theory?

Answer 20

As long as drug is present, the drug effects and the opponent processes “balance” out at the altered set point however when the drug wears off the body is no longer in balance as the opposing process is still active
-person seeks out drug to maintain allostérie balance

Question 21

The opponent process theory emphasizes ____

Answer 21

Negative reinforcement
-drug seeking/taking is used to prevent withdrawal effects (opponent processes)

Question 22

Incentive salience model (theoretical models)

Answer 22

Argues that drug addiction occurs after there is a shift from how much a drug is “liked” to how much a drug is “wanted”

Question 23

Relapse (incentive salience model)

Answer 23

Return to drug use; may result from re-encountering a stimulus with high incentive salience
-encouraging a stimulus with high incentive salience may command attention and re-engage drug seeking behaviour

Question 24

Disease model of drug addiction

Answer 24

Drug addiction is characterized as a medical disease; drug is seen as cause of disease; one may have a predisposition for drug addiction; treatment goal is to manage the disease

Question 25

Drugs of abuse affect (directly or indirectly) the brain’s ____

Answer 25

Reward pathway; specifically the mesolimbic dopamine pathway from the VTA to the nucleus accumbens

Question 26

What does the mesolimbic dopamine pathway do in drug abuse?

Answer 26

Pathway is activated by naturally rewarding stimuli (food, sex, etc) however drugs of abuse powerfully activate and “hijack” this pathway, making drugs more desired

Question 27

What is the Reward Circuitry?

Answer 27

Olds and Milner (1954) designed an operant chamber equipped with a level; electrons placed in the medial forebrain bundle of rats; rats could then press the level to stimulate their own brain
-rats pressed up to 5000 times per hour; did not eat/drink/etc

Question 28

The amount of ____ released is proportional to the ____ (reward circuitry)

Answer 28

dopamine; expectation of the reward

Question 29

When DA is released into nucleus accumbens it…. (reward circuitry)

Answer 29

Inhibits GABA neurons, leading to disinhibition of GABA and increased DA release

Question 30

Amygdala’s role in the reward circuit

Answer 30

Forms associations between stimuli and reward pathway activation
-connected to thalamus and frontal cortex
-when reward effects are expected but don’t occur the amygdala may initiate a stress response via cxn to hypothalamus
-activation of amygdala inhibits DA neurons in the VTA (anti reward process!)

Question 31

Orbitofrontal cortex’s role in reward circuitry

Answer 31

Increased incentive value of conditioned stimuli leading to cravings (inputs from amygdala and thalamus)

Question 32

Hippocampus’s role in reward circuitry

Answer 32

Forms associations between environmental contexts and reward pathway activation; important for conditioned place preference effects; mediates dopamine release in environments in which drugs of abuse were experienced

Question 33

Dorsolateral prefrontal cortex’s role in reward circuitry

Answer 33

important for executive control— planning actions/decision making
-important for making choices (ex delay immediate gratification for bigger reward)
-compromised with chronic drug use; more impulsive, less decisions, etc

Question 34

Basal ganglia’s role in reward circuitry

Answer 34

Important for automatic, procedural memories; becomes increasingly engaged with drugs of abuse; readily for repetitive, compulsive behaviours associated with drug use (ex reaching for a cig and lighting it while driving)

Question 35

Intoxication (addiction stage)

Answer 35

Acute drug effects that produce a maladaptive and impaired state

Question 36

What is involved in the intoxication stage?

Answer 36

The reward system

Question 37

Withdrawal (addiction stage)

Answer 37

Repeated drug use results in physical and/or psychological withdrawal effects

Question 38

What parts of the brain are involved with withdrawal?

Answer 38

Amygdala, hypothalamus, ANS

Question 39

Preoccupation/anticipation (addiction stage)

Answer 39

Behaviour orients from seeking natural reinforcers to seeking drug reinforcers

Question 40

What parts of the brain are involved with preoccupation/anticipation?

Answer 40

Prefrontal cortex, amygdala, thalamus, hippocampus

Question 41

Therapy/treatment must begin with ____ which involves ____

Answer 41

Detoxification; easing the withdrawal symptoms as drug administration is stopped
-two key approaches: medication + the prevention

Question 42

Drug replacement therapies

Answer 42

Involve exchanging the addictive drug to a more socially acceptable alternative

Question 43

Cognitive-behavioural therapy

Answer 43

Designed to aid the drug user in engaging strategies to reduce to urges to use the drug

Question 44

Twelve-step anonymous programs

Answer 44

Involve anonymous testimony and guidance through 12 steps of recovery

Question 45

Food addiction

Answer 45

Compulsive eating shares many similarities with drug addiction; underlying reward circuitry involved in drug addiction is also involved in food addiction