Drug Addiciton Flashcards
How do the physical harm/depedence of drugs relate to their legality?
Laws don’t reflect them at all!
Physical harm: obtaining and harm on body.
Dependance: physiological changes on your systems and how much it links to withdrawl.
Heroin (opiates) and cocaine have high risk of dependance and harm, but more intermeidate ones are legal. (tobacco, xanax, alcohol)
Low risk (LSD, Ecstasy, K) are all illegal!! Alcohol is the most dangerous drug to the population.
DOn’t judge people
Worst for personal harm: methamphetamine (crystal meth)
Who is at risk for drugs?
Men 1:3 (used to be 1:5) maybe due to social acceptance?
Women are at greater risk for psychostimulants.
Telescoping: measurement from 1st use to seeking help is lower in women. Seek help faster.
Starting young: bad for the developing brain and just longer time using the drug.
Drug and Anxiety are both causes and effects of substances.
Who is predisposed to addiction issues?
No one gene!
Ethnicity: some communities are more predisposed (Scottish people)
Family clusters of alcoholism.
Genes break down alcohol more or less than others. The better you metabolize the more likely you are to get addicted cause you need more of that substance.
Some people can’t drink at all, or certain alcohols.
BIGGEST PREDICTORS
- family (norms)
- childhood trauma
- chronic stress
- poverty
What causes drug addiction?
Changes in structure and function of the brain
Drugs lead to drug seeking behavior. THey seek themselves.
Addiction isn’t a failure of willpower.
(used PET to see)
Drug users have hypoactive dopamine systems, especially in striatal neurons.
What are the features of Drug addiction?
- Pleasing Effects (which diminsh over time, whcih is funny cause they get more motivating over time - think of the sauder smoker)
- Craving: urges to seek
- Tolerance: need more to have the same effect, escalation of intake. more drug more often.
- Dependence: developing a baseline. Need the drug to keep up that baseline. WITHDRAWL.
- Relapse: decades after abstinance, build therapies around getting outta withdrawl.
- NEGATIVE EFFECTS ON YOUR LIFE. THE MOST IMPORTANT.
What are the “stages” of drug addiction?
Intoxication
one in the system, go into withdrawl (adapted to regular intake of drug) many types of this.
Preoccupation/anticipation: when you’re clean you think about using it and get excited to take it agian.
not the best model. We are addicted to things that aren’t intoxicating, and some things don’t have withdrawl (biologically)
Whats a good example of tolerance?
Caffeine! An Adenosine receptor antagonist. STops the tired across the day. BUt body builds more receptors so you need more and more coffee to cover them all up. then when you don’t have coffee you have too many adenosine receptors and you’re exhausted. Wake up in withdrawl.
Resets itself in a few weeks tho
Whats the opponent process theory of drug addiction?
Withdrawl theory (KOOB) Explains things like opiods that have terrible withdrawls.
Taking drugs to feel good to taking drugs to feel NORMAL.
receptor density.
This is like the coffee example.
PROBLEM
but then why do we relapse once we get out?
even after years people will go back to it. AND withdrawl doesn’t last forever so why do people avoid it so heavily?
withdrawl is part of it but not the whole story…
BODY prepares for the amount of drug that its excepting. in cue situations its ready and body preapres for this, which is why so many overdoses happen in new places cause body isn’t prepared for it. no opponent process mounted.
Whats a better idea of drug addictoin?
Associative learning principles like operant conditioning, reinforcment and incentive salience.
Neutral things acquire intense value.
Drug use is somewhat of a habit, but they aren’t habitually behaving, they’re planning in pursuit of drugs.
Is Dopamine the Pleasure molecule?
All drugs act on dopamine system directly or indirectly.
(people dont get addicted to acid cause its so low on dopamine system)
WHY do people think that is is? Olds and Milner did a dopamine pleasure sutdy where they hit the medial forebrain bundle (mesolimbic dopamine pathway) and rats pressed the lever above all else to get this. Intracranial self stimulation. Motivation.
1. -howver humans say they’re just about to remember something. maybe its just really motivating.
- Parkinsonian patients don’t have baseline lack of pleasure, its lack of movement that they’re concerned with. When given L-DOPA, movement goes up but pleasure doesn’t go up!!
- Dopamine antagonists for schizophrenic patients! Reduce the positive symptoms. Schizophrenics don’t have too much pleasure, but they have hyperactive dopamine systems. All D2 receptor family, inhibiting effects.
Drugs that need higher doses inhibit more weakly. direct correlation.
Maybe dopamine has to do with our touch to reality.
ALSO
side effects of these drugs take a toll on their ability to move around and look parkinsonian.
- Salamone did a study where rats had to work for a larger reward, and with the dopamine antagonist (antipsychotic D2), IP injection or cannula into VTA or NACC.
it decreased motivation, but not the preference for it(still chose higher reward if there was no work)
Alsoworks the other way: if given amephetamine, they will work harder for a high reward option!!
What is the 2nd theory of addiction?
Incentive sensitization theory.
- separates liking from wanting. (pleasure from motivation)
Drug use ads incentive salience to drug stimuli by artificially increasing DA levels. SIGHT OF DRUG/DRUG CUE facilitates motivation.
REALLY HIGH: methamphetamine has dopamine system 2000% higher. Adds incentive salience to things that were present during time.
- cues can be stress levels, lighters, freinds etc. motivational value added to all these things.
Separates hedonic aspects from motivational aspects.
EXPLAINS relapse: even if you don’t like drinking, cues (like stress) will urge you to take a drink.
What is the primate grape juice study?
Schultz (pavlovian learning)
VTA neurons fire for unexpected rewards, but then eventually fired for when they THOUGHT the reward was coming and NOT for the actual reward. Not pleasure (pleasure is the actual juice) but more of tracking our expectations. NEurons go silent when reward isn’t given. \
VTA dopamine neurons tracking expectations. (better than predicted vs worse than predicted)
this is good for when you control an enviornment (I will never come back to this place again or i will when you get a dopamine release when getting pizza)
What does dopamine do?
Some stimuli have innate or learned incentives, which facilitate dopamine release onto the NACC, as a teaching signal, motivational signal. So the NAcc gets many inputs that guide behavior.
Dopamine teaches you to “come to clss” even tho its not rewarding now.
Activating it means activating the go pathway. inactivating the stop pathway.
How does drug use change systems in our brain?
See adaptations after long use, all places are potentially damaged.
Same regions wehre dopamine targets from the VTA.
How can we help people with drug addiction?
Detox, drug replacement therapy, behavioral/cogntive behavioral therapy, 12 step program. none of which really work. 12 is better than CBT. Detox is often a failure.
Drug replacement with longer half lives is usually good.
Detox: 90% of users go backt oi t.
Drug replacement: 70% go back to it.
Why doesn’t it work?
if you get cues again , you’ll have cravings again!!
Need access to a new environment!!
