Drug Dependence

Question 1

Define addiction

Answer 1

A chronic disease characterised by drug seeking and use that is compulsive or difficult to contorl, despite harmful consequences

Question 2

What is the reward system of the body?

Answer 2

Mesolimbic system

Question 3

What does the mesolimbic system do?

Answer 3

Connect the ventral tegmental area to the nucleus accumbens

Question 4

Where is the origin of dopaminergic cell bodies and where is it found?

Answer 4

VGA

Midbrain

Question 5

What are the stages of drug dependence?

Answer 5

Binge (positive reinforcement)
Withdrawal (Negative reinforcement)
Anticipation (Positive and negative reinforcement)

Question 6

What can drugs cause the upregulation of?

Answer 6

Opioid peptide (dynorphin)

Question 7

How do drugs cause the upregulation of opioid peptide?

Answer 7

Increased expression of cAMP which activates CREB

Question 8

What does CREB do?

Answer 8

Upregulates expression of dynorphin

Question 9

What does dynorphin do?

Answer 9

Negatively feedbacks to the VTA, causing less production of dopamine

Question 10

What does reduced dopamine do?

Answer 10

Cause withdrawal effect

Question 11

Symptoms of withdrawal?

Answer 11

Bingeing
Withdrawal
Cravings
Intoxification

Question 12

Effects of alcohol abuse?

Answer 12

GI haemorrhage
Pancreatitis
Alcoholic liver disease
peripheral neuropathy
CV issues
metabolic disorders

Question 13

What happens in alcohol abuse?

Answer 13

Acute euphoria followed by depressed mood, slurred speech, ataxia and pupillary dilation

Question 14

What does ecstasy do?

Answer 14

Targets 5 HT uptake and 5HT2 receptors
Affects dopamine uptake system
Causes increased levels of NT release

Question 15

What effects does ecstasy have?

Answer 15

Psychomotor effects e.g. repetitive movements + hyper-locomotion

Question 16

What does Acute MDMA toxicity include?

Answer 16

Body tmeperature elevation
Incrreased intravascular coagulation
Rhabdomyolysis
Increased renal absorption of water
Hyponataemia
Cerebral oedema

Question 17

What may overuse of MDMA lead to alteration wise in CAN?

Answer 17

Serotonin axon loss

Question 18

What is the main agonist in cannabis?

Answer 18

THC (tetrahydrocannabinol)

Question 19

What do cannabinoids bind to?

Answer 19

CB1 and CB@ receptors

Question 20

Where are CB1 receptors concentrated?

Answer 20

CNS

most abundant CPCR in mammal brain

Question 21

Where are CB2 receptors present?

Answer 21

peripheral organs (associated with immune system)

Question 22

What effects do cannabinoids (e.g. NTS) do?

Answer 22

Produce mostly inhibitory effects by inhibiting glutamate and GABA release pre-synaptically

Question 23

What risks does cannabis have?

Answer 23

Gateway drug

Long term use increases risk of developing schizophrenia and major depression

Question 24

How would you manage addiction?

Answer 24

Detoxification
Psychological support counselling
Medication
Evaluation and treatment for co-occurring mental health problems
Long-term follow up

Question 25

What management to give to alcohol addiction?

Answer 25

BZDs
Direct GABA agonists
Antiepileptic agents (carbamazepine)
Selective serotonin reuptake inhibitors
Thiamine

Question 26

What to give for nicotine addiction?

Answer 26

Nicotine agonists

Question 27

What to give opiate addiction?

Answer 27

Opioid agonist (methadone)