Drug Taking Behaviour

Question 1

Environmental cues can contribute to

Answer 1

Drug waking behaviour

Question 2

The known mechanisms of conditioning can account for

Answer 2

the response profiles characteristic of addiction

Question 3

The Anatomy of Drunkenness (Macnish, 1859)

Answer 3

‘Man is very much a creature of habit. By drinking regularly at certain times he feels the longing for liquor at the stated return of these periods – as after dinner, or immediately before going to bed, or whatever the period may be. He even finds it in certain companies, or in a particular tavern at which he is in the habit of taking his libations.’

Libation = a drink poured out as an offering to a deity.
“he poured the libation of rum on the ground”
synonyms:liquid offering, offering, tribute, dedication, oblation; sacrifice

Question 4

US (1915) addiction treatment facilities (Kolb, 1927)

Answer 4

Cue-elicited relapse:
‘We see this plainly exemplified in the cured tobacco smoker. …A cured smoker who usually does not crave tobacco may feel an intense desire resembling hunger when he gazes on a box of cigars or sits in the company of friends who are smoking.’

Question 5

Environmental factors in relapse

Answer 5

Primary withdrawal
Followed by relapse in drug-taking environment
Reports that lavatory smell elicits craving
Addicts shown video of heroin preparation and administration report anxiety and craving
Compare triggers for eating

Question 6

Overdose in novel environments

Answer 6

definition, usually in the usual place (!) except in cases of OD, relatively more likely to occur in unusual environment

Question 7

Stimulus substitution vs opponent processes

Answer 7

Solomon & Corbit, 1973

Question 8

Compensatory conditioned responses: Diabetes

Answer 8

Compensatory CRs would result in an aversive withdrawal reaction (as the counterbalancing action overshoots)
If blood sugar is repeatedly increased by glucose injection, placebo injection results in decreased blood sugar level (hypoglycaemia)
If blood sugar level is repeatedly decreased by insulin injection, placebo injection results in increased blood sugar level (hyperglycaemia)
So we can see how compensatory physiological reactions may result in tolerance..

Question 9

Compensatory responses: Drug addiction (Siegel, 1977)

Answer 9

Repeated morphine injections are less and less effective (because of the development of tolerance)
If a substitute placebo injection is made, pain sensitivity may be even further increased because of conditioned withdrawal
Siegel (1977): proposed conditioned withdrawal as a mechanism to account for relapse into drug taking

Question 10

Compensatory conditioned responses

Answer 10

A ‘real response’ to a US is the reaction of the nervous system
But when a US has a peripheral effect, this can stimulate the nervous system to compensate
The peripheral effect can be mistaken for the UR, but actually it stimulates the nervous system to compensate, which is the true UR
When the UR is compensatory, so is the CR

Question 11

Agonistic responses: Drug addiction (Stewart et al., 1984)

Answer 11

When a little of what you want makes you want more
Stewart et al. (1984): evidence for conditioned incentive effects
➢Hebb effect, cf. peanuts or an aperetif
Stewart’s incentive effects can only work when drugs are actually available?
Both kinds of reaction seen successively (Solomon & Corbit, 1974)

Question 12

Reaction & counter-reaction to shock (Church et al.,1966)

Answer 12

Heart rate

Time after shock onset

Question 13

Activity after morphine or saline injections

Answer 13

After morphine, activity first decreased and then increased above normal
When morphine was associated with a unique box or environment (m-e in the insert), the box elicited an increase in activity, as if it were additive with that (compensatory) aspect of the reaction to morphine

Question 14

Implications: Risk of overdose

Answer 14

Siegel & Kim (2000): overdose in patient switched from oral morphine to skin patch substitute
Zador (1999): ‘ingesting heroin in an unusual or unfamiliar setting is not currently publicized as a risk’

Question 15

Implications: Exposure treatments

Mixed results but variety of outcome measures:

Answer 15

• Latency to relapse
• Extent of relapse
• Cue reactivity
• Self-reports of drug use and urges
• Withdrawal symptoms

Question 16

Applying animal learning in CBT (Siegel & Ramos, 2002)

Answer 16

Spontaneous recovery – best to use widely spaced extinction trials to minimize
Context effects – extinction as CS-no-US associations (thus context-specific)
Occasion setting role of context – occasion setters don’t extinguish when presented on their own
Ineffective exposure therapy maybe working with ‘wrong’ cue

Question 17

21. Further implications: Exposure treatments

Answer 17

Other reasons for mixed results:
Exposure to occasion setter
Cues from act of self-administration
Interoceptive drug-associated cues, early direct effects or drug onset cues
Potential for overshadowing, drug onset cues likely highly salient
Cue exposure treatment procedures for problem drinking include priming doses of alcohol

Question 18

Overly reductionist approach?

Answer 18

Psychological dependency
Imagining drug cues elicits craving
Emotions elicit withdrawal distress and craving
‘Psychological dependency’ or interoceptive cues?

Macnish (1859):‘Man is very much a creature of habit. By drinking regularly at certain times he feels the longing for liquor at the stated return of these periods

Question 19

Drug addiction well worked out in terms of

Answer 19

Bio associative model

Question 20

Drugs of abuse can result in ‘over-conditioning’

Answer 20

Amphetamine increases conditioning to weak cues, in latent inhibition procedures for example
Saline higher then drug

Question 21

Conditioning to context vs other drug cues

Answer 21

User A has relatively valid cues – odour and friend

User B will condition to the room context

Question 22

Drug-related thoughts as well as behaviours

Answer 22

During learning
Stimulus A + Stimulus B =====> Thought of B
(lavatory) + (cocaine) (excited)

After learning
Stimulus A ============> Thought of B
(lavatory) (excited)

Question 23

Extending the two-process account to drug addiction

Answer 23

In addition to the role of classically conditioned cues in drug addiction, instrumental mechanisms come into play
There can be a chain of responses which bring the addict into contact with the drug (US); initial responses most likely just result in exposure to the cues (CSs) associated with drug-taking which can act as secondary reinforcers (e.g., the cigarette in the hand)
Negative reinforcement, which involves reducing exposure to aversive stimuli, plays an important role for drugs which produce withdrawal symptoms
Withdrawal symptoms can also be triggered by classically conditioned cues…