Drugs of Misuse Flashcards
Outline the risk factors for substance addiction.
Describe the cycle of addiction.
Describe how the method of administration affects the effects of a drug.
- The route of administration determines how quickly a drug takes effect and how long these effects last.
- How much and for how long a drug acts in the brain depends on the dose and the method of administration.
- The way a drug is administered determines the amount and permanence in the brain and therefore its effect on behaviour.
What are the effects on behaviour of the single-use of a drug vs the repeated use of a drug.
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Acute - single use.
- Hyperactivity
- Alertness
- Intense pleasure
- Relaxation
- Relieves of anxiety
- Stress and fatigue
- Perception changes
-
Chronic - repeated use.
- Tolerance and dependence.
- ADDICTION
Give an overview of the neural mechanisms of addiction.
- Long-term administration of a drug elicits changes in the neurons of the CNS that alter the functioning of neural circuits.
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Receptor and transporters level:
- Increased or decreased number of binding sites (upregulation or downregulation).
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Structural level:
- Rearranging of synapses and connections
- Neuroplasticity
- Learning
Describe the reward system.
- Natural rewards (things we get pleasure from):
- Food, water
- Sex
- Nurturing
- Music / Art
- Then there are DRUGS
- What happens is that when these areas are activated there is a release of dopamine
Describe the mechanism of action of cocaine.
- The dopamine transporter is blocked by cocaine.
- This means that dopamine is not taken back up when it is released because there is recycling and the result is that there is more dopamine in the synaptic cleft.
- So, there is more activation of the dopamine receptor postsynaptically and this causes pleasure and euphoria.
How do drugs affect the reward circuit?
- Drugs disrupt the reward circuit.
- Nucleus accumbens and the ventral tegmental area are very primitive structures. In terms of evolutionary development of the brain, food and sex are important for development and survival.
- Nicotine acts in an excitatory way in the ventral tegmental area on dopamine.
Describe the temperance model of addiction.
- The drug is dangerous and causes the problems.
- Moderation is unreliable so the answer is prohibition.
- “Once you start you can’t stop”.
- The drug takes control.
Describe the moral model of addiction.
- People decide to use alcohol and other drugs based on social and / or religious norms.
- Addiction is the result of weakness and defective character.
- Biological basis of addiction is rejected - total responsibility is placed on the person.
- So, we need to help people make better decisions with education and deterrents.
- “They can always choose not to use…”.
- But social and religious norms change over time.
- This model is no longer used.
Describe the disease model of addiction.
- Certain people have a specific physiological process off addiction which leads to a loss of control when the drug is used.
- These people need to be identified and can not drink / use.
- “I have a disease…”.
- They individual has the responsibility of managing his / her disease, but if use, then loss of control.
Describe the medical model of addiction.
- A number of potential physiological medical factors have been considered which put the person at risk / more vulnerable to problems.
- Assess risk and address factors as possible.
- “Alcoholism runs in the family”.
- Again, control is related to risk management.
Describe the psychodynamic model of addiction.
- Alcohol and other drug problems are primarily related to psychodynamic factors such as early childhood experiences or trauma.
- Addictive personality disorder / self medication.
- People need psychotherapy to address underlying issues.
- “I have an addictive personality”.
- Substance misuse as maladaptive coping.
Describe the sociocultural model of addiction.
- A number of sociocultural factors have been identified which increase the risk of problems within a population.
- Need to address these factors.
- “Who wouldn’t have a roblem living in my neighbourhood…?”
- Sociocultural factors are seen as key.
Describe the systems and family model of addiction.
- Need to see alcohol and other drug use in relationship to the functioning of familty and social systems.
- For people to change, need to consider relationships and change within the system.
- “You can’t be sober and deal with my family”.
- Much more difficult for a person to change because of system.
Describe the learning model of addiction.
- Alcohol and other drug use is learned behaviour.
- If a behaviour is learned it can be unlearned and new behaviour is learned in its place.
- “I use Valium becuase I don’t know how else to get to sleep”.
- The person is responsible for learning and practicing.
Describe the principal of instrumental learning.
- Based on principles of reinforcement.
Describe the choice aspect of psychological theory of addiction.
- A person often chooses to engage in addictive behaviour as a result of a cost benefit analysis of the alternatives (may be influenced by biases and changing preferences).
Describe the compulsion and self-control aspect of psychological theory of addiction.
A person sometimes sincerely choses to refrain from a behaviour but fails to enact their choice.
Describe the learning mechanisms aspect of psychological theory of addiction.
Sometimes behaviour results from a habit with little conscious decision-making, and certain behaviours come to be valued out of proportion to the benefits they bring.
Describe the integrated theory of addiction (PRIME).
- PRIME is a synthetic theory of addiction.
- Based on a multifaceted theory of motivation.
- Takes into account the biological, psychological and social elements.
- Encompasses varying forms of addiction.
- Notes that addiction is related to other behaviours where strong desires / motivation overtake reason.
Describe the DSM-5 criteria for substance use disorders (SUD).
- 2-3 = mild SUD
- 4-5 = moderate SUD
- >6 severe SUD
Describe the effects of stimulants.
- “Uppers”
- Increased energy
- Increased HR
- Euphoria
- Dilated pupils
- Paranoia
- Anxiety
- Sexual arousal
- Sexual impotence
- Comdowns
Describe the effects of taking empathogens.
- ‘Loved-up’
- Connectedness
- Warmth
- Understanding
- Arousal
- Belonging
- Mood swings
- Depression
Describe the effects of taking psychedelics.
- ‘Trips’
- Spiritual connection
- Heightened senses
- Visual or auditory hallucinations
- Anxiety
- Panic
- Mental health issues
Describe the effects of taking dissociatives.
- ‘Out-of-body’
- Euphoric
- Floaty
- Disconnected
- Relaxed
- Numb
- Scared
- Disconnected
- Unable to move
- In a ‘hole’
Describe the effects of taking cannabinoids.
- ‘Stoned’
- Calm
- Munchies
- Chilled out
- Floaty
- Giggle
- Sensual
- Paranoid
- Dry mouth
- Lazy
- Sleepy
- Mental health issues
Describe the effects of taking depressants.
- Euphoric
- Confident
- Relaxed
- Risk-taking
- Vomiting
- Withdrawl
- Unconsciousness
- Coma
- Death
Describe the effects of taking opioids.
- Confident
- Warm
- Safe
- Pain-free
- Invincible
- Constricted pupils
- Hallucinations
- Addiction
- Withdrawl
- Overdose
