Exam 3 - Alcohol Abuse

Question 1

Addiction

Answer 1

chronic relapsing disease characterized by compulsive drug-seeking and abuse and by long lasting structural and functional changes in the brain

Question 2

What was the Pure Food and Drug Act (1906), and the Harrison Narcotic Act (1914)?

Answer 2

• prohibited the sell of alcohol
• had to have a license to market or sell drugs

Question 3

What are the different schedules of drugs?

Answer 3

Schedule 1 - high risk for abuse and no therapeutic use
Schedule 2 - high risk for abuse and some therapeutic use
Schedule 3 - lower risk for abuse
Schedule 4 - even lower risk for abuse
Schedule 5 - lowest change of abuse

Question 4

What 4 things usually occur in substance abuse?

Answer 4

1. failure to fulfill major role obligations and work, school, or home
2. recurrent use in situations that are physically hazardous (drinking and driving)
3. recurrent substance-related legal problems
4. continued substance use despite persistent or recurrent social or interpersonal or exacerbated by substance (getting in fights with friends and family)

Question 5

Substance dependence is characterized by? (DSM-5)

Answer 5

1. tolerance
2. withdrawal symptoms
3. greater intake of substance
4. persistent desire or unsuccessful attempts to cut down
5. significant time spent using, obtaining, or recovering
6. giving up or reducing important social activities
7. continued use despite knowledge of its negative effects

Question 6

Who is substance dependence common in?

Answer 6

• young (18-25 yo) men

Question 7

What are the 3 personality dimensions that could influence alcohol dependence?

Answer 7

• risk taking and sensation or novelty seeking behavior
• lack of emotional control
• interpersonal relatedness (attachment style,)
• mental health

Question 8

What family factors contribute to alcohol dependence?

Answer 8

• parental substance abuse/dependence
• parental personality/psychopathology
• parent-offspring relationship
• sibling influences

Question 9

What are the developmental factors that could contribute to alcohol dependence?

Answer 9

• peer influences, may seek out friends that do that, or fall victim to peer pressure
• marital partner relations and occupational status (single/divorced) and occupational status
• educational status

Question 10

What contextual influence could contribute to alcohol dependence?

Answer 10

• low socioeconomic status (residence in impoverished and stressful neighborhoods, drug-salient milieu, social disorganization)

Question 11

What is the physical dependence model of addiction?

Answer 11

• initial drug use -> repeated drug use -> physical dependence -> attempts at abstinence -> withdrawal symptoms -> relapse
• once physically dependent, attempts at abstinence lead to withdrawal symptoms
• negative reinforcement - continued use to avoid withdrawal

Question 12

What is the positive reinforcement model of addiction?

Answer 12

• initial use -> positive reinforcement -> repeated drug use -> attempts at abstinence -> compulsive desire for euphoria -> relapse
• support for this model comes from the self-administration paradigm

Question 13

What is the incentive sensitization model?

Answer 13

• initial use -> positive reinforcement -> repeated use -> sensitization of drug wanting but not liking -> attempts at abstinence -> compulsive desire for the drug due to a sensitized incentive salience system -> relapse
• repeated exposure can change brain cells and circuits that normally regulate the attribution of incentive salience to stimuli

Question 14

Opponent-process model of addiction

Answer 14

• initial use -> positive reinforcement -> repeated use -> sensitization of drug-induced hedonic response but loweing of the hedonic set point -> attempts at abstinence -> compulsive desire for the drug due to dysphoria and sensitized drug salience -> relapse
• the longer you’re on a drug, the less of a high you get, and you get more wtihdrawal

Question 15

Disease model of addiction, susceptibility models

Answer 15

• inherited susceptibility to uncontrolled drug use/initial drug use -> repeated drug use -> loss of control
• addiction models - addiction comes from an inherited susceptibility

Question 16

Disease model of addiction, exposure models

Answer 16

• initial use ->repeated/chronic use -> altered brain function -> loss of control

Question 17

Who is the highest prevalence of binge and heavy drinking in?

Answer 17

young adults - 18-25

Question 18

What is the first phase of alcoholism?

Answer 18

• pre-alcoholic phase:
  
  • drinking for social reasons
  • anticipated stress reduction and relief from psychological pain/tension
  • individual seeks out drinking occasions, increases consumption
• becomes part of daily living
• begin to develop tolerance

Question 19

What is the second phase of alcoholism?

Answer 19

• prodromal phase:
  
  • develops feeling of guilt about drinking
  • need for increased intake (tolerance)
  • physiological dependency is established (withdrawal)
  • may also experience black outs, and begin to lose control

Question 20

What is the third phase of alcoholism?

Answer 20

• crucial phase
  
  • solitary drinking
  • may restrict consumption, but this is temporary
  • reverse tolerance (need less drinks to get desired effect)
  • may have nervous or GI disorders, cirrhosis, malnutrition
  • personality deterioration

Question 21

What is reverse tolerance indicative of?

Answer 21

liver damage

Question 22

What is the fourth phase of alcoholism?

Answer 22

• chronic phase
  
  • develops after years of excessive intake
  • medical complication may require institutionalization or death may occur

Question 23

What stages of alcoholism could an alcoholic enter remission?

Answer 23

stage 2 or 3

Question 24

What are the sites of action of alcohol?

Answer 24

• decrease amplitude of AP, decreasing NTs released
• depressant of the CNS, capable of entering every cell in the body
• alter cell membrane anatomy by entering internal structure

Question 25

Pharmacokinetics of alcohol: absorption

Answer 25

- passes from the stomach to the small intestine for rapid absorption - rate is affected by: variability among individuals, and stomach content

Question 26

What is the distribution of alcohol affected by?

Answer 26

- can cross BBB, and blood distributes alcohol to all body tissues - LD 50 of alcohol is about 25 drinks

Question 27

BAC, what factors affect it?

Answer 27

- blood alcohol concentration - amount of alcohol in the bloodstream, % of weight of alcohol per 100 units of blood volume - total body mass, differences in the rate of metabolism

Question 28

What is the process of breaking down alcohol?

Answer 28

- alcohol dehydrogenase + alcohol = acetaldehyde + acetaldehyde dehydrogenase = acetic acid - cytochrome P450 family of enzymes from liver also aid

Question 29

Chronic use of alcohol increases what enzymes? What happens because of this?

Answer 29

- alcohol dehydrogenase and P450 - reduces BAC, increases metabolism

Question 30

What are the phases of dependence?

Answer 30

Phase 1: occurs after a few hours after drinking (agitation, nausea, vomiting) Phase 2: onset is w/n 24 hours of after drinking (risk for seizures) Phase 3: about >30 hours after drinking, may last 3-4 days, commonly called delirium tremens

Question 31

What is alcohol withdrawal syndrome?

Answer 31

- fever, hallucinations, hypertension, incapable of thinking, cardiovascular collapse

Question 32

What are the acute affects of alcohol?

Answer 32

- inhibits secretion of antidiuretic - reduces amount of fat that is oxidized (beer belly) - disrupts sleep patterns - impairs memory - causes slight respiratory depression

Question 33

What are the sensorimotor affects of alcohol?

Answer 33

- vision acuity decreases, taste and smell are not as sensitive - reaction time slows - impairs psychomotor skills - impairs driving abilities

Question 34

What are the psychological effects of alcohol?

Answer 34

- alters emotion and mood (low doses increase mood, high doses decrease mood) - correlated with aggression

Question 35

Can alcohol damage the brain?

Answer 35

yes, it can cause overall atrophy

Question 36

What can alcohol do to the liver?

Answer 36

- fatty liver - cirrhosis - alcohol hepatitis

Question 37

Fetal alcohol syndrome

Answer 37

- children have physical deformities - also show low-normal to sever impairments of intellectual functioning

Question 38

What are the specific effects of alcohol on neuronal membranes?

Answer 38

- acts at a NT - modifies gating mechanism inside channel - stimulates Gs which is linked to adenylyl cyclase - direct interaction with channel protein

Question 39

What are the nonspecific effects of alcohol on neuronal membranes?

Answer 39

- disturbs the relationship of protein in membrane - interacts with polar heads of phospholipids - alters lipid composition

Question 40

What NTs does alcohol act on?

Answer 40

- Glutamate: inhibits, reducing effects of NMDA receptor (cause for amnesia) - GABA: modulates function, withdrawal can cause seizures - Dopamine: increases transmission in mesolimbic pathway (reward pathway)

Question 41

What system is highly sensitive to alcohol? Explain.

Answer 41

- opioid system - causes release, which is why you don't feel as much pain

Question 42

Modern treatment for alcoholism is considered in 3 stages, what are they?

Answer 42

1. detoxification (ridding the body of alcohol, drying it out) 2. medical care for health problems 3. changing long term behavior (psychotherapy, family therapy, AA)

Question 43

What 3 main drugs are used in alcoholic treatments?

Answer 43

- disulfiram (antabuse - interferes w/ metabolism, makes them sick) - naltrexone - anticraving - benzodiazepines (valiums, helps with seizures, anxiety, and anger) - antidepressants