G04--> Addiction Flashcards
Describe in a very basic form dependence syndrome
based on the past year three or more of certain behaviors must be present
considered a bio-psycho-social disease
what are the behaviors present in those with dependence syndrome?
urge, desire to consume drugs
reduced ability to control beginning, end and amount of consumption of drugs
consumption of drugs to reduce withdrawal symptoms
physical withdrawal syndrome
tolerance, increasing dose to achieve the desired effect
unrestricted behavior pattern dealing with drugs
progressive neglect of pleasure or fields of interest
progressive consumption of drugs despite evidence of negative consequences
Cause of dependence, risk factors?
plentiful including neurologic developmental effects, social interactions, self esteem, family and many more
In dependence disorders part of the cause is biological/genetic factors. Describe the study with twins that was done to display this genetic link
studies with twins from alcoholic and non-alcoholic families that are raised separately show definitive evidence for a greater likelihood for developing alcoholism
which neurotransmitters must be lacking (most likely genetically) in individuals with an addiction disease?
serotonin
what are personality factors that go along with addiction?
novelty seeking
harm avoidance
reward dependence
Describe the ventral tegmental reward system?
addictive substances as well as electrical stimulation activate the reward system
which neurotransmitter is thought to be initially low in individuals with addiction
dopamine is able to induce feelings like euphoria or orgasm.
the concentration of dopamine in the brains of individuals who become addicted is thought to be low.
Use of addictive substances by addicts does what to the dopamine levels?
all addictive substances are able to increase the activity of dopaminergic neurons in the NUCLEUS ACCUMBENS resulting in a release of dopamine
Sexual behavior and food intake can be extinct through what?
electrical stimulation or injection of cocaine in the nucleus accumbens, which is part of the reward system
remember that when individuals are high this over rides all other pleasurable activities, the addiction is all they can think about.
The brain reward system plays an important role in what else?
generating normal behavior like food or water intake or reproductive behavior.
Neurons in the ventral tegmental area (VTA) send their axons where?
to nucleus accumbens, striatum and frontal cortex (Structures, involved in motivation)
Electrical stimulation in midbrain activates what?
dopaminergic neurons in VTA which causes a greater release of dopamine in nucleus accumbens
Therefore the midbrain dopaminergic neurons do what/
reward dependent learning
There are two types of addiction personalities what are they?
type 1 –> low in novelty seeking, high harm avoidance and high reward dependence
type 2 –> high novelty seeking, low hard avoidance and low reward dependence
how does psychology and upbringing factor into addiction?
majority of addicts have hx of abusive childhood
the mood change upon engaging in the addiction (Drugs, gambling ,sex) is what they crave
their addiction is used to replace the uncomfortability of normal life.
The learning model of addiction discussed an example of shy man at a bar: describe the scenario of this man
feels better and relaxed to be social after a few drinks (positive, internal and short term)
argument may develop from loose lips (negative, external and short term)
hangover the following day (negative, internal and long term)
If the man encountered so many negative consequences from a night at the bar, then why does he keep wanting to go back?
negative consequences would presumably stop him from drinking but the short term effects are remembered better than the long term, thus he will drink again
The learning model describes different types of consequences what are they?
external and internal consequences
long and short term consequences
positive and negative consequences
our society is very addictive and there are many socio-cultural stress factors that influence addition.Each card will go through the different social characteristics and associated pathology
- Performance: deadlines must be met, quantity of output predisposes for stimulants to work and sedative to sleep
next social characteristic
- Consumption: need for consumption hunger for satisfaction leads to excessive eating of different things and addiction of consumption (junk food)
3rd social characteristic?
- Industrial: viability therefore inadequate switch-behavior (on/off) with drugs
4th social characteristic?
- Urbanization: loss of nature and therefore adaption and dependence on technical environment
5th social characteristic?
- Damage of nature: unlimited utilization of nature therefore exploitation of the body with drugs
6th social characteristic??
- Information society: alienation through abstraction causes decreased relation to reality and decrease of decidability
7th social characteristic?
- Mass society: de-individualization and standardization causing isolation, self estrangement and loneliness
8th social characteristic?
- World Society: dependence on global structures causing complexity and feelings of powerlessness
9th social characteristic?
- Materialism: material interests spiritual deficiency causing new dependences on material articles and need for spiritual life
10th social characteristic?
- Change: loss of traditions and therefore loss of roots, instability and strangeness
11th social characteristic?
- Mobile society: loss of relations therefore instability, isolation, disposable contacts and ambiguity
List some sedation drugs
Tetra-Hydro-Cannabinol Alcohol Benzodiazepine Barbiturate Opiate/opioid
Describe the withdrawal syndrome of sedative drugs
excitation, high blood pressure, and tachycardia, epileptic seizures, and psychosis might develop, and medical treatment is needed
List stimulation drugs
Amphetamine
Cocaine
Ecstasy
Describe the withdrawal syndrome of stimulation drugs
sedation, low blood pressure and bradycardia occurs. those symptoms do not usually require medical attention
List Hallucination drugs
Magic Mushrooms (psilocybin) Ketamine LSD Phencyclidine (Angel dust) Solvents
what is the difference between psychic dependence and physical dependence?
psychic –> all drugs
physical –> sedatives
Alcohol Detoxification, describe the withdrawal symptoms
As the body is accustomed to alcohol regularly, in the absence, the body exhibits withdrawal symptoms making it exceedingly difficult to stop
not a life threatening situation
What are the withdrawal symptoms associated with alcohol or any sedative drug?
Hyperhidrosis, tachycardia, hypertension and tremor (Due to increased noradrenaline )
Psychotic symptoms (increased dopamine)
Epileptic seizures (increased glutamate)
remember drug effect is always opposite of withdrawal symptoms
How long do withdrawal symptoms last in alcoholics?
last about 5-7 days but the craving for alcohol persists longer
When do delirium tremors start in alcoholics?
occurs in about 5% of alcoholics usually 2-3 days after they have stopped drinking and in extreme causes they can be fatal
what is the most commonly used medication for detoxification of alcohol?
benzodiazepines (work on the same GABA receptors)
why is vitamin B1 (thiamine) given to alcoholics?
thiamine is a co-enzyme needed to metabolize carbs and without it can alter PPP and cerebral energy metabolism
remember most alcoholics do not eat properly and therefore lack this vitamin
Acute deficiency of Vitamin B1 causes what?
oculogyric crisis, ataxia, and delirium similar to a diabetic coma
Giving what drug without thiamine can be fatal for an alcoholic with B1 deficiency ?
glucose
what other medial treatment drugs can be giving to alcoholics and sedative drug users?
diazepam–> anti adrenergic, anti convulsive and anti psychotic
haloperidol –> anti psychotic
Clonidin –> anti adrenergic
Describe cold opiate detoxification
Symptoms like GI-influence Non life threatening Symptomatic medication against: nausea, diarrhea, tachycardia and hypertension 2nd and 3rd days are the worst not longer than 5-7 days Hyposomnia can continue for weeks
Describe the warm opiate detoxification
Substitution of opiates with methadone
reduction of methadone dose over about 3 weeks (long half life so they cant leave the ward)
symptomatic medication against: nausea, diarrhea, and tachycardia/HTN
problem: long stay in closed ward
high chance of breaking off the treatment
what is the end goal of the methadone program?
Competence in life management, contentment
what are the steps in the methadone program?
Survival and improvement of physical conditions
reduction in relapses and reduction in the use of drugs
reduction of methadone doses
abstinence
