Intro to Addiction

Question 1

terminology: drug, recreational drug use, drug misuse

Answer 1

drug = administered substance that alters physiological functioning
recreational drug use = drug used to experience its effects
drug misuse = drug that is not used as intended

Question 2

drug classification (6)

Answer 2

1. CNS depressants
2. CNS stimulants
3. opiates
4. cannabinoids
5. hallucinogens
6. inhalants

Question 3

CNS depressants (3)

Answer 3

1. alcohol
2. barbiturates
3. sedatives

Question 4

CNS stimulants (4)

Answer 4

1. cocaine
2. amphetamines
3. caffeine
4. nicotine

Question 5

opiates (4)

Answer 5

1. heroin
2. oxycodone
3. morphine
4. methadone

Question 6

hallucinogens (4)

Answer 6

1. lsd (acid)
2. mescaline
3. psilocybin (mush)
4. mdma

Question 7

inhalants (4)

Answer 7

1. aerosol sprays
2. glues
3. paint thinner
4. gasoline

Question 8

what is addiction (4)

Answer 8

chronic (1), relapsing (2) brain disorder characterized by a compulsive desire (3) to use a drug despite catastrophic consequences (4)

Question 9

what does addiction involve (3)

Answer 9

1. compulsive use in the face of consequences
2. decreased pleasure from the drug
3. loss of control over use

Question 10

biological basis of addiction

Answer 10

disrupts the normal, healthy functioning of organ in the body (like diabetes and the pancreas) -> abnormalities in brain anatomy, function and chemistry

Question 11

addiction cycle phases (3)

Answer 11

1. binge/intoxication -> drug is being consumed
2. withdrawal/negative affect -> drug is ceased
3. preoccupation/anticipation -> drug-seeking behavior

Question 12

brain regions associated with each phase in the addiction cycle (3)

Answer 12

1. binge/intoxication -> basal ganglia (reward center)
2. withdrawal/negative affect -> extended amygdala
3. preoccupation/anticipation -> PFC

Question 13

summary of binge/intoxication phase (4)

Answer 13

1. DA released in reward centers (BG) of the brain
2. brain becomes hypersensitive to drug cues -> strong feelings of craving
3. increased craving for drug + decreased liking of drug
4. cue-craving association stored in brain as enduring memory; relapse is possible even after long abstinence

Question 13

role of DA in addiction (3)

Answer 13

0. DA = motivation to repeat behaviors that help us survive (learn smth new -> DA release)
1. drugs cause unnaturally large releases of DA in BG = creates motivation to consume the drug again
2. assigns salience to drug and drug-related things (cues)
3. DA facilitates consolidation of maladaptive memory traces connected to drug in the hippocampus

Question 13

what brain pathway facilitates natural and drug rewards and reinforcement

Answer 13

mesolimbic pathway

Question 13

activation of VTA neurons creates

Answer 13

increased levels of DA in NAc

Question 13

what is the mesolimbic pathway

Answer 13

dopaminergic pathway connecting VTA to NAc

Question 14

DA levels in reward centers when consuming high vs low fat diet

Answer 14

greater DA release when consuming high fat diet

Question 15

graphical elements that show level of addiction severeness

Answer 15

1. peak of DA
2. how fast it reaches the peak and how fast it drops

Question 16

what is the capture rate

Answer 16

% of people who became addicted after trying drug / % of people who tried the drug (likelihood of becoming dependent if use drug)

Question 17

drug with the highest capture rate

Answer 17

tobacco

Question 18

influence of DA on salience (3)

Answer 18

1. drug = high value
2. drug-related things (people, places, contexts, etc.) = high value
3. other aspects of life = lower value

Question 19

how do cues work (4)

Answer 19

1. attention is automatically driven to cues
2. brain is conditioned to expect reward after seeing cue
3. leads to strong feeling of craving
4. compulsion to satisfy craving at /any expense/

Question 20

results of testing brain hypersensitivity to drug cues (control vs CUD+ vs CUD-A)

Answer 20

1. control = strong activity when pleasant and unpleasant images; no activity when cocaine-related
2. CUD+ = weak activity when pleasant images; high activity when cocaine-related
3. CUD-A = high activity when pleasant, unpleasant and cocaine-related images

Question 21

what explains that SUD people find natural rewards less important

Answer 21

less brain hypersensitivity to pleasant images

Question 22

what explains that abstinent SUD people can still relapse

Answer 22

high brain hypersensitivity to cocaine-related images (cues)

Question 23

what is tolerance

Answer 23

with repeated drug use over time, same amount of drug is not producing same effect (need higher dose to achieve same effect)

Question 24

molecular-level changes in brain due to drug use and consequence

Answer 24

DAr downregulation -> tolerance (too much DA release, brain wants to keep homeostasis so decreases # of DAr: high is not as high, start using more)

Question 25

over time, characteristics of addiction (2)

Answer 25

1. increased wanting of drug 2. decreased liking of drug

Question 26

relationship bw liking and wanting systems

Answer 26

1. under normal circumstances, work in sync 2. repeated drug use disturbs balance (separate psychological processes w/ independent mechanisms)

Question 27

events of withdrawal phase (3)

Answer 27

1. "coming down" from high 2. body feels (physiological) its absence 3. withdrawal symptoms

Question 27

when do DA neurons become active in addiction

Answer 27

anticipation of reward leads to DA release; DA neurons in VTA activated when reward is expected (provides motivational drive)

Question 28

how can withdrawal symptoms vary (3)

Answer 28

1. drug 2. duration of use 3. consumption pattern

Question 29

withdrawal symptom ex (12)

Answer 29

1. sweating 2. nausea 3. trembling 4. irregular sleep patterns 5. irritability 6. mood swings 7. body aches 8. chills 9. cravings 10. vomiting 11. anxiety & depression 12. seizures

Question 30

onset, peak and duration of withdrawal symptoms

Answer 30

usually between 4-12 hours after last use; peak 1-2 days later; last weeks to months

Question 31

why do withdrawal symptoms drive drug use

Answer 31

drug use relieves symptoms (back to homeostasis)

Question 32

role of the PFC (3)

Answer 32

1. executive function 2. performs reasoning 3. weighs pros and cons

Question 33

PFC in addiction (3)

Answer 33

1. reduced ability to inhibit impulsive behavior 2. stop signals are very weak 3. smaller PFC associated with greater lifetime drug use

Question 34

effect of weak stop signals from PFC

Answer 34

drive to use drug surpasses ability to inhibit drug use

Question 35

what is drug dependence

Answer 35

chronic drug use that results in physiological changes that will lead to the occurrence of negative symptoms (withdrawal) when drug is ceased

Question 36

physical vs psychological dependence

Answer 36

physical = tolerance; withdrawal symptoms when stop use psychological = subjective feeling that need drug to maintain feeling of well-being

Question 37

what is SUD

Answer 37

problematic pattern of use that impairs functioning (>2 criteria must be met within 1 year)

Question 38

risk factors for problematic substance use (5)

Answer 38

1. genetics/family history 2. environment/stress -> early-life trauma (childhood experiences) 3. personality -> impulsivity, novelty-seeking, risk-taking 4. comorbidity 5. age -> younger ~ greater risk

Question 39

why is drug use during adolescence riskier than in adulthood

Answer 39

brain doesn't finish developing until 25 years old (last part of brain to develop is PFC)

Question 40

adolescent brain characterized by (2)

Answer 40

1. high functioning reward system: GO signals (reward center sensitive to reward) 2. underdeveloped PFC: STOP signals (less ability to inhibit risky behaviors)

Question 41

adolescent drug use may prime the brain for (3)

Answer 41

1. cognitive problems (improper development of PFC) 2. psychiatric disorders 3. addiction

Question 42

treatments for addiction (3)

Answer 42

1. pharmacological treatments 2. psychosocial treatments (CBT, MI, etc.) 3. neuromodulation (rTMS, TCDS)

Question 43

does the brain recover with abstinence (3)

Answer 43

1. increased activity in reward brain regions 2. increased GMV in PF brain regions 3. connection with cues stays present