Lecture 1 - Craving in Addiction Flashcards
What five barriers for seeking treatment for substance abuse are mentioned in the lecture?
- Attitudinal (“I though I could handle it”)
- Readiness for change
- Stigma
- Financial/cost
- Structural (“I didn’t know where to go”)
What are three common triggers for relapse?
- Context-dependent (place/person associated with drug use)
- Stressful circumstances
- Pre-existing emotional/mental-health challenges
Relapse rate for drug abuse?
40-60%
What are three components of craving (as reported by individuals) mentioned in the lecture?
- Anticipation
- Sensory experience (e.g., taste)
- Imagery (e.g., sipping a glass of wine, chilling on a sofa & feeling good)
Relates to intrusive thoughts about substances
What, besides drugs, evoke strong dopamine responses?
Drug-associated cues
What is “D2 receptor down-regulation”?
Increased dopamine activity due to drugs > decrease of dopamine D2 receptors
Why is low dopamine D2 receptor availability not seemingly just a consequence of chronic drug use?
Relatives of drug addicts also show (relatively) low D2 density > RDS theory
Within pavlovian learning & addiction, what are examples of the US, CS, UR & the CR
US = Substance
CS = Cue associated with substance (e.g., bar)
UR = Effect of the Substance
CR = Craving/mental imagery/etc. (?)
Pavlovian learning in the brain?
- When the prediction of a reward in a situation is currently inaccurate = reward prediction error
- Midbrain dopamine neurons encode prediction error > signal to cortico-striatal brain circuits > Teaching signal
- Thus, the CS (predictive cue) will trigger a dopamine response, and not the US
In what three behavioural ways can it be seen that the incentive salience of drug-asociated stimuli increases in substance abuse?
I-S theory
- Drug-associated stimuli act as motivational magnets because they elicit attention (they are wanted/craved)
- Drug-associated stimuli become reinforcers themselves
- Drug-associated stimuli (and drugs) can induce relapse
This is a repeat, but important theory
What is the conditioned place preference (CPP)?
- A method to study incentive salience of drug-associated cues (“motivational magnets”)
- How do “magnets” draw the user to them, thereby increasing the likelihood of more substance abuse
- Can be studied in humans using real of virtual environments
What is needed, neurobiologically, for the CPP?
- Neuronal activation in the ventral tagmental area (VTA), is necessary for the acquisition of drug CPP
- Increases in dopamine in the nucleus accumbens are correlated with drug CPP
The lecture mentions three critics in specific for the brain disease model (Heyman, Dalrymple & Lewis), what are their “critiques” against this model?
- Heyman = addiction is voluntary & self-destructive (give this man some drugs and see how he fares)
- Dalrymple = Addicts are not blameless victims of an illness (almost no one believes this??)
- Lewis = Addiction can be overcome with hard work (the argument = illnesses cannot)
also Dalrymple sounds lowkey like Rumpelstiltskin
What is conditioned reinstatement?
The ability of drug-associated cues (CS) to powerfully reinstate a previously extinguished instrumental response
How does conditioned reinstatement work in the context of relapse?
Drug-associated cues can rainstate drug-seeking behaviour, even after a period of abstinence (potentiated by stimulating dopamine release in the nuclues accumbens)
What is “incubation of craving”?
Craving that increases during extinction (has also been observed in animals)
not a definite thing that happens, ofc
What are two other types of reinstatement, besides conditioned reinstatement?
- Drug reinstatement (“just having one drink”)
- Stress reinstatement (e.g., being fired)
How can reinstatement be prevented (experimental studies)?
Manipulation of the ventral tegmental area & nucleus accumbens
What can be studied with progressive ratio experiments and what does the experiment entail?
Repeated drug use increases the motivation to obtain it:
- The instrumental response requirement to obtain a substance gradually increases
- The maximum number of responses made to obtain the substance = break point (i.e., primary outcome variable; the point where the subject no longer willing to work hard for the drug)
What is the instrumental response requirement?
Number of responses needed to obtain a substance (in progressive ratio experiments)
What are (animal) results of the progressive ratio experiments?
- Rats will work harder to self-administer a drug when they have been pre-exposed to it
- Effort exerted + and vigor to initiate lever presses signaled by dopamine transmission in the nucleus accumbens
What are “human translations” for the conditioned reinstatement paradigm?
Choice reinstatement test (Instrumental training, followed by this test, i.e., smokers preferred response corresponding to cigarettes in training)
