Lecture 16: Addictive disorders: substance use Flashcards
Concept of addiction
- addiction= primary chronic disease of brain reward, motivation, mem + related circuitry, with potential for both relapse + recovery
- physical + paychological dependence: adaptation resulting in tolerance + withdrawal, urges
- reward seeking beh has become out of control– keep doing it despite negative consequences
- common components of addiction
- salience–> nothing else helps
- mood modification
- tolerance–> increase dose
- withdrawal–> to eliminate withdrawal symptoms
- conflict
- relapse
Brain disease?? vs psychosocial factors
- blame addiction as brain disease
- social factors don’t play important role
- “my brain made me do it”
what is dominant theoretical framework in addiction science
biopsychosocial framework
what is multifactorial interaction between biopsychosocial factors
bio, social, psycho
- syndrome (signs + symptoms), rather than unitary disorder
how does addiction lead to motivational shifts
- anxiety, depression, low self-esteem= drinking
- genetic / neurobiological + env (poverty, lifestyle, trauma exposure)= drugs, smoking
what are addiction models of beh
- medical model
- rational choice model
what is medical model
no control over cravings
+ reduced stigma, blame
- reduced personal responsibility, trust in beh (can relapse)
what is rational choice model
characterised by voluntary beh under control
+ increased personal responsibility
+ increased sense of control
- majority don’t want treatment
which reward systems are affected by drugs
- dopaminergic system
2. endogenous opioid system
how does dopamine work (from drugs)?
- concentrations of dop. increase (directly or indirectly) due to most drugs
- ex. alcohol, nicotine, weed, opioids, coke
- dopamine in cell body
- conveyed down axon
- released in terminal
- stimulates receptors
water as dopamine ex.
- drugs= act like rubber stopper
- molecules block dopamine transporter
- stops reuptake of dopamine into neurons
= excess of dopamine in synapse + overflow of dopamine= pleasure
explain opponent process theory of addiction
Experienced state:
- feel pleasure–> feel unpleasant
- addictive stage: build tolerance, so not that pleasurable= thats why increased unpleasance
Opponent process:
- happy for some time–> little sad
- addictive stage: happy for some time= really sad (hedonic contrast)
tolerance in substance dependence
homeostatic state: opponent-process (b process) balances drug activation (a process)–> can return to homeostatic state
- after repeated exposure to drug= affective system transitions to lower allostatic level– cause you build tolerance
- not that much pleasure and more sad
I-RISA (Goldstein + Volkow)
- drug addiction= mediated by changes in circuits modulated by dopamine: mesolimbic and mesocortical
