Lecture 23- Opiates and Alcohol (specifically alc)

Question 1

How many drinkers progress to detrimental drinking levels?

Answer 1

around 10-15%

Question 2

What leads to drug seeking and craving of alcohol?

Answer 2

• The switch from controlled use to compulsivity is not clear
• Alteration in DA reward system
• PFC is damaged- has decision making and emotional effects/ compromised executive function

Question 3

What are the symptoms of brain damage from alcohol (Korsakoff Syndrome)?

Answer 3

• cognitive functioning and judgement
• leading cause of dementia
• loss of white and gray mater (shrinkage)
• frontal lobes are particularly sensitive- older individuals are more susceptible

Question 4

What dose the J-shaped dose-mortality curve say about the Cardiovascular System w/ low alcohol use?

Answer 4

• cardio-protective effects with low amounts
• 10-40% reduced risk of coronary heart disease
• these studies are not rigorous enough to actually prove anything

Question 5

What does the J-Shaped curve say about the cardiovascular system with large amounts of alcohol?

Answer 5

• Coronary heart disease- correlated with high saturated fat and cholesterol
• Arrhytmias, cardiomyopathy, hemorrhagic stroke
• hypertension

Question 6

Which four parts of the GI system does alcohol affect?

Answer 6

esophagus, stomach, intestine, pancreas

Question 7

Alcohol effect on esophagus

Answer 7

• reflux
• cancer

Question 8

Alcohol effect on stomach

Answer 8

gastritis

Question 9

Alcohol effect on intestine

Answer 9

• chronic diarrhea
• malabsorption

Question 10

Alcohol effect on Pancreas

Answer 10

• inflammation
• pain

Question 11

Alcohol Pharmacotherapy

Disulfiram (Antabuse)

Answer 11

• Acetaldehyde dehydrogenase inhibitor, leads to acetaldehyde accumulation
• Fallen out of favor due to side effects and attrition

Question 12

Alcohol Pharmacotherapy

Naltrexone (Revia)

Answer 12

• opiod antagonist
• reduces urge/craving (reduction in psychological dependence)
• blocks reinforcing effects- reduces relapse
• works best with behavioral therpy

still must be willingly taken -attrition

Question 13

Alcohol pharmacotherapy

Acamprosate

Answer 13

• may block NMDA receptors (which are upregulated folllowing chronic alcohol use)
• may help withdrawal w/ extended abstenence period

alcohol directly interacts with the receptor

Question 14

Behavioral treatment- AA

Answer 14

• 26-50% success rate after 1 year
• total abstinence, patients recognize they are helpless

Question 15

Behavioral treatment- Behavioral therapy

Answer 15

• controlled drinking: teach people how to modify/control amount and how often

Question 16

Behavvioral treatment- aversive therapy

Answer 16

• pairing alcohol w/ unpleasant consequences (may also include psyhosocial factors)