Leshner - Addiction is a Brain Disease Flashcards
What treatment does Leshner perpetuate?
Multi-modal, including biological, behavioural and social aspects
As what does Leshner recognize addiction?
i.e., definition
A chronic, relapsing brain disorder characterized by drug-seeking and use
What is the view of the general public on addiction (at the time of publishing the artcle), as postulated by Leshner?
Seen as a social problem, which should be handled with social solutions (mostly the criminal justice system)
What barriers does Leshner mention in conveying current scientific knowledge regarding addiction to the general public? (3)
- Normal delay in transferance of scientific knowledge (in part)
- Stigma attached to being a drug user/addict (+ moralistic aspect)
- Ideologies of people working in the substance use fields
What is a common view of addicts still prevalent (during Leshner’s article)?
That of drug addicts being weak or bad people, unwilling to lead moral lives and to control their behaviour/gratifications
What is an example of an ingrained ideology of people working in substance use fields that is problematic (Leshner)?
Many of the workers are themselves former substance abusers, and defend/abide by a single approach (the one that worked for them)
How can substance abuse not only be detrimental for the user’s health, but also that of the public?
Is a major vector (indirectly/directly) for the transmission of infectious diseases (e.g., AIDS, hepatitis and tuberculosis)
Why is the view on more fucked withdrawal symptoms = the more dangerous the substance outdated, as of Leshner? (2)
- Most withdrawal symptoms can be easily managed with meds
- Many of the most addicting/dangerous substances do not produce severe physical symptoms upon withdrawal (e.g., crack cocaine).
What is something that does matter in addiction (Leshner)?
It causing compulsive drug seeking and use, even in the face of negative health and social consequences
What circuit is commonly affected by all (?) substances?
The mesolimbic reward system
What four general brain changes are reportedly seen in addicted brains (Leshner)?
Changes in:
- Brain metabolic activity
- Receptor availability (density?)
- Gene expression
- responsiveness to environmental cues
Why does Leshner see addiction as a brain disease?
He doesn’t fully, btw
Because of its ties with changes in brain structure and function
Does Leshner lean more towards the brain changes as a consequence or an instigator of drug use and/or addiction?
Kind of both actually; Drug use is initially voluntary, but a “switch” is thrown in the brain, which means the individual moves into the state of addiction.
- Repeated drug use causes brain changes, but addiction comes forth from said changes (lowkey confusing)
How are the Vietnam war veterans (addicted to heroin) an example of the importance of social contexts in addiction?
Leshner
Their treatment was relatively easy, (assumedly) possible because they had become addicted in a wholly different setting than the one they returned to (i.e., less exposure to conditioned environmental cues)
How does Leshner’s view of addiction being chroning, affect treatment?
Treatment is to be approached like that of any other chronic illness; not that of a cure, but as the management of it (see: significant decrease in use, with only occasional relapses)
Leshner’s view of addicts in a criminal setting?
Treated for said addiction in prison, as denying treatment whilst incarcerated is futile
