Mate again Flashcards
Four components of addiction according to Mate
P DIC
1) Persistence or relapse, despite evidence of harm
2) Dissatisfaction, irritability, intense craving when object – drug, activity, other goal – is not immediately available
3) Impaired control over behaviour
4) Compulsive engagement/preoccupation with behaviour
Tolerance
addict needs to use more and more of same substance or engage in more and more of the same behaviour to get the same rewarding effects
Physical dependence
manifested when a person stops taking substance and, due to changes in brain/body experiences withdrawal sx
“Dependence”
a powerful attachment to harmful substances or behaviours
The addict depends on the substance to make him feel momentarily
calmer
more excited
less dissatisfied
with life
What do not necessarily imply addiction
physical dependence
withdrawal
physical dependence and withdrawal do not necessarily imply addiction. for addiction you need…
craving and relapse
Addiction and the continuum. Say more
Central defining characteristics are active in all addicts, regardless of how severe or not severe
Honoured workaholic to criminal crack fiend
Drug dependency rates after use
Tobacco
Heroin
Alcohol/MJ/Coke
32%
23%
15%
Do drugs cause addiction?
Addiction is a human problem that resides in people,
not the drug or the drug’s capacity to produce physical effect
What 3 factors need to coincide for substance addiction to occur?
susceptible organism
drug with addictive potential
stress
Elaborate on the triad
Just like playing cards don’t make someone a gambling addict…
The triad must be present
3 brain changes with cocaine
NAG
Number of D receptors reduced
Age-related expansion of white matter absent
Grey matter in cerebral cortex reduced
Alcohol/heroin brain change?
Correlated with?
Grey matter in cerebral cortex reduced
Correlated with years of use
Opiates and nicotine brain changes (2)
altered structure
altered branching of nerve cells
Brain change in all addicts?
reduced activity in parts of cerebral cortex responsible for regulating emotional impulses and making rational decisions
What is D responsible for in the brain?
DIMES
Drive for normal activities Incentive Motivation Energy Stamina
What does nicotine do to dopamine?
directly triggers D release from cells into synaptic space
What does alcohol do to D?
reduces inhibition of D-releasing cells
Describe what goes on in the brain with:
ST drug use
LT consequences
• "high" produced by means of rapid chemical shift • brain's – chemical structure – anatomy – physiological functioning are remodelled
When is the disease model useful? (3)
Since the brain determines the way we act, biological changes lead to altered behaviours.
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In the sense of a drug-affected brain state, the disease model is useful.
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Does not fully define addiction, but helps define some of its most important features.
Addiction is not a natural state, but
The brain regions in which its powers arise are central to our survival
The circuits that addiction “subverts” are part of?
our central machinery for survival
3 major networks involved w/ addiction?
Opioid apparatus
Dopamine system (incentive-motivation apparatus)
Self-regulation system
Opioid apparatus (3)
brain system that governs attachment instinct
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feelings of reward and soothing
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hels consumate reward-seeking activities by giving us pleasure
Dopamine system (incentive-motivation apparatus)
initiates reward-seeking activities in the first place
Self-regulation system (2)
rational decision making
impulse regulation
Opioids fit our endorphin receptors. What do they do? (2)
Soothe physical/emotional pain
Reduce consciousness of pain as unpleasant stimulus
Endorphins can be described as
the brain’s natural narcotics
Our endorphins ... Relationships NS Gut Mouth Regulate
Enable mother/child emotional bonding tranquilizers and painkillers slow down muscle contractions diminish secretions BP, HR, breathing, temp
Describe placebo effect
when relief of pain expected, opioid receptor activity increases, thus leading to decreased pain perception
What does oxytocin do?
• orgasmic pleasure • induces labour • affects – mother's moods – physical/emotional nurturing of kid
Is oxytocin an endorphin?
No.
It increases the sensitivity of the brain’s opioid system to endorphins.
Oxytocin increases the sensitivity of the brain’s opioid system to endorphins. For what purpose?
Nature’s way of ensuring we don’t develop tolerance to our own opioids
Alcoholics and opioid receptor activity
diminished in several regions
this is assoc. with increased craving
Cocaine and opioid receptor activity
activates opiate pathways and results in increased opioid activity
Ventral tegmental apparatus >
gives rise to intense feelings of elation/desire
Ventral tegmental apparatus gives rise to intense feelings of elation/desire.
This triggers
D release
Ventral tegmental apparatus gives rise to intense feelings of elation/desire.
This triggers D release, where?
in the nucleus accumbens
How does the nucleus accumbens play a central role in addiction?
(2)!!!
all abusable substances raise levels of D in the nucleus accumbens. this rise sets off the initial excitement and elation experienced by drug users
What is the purpose of the incentive-motivation apparatus?
For this reason?
performance of survival-related behaviours
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food and sex trigger VTA activation and D release in the NA
The incentive-motivation apparatus. How is consummatory behaviour incited?
a cue associated w/ a previously pleasurable experience triggers a surge of D in the NA and incites consummatory behaviour
3 networks involved w/ addiction?
Opioid apparatus
Dopamine system (incentive-motivation apparatus)
Self-regulation system
Opioids =
Dopamine =
pleasure-reward aspects of addiction
incentive and reinforcement
opioid circuites and dopamine pathways =
important components of limbic system
the emotional brain
Emotions modulate what 2 drives essential to human life?
Attachment - love, compassion, healthy social interaction
Aversion - facilitates self-protection
Attachment/Aversion - when impaired?
Addiction = one of the chief dysfunctions
What happens to the # of D receptors in the brain of a chronic user?
they are reduced
driving the addict to use the drug simply to make up for the loss of D activity
What is the self-regulation system in charge of?
rational decision-making
impulse regulation
What happens to the “choice option” for using according to science? (3)
1) Self-regulation system impaired
2) Incentive/reward mechanisms drive craving
3) Circuits that inhibit and control those mechanisms are not up to task
3 networks involved w/ addiction?
Opioid apparatus
Dopamine system (incentive-motivation apparatus)
Self-regulation system
What is the orbitofrontal cortex responsible for?
works abnormally in drug users
E AI BI
• Evaluates nature/potential value of stimuli based on present info. and prev. exp.
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• Assesses interactions
• Interprets emotional content of communications
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• Balancing ST objectives against LT consequences in decision-making process
• Inhibits acting out on impulses that would be harmful
Why is the orbitofrontal cortex called the “apex of the emotional brain?”
rich connections with limbic systems
serves as its control room
What is found in the orbitofrontal cortex?
For this reason?
abundant supply of opioid and D receptors
powerfully affected by drugs
powerfully reinforces all manner of addictions
“Either you got it or you don’t…” subtle and extensive continuum
central defining qualities are active in all addicts
workaholic to crack fiend
Cross addiction
addicts, once addicted, are far more likely to get hooked on other drugs or behaviour in addition to drug of choice
origins of drugs opium cocaine hemp alcohol
basis for heroin. tx pain, diarrhea, alter mind state
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antidote for fatigue and hunger on long mtn journeys
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nasal and bronchial congestion
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Greek elders in decision making
