MOM addiction

Question 1

what is the first method of modifying addictive behaviour

Answer 1

agonist and antagonist substances is a way of modifying addictive behaviour

Question 2

what do agonist and antagonist substances do

Answer 2

work to treat addiction by either mimicking or blocking the effects of substances in the brain

Question 3

one example of an agonist substance

Answer 3

methadone

Question 4

what is methadone used for

Answer 4

to treat addiction to opioid drugs like heroin, by binding to a postsynaptic receptor and activate it to produce a response (imitate heroin)

Question 5

what is methadone used as part of

Answer 5

a maintenance treatment, it reduces cravings and prevents withdrawal symptoms. has the same effects as heroin without the high. it is used until abstinence from the drug

Question 6

dosage of methadone

Answer 6

initial dosage of 10-40mg each day which is increased by up to 10mg daily until no withdrawal symptoms are seen. an individual will reach a maintenance dose of 60-120mg a day

Question 7

how is methadone usually given

Answer 7

orally as a green liquid to avoid risk associated with needle usage and injections. a nurse or doctor will see the patient each day for the first three months until they can continue without supervision

Question 8

what is also given with methadone

Answer 8

to ensure people don’t take multiple doses or sell on their methadone, this treatment is given alongside psychological support

Question 9

an example of an antagonist drug

Answer 9

naltrexone, it works binding to a receptor and blocking the usual function of a substance. nalextrone blocks euphoric and pleasurable effects associated with opioids/makes them less rewarding.

Question 10

who should nalextrone be used for

Answer 10

according to NICE guidelines, nalextrone should be used by people who have stopped using opioids and have proven they are highly motivated to stay free from drugs. it is given as an oral medication

Question 11

who else can nalextrone also be used for

Answer 11

might also be offered in cases of alcohol addiction. it is recommended alongside psychological intervention and should be used after withdrawal symptoms from alcohol have occurred

Question 12

dosage of nalextrone

Answer 12

can be used for up to 6 months and users should be supervised to ensure they haven’t started to drink again

Question 13

who is nalextrone said to also possible be able to help

Answer 13

problem gamblers although more research is needed

Question 14

what is the second method of modifying addictive behaviour

Answer 14

aversion therapy

Question 15

what is aversion therapy based on

Answer 15

the principles of classical conditioning, where a naturally unpleasant stimulus (unconditioned stimulus) produces a negative response (UCR) the UCS is then paired with the addictive behaviour (NS) and a conditioned response is learned. the individual associated the addictive behaviour (CS) with the negative CR rather than previous pleasure they would experience

Question 16

first type of aversion therapy

Answer 16

antabuse

Question 17

describe how antabuse works

Answer 17

by affecting how the body metabolises alcohol. alcohol is normally briken down to a compound called acetaldehyde and then further broken down by an enzyme in the liver called . antabuse stops the enzyme from working, causing a build-up of acetaldehyde in the bloodstream

Question 18

what can antabuse cause

Answer 18

unpleasant sysmptoms (sweating, heart palpitations, headaches, nausea/vomiting)

Question 19

what are the NICE guidlines around ANTABUSE use

Answer 19

antabuse can begin after individuals has undergone withdrawal, they are given a dose of 40mg daily but this may be increased if the reaction with alcohol is not aversive enough

Question 20

what is the second form of aversion therapy

Answer 20

rapid smoking

Question 21

what is rapid smoking

Answer 21

used to help smokers overcome their addiction, smokers sit in a closed room and take a puff on a cigarette every six seconds until they’ve finished a specific number of cigarettes or they feel sick
theory is the smoker will associate this unpleasant feeling with smoking and develop an aversion to it. this might be repeated over several sessions to try and make the association stronger

Question 22

how popular is this treatment today

Answer 22

it is used much less often now since the development of other therapies

Question 23

evaluate the effectiveness of methadone as a method of modifying addiction

Answer 23

NICE assessed 31 reviews of the effectiveness of methadone, including 27 randomised controlled trials. found higher levels of retention for people using methadone than placebo or no treatment and lower rates of illicit opioid use.
however many studies may not have followed up over a long period of time- people may have relapsed months/years after treatment. research didn’t pick up on this

Question 24

effectiveness of naltrexone

Answer 24

NICE reviewed 17 studies concerning the effectiveness of naltrexone for heroin addiction. overall they found conflicting results, and many showed no significant difference between naltrexone and a control treatment for retention on the treatment programme. however they did find naltrexone was associated with a reduction in relapse rate especially in those who were highly motivated

Question 25

evidence to support the effectiveness of naltrexone

Answer 25

Lahti tested the effectiveness of naltrexone on a small sample of gamblers who were instructed to take it before gambling or when they felt the urge to. they found significant decreases in gambling levels, although they highlight further research is needed

Question 26

ethical criticisms of the use of methadone agonist/antagonist

Answer 26

there are side effects that need to be taken into consideration. methadone may interact with other drugs such as alcohol and antidepressants to cause respiratory problems. also a danger of overdose if an addict combines methadone with other drugs the office for national statistics reported that in 2013 methadone was responsible for 429 deaths in the UK

Question 27

social implications financial cost of methadone to society

Answer 27

a report by Gyngell said that prescribing methadone was a 'expensive failure' and cost society money, for both the methadone and the 320,000 problem drug users on benefits. it suggested that greater success would be achieved by funding rehabilitation units encouraging abstinence.

Question 28

PB point of the financial cost of methadone to society antagonist/agonist

Answer 28

the charity DrugScope has disputed the claims in this report. saying that they overestimated the cost of prescribing methadone, they described trug treatment as good value for money for taxpayers as people taking methadone become able to function in society

Question 29

effectiveness strength of antabuse

Answer 29

Niederhofer and Staffen compared antabuse to a placebo and assessed their participants using a self-report method and screening for 90 days. the antabuse patients had significantly greater abstinence duration than the placebo group Jorgensen found that those treated with antabuse had more days until relapse and fewer drinking days.

Question 30

weakness of aversion therapy as a MOM

Answer 30

a key issue is that it is only treating the behaviour and not the underlying cause. the aversion towards the specific behaviour may remain but if there is an underlying problem like cognitive bias then it will not be addressed. it is even possible that the individual will engage in other addictive behaviour e.g. gambling. individuals may need something like CBT to properly address the issues

Question 31

evaluation ethical issues of aversion theraoy

Answer 31

taking antabuse can clearly cause very negative effects to an individual if they drink alcohol while on the medication. rapid smoking is also an unpleasant experience. however those taking the treatment would have given valid consent based on information provided to them by a professional therefore reducing the risk of harm. however there may be problems with effectiveness as people may drop out due to the potential harm.

Question 32

evaluation:social implications aversion therapy

Answer 32

there is a social cost of addiction, alcohol abuse costs the taxpayer £21 billion a year. e.g an addiction can lead to unemployment which may lead to the individual clamining benefits. the effects of addiciton on the physical health will also cost the NHS money addiction also causes the breakdown of families, homelessness, debt and crime. therefore it is important that the right treatment decisions are made, aversion therapy could be one option to be considered, the benefits of the treatment to society may outweigh any potential costs (ethical or financial)