Psych of drug use and abuse

Question 1

Learning

Answer 1

a permanent change in behavior as a result of experience. Drug use and addiction are learned behaviors because people aren’t born addicted to certain drugs

Question 2

Genetic component of addiction

Answer 2

People can inherit certain genes that make them more or less susceptible to addiction- but you can’t be addicted to something without ever taking it. Infants can be born with a drug dependence (not addiction) if moms take drugs during pregnancy

Question 3

When you take a drug or medication repeatedly, what happens in your body? (3)

Answer 3

1. You learn how to administer it
2. Your body gets better at processing it (tolerance)
3. Your body starts to anticipate delivery of the drug and prepare for it- your body wants to maintain homeostasis- craving and withdrawal

Question 4

Mithridates VI (king of Pontus)

Answer 4

A historical example of tolerance. The king had spent his life afraid of being poisoned. Throughout his life, he took increasing doses of well known poisons and his body learned how to metabolize the drugs. The king later attempted to take his own life by ingesting poison, but it didn’t work due to tolerance.

Question 5

Tolerance

Answer 5

Decreased effectiveness or potency of a drug after repeated exposure. You need to use larger doses of the drug to achieve the same effects as when you first took it. Typically, tolerance occurs with drugs that are really disrupting homeostasis

Question 6

Do you develop tolerance to all of a drug’s effects at the same rate?

Answer 6

No. One example is morphine and other opioids. Nausea and vomiting is a common symptom- tolerance occurs very quickly, after only a few administrations. You can’t develop tolerance toward constriction of pupils, however- this symptom will occur during every administration. It is a physiological effect that won’t go away.

Question 7

Cross tolerance

Answer 7

Sometimes tolerance to one drug will diminish the effect of another drug- this usually occurs between the same class of drug. All opioid drugs show cross tolerance. If you develop a tolerance to heroin, you will also have tolerance toward oxycodone and morphine. This suggests that these drugs are producing their effects by common mechanisms.

Question 8

Why can cross tolerance potentially be dangerous?

Answer 8

For opioids, cross tolerance can be problematic. A person may eventually be in a situation where they are very sick or badly injured and need these drugs to work to reduce their pain

Question 9

Pharmacokinetics

Answer 9

Refers to how drugs move throughout the body. This concerns how a drug is administered and how it is absorbed into the bloodstream, reaches different parts of the body, and is eliminated from the body

Question 10

Pharmacodynamics

Answer 10

Refers to how drugs cause biological changes in the body. Deals mostly with the actions of drugs at synapses

Question 11

Absorption

Answer 11

The passage of a drug from the site of administration to the bloodstream. To do this, a drug must pass through different membranes, like the mucous membranes in the mouth or the walls of the intestines. The specific membrane the drug has to pass through depends on the drug’s route of administration.

Question 12

Administration routes and speed of drug absorption

Answer 12

The route of administration determines how much drug reaches the bloodstream and the length of time needed for drug absorption. When administered intravenously, peak occurs in the blood almost immediately and then diminishes quickly as it’s processed by the body. With inhalation, the peak occurs and drops off very quickly, but not as quickly as IV use. By mouth routes takes the longest to peak and therefore has less potential for addiction.

Question 13

Elimination

Answer 13

The process by which a drug leaves the body. This can be through urine, sweat, saliva, and breath. The specific route of elimination depends on the drug. Alcohol is one example of a drug that is mostly eliminated through the breath

Question 14

Pharmacokinetic tolerance

Answer 14

A type of tolerance that occurs as the body becomes more efficient at metabolizing a drug- your body gets better at metabolizing the drug over time. When you experience pharmacokinetic tolerance all effects of the drug are diminished. Someone who frequently drinks hard liquor will be producing enzymes to break down the alcohol before they even start drinking. Someone who is well practiced at drinking will have a lower blood alcohol level than someone who doesn’t typically drink since they are better at breaking down the drug

Question 15

What changes can occur in the body with pharmacokinetic tolerance? (3)

Answer 15

1. Fewer drug molecules reach their sites of action
2. Increase of enzymes the body uses to break down the drug- the drug is more quickly converted to metabolites so fewer molecules of the drug remain
3. Drug does not reach the same peak levels and doesn’t last as long

Question 16

Pharmacodynamic tolerance

Answer 16

Reduced responsiveness to a drug at the drug’s site of action. This arises from adjustments made by the body to compensate for effects of continued presence of a drug. It is a result of the body trying to maintain homeostasis. With this type of tolerance, there can be a change in the number of receptors available for the drug

Question 17

Upregulation

Answer 17

Refers to an increased number of receptors for a drug

Question 18

Downregulation

Answer 18

Refers to a decreased number of receptors for a drug

Question 19

When a person first ingests a drug, what happens? (3)

Answer 19

1. Detects the drug and the effects on homeostasis- often the hypothalamus
2. Responds by compensating to restore normal functioning
3. Over time- the body gets better at restoring normal functioning

Question 20

How does the compensatory response change when a person stops taking a drug?

Answer 20

When you take a break from using a particular drug, the compensatory process weakens and you have more of an effect from the drug if you take it again. When you go through withdrawal multiple times, your body also gets better at going through withdrawal and processing that compensatory response

Question 21

Behavioral tolerance

Answer 21

Decreased behavioral responses to a drug. You learn to function while impaired on a drug, and the drug has less of an impact on your behavior. It doesn’t necessarily mean you can still do activities as well as you would sober. A doctor with an alcohol use disorder can still perform surgery, and a person addicted to marijuana can still get a good grade on an exam

Question 22

State dependent learning

Answer 22

Someone who is dependent on a substance and studies while under the influence will do worse on an exam if they try to take it sober. The fully sober test takers still perform better overall

Question 23

Tolerance only develops in which situations?

Answer 23

Tolerance develops (or develops quickly) only when a drug places a demand on homeostasis- tolerance will not be generated if the drug is not detected or does not disrupt function. Pain is one example- it is unpleasant but still really useful for survival. Tolerance to morphine develops much faster when rats experience pain following injection- when morphine is given in the presence of a painful stimulus

Question 24

Withdrawal

Answer 24

Physiological and psychological changes that occur when drug use stops. These symptoms are due to compensatory mechanisms to maintain homeostasis when the body expects the drug. Can be quite mild or quite intense (can cause death). The level of danger of withdrawal depends on the level of dependence. Death can occur from withdrawal from alcohol and heroin/opioids. Withdrawal from alcohol is probably so dangerous because alcohol is very available in everyday life and more socially acceptable to consume- people generally consume much higher amounts

Question 25

Why does withdrawal occur?

Answer 25

The body “expects” delivery of a drug- you are reminded of the drug or tend to take the drug at a specific time of day. At this time, the body begins its compensatory mechanisms to maintain homeostasis in the presence of the drug. However, the drug is never delivered.

Question 26

Withdrawal vs toxic effects

Answer 26

There is a difference between withdrawal (compensatory effects) and toxic effects of the drug (hangover). Toxic effects are when you feel sick after a night of excessive drinking. Many of these effects are the result of toxic effects- dehydration and stomach irritation. This is your body dealing with being poisoned. Withdrawal is a compensatory response that occurs from expecting a drug and not receiving it.

Question 27

Cocaine “letdown”

Answer 27

After taking a large amount of cocaine- people often experience a “letdown”. This is a period of depression as the body returns to homeostasis. This is a compensatory response- your body is trying to compensate for the drug never being delivered

Question 28

Craving

Answer 28

A strong urge to use a drug

Question 29

Dependence

Answer 29

When stopping a drug triggers withdrawal. You are much more likely to abuse a drug if you are dependent, but they’re different concepts. People can experience withdrawal symptoms even when they do not take a drug compulsively- this is where genetic sensitivity to drug dependence comes in. Other people that are not likely to be dependent on a drug can take a drug compulsively, but will not necessarily experience withdrawal when they stop- social smokers or social drinkers

Question 30

Does tolerance always mean a person will experience withdrawal?

Answer 30

People can become quite tolerant of a drug, and fail to show withdrawal symptoms when they stop taking the drug-many people develop a tolerance to alcohol but do not show withdrawal. Also more likely to happen when rate of elimination of the drug from the body is slow. Ex- THC (marijuana)

Question 31

Pavlov’s conditioning experiments

Answer 31

Dogs naturally salivated when they were given meat. Then, the dogs were given meat when a bell rang. Eventually, when the bell rang without the meat being presented, the dogs still salivated. This is an example of conditioning because the dogs learned that the bell indicated that meat was coming.

Question 32

Classical conditioning

Answer 32

Learning that one thing predicts another thing. A “conditioned response” means that a response to the stimulus was learned. An unconditioned response was not learned and just naturally occurred without teaching.

Question 33

Stimulus

Answer 33

In conditioning, the noun/thing the animal is responding to

Question 34

Response

Answer 34

In conditioning, the verb/behavior occurring after exposure to the stimulus

Question 35

Unconditioned response (UR)

Answer 35

A response that occurs naturally without any teaching. Experiencing a withdrawal reflex from a hot stove is an example

Question 36

Conditioned stimulus (CS)

Answer 36

A stimulus that is neutral (like the bell) at the start of training. It produces the conditioned response at the end of training. It is the stimulus that predicts the US is coming

Question 37

Conditioned response (CR)

Answer 37

The response to the conditioned stimulus at the end of training, like salivating in response to the bell only. Often looks similar to unconditioned response (UR). Response to the conditioned stimulus is compensatory- you’re getting ready for the delivery of the stimulus

Question 38

Unconditioned stimulus (US)

Answer 38

The stimulus that produces the UR- the natural, unlearned response

Question 39

Bunny eye blink experiment

Answer 39

The bunny was exposed to a tone and a puff of air toward its eye- the bunny blinks due to the puff of air. Over time, just playing the tone caused the bunny to blink

Question 40

Pavlov apomorphine study

Answer 40

Apomorphine is a short acting dopamine agonist. In healthy dogs, it causes restlessness, salivation, and nausea. Pavlov gave the dog the drug and waited a few minutes, and just as the drug took effect, he played a tone (sound). After several trials, the sound alone produced symptoms of the drugs (less intense)

Question 41

What is the CS for drug use?

Answer 41

For drugs use, this is often the objects used to administer the drug or locations where drugs have been administered. Includes- cigarette lighters, bongs, needles, pill bottles, or the sight of the drug (cigarettes, cocaine, marijuana). Exposure to these objects act as CS and predict the delivery of US

Question 42

What is the US for drug use?

Answer 42

The drug itself

Question 43

What is the UR for drug use?

Answer 43

The effects of the drug- this varies depending on the drug. For alcohol, the UR is intoxication, for marijuana, it is feeling high, for cocaine, it is mania/grandiosity.

Question 44

What is the CR for drug use?

Answer 44

The body compensating for the drug. Often the “opposite” response of the UR

Question 45

CR vs UR

Answer 45

With drugs use, CR and UR can look very different. Often, when presented with a CS, the CR is compensation for the drug. Ex- needle (CS)- morphine (US)- euphoria/resistance to pain (UR). The UR to morphine= analgesia (decreased responsiveness to pain). CR to needle= hyperalgesia (increase sensitivity to pain), which is the opposite of the UR and is the body compensating for the drug

Question 46

Analgesia

Answer 46

decreased responsiveness to pain

Question 47

Conditioned tolerance

Answer 47

When your body learns how to tolerate a drug. Siegel (1975) studied conditioned tolerance to morphine

Question 48

Siegel paw lick latency test

Answer 48

Studied conditioned tolerance to morphine. Paw lick latency test- put animal on a hot plate (uncomfortable but not dangerous). Measured how long until the animal licks its paws to indicate discomfort. Longer latency= more analgesia. The mice that were given morphine and then exposed to pain were more likely to develop tolerance to morphine and therefore had shorter latencies/less tolerance to pain when they were placed on the hotplate later in the study.

Question 49

Siegel’s paw lick latency groups (3)

Answer 49

1. Morphine-Hot Plate group
2. Morphine-Cage group
3. Test base (both groups- 48 hours after trial 3)

Question 50

Siegel’s paw lick latency morphine-hot plate group

Answer 50

3 trials. The mice were taken from the colony room to a separate test room. They were injected with morphine and placed in hotplate apparatus, and paw lick latency was measured on the hotplate. Trial 1 showed high analgesia, while data from Trial 3 were similar to saline/placebo

Question 51

Siegel’s paw lick latency morphine-cage group

Answer 51

3 trials. The mice stayed in the colony room. They were removed from cage, given morphine, and returned to cage (no hot plate/no pain)

Question 52

Siegel’s paw lick latency test base

Answer 52

Both groups were studied in this phase, 48 hours after the third trial. Both groups given were morphine and put on the hotplate. M-HP group had short latencies (tolerance to morphine)- they were more likely to experience pain. M-cage- long latency (no tolerance to morphine)

Question 53

Conditioned tolerance in humans

Answer 53

With alcohol, a familiar drink (beer) can be compared to the same dose of alcohol in a different drink (wine) or a drink that doesn’t usually contain alcohol (juice). When the dose of alcohol is contained in a different than expected context, it will produce more impairment. It will also produce more impairment when it is consumed in an unusual location (office) vs familiar (bar), or at an unusual time of day, like 5 AM

Question 54

Siegel heroin study

Answer 54

On 30 consecutive days, 3 groups of rats were injected with placebo or heroin (on alternating days). Group 1- received heroin with white noise in room A and a placebo in colony room. Group 2- received counter balance of group 1. Group 3- injected on alternating days, in either room- but only with placebo

Question 55

Test phase- Siegel heroin study

Answer 55

All 3 groups were given a large dose of heroin- 15 mg/kg. In the similarly tested group, the rats received heroin in the same room where they usually received heroin. In the different tested group, the rats received heroin in the placebo room. Control group- was given heroin in either room

Question 56

Siegel heroin study results

Answer 56

1. Control group- 96% died of an overdose. This dose was toxic to non tolerant animals
2. Different room group- 64% showed overdose
3. Same room group- 32% overdose

Question 57

How can the result of the Siegel heroin study be explained?

Answer 57

Animals given the high dose in the same room where they usually received the drug experienced conditioned tolerance- the room was the CS. These animals were better prepared to receive the drug when they were in the same room, and they were therefore less likely to overdose. Animals in the different room did not compensate as well because they did not have conditioned tolerance.

Question 58

How does the amount of time between the US and CS affect learning?

Answer 58

In general, learning occurs faster when there is a short delay between the presentation of the CS and the presentation of the US. Drugs are often more addictive when the effects (US) reach the brain more quickly following administration (CS)

Question 59

Which method of drug administration is more likely to result in addiction?

Answer 59

Intravenous- peak occurs in the blood almost immediately and then diminishes quickly as it’s processed by the body. When you get a sharp drop off of the drug, you’re more likely to experience craving quickly. Administration by mouth has the least potential for addiction because it has the longest peak of the drug’s concentration in the bloodstream

Question 60

Can be the relationship between CS and US be “unlearned”?

Answer 60

No such thing as unlearning- once you learn the relationship, it’s always there.

Question 61

What happens when an unpleasant stimulus is paired with a pleasant stimulus?

Answer 61

When an unpleasant stimulus is paired with a pleasant stimulus, the negative stimulus typically becomes more positively valanced. Silver nitrate and cigarettes are an example.

Question 62

Shock-avoidance-escape experiments

Answer 62

Animals are placed at the bottom of the T shaped maze. Choose either R/L arm when they get to the top. If they choose incorrectly, they receive a small shock- this is a type of conditioned learning experiment.

Question 63

Overton state dependent learning experiments

Answer 63

Researchers administered pentobarbital (a mild barbiturate) and trained animals to avoid shock in the shock-avoidance-escape maze. Animals could not avoid shock when given a placebo, and vice versa. These findings suggest that cues from when you learned information are relevant for retrieving the information. For example, if you take an exam in a different room from when you learned the information, performance tends to be worse

Question 64

Discriminative stimulus

Answer 64

A stimulus that informs your behavior

Question 65

Overton discriminative stimulus experiment

Answer 65

Overton et al administered pentobarbital and saline on alternating days. On drug days one response was taught (Left= safety). On saline days the opposite response was taught (right= safety). Animals quickly learned to make a response depending on if they were drugged. The stimulus (the drug) was discriminative because it informed the behavior of the animals

Question 66

When a person is exposed to a CS and does not receive the drug, what happens?

Answer 66

Craving can occur when you are exposed to a CS and expect the drug, withdrawal can occur when you do not get drug delivery

Question 67

California public health campaign to decrease heroin use

Answer 67

Original billboard image featured an arm with a tourniquet and needle, and a spoon with heroin next to it. Problem- people in recovery are now exposed to a CS in a situation where they aren’t prepared. Heroin relapse rates increased drastically as a result of this campaign

Question 68

Former addicts often experience withdrawal when (3)

Answer 68

1. They go to places where they used to use
2. They see people they used to use with
3. They see/hear/smell things that remind them of the drug
   All of these things act as a CS and cause their body to expect the drug.

Question 69

Extinction

Answer 69

Withdrawal symptoms go away after repeated exposure to CS without the US, so the person may no longer respond to the CS. When the CS is presented alone (repeatedly)- the compensatory response weakens. The relationship between the CS and US is never totally unlearned or forgotten but can be weakened.

Question 70

Relapse

Answer 70

A return to chronic drug use and exhibiting features of the substance use disorder. Craving/withdrawal symptoms can occur when a person is exposed to the CS even when they are no longer dependent on the drug, and relapse can occur

Question 71

Drug dependence

Answer 71

A user experiences a need or urge to continue using a substance and has difficulty reducing use of the substance.

Question 72

What happens during relapse/reinstatement of drug use?

Answer 72

During extinction, the animal has learned that the CS does not predict the US anymore. Therefore, once the drug is actually administered, the initial response to the drug is very strong. People often take a large quantity of the drug in this situation, and often feel the effects more strongly. They are not compensating anymore, and overdose can occur. When people first fall off the wagon is when they are most vulnerable to overdose

Question 73

Sensitization (reverse tolerance)

Answer 73

When repeated exposure makes you more sensitive to a stimulus. It is possible for certain effects of a drug to increase with repeated exposure, although sensitization is more likely to occur with certain drugs than others.

Question 74

Activating effect

Answer 74

When a person administers a low dose of a drug (cocaine, amphetamine, nicotine, alcohol, opioids), you can observe an “activating effect” (short term change in behavior). With repeated doses there is an increase in these behaviors. At high doses, individuals can exhibit stereotyped behavior

Question 75

Stereotyped behavior

Answer 75

Invariable, repetitive movements, with no purpose- occurring for a prolonged period of time

Question 76

Pavlovian/classical conditioning

Answer 76

You learn that CS signals the US- people learn that things go together. This is why people think correlation= causation. You do not have to “choose” to act in this case. For example, the sound of a lighter (CS) predicts the cigarette (nicotine, US)

Question 77

Operant/instrumental conditioning

Answer 77

Animals learn the relationship between a behavior and a consequence- they must behave a certain way to receive a certain consequence. The consequences can be positive or negative. Positive means addition- adding something to the environment. It does not mean good. Negative means taking something away

Question 78

Reinforcement

Answer 78

Increases the likelihood of a target behavior occurring again

Question 79

Punishment

Answer 79

Decreases the likelihood of a target behavior occurring again

Question 80

Negative reinforcement and withdrawal

Answer 80

When you stop taking a drug, withdrawal occurs. When you take the drug, the unpleasant symptoms of withdrawal go away. Therefore, you’re increasing the drug taking behavior by removing the withdrawal symptoms (negative reinforcement). Drug taking is the target behavior in this case. One example- taking an aspirin (behavior) to get rid of a headache (consequence)

Question 81

Positive reinforcement

Answer 81

Taking heroin causes you to feel really good- you’re adding the feeling of euphoria which increases drug taking behavior. With pain medication, the positive reinforcement of taking a medication and having the pain go away can result in dependence. To prevent addiction, pain drugs should be taken every 6 hours at a specific time interval. This prevents the painful stimulus from occurring in the first place and prevents people from learning the relationship between the drug and the pain.

Question 82

Types of reinforcement (2)

Answer 82

1. Escape
2. Avoidance

Question 83

Escape reinforcement

Answer 83

Taking a drug only when in pain (to escape the pain)

Question 84

Avoidance reinforcement

Answer 84

Taking the drug every 6 hours to prevent the pain from occurring in the first place. You never experience the negative event

Question 85

Positive punishment

Answer 85

Drinking too much (behavior) makes you sick (consequence)

Question 86

Negative punishment

Answer 86

Throwing out your drugs (behavior) makes you ill (consequence)

Question 87

Drug addiction

Answer 87

When people first start taking a drug, it is usually because of the positively reinforcing effects of the drug (the high, social rewards, physical abilities). Once dependence sets in, you take the drug, in part, to avoid the effects of withdrawal. This is negative reinforcement

Question 88

Mesolimbocortical dopamine system

Answer 88

This is the brain’s reward system. It begins in the midbrain (mesencephalon) and projects to the limbic system and prefrontal cortex. It also projects from the ventral tegmental area (VTA) to the nucleus accumbens. Reacts to stimuli that is relevant to survival (food when you’re hungry). Dopamine release in the nucleus accumbens produces the rewarding effects associated with many drugs. Habitual drug users can’t prolong reward- delay drug use to do something else

Question 89

3 parts of the mesolimbocortical dopamine system

Answer 89

1. Ventral tegmental area is where the pathway begins- activation sends circuits to other regions
2. The medial forebrain bundle (mesolimbic dopa pathway)
3. Nucleus accumbens is where the pathway terminates

Question 90

Role of the nucleus accumbens in drug addiction

Answer 90

Virtually all abused drugs and addictive behaviors increase dopamine levels in the nucleus accumbens- includes caffeine, nicotine, opiates, alcohol, THC, and many others. Survival related reinforcement (food/sex) increases dopamine in the NA (50-100%). Many drugs (and electrical stimulation) can increase dopamine 3-6 fold in the NA (300-600% increase, you’re creating a state that doesn’t exist in nature).

Question 91

Lever pressing studies for dopamine release in the nucleus accumbens

Answer 91

Animals will press a lever for a release of dopamine in the NA. They will stop pressing the lever if they are given a dopamine antagonist. When drugs (or EBS) are delivered to the NA (or medial forebrain bundle), the animal presses lever 1000s of times per hour. The animals will also ignore food, water, and potential mates- they will lose weight and will not sleep

Question 92

What is observed on the PET scans of chronic drug users?

Answer 92

PET scans of the nucleus accumbens reveal that chronic drug users have diminished dopamine release and number of receptors. In these studies, radioactive dye is given with an affinity for D2 receptors. As your brain carries out processes requiring D2 receptors, the dye is used. Red areas (warm colors) equals more activation. This is the paradox of dopamine and drug use

Question 93

Volkow Ritalin study

Answer 93

Subjects were non-drug users and were given a low dose of a stimulant (Ritalin). People who were more likely to use and abuse drugs had lower amounts of D2 receptors in the brain. People with lots of dopamine receptors typically find drugs like cocaine unpleasant. Hypothesis- the brains of people who are more likely to use drugs are understimulated, so they use artificial methods to stimulate it. This is a correlation- the dopamine receptors probably precede drug use

Question 94

Reward deficiency syndrome (hypothesis)

Answer 94

It is probable that lowered dopamine receptors causes life to be generally less rewarding for these individuals and makes them more vulnerable to addiction. Drugs elevate the level of perceived reward. Experimental support- Thanos study

Question 95

Thanos dopamine receptors study

Answer 95

Trained rats to self administer alcohol and inserted a gene that increased D2 receptors in the NA. As receptors increased, rats reduced alcohol intake. This provides support for the reward deficiency syndrome hypothesis. The levels of dopamine receptors expressed in the nucleus accumbens might be heritable

Question 96

How does prolonged drug use impact the brain?

Answer 96

Prolonged drug use leads to measurable changes in brain function and structure. It results in reduced dopamine activity and deactivation of prefrontal areas involved in inhibition/frontal dysfunction. For example, chronic amphetamine use causes increased dendrite length and complexity in the NA and prefrontal cortex

Question 97

Frontal dysfunction

Answer 97

Leads to trouble controlling behaviors, weighing reward/consequence- makes it harder to control your own behavior. Can be caused by long term drug use.