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BRS Year 2 > Psych Substance use and addictions > Flashcards

Psych Substance use and addictions Flashcards

1
Q

what is positive reinforcement?

A
  • gaining positive state

- e.g. getting high

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2
Q

what is addiction?

A

compulsive drug use despite harmful consequences, characterised by an inability to stop using a drug. Failure to meet work, social or family obligations and tolerance and withdrawal

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3
Q

what is dependence?

A

physical adaptation to a substance

  • tolerance/withdrawal
  • can be dependent and not addicted
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4
Q

behavioural addictions

A
  • gambling disorder

- internet gaming disorder

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5
Q

hazardous use meaning

A

A pattern of substance use that increases the risk of harmful consequences for the user. Some would limit the consequences to physical and mental health (as in harmful use); some would also include social consequences. In contrast to harmful use, hazardous use refers to patterns of use that are of public health significance despite the absence of any current disorder in the individual user. The term is used currently by WHO but is not a diagnostic term in ICD-10.

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6
Q

harmful use meaning

A

A pattern of psychoactive substance use that is causing damage to health. The damage may be physical (e.g. hepatitis following injection of drugs) or mental (e.g. depressive episodes secondary to heavy alcohol intake).

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7
Q

reasons for taking drug for recreational use

A
  • boredom
  • reduce anxiety
  • get sleep
  • wanting to fit in
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8
Q

what characteristic do you see in dependence?

A
  • spiraling dependence
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9
Q

what drug (legal or illegal) is causing the greatest quotation of harm in our society?

A

alcohol

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10
Q

does dependence mean you take more of a drug than you should?

A

no

- however if withdraw need to taper the drug down.

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11
Q

what does the speed of a drug entering the brain determine?

A

how addictive it can be

- faster brain entry = more rush = more addiction

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12
Q

routes for tobacco taking effect?

A

chewing -> snuff -> cigarettes/vaping

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13
Q

routes for cocaine taking effect?

A

coca leaves -> coca paste

  • > cocaine
  • > crack
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14
Q

routes for heroine taking effect?

A

opium -> morphine -> heroin -> snorted heroine -> smoked heroin

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15
Q

How factors come together to alter how drugs impact the brain?

A
  • social/environmental factors
  • Personal factors e.g. genetic; personality traits
  • Drug factors
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16
Q

what causes pre-existing vulnerability to a drug?

A
  • family history

- age

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17
Q

what does exposure to a drug cause?

A
  • compensatory neuroadaptations to maintain brain function

- resilience

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18
Q

what system balance does lacohol alter in the brain?

A

the balance between the brains inhibitory and excitatory systems

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19
Q

What neurons are in the excitatory system?

A
  • glutamatergic
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20
Q

what neurons are in the inhibitory system?

A
  • GABAergic
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21
Q

What happens to excitatory system when you drink alcohol acutely?

A
  • blocks excitatory system
  • impaired memory (alohol blackouts)
  • No NMDA receptors
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22
Q

What happens to inhibitory system when you drink alcohol acutely?

A
  • anxiolysis

- sedation

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23
Q

What is anxiolysis?

A

A level of sedation in which a person is very relaxed and may be awake.

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24
Q

What happens to excitatory system when you drink alcohol chronically?

A
  • less NMDA receptors

- causes upregulation of the excitatory system

25
Q

What happens to inhibitory system when you drink alcohol chronically?

A
  • reduced function in inhibitory system

- however the GABA-A receptors switch their subunits to make them less sensitive to alcohol tolerance

26
Q

What happens when you are a chronic drinker and withdraw alcohol suddenly?

A

withdrawal

27
Q

What happens to systems when chronic alcohol exposure is withdrawn suddenly?

A
  • upregulation of excitatory system

- reduced function in the inhibitory system

28
Q

processes in excitatory system when chronic alcohol exposure is withdrawn?

A

NMDA receptors cause increase in Ca2+

- toxic leading to hyperexcitability (seizures) and cell death (Atrophy)

29
Q

processes in inhibitory system when chronic alcohol exposure is withdrawn?

A

Reduced function

30
Q

How to treat reduced function of inhibitory system during periods of withdrawal?

A
  • treat with benzodiazepines to boost GABA function
31
Q

What type of imaging can be used to measure the (low) glutamate levels during alcohol withdrawal?

A

MRI

32
Q

what medication helps people remain abstinent from alcohol?

A

Acamprosate

33
Q

How does acamprosate help people remain abstinent from alcohol?

A

reduces NMDA function

34
Q

natural rewards (food, sex) increase levels of ____ in the part of the brain called the ___ ____

A
  1. dopamine

2. central striatum

35
Q

what is the name of the dopamine- reward pathway?

A

the ‘pleasure-reward-motivation’ system

36
Q

What is a key modulator of the pleasure-reward-motivation system?

A

the opioid system, especially MU opioid that mediates pleasurable effects (e.g. of alcohol, endorphin rush)

37
Q

other modulators of the pleasure-rewards-motivation system?

A

GABA-B, cannabinoids, glutamate

38
Q

which drugs block reuptake at dopamine synapses?

A
  1. amphetamine

2. cocaine

39
Q

which drug enhances release of DA?

A
  1. amphetamine
40
Q

which drugs increase dopamine firing in the VTA? (3)

A
  1. alcohol
  2. nicotine
  3. opiates
41
Q

If you have lots of dopamine D2 receptors, do you like receiving psychostimulants?

A

no (maybe like schizophrenia when too much dopamine induces psychotic states)
- pleasurable effect seen in people with lower levels of receptors

42
Q

what imaging is used in assessing function in the rewards pathway?

A

fMRI

- challenging because uses radiation

43
Q

what light’s up on an fMRI in anticipation of receiving a rewards (e.g. money)

A

the ventral striatum

44
Q

what can drug use cause to happen to the rewards pathway?

A

reward deficiency

- worst in people who are abstinent polydrug (e.g. opiate+alcohol), then abstinent alcohol dependent

45
Q

fMRI shows what observation in adolescents who go on to develop drug issues?

A

reward deficiency

46
Q

fMRI shows what development in people with addictions who relapse?

A

very blunted reward deficiency

- also in abstinent addicts, those with blunted response in brain to “anticipation of reward” are more likely to relapse

47
Q

structures involved in the arousal-stress system which is active in withdrawal

A
  1. amygdala

2. the brainstem

48
Q

what type of reinforcement wanes in people who become addicted?

A
  1. positive reinforcement

- becomes driven by negative reinforcement

49
Q

what structure is dysregulated in anxiety disorders?

A

the amygdala

50
Q

NTs increased in the arousal system when stressed

A
  1. CRF
  2. Dynorphin
  3. glucocorticoids
  4. hypocretin
  5. neuroimmune factors
  6. noradrenaline
  7. substance P
  8. vasopressin
51
Q

NTs decreased (antistress) in the arousal system when stressed

A
  1. Neuropeptide gamma
  2. Nociceptin
  3. Oxytocin
  4. Endocannabinoids
52
Q

left amygdala response for polydrug users (versus control_ when exposed to aversive images

A

heightened emotional response

-> alcohol users did not show a different response to the control however

53
Q

what does the change from voluntary to habitual and compulsive drug use involve transition from?

A
  • prefrontal to striatal control over drug taking changes
  • > control goes from ventral (limbic or emotional) to dorsal (habit) striatum
  • > becomes so dysregulated that it underpinds further drug use
54
Q

what is the dorsal striatum area involved in?

A
  • parkinsons disease and habits
55
Q

how do you test the neurocircuitry involved in inhibitory control?

A

the go-nogo gauge

56
Q

what happens in the cortex with increasing abstinence by an alcoholic?

A

increasing bold activity

- able to mount a greater response in the inhibitory response may lead to successful abstinence?

57
Q

what treatments can enhance treatments in the part of your brain involving inhibition and therefore help you stay abstinent?

A
  • drugs

- psychological treatments

58
Q

what is the function of naltrexone?

A

it’s an opioid antagonist that blocks heroine use in opioid addicts
- modulates rewards system in alcoholism

59
Q

what drugs would be useful to develop to treat addiction?

A

anti-stress medications

BRS Year 2 (110 decks)

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