Reducing addiction: Drug therapy Flashcards
What is the assumption of drug therapy?
Addiction may have a biological cause, then a natural extension of this is to assume that drug treatments may be effective in reducing addictive behaviours.
What are antagonists?
These bind to receptor sites and block them so the drug cannot be as effective, as it is not being passed on to the next neuron. This works on the concept of preventing the addicted drug from moving through different neurons.
What ae agonists?
Drug substitutes, like NRT . They bind to neuron receptors and activate them, much like the addicted drug. But the key difference is that agonists are safer, more regulated and not contaminated. Slowly, under supervision of clinics, users can wean themselves off of the substance.
What is the agonist substitution used?
Nicotine replacement therapy
What is the antagonist that is used?
Bupropion
What is nicotine replacement therapy?
This works by delivering therapeutic doses of nicotine (without the undesirable parts of tobacco) in the early stages of stopping smoking. This release of nicotine is absorbed much more slowly and steadily than in tobacco. However, ultimately it still causes action on NAcR (NICOTINE ACETYLCHOLINE) and dopamine
What forms can NRT come in?
Inhalers
Patches
Gum
Inhalers can be seen as the most effective as they also resemble the activity of smoking like handling and inhaling
What is the mode of action in nicotine replacement therapy?
Nicotine replacement therapy (NRT) works by releasing a clean (no tar etc) controlled dose of nicotine into the bloodstream
This nicotine binds to NICOTINIC ACETYLCHOLINE (NAcR) receptors in the MESOLIMBIC PATHWAY stimulating the release of DOPAMINE.
Using NRT means that the amount of nicotine can be gradually reduced over time reducing the severity of withdrawal symptoms.
Bupropion mode of action - step one?
Bupropion appears to be an antagonist at nicotinic receptors and may work – in part - by blocking nicotine effects so there is no rise in dopamine levels when you smoke a cigarette.
Bupropion mode of action step two?
In addition, Bupropion is also a weak inhibitor of dopamine and noradrenaline reuptake, which leads to an overall increase in dopamine whilst taking the drug. This may help to relieve withdrawal symptoms and/or reduce the depressed mood which could help reduce the chances of relapse.
Bupropion mode of action - step three?
The treatment generally lasts 7 to 12 weeks with a week of treatment before the smoker attempts to stop smoking.
DRUG THERAPY: Research evidence?
Stead et al (2012) reviewed 150 studies into the effectiveness of NRT and found it to be more effective than placebo treatments or no treatment at all, with NRT users up to 70% more likely to still be abstaining from smoking 6 months after quitting than the other groups.
DRUG THERAPY: Limited treatment?
In NRT, nicotine is still released into the body, which increases heart rate, constricts blood vessels, temporarily raises blood pressure and can lead to reproductive disorders, as well as potential complications with pregnancies.
In this way, particularly if an individual stays on NRT therapy for a long time rather than gradually weaning themselves off, it may be a case of replacing one addiction for another
DRUG THERAPY: Ineffective in the longer term?
For example some people may be smoking as a way of coping with stress from traumatic incidents and smoking is their way of dealing with the trauma so drugs may just be helping deal with the symptoms of nicotine addiction rather than dealing with the reasons for the addiction occurring in the first place that would still exist.
DRUG THERAPY: Side effects?
Side effects can include dizziness, sleep disturbance, nausea skin irritation, headaches and insomnia amongst others.
