Reducing addiction: Drug therapy Flashcards
State the three types of drug therapy
> Aversives
Agonists
Antagonist
Explain aversion therapy
- example?
The main effect of aversives is to produce unpleasant consequences which relies on the association to make you not want to take the drug again
E.g Disulfiram
- drug therapy used to treat alcoholism by creating hypersensitivity to alcohol
- if have person has taken disulfiram and then an alcoholic drink, within about 5 minutes the effect of a severe hangover (especially nausea) are felt
- client associates drinking alcohol with these unpleasant outcomes rather than with enjoyment (classical conditioning)
Explain agonists
- example?
Agonists are less harmful drug substitutes, and they act as drug replacements by binding to neurone receptors and activating them in a similar way that the addictive substance does. Hence, the addict experiences a similar effect, which also reduces withdrawal symptoms.
They bind to the opioid receptor causing a reduced but satisfying effect
E.g Methadone
- used to treat heroin addiction, satisfy the addicted person’s craving for a state of euphoria
- few harmful side effects and are ‘cleaner’ because they are administered medically rather than dealt on the streets
Explain antagonists
- example?
Antagonists bond and block receptor sites to stop the addict from feeling the pleasurable effects of their addiction (psychological dependence)
E.g Naltrexone is an opioid antagonist used to treat the physiological dependence of heroin addiction. However other interventions (such as counselling) should be used alongside the drug therapy to tackle the psychosocial causes of the addiction
Drug therapy for nicotine addiction: Nicotine Replacement Therapy (NRT)
Uses gum, inhalers, or patches to deliver the psychoactive substance in tobacco, but it is not the most harmful to health
It provides the user with a clean controlled dose of nicotine which operates neurochemically as an agonist which activates nicotinic acetylcholine receptors (nAChRs) in the mesolimbic pathway of the brain
- release dopamine in the nucleus accumbens
Withdrawal symptoms managed over a period of two or three months, reducing the unpleasantness of withdrawal symptoms as nicotine can be reduced over time
Drug therapy for gambling addiction
Although there are no official drug therapies for gambling addiction, some are being trialled, and opioid antagonists are the front runners.
Naltrexone, a drug conventionally used to treat heroin addiction, has been used because of the similarities between gambling and substance addiction recognised in the DSM 5.
Drug addiction and gambling share a similar dopamine reward system, with opioid antagonists reducing dopamine release in the nucleus accumbens by increasing GABA release, effectively reducing gambling cravings.
What are three strengths of drug therapy reducing addiction?
Research support
Removes stigma
Easy to take
EVALUATION: Research support
The effectiveness of drug therapy has been demonstrated by studies. A meta-analysis of 150 high quality studies on the effectiveness of nicotine replacement therapy (NRT) was carried out by Stead et al. (2012). They came to the conclusion that NRT in any form is far more successful at helping smokers stop than placebos or receiving no therapy at all.
The best method for delivering nicotine was the nasal spray. After quitting, NRT users had a 70% higher likelihood of not smoking for six months.
NRT is therefore worthwhile as a treatment for nicotine addiction since it is safer than smoking and does not promote dependence.
EVALUATION: Removes stigma
The stigma associated with addiction is removed by the use of drug therapies, which promote the idea that addictions are medical conditions. This undermines the idea that moral or psychological flaws are the cause of addictions.
Eliminating this stigma may encourage greater study and increase the number of people who seek help.
EVALUATION: Easy to take
One benefit of drug therapy is the simplicity of use. It is simple to take a medication on a daily basis without attempting to alter your behaviour or brain processes.
What are three weaknesses of drug therapy in reducing addiction?
Side effects
Limited treatment and may not be effective on its own
Ethical issues
EVALUATION: Side effects
NRT and opioid antagonists have severe side effects, including dizziness, gastrointestinal problems, sleep disturbance, and headaches. These effects are similar to nicotine effects if the patient continues smoking.
Opioid antagonists require a higher dose to treat gambling than drug addiction, causing worse side effects like tiredness, anxiety, headaches, joint and muscle pains, cramps, and nausea.
These side effects are a negative aspect of drug therapy, hindering the completion of treatment.
EVALUATION: Limited treat and may not be effective on its own
Drug therapy is limited due to addictions, which can make addicts disorganized and unmotivated.
Chung et al. (2012) suggest that treatments should be tailored to individual genetic profiles for consistent effectiveness.
McLellan et al. (1993) found that psychological intervention was more effective for methadone addicts than methadone alone, indicating that drug treatment may not be effective alone.
EVALUATION: Ethical issues
Ethical issues also exist with using certain drug therapies to treat addictions. Aversive drugs induce uncomfortable and unpleasant side effects. Drug therapies are often best used in conjunction with other therapies, such as cognitive behavioural therapy.
Aversion therapy
-> Informed consent is difficult
-> They don’t really know what they are letting themselves in for
-> Compliance with the treatment is low due to the unpleasant nature of the stimuli used, e.g., inducing violent vomiting.
-> Much less common in recent years
Also, relapse rates are very high – the success of the therapy depends on whether the patient can avoid the stimulus they have been conditioned against.
