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substance abuse Flashcards

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1
Q

substance abuse

A

a pattern of drug use in which people rely on drug chronically and excessively and not for therapeutic reasons

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2
Q

addiction or dependence

A

being physically dependant on a drug in addition to abusing it

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3
Q

dangers of cocaine

A

psychotic behaviour, brain damage, death

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4
Q

dangers of designer drugs

A

untested, potentially contaminated

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5
Q

dangers of intravenous drugs

A

risk of contracting infectious diseases, overdoes and death, harm to an individuals life, loved ones and society

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6
Q

dangers of alcohol

A

cirrhosis of the liver, increased risk of heart disease and stroke , korakoff’s syndrome

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7
Q

dangers of smoking

A

increased risk of cancer, heart disease, stroke etc

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8
Q

what makes drugs so attractive

A

positive reinforcement and/ or negative reinforcement

learned conditioned responses

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9
Q

positive reinforcement

A

the addition of a reinforcing stimulus following a behaviour that makes it more likely the behaviour will occur again in the future

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10
Q

what is the reward in positive reinforcement

A

the reinforcing stimulus

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11
Q

when do reinforcing stimuli have a greater effect?

A

if it occurs immediately after the behaviour

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12
Q

why does heroin act faster than morphine?

A

it is lipid soluble, can pass the blood brain barrier

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13
Q

long term changes produced by substance abuse

A

in the ventral tegmental area

increased strength in the excitatory synapses of dopaminergic neurons of mice after single administration, administration for 2 weeks lead to permenant changes

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14
Q

4 dopaminergic pathways

A

mesolimbic
mesocortical
nigrostratial
tuberoinfundibular

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15
Q

most important dopaminergic pathway? where it starts and ends?

A

mesolimbic pathway

VTA to nucleus accumbens

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16
Q

what do changes in teh VTA lead to?

A

increased activation in a variety of regions that receive dopaminergic input from the VTA

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17
Q

where does the process of addiction begin?

A

the mesolimbic system

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18
Q

what does mesolimbic dopaminergic system do?

A

trigger the release of dopamine in teh nucleus accumbens

different drugs stimulate this release in different ways

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19
Q

what are synaptic changes responsible fort he compulsive behaviours that characterise addiction occur?

A

only after continued use

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20
Q

where do important changes occur?

A

in the dorsal striatum which is a part of the basal ganglia

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21
Q

what does the dorsal striatum play a key role in?

A

operant conditioning

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22
Q

negative reinforcement

A

a behaviour that turns off or reduces aversive stimuli will be reinforced
not a punishment
rather a removal of something unpleasant

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23
Q

negative reinforcement explains

A

maintenance of addiction
explanation for start of addiction
why people take more when tolerance occurs
avoidance of withdrawal symptoms

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24
Q

tolerance

A

decreased sensitivity from continued use
must take a larger amount for the same effect
body may have started to compensate for homeostatic mechanisms

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25
Q

withdrawal symptoms

A

effects when you stop taking the drug

generally the opposite of the drug itself

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26
Q

craving can occur:

A

months or years after without the drug

after a long period of abstinence

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27
Q

what is craving due to?

A

potentially: long lasting changes in brain

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28
Q

what do cravings increase the likelihood of?

A

relapse

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29
Q

what can craving be elicited by?

A

drug related stimuli can elicit conditioned responses in substance abusers, both physiologically and subjectively

stress

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30
Q

role of dopamine

attentional bias model (4 stages)

A

1) conditioned drug stimuli
2) dopamine level increase in certain brain areas
3) further draws the individuals attention to drug related stimuli
4) this promotes craving and relapse

31
Q

attentional bias is the hypothesised role of?

A

the nucleus accumbens

32
Q

dopamine increased in relation to cocaine cues in?

A

the dorsal striatum

33
Q

people who use drugs show impairment where?

A

prefrontal cortex

34
Q

prefrontal cortex impairments in drug users

A

function- activity

structural abnormalities

deficits on task

35
Q

where do opiates come from?

A

opium poppy- sticky resin

36
Q

types of opiates

A

heroin, morphine, methadone, codeine

37
Q

effects of opiates

A

pain killer effects

38
Q

how can opiates be taken?

A

eaten, smokes, administered intravenously

39
Q

societal costs of heroin

A

tolerance
needle use
transmission to unborn child
uncertainty of strength and what it is mixed with

40
Q

what does systematic administration of opiates stimulate?

A

opiate receptors

41
Q

effect at periaqueductal grey matter

A

analgesia

42
Q

effect at preoptic area?

A

hypothermia

43
Q

effect at mesencephalic reticular formation

A

sedation

44
Q

effect at VTA and nucleus accumbens

A

reinforcement

45
Q

opiates positive reinforcement

A

Dopamine - the reinforcing effects of opiates are produced by the activation of neurons of the mesolimbic system and release of
dopamine in the nucleus accumbens

46
Q

opiates negative reinforcement

A

painkiller

feeling of pleasure

withdrawal

47
Q

opiate craving

A

opiate related stimuli trigger the release of dopamine in the nucleus accumbens

48
Q

stimulant drugs

A

cocaine and amphetamine

dopamine agonists, have similar effects but their sites of action are different

49
Q

cocaine action

A

deactivated dopamine transporter proteins, blocking the reuptake of dopamine

50
Q

amphetamine action

A

inhibits the reuptake of dopamine and directly stimulates the release of dopamine from the terminal buttons

51
Q

positive reinforcement stimulant drugs

A

action at mesolimbic dopamine system

potent and rapid effects

52
Q

what happens if you block dopaminergic receptors or destroy terminals in the nucleus accumbens

A

cocaine and amphetamines loose much of their reinforcing effect

53
Q

positive reinforcement nicotine

A

smoking stimulates nicotinic acetylcholine receptors

associated with the release of dopamine in the nucleus accumbens, reinforcing the behaviour

54
Q

negative reinforcement smoking

A

appetite increase
overeating
weight gain

55
Q

craving nicotine

A

associated stimulus

nicotine stimulates orexin

56
Q

what disrupts smoking addiction and why?

A

damage to the insula

19 smoker with insula damage following acquired brain injury
50 smokers with other brain damage
those with insula damage significantly more likely to have a disruption of smoking addiction

57
Q

kosarkoff syndrome (alcohol)

A

chronic memory disorder
anterograd amnesia
caused by a severe deficiency of thiamine (vitamin B-1)

58
Q

effect of lack of thiamine

A

damage to areas of the thalamus and mammillary bodies- structures important for encoding new memories

59
Q

anterograd amnesia

A

loss of the ability to form new memories

explicit memories are effected- inabillity to learn new facts or remember events
implicit memories not effected

60
Q

societal costs of alcohol

A 
accidents 
violence and aggression
chronic alcoholism- unemployment, homelessness 
health: liver cirrhosis 
fetal alcohol syndrome
61
Q

disinhibition theory

A

alcohol acts as a selective depressant on the cortex and activates subcortical structures

62
Q

alcohol myopia theory

A

tendency for people to respond to near and immediate cues while ignoring remote cues and potential cues

63
Q

alcohol positive reinforcement

A

mild euphoria

increases activity in the dopaminergic neurons of the mesolimbic system

can trigger the release of endogenous opioids

64
Q

alcohol and mesolimbic dopamine system

A

indirect antagonist at NMDA receptors

indirect agonist at GABAA receptors

65
Q

alcohol and endogenous opiates

A

drugs that block opiate receptors also block the reinforcing effects of alcohol in a variety of species

66
Q

negative reinforcement of alcohol

A

anxiolytic and sedative effects : reduces discomfort and anxiety
-indirect agonist at GABAA receptors

disinhibition

67
Q

craving alcohol

A

opiate receptors: level of opioid receptors increases with abstinence and is thought to be related to cravings for alcohol

68
Q

withdrawal alcohol

A

mild symptoms then more serios problems

seizures

69
Q

seizures and alcohol withdrawal

A

increased sensitivity of NMDA receptors after suppressive effect of alcohol is removed can trigger seizures and convulsions

drugs that block NMDA receptors were shown to prevent seizures in mice

70
Q

two natural components of cannabis

A

tetrahydrocannabinol (THC)
principle psychoactive component of cannabis

cannabidiol (CBD)
does not produce a high

71
Q

THC

A

small dose cause euphoria

large doses can produce anxiety and psychotic like behaviours

72
Q

CBD

A

antianxiety and antipsychotic effects

studies being completed to evaluate whether it would be an appropriate treatment for people with:
schizophrenia
social anxiety
post traumatic stress…

73
Q

cannabis positive reinforcement

A

THC has stimulating effect on dopaminergic neurons

CB1 receptors mediate most of the psychotic effects on THC

74
Q

CB1 receptors

A

probable role in reinforcing effects on other drugs as well as cannabis

-Blocking CB1 receptors in mice abolishes reinforcing effect of cannabis, heroin, morphine and reduces that of alcohol

rimonabant, which blocks CB1 receptors, decreases the reinforcing effects of nicotine

brain and behaviour (12 decks)

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