Substance Abuse Flashcards
What is substance abuse?
A pattern of drug use in which people rely on a drug chronically and excessively and not for therapeutic reasons
A pattern of drug use in which people rely on a drug chronically and excessively and not for therapeutic reasons
This is known as…?
Substance abuse
What is addiction or dependence?
Being physically dependent on a drug in addition to abusing it
Being physically dependent on a drug in addition to abusing it
This is known as…?
Addiction or dependence
What are the 5 substances that can pose a serious threat?
1) Cocaine
2) Designer drugs
3) Intravenous drugs
4) Alcohol
5) SMoking
How can cocaine pose a serious threat? List 3 points
It can induce:
1) Psychotic behaviour
2) Brain damage
3) Death
Which substance can induce:
1) Psychotic behaviour
2) Brain damage
3) Death
Cocaine
How can designer drugs (designed to get around any drug prevention laws) pose a serious threat? List 2 points
1) They are untested for
2) They are potentially contaminated (e.g. synthetic opiate tainted with a neurotoxin)
Which substance does this apply to?
1) They are untested for
2) They are potentially contaminated (e.g. synthetic opiate tainted with a neurotoxin)
Designer drugs
How can intravenous drugs pose a serious threat? List 3 points
It can induce:
1) A risk of contracting infectious diseases
2) An overdose and death
3) Harm caused to an individual’s life, loved ones and society
Which substance can induce:
1) A risk of contracting infectious diseases
2) An overdose and death
3) Harm caused to an individual’s life, loved ones and society
Intravenous drugs
How can alcohol pose serious threats? List 3 points
It can induce:
1) Cirrhosis of the liver
2) Increased risk of heart disease and stroke
3) Korakoff’s syndrome
Which substance can induce:
1) Cirrhosis of the liver
2) Increased risk of heart disease and stroke
3) Korakoff’s syndrome
Alcohol
How can smoking pose serious threats? List 3 points
It can induce:
1) An increased risk of many cancers
2) Heart disease
3) Stroke
Which substance can induce:
1) An increased risk of many cancers
2) Heart disease
3) Stroke
Smoking
Taking certain substances results in positive reinforcement.
What is positive reinforcement?
The addition of a reinforcing stimulus following a behaviour that makes it more likely that the behaviour will occur again in the future
The addition of a reinforcing stimulus following a behaviour that makes it more likely that the behaviour will occur again in the future
This is known as…?
Positive reinforcement
Taking Ritalin (a drug known for enhancing performance and attention) before an exam allows one to achieve straight As in their exams.
The individual will be more likely to repeat taking Ritalin in the future.
This is an example of…?
Positive reinforcement
Reinforcing stimuli have a greater effect if it occurs ……… the behaviour
a. Immediately before
b. immediately after
c. Slightly before
d. Slightly after
b. immediately after
Drug users prefer heroin to morphine because…?
Heroin has a more rapid effect; it is more lipid soluble
This means the effect of the drug is felt through the brain sooner because it goes through the blood quicker
The effect of heroin is felt through the brain sooner because it goes through the blood quicker
Why?
Heroin is more lipid soluble
Drug users prefer:
a. Heroin
b. Morphine
a. Heroin
What are the neural mechanisms behind taking drugs? List 7 steps
1) Drug triggers the release of dopamine in the nucleus accumbens (NAC)
2) Process of addiction begins in the mesolimbic dopaminergic system
3) Produce long-term changes in other brain regions – starting with the ventral tegmental area (VTA)
4) Changes in the VTA lead to increased activation in a variety of regions that receive dopaminergic input from the VTA.
5) Synaptic changes that are responsible for the compulsive behaviours that characterise addiction occur only after continued use.
6) Important changes occur in the dorsal striatum which is part of the basal ganglia
7) The basal ganglia play a critical role in instrumental conditioning.
Saal et al. (2003) found that after a single administration of an addictive drug, there was an increase in the strength of the ……… on ……. in …… of mice
a. The excitatory synapses
b. Dopaminergic neurons
c. The VTA
What are the functions of the dopamine pathways? List 5
1) Reward (motivation)
2) Pleasure/euphoria
3) Motor function (fine tuning)
4) Compulsion
5) Perseveration
Which pathway is this involved with this?
1) Reward (motivation)
2) Pleasure/euphoria
3) Motor function (fine tuning)
4) Compulsion
5) Perseveration
a. Dopamine
b. Serotonin
a. Dopamine
What are the functions of the dopamine pathways? List 4
1) Mood
2) Memory processing
3) Sleep
4) Cognition
Which pathway is involved with this?
1) Mood
2) Memory processing
3) Sleep
4) Cognition
a. Dopamine
b. Serotonin
b. Serotonin
What is the basal ganglia?
A collection of subcortical nuclei that are located within the forebrain
A collection of subcortical nuclei that are located within the forebrain
This is known as…?
Basal Ganglia
Other than being important for instrumental conditioning, what else are basal ganglia important for?
Movement
A behaviour that turns off or reduces an aversive stimulus
Simply = Removal of something negative that makes a behaviour more likely to happen again in the future
This is known as…?
Negative reinforcement
What is negative reinforcement
A behaviour that turns off or reduces an aversive stimulus
Simply = Removal of something negative/unpleasant that makes a behaviour more likely to happen again in the future
What is tolerance?
Decreased sensitivity from continued use
Decreased sensitivity from continued use
This is known as…?
Tolerance
Does tolerance fall under positive or negative reinforcement?
Negative reinforcement
What are withdrawal symptoms?
Functioning the opposite way than if you were to have taken the drug
Why do withdrawal symptoms occur?
It is the body’s way of compensating for the disturbed homeostatic mechanisms
Taking heroin induces the feeling of euphoria, and happiness and reduces constipation
Stopping the intake of heroin results in dysphoria, sadness and diarrhoea
This is an example of…?
Withdrawal effects
Do withdrawal symptoms fall under negative or positive reinforcement?
Negative reinforcement
How does negative reinforcement potentially maintain addiction?
Withdrawal symptoms are unpleasant, taking the drug removes them, producing negative reinforcement
How does negative reinforcement potentially start the addiction to drugs?
Some people start taking a drug to deal with stress or other problems
Withdrawal symptoms are unpleasant, taking the drug removes them, producing negative reinforcement
Does this apply to negative or positive reinforcement?
Negative reinforcement
Some people start taking a drug to deal with stress or other problems
Does this apply to negative or positive reinforcement?
Negative reinforcement
What are substance cravings?
Having the sudden urge to take a substance
Having the sudden urge to take a substance
This is known as…?
Substance craving
When can cravings occur?
After a long period of abstinence
Cravings can occur after a long period of abstinence
Why?
Potentially due to long-lasting brain changes
Drug-related stimuli can elicit classically conditioned responses in substance abusers, both physiologically and subjectively
This is known as…?
Cravings
Franken (2003) suggests craving and relapse are due to …?
Attentional bias
Franken (2003) suggests craving and relapse are due to ‘attentional bias’
What does this mean?
Craving and relapse are cued by cognitive processes and increases in dopamine in response to drug stimuli
Franken’s (2003) review indicated dopamine increases in the ……… (among other areas) in response to drug-related stimuli
Nucleus accumbens
Volkow et al. (2006) used imaging to demonstrate that dopamine increased in relation to cocaine
What were the results?
There were cues in the dorsal striatum but not the ventral striatum (where the nucleus accumbens is located)
True or False?
Dopamine release is not important in the positive reinforcement of drug use
False
Dopamine release is important in the positive reinforcement of drug use, also playing a role in craving and relapse
The prefrontal cortex plays an important role through ….? List 2 things
1) Emotion regulation
2) Inhibitory control
Which substance is the most commonly abused opiate?
Heroin
What does tolerance mean?
Tolerance means the person will have to take more and more of the drug to achieve a high
A person will have to take more and more of the drug to achieve a high
This is known as…?
Tolerance
How are heroin and other opiates consumed?
Using needles
List 2 reasons why heroin is dangerous.
1) Transmission to an unborn child (opiates can cross through the placenta’s semi-permeable membrane)
2) Uncertainty of strength and what it can be mixed with
Systematic administration of opiates stimulates…?
Opiate receptors
What are the 4 behavioural effects of heroin?
1) Analgesia
2) Hypothermia
3) Sedation
4) Reinforcement
Which opiate receptor location is analgesia involved in?
Periaqueductal grey matter
Which opiate receptor location is hypothermia involved in?
Preoptic area
Which opiate receptor location is sedation involved in?
Mesencephalic reticular formation
Which opiate receptor location is reinforcement involved in?
Ventral tegmental area and nucleus accumbens
Periaqueductal grey matter contains opiate receptors involved with which behaviour of heroin?
Analgesia
Preoptic area contains opiate receptors involved with which behaviour of heroin?
Hypothermia
Mesencephalic reticular formation contains opiate receptors involved with which behaviour of heroin?
Sedation
Ventral tegmental area and nucleus accumbens contain opiate receptors involved with which behaviour of heroin?
Reinforcement
Opiate-related stimuli trigger the release of …… in the ……
a. Dopamine
b. Nucleus accumbens (NAC)
Wise et al. (1995) found that rats which pressed a lever that delivered heroin experienced an increase of % in levels of dopamine in rats’ nucleus accumbens
150-300%
Wise et al. (1995) also found that rats will also press a lever to ….?
Inject opiates into the NAC or the ventral tegmental area
Rats will also press a lever to inject opiates into the NAC or the ventral tegmental area
What does this suggest?
The reinforcing effects of opiates are produced by the activation of neurons of the mesolimbic system and the release of dopamine in the NAC
What are 2 examples of stimulant drugs?
1) Cocaine
2) Amphetamine
What happens in the sites of action of cocaine?
Cocaine deactivates dopamine transporter proteins, blocking the reuptake of dopamine
Which stimulant drug deactivates dopamine transporter proteins, blocking the reuptake of dopamine?
Cocaine
What happens in the sites of action of amphetamine?
Inhibits the reuptake of dopamine but directly stimulates the release of dopamine from terminal buttons as well
Which stimulant drug inhibits the reuptake of dopamine but directly stimulates the release of dopamine from terminal buttons as well?
Amphetamine
What are the 2 dangers of stimulant drugs?
1) Likely highly addictive
2) Blocking dopamine receptors or destroying dopaminergic terminals in the NAC causes cocaine and amphetamines to lose much of their reinforcing effect
Bozath & Wise (1985) reported that rats that self-administered cocaine were ….. times more likely to die than rats who self-administered heroin
a. 2
b. 3
d. 4
e. 5
b. 3
Blocking dopamine receptors or destroying dopaminergic terminals in the NAC causes cocaine and amphetamines to ….?
Lose much of their reinforcing effect
Blocking dopamine receptors or destroying dopaminergic terminals in the NAC causes cocaine and amphetamines to lose much of their reinforcing effect
What does this suggest?
The mesolimbic dopamine system plays an important role in reinforcement
Which substance is the leading cause of preventable death in countries such as the UK and US?
Smoking
Despite decreases in the prevalence of smoking, the risk of smoking-related deaths has increased over the last 50 years
True or False?
True
Why do people continue to smoke?
It is highly addictive
e.g. continuing to smoke after a heart attack, cancer surgery etc.
What receptors does smoking stimulate?
Nicotinic acetylcholine receptors
Nicotinic acetylcholine receptors are stimulated by what substance?
Smoking
What is nicotine associated with?
The release of dopamine in the NAC, reinforcing the behaviour
What happens to the dopamine levels of individuals in the Nucleus Accumbens within the first 45 mins of nicotine injection?
Dopamine levels rapidly increase
What disrupts smoking addiction?
Damage to the insula
Describe Naqvi et al.’s study on the effects of insula damage and its effect on smoking
1) 19 smokers with insula damage following acquired brain injury
2) 50 smokers with no insula damage following acquired brain injury
3) No difference in whether or not they had quit when they participated in the study
4) However, those who had insular damage were significantly more likely to have a disruption of smoking addiction
Those who did not have insular damage were significantly more likely to have a disruption of smoking addiction
True or False?
False
Those who had insular damage were significantly more likely to have a disruption of smoking addiction
What are the 4 potential effects of alcohol
1) Mild euphoria
2) Anxiolytic: reduces the discomfort of anxiety
3) Disinhibition
4) Alcohol myopia
1) Mild euphoria
2) Anxiolytic: reduces the discomfort of anxiety
3) Disinhibition
4) Alcohol myopia
These are effects of which substance?
Alcohol
What happens when one experiences Anxiolytic?
Reduces the discomfort of anxiety
The tendency for people to respond to near and immediate cues while ignoring more remote cues and potential consequences
This is known as…?
Alcohol myopia
What is alcohol myopia?
The tendency for people to respond to near and immediate cues while ignoring more remote cues and potential consequences
Alcohol increases activity in the …… of the…….
a. Dopaminergic neurons
b. Mesolimbic system
What are the 2 major sites of action of alcohol?
1) Indirect antagonist at NMDA receptors
2) Indirect agonist at GABAA receptors (anxiolytic and sedative effects)
1) Indirect antagonist at NMDA receptors
2) Indirect agonist at GABAA receptors (anxiolytic and sedative effects)
These are major sites of action for which type of substance?
Alcohol
What can trigger seizures and convulsions?
Increased sensitivity of NMDA receptors after the suppressive effect of alcohol is removed
Increased sensitivity of NMDA receptors after the suppressive effect of alcohol is removed can trigger ….?
Seizures and convulsions
According to Liljequist (1991), drugs which block NMDA receptors were shown to …?
Prevent seizures in mice
According to Liljequist (1991), what types of drugs prevent seizures in mice?
Drugs which block NMDA receptors
The reinforcing effect of alcohol is not solely due to the dopaminergic system
Alcohol can also trigger the release of ….?
Endogenous opioids
Several studies have shown that drugs that block opiate receptors also block …. in a variety of species, including rats, monkeys, and humans
The reinforcing effects of alcohol
Several studies have shown that drugs that block opiate receptors also block the reinforcing effects of alcohol in a variety of species, including ….? List 3
- Rats
- Monkeys
- Humans
The level of opioid receptors increases with …?
Abstinence
The level of opioid receptors is thought to be related to ….?
Cravings for alcohol
True or False?
There are more opiate receptors in the dorsal striatum of healthy control subjects than in detoxified alcoholic patients
False
There are more opiate receptors in the dorsal striatum of detoxified alcoholic patients than in healthy control subjects
Describe what happened in the case study of Jimmie G
- Jimmie G was admitted to a home for the elderly aged 49
- He served in the navy
- He’s got great abilities to solve complex problems and puzzles
- But he seems to be a man without a past or future (he was surprised when people told him he was 49 and not 19, he can still recall the things he learned when he was 19 but nothing before that or after that)
Korsakoff syndrome is often seen in ….?
Alcoholics who are malnourished
Alcoholics who are malnourished often develop…?
Korsakoff syndrome
What causes Korsakoff syndrome?
A lack of vitamin B1 in the brain and exacerbated by the toxic effects of alcohol
A lack of vitamin B1 in the brain and exacerbated by the toxic effects of alcohol causes what syndrome?
Korsakoff syndrome
What syndrome is related to irreversible damage to areas of the thalamus and the mammillary bodies?
Korsakoff syndrome
Korsakoff syndrome is related to irreversible damage to areas of the ……. and the…..?
a. Thalamus
b. Mammillary bodies
What are the 2 structures in the brain that are important for encoding new memories?
- Thalamus
- Mammillary bodies
What is the principal psychoactive component of cannabis?
Tetrahydrocannabinol (THC)
Tetrahydrocannabinol (THC) is the principal psychoactive component of ….?
Cannabis
Which receptors mediate most of the psychotropic effects of THC?
Cannabinoid Type 1 (CB1) receptors
Cannabinoid Type 1 (CB1) receptors mediate most of the psychotropic effects of …?
Tetrahydrocannabinol (THC)
What happens when Cannabinoid Type 1 (CB1) receptors get blocked?
It abolishes the high/euphoria produced by smoking cannabis
What abolishes the high/euphoria produced by smoking cannabis?
Blocking Cannabinoid Type 1 (CB1) receptors
Tetrahydrocannabinol (THC) also has a stimulating effect on …..?
Dopaminergic neurons
What also has a stimulating effect on dopaminergic neurons?
Tetrahydrocannabinol (THC)
Does injection of THC increase or decrease dopamine secretion in the nucleus accumbens?
Increase
Blocking CB1 receptors in mice can abolish the reinforcing effect of ….? List 3 drugs
- Cannabis
- Morphine
- Heroin
Blocking CB1 receptors in mice can reduce the reinforcing effects of …?
Alcohol
Which drug blocks CB1 receptors and decreases the reinforcing effects of nicotine?
Rimonabant
What is Rimonabant?
A drug which blocks CB1 receptors and decreases the reinforcing effects of nicotine
Why can some people use drugs and not become dependent?
Genetic and environmental factors influence whether someone is likely to take the substance in the first place and their likelihood of becoming dependent
What 2 factors influence whether someone is likely to take the substance/drugs in the first place and their likelihood of becoming dependent on them?
1) Genetic factors
2) Environmental factors
Kendler et al. (2003) investigated the specificity of genetic and environmental risk factors for the use and abuse/dependence of 6 classes of illicit substances
Describe the results of this study
Interviews of 1,196 male-male twin pairs found that:
1) The environment plays a stronger role in drug use
2) But genetics play a stronger role in determining whether the person becomes addicted
Which factor plays a stronger role in determining whether the person becomes addicted to drugs?
a. Genetics
b. Environmental
a. Genetics
Which factor plays a stronger role in drug use?
a. Genetics
b. Environmental
b. Environmental
What % of the vulnerability to addiction can be attributed to genetic factors?
40-60%
It is estimated that 40-60% of the vulnerability to addiction can be attributed to…?
a. Genetic factors
b. Environmental factors
a. Genetic factors
It is estimated that 40-60% of the vulnerability to addiction can be attributed to genetic factors
This includes…? List 2 things
1) Variability in the metabolism of the drug
2) Variability in the sensitivity to the reinforcing effects
How do environmental factors influence addiction?
List 4 prominent environmental factors that could lead to drug addiction
1) Drug availability
2) Low socioeconomic status
3) Poor parental support
4) Stress
Personal and societal costs of drug abuse means ….?
Effective treatments are important
Opiate addiction is most commonly treated with…?
Methadone
What can methadone help with?
Treating opiate addiction
What is methadone?
An orally administered replacement drug that is used to treat opiate addiction
Which drug blocks the effect of opiates and produces only a weak opiate effect?
Buprenorphine
What does buprenorphine do to help treat drug addiction?
it blocks the effect of opiates and produces only a weak opiate effect
What is buprenorphine?
A newer drug which blocks the effect of opiates and produces only a weak opiate effect
What are the 5 types of therapies for drug abuse?
1) Methdone (opiate addiction)
2) Buprenorphine (opiate addiction)
3) Immunotherapy
4) Deep brain stimulation (DBS)
5) Transcranial magnetic stimulation (TMS)
Which substance works best to treat opiate addiction?
a. Buprenorphine only
b. Buprenorphine + Naloxone
c. Placebo
b. Buprenorphine + Naloxone
What is Immunotherapy?
Vaccines that are specific to the substance abused
What is deep brain stimulation (DBS)?
Involves implanting electrodes within certain areas of the brain
These electrodes produce electrical impulses that regulate abnormal impulses or affect certain cells and chemicals within the brain
What is Transcranial magnetic stimulation (TMS)?
A procedure that uses magnetic fields to stimulate nerve cells in the brain to improve symptoms of major depression
A procedure that uses magnetic fields to stimulate nerve cells in the brain to improve symptoms of major depression
Which therapy for drug abuse is this?
Transcranial magnetic stimulation (TMS)
Involves implanting electrodes within certain areas of the brain
These electrodes produce electrical impulses that regulate abnormal impulses or affect certain cells and chemicals within the brain
Which therapy for drug abuse is this?
Deep brain stimulation (DBS)
Vaccines that are specific to the substance abused
Which therapy for drug abuse is this?
Immunotherapy
Which therapy for drug abuse has had some promising effects, but is a high-risk procedure?
a. Immunotherapy
b. Deep brain stimulation (DBS)
c. Transcranial magnetic stimulation (TMS)
b. Deep brain stimulation (DBS)
Which therapy for drug abuse is less invasive and has shown efficacy in reducing tobacco use but the effects on nicotine use diminished over time?
a. Immunotherapy
b. Deep brain stimulation (DBS)
c. Transcranial magnetic stimulation (TMS)
c. Transcranial magnetic stimulation (TMS)
Transcranial magnetic stimulation (TMS) has shown efficacy in reducing ….. use
a. Alcohol
b. Opiate
c. Nicotine
d. Tobacco
d. Tobacco
Transcranial magnetic stimulation (TMS) has shown the effects on ….. use diminishing over time
a. Alcohol
b. Opiate
c. Nicotine
d. Tobacco
c. Nicotine
