Substance Use and Addictions Pt.1 Flashcards

1
Q

outline the general course of addiction

A

experimental/recreational use > increasingly regular use > addiction

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2
Q

list six diagnostic criteria for dependence syndrome

A

strong desire /sense of compulsion to take substance, difficulty controlling substance taking behaviour (onset, termination, or levels), withdrawal state when use stopped / reduced, evidence of tolerance, progressive neglect of alternative interests, persisting use despite evidence of harmful consequences

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3
Q

define addiction

A

compulsive drug use despite harmful consequences, characterized by an inability to stop using a drug; failure to meet work, social, or family obligations; and, (depending on the drug) tolerance and withdrawal

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4
Q

define dependence

A

refers to a physical adaptation to a substance

Tolerance/withdrawal eg opioid, benzodiazepine, alcohol, so can be dependent and not addicted

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5
Q

list behavioural addictions

A

gambling disorder

internet gaming disorder

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6
Q

substance use issues can be classified as?

A

hazardous use
harmful use
addiction
dependence

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7
Q

faster onset of a drug is related to?

A

speed of reaching the brain crossing the blood-brain barrier lipophylic

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8
Q

list heroin types from slower to faster brain entry

A

opium > morphine > heroin > snorted heroin > i.v./smoked heroin

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9
Q

list cocaine types from slower to faster brain entry

A

coca leaves > coca paste > cocaine > crack

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10
Q

list tobacco types from slower to faster brain entry

A

chewing tobacco > snuff > cigarettes/vaping

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11
Q

what elements are involved in alcohol/drug use and addiction?

A
social
environmental
drug
personal
genetic
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12
Q

the brain: from use to addiction

A

pre existing vulnerability, family hx, age > drug exposure, compensatory neuroadaptations to maintain brain fx, resilience > sustained recovery or cycles of remission and relapse

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13
Q

the brain: from alcohol use to addiction

A

pre existing vulnerability, family hx, age > drug exposure, compensatory neuroadaptations to maintain brain fx > tolerance, withdrawal

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14
Q

alcohol alters the balance between what systems in the brain?

A

excitatory > glutamate (NDMA receptor)

inhibitory > GABA-benzodiazepine (GABA-A receptor)

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15
Q

acute alcohol exposure has what effect on excitatory systems?

A

Blocks excitatory system

- Impaired memory (alcoholic blackouts)

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16
Q

acute alcohol exposure has what effect on inhibitory systems?

A

Boosts inhibitory system
Anxiolysis
Sedation

17
Q

Chronic alcohol exposure results in what neuroadaptations in the presence of alcohol?

A

GABA & glutamate remain in balance: upregulation of excitatory, reduced fx in inhibtory > GABA-A receptor: switch in subunits to make less sensitive to alcohol

18
Q

Chronic alcohol exposure results in what neuroadaptations in the absence of alcohol?

A

GABA & glutamate are no longer in balance – withdrawal state
NMDA receptor: increase in Ca2+
- toxic leading to hyperexcitability (seizures) and cell death (atrophy)

19
Q

how to treat alcohol withdrawals

A

treat with benzodiazepines

20
Q

name a medication used to help people remain abstinent from alcohol

A

acamprosate > reduces NMDA function

21
Q

models of addiction

A

reward deficiency (+ve reinforcement)
overcoming adverse state (-ve reinforcement)
impulsivity/compulsivity

22
Q

list key modulators in addiction

A

mu opioid, GABA B cannabinoids, glutamate

23
Q

action of amphetamine?

A

enhances the release of dopamine

24
Q

action of cocaine on neurotransmitters

A

blocks reuptake of dopamine

25
action of alcohol, opiates, nicotine on neurotransmitters
increase dopamine neuron firing in VTA
26
hypothesised that levels of _________ predisposes subjects to drugs
brain dopamine D2 receptor levels
27
how to assess function in the reward pathway with fMRI?
Monetary Incentive delay task - anticipation of winning money
28
blunted brain activation is seen where?
years prior to development problematic drug use in adolescents in abstinent addicts
29
in abstinent addicts, those with blunted response in the brain to ‘anticipation of reward’ are more or less likely to relapse?
more likely
30
what regions of the brain are involved in binge/intoxication?
thalamus dorsal striatum ventral tegmental area
31
what regions of the brain are involved in withdrawal/negative affect?
amygdala | brainstem
32
what regions of the brain are involved in anticipation 'craving'?
insula hippocampus prefrontal cortex
33
how does motivation for substance use change are addiction/dependence develops?
Change from positive to negative reinforcement
34
Assessing amygdalar function with fMRI
Emotional processing of aversive images
35
amygdalar function in abstinent polydrug addicts and alcoholics
Heightened brain response in left amygdala in abstinent polydrug addicts to aversive images but not in alcoholism
36
Change from voluntary drug use to more habitual and compulsive drug use involves transition from?
prefrontal to striatal control over drug taking ventral (limbic or emotional) to dorsal (habit) striatum
37
Assessing neurocircuitry involved in inhibitory control with fMRI: go-nogo task
Greater response in frontal pole/inferior frontal gyrus during inhibiting response in abstinent alcoholics: greater response associated with longer abstinence