SUD and Cannabis

Question 1

What is reward?

Answer 1

Reward refers to stimuli that are in some way desirable or positive and can affect behaviour

Question 2

What is the Mesocorticolimbic dopamine system?

Answer 2

The mesocorticolimbic dopamine system is made up of the Ventral tegmental area, Hippocampus, Nucleus accumbens, and the prefrontal cortex?

Question 3

How does the mesocorticolimbic system work?

Answer 3

The Ventral tegmental area (VTA) is at the center of it. It contains neurons that produce dopamine. When a rewarding stimulus is detected, neurons in the VTA are activated. They then send dopamine into the PFC, NAc, and hippocampus

Question 4

Which aspect of the mesocorticolimbic dopamine system is involved with learning?

Answer 4

The Nucleus Accumbens (NAc)

Question 5

What do addicvtive drugs lead to in the mesocorticolimbic dopamine system?

Answer 5

They lead to a supraphysiological dopamine, which means a dopamine release much larger than what is seen with naturally occurring rewards

Question 6

What is addiction

Answer 6

A syndrome at the centre of which is loss of control over a reward seeking behaviour

Question 7

What is person first language?

Answer 7

Person-first language is language that acknowledges someone as a person before describing their personal attributes or health conditions.
eg. instead of “druggie” use “person who uses substances”

Question 8

What is the term used to refer to addiction in the DSM%

Answer 8

Substance Use Disorder is used to classify the term addiction

Question 9

What are the symptoms that need to be shown in order to Substance Use Disorder?

Answer 9

Need to show 2 of 11 listed behavioural criteria within the past year
-Using in spite of adverse consequences
-Preoccupation with obtaining the drug
-Great deal of time spent trying to get the drug
-Craving
-Use results in failure to fulfill major role obligations
-Tolerance
-Withdrawal

Question 10

What is drug intolerance?

Answer 10

The increased amount of drug needed to achieve intoxication, or a diminished drug effect with a continued drug use of the same of a drug

Question 11

What is drug withdrawal?

Answer 11

Behavioural and physiological symptoms that occur upon cessation of drug use. It is the compensation of drug effects on the body

Question 12

What leads to drug withdrawal?

Answer 12

Acute and protracted drug use leads to drug withdrawal

Question 13

What are the steps in withdrawal effects?

Answer 13

1. The brain normally exists in a state of drug-free homeostasis
2. Taking drugs leads to an imbalance
3. Compensatory adaptations attempt to restore homeostasis
4. Withdrawal: Quitting drugs leads to an imbalance in the opposite direction

Question 14

How common are substance use disorders?

Answer 14

It varies across countries and by substances but around 4% of population will receive a diagnosis of a substance use disorder

Question 15

What are addictions associated with?

Answer 15

-recent stressful experiences
-negative early life events
-multiple or cumulative stressor experiences
-chronic psychiatric illnesses

This leads to strong suggestion that addiction is not the disease but rather a result of coping with stress/ or a form of PTSD

Question 16

What is one of the biggest predictors of later life addiction?

Answer 16

Early life trauma

Question 17

What is the Adverse Child Experiences Scale and what are Adverse Childhood Experiences linked to?

Answer 17

The Adverse Child Experiences Scale is a scale that assesses negative childhood experiences.
Adverse Childhood experiences are linked to
-Risky health behaviours
-Chromic health conditions
-Increased morbidity and mortality

Question 18

What is cannabis? Where does it come from?

Answer 18

Cannabis is the most commonly used illegal drug in the world, it comes from the cannabis sativa and indica plant. There are over 80 cannabinoids know.

Question 19

What are the ways to administer cannabis?

Answer 19

• Through Inhalation: 50% enters lungs, and almost all of that enters the body, it reaches brain in 30 seconds, peaks in 30-60 mins, and lasts 3-4 hours (Vaping: peak concentrations occur 10 mins in). When inhaled it likes to stay in fatty tissue
• Orally: Absorbed from gut slowly, absorption improved by adding oil, Onset hits around 1 hour in and peak hits 2-3 hours in

Question 20

What is the endogenous cannabinoid( endocannabinoid; eCB) system?

Answer 20

The endocannabinoid system is a system activated in times of stress that helps regulate stress and return it to baseline.
It has 2 endogenous ligands: anandamide (AEA) and 2-arachidonoylglycerol (2-AG)
Its 2 main receptors are CB1(brain) and CB2(immune system)
Anandamide and THC bind to CB1
2-AG and CBD bind to both CB1 and CB2

Question 21

Where are CB1 receptors located?

Answer 21

They are located presynaptically on axon terminals

Question 22

How does THC work in the brain?

Answer 22

AEA and 2-AG are retrograde messengers, which means that they carry information in the opposite direction. They are released in response to depolarization of the postsynaptic cell. THC then mimics the shape of AEA and works by this mechanism
Cumulative effect of pathways is euphoric feelings associated with cannabis use -> increased dopamine in nucleus accumbens

Question 23

What are the harms associated with cannabis use?

Answer 23

-Can be harmful to physical health
-Can be harmful to mental health
-Can be addictive

Question 24

Who is using cannabis?

Answer 24

16-24 year olds are 2x more likely to use
Students used more than working, unemployed, etc, and the average of initiation os 18.7 years

Question 25

What is the sex difference in usage?

Answer 25

Males: Males usually use dried cannabis flower, males use alone, and men use in the evenings
Females: Usually use edibles, and women use socially