W7 - Rob Hester 1: Addiction Flashcards

1
Q

What is the largest contributor to disease burden in Australia?

A

Dependent Drug Use

  • Alcohol and Tobacco
  • Highest causes of preventable death (15,000 per year)
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2
Q

What are some persepctives of addiction

A
  1. Social Problem
  2. Brain Disease
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3
Q

Consequences of viewing addiction as a social problem?

A
  • Social Stigma
  • Treatment for addiction and drug dependency becomes unnecessary or ineffective
    • Current government policy still emphasise personal responsibility
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4
Q

Viewing addiction as a brain disease? What is the field of study

A
  • Addiciton neurobiology
  • Support ‘disease principle of addiction’
    • Addiction is a neurobiological disease—it is not a lifestyle choice and its about time we start treating it (as a health problem rather than a social problem)
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5
Q

What evidence, and implications, suggest that addiction is not a brain disease?

A

Evidence

Vietnam war soldiers. Only 5% of dependent users relapsed after returning to USA (though typical relapse is 75%)

Implications

  • Addiction is an entrenched habit that alters the brain in the way that other learned habits do
    • It is not a disease, rather it is an example of a habit formed within a particular context using the learning mechanisms in the brain
  • Medicalisation is unhelpful and potentially harmful
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6
Q

What evidence supports drug addiction, or addiction more generally, being a brain disease that features dysfunction of self-control?

A

People who are drug dependent have poor self control > transitions from regular use to drug dependence and their risk for relapse

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7
Q

How are drugs produce addiction?

A
  • Drugs produce euphoria by overactiving limbic centres via. release of Dopamine in NAc
  • Limbic centres is tied to hippocampus, repeated pairing of drug-induced euphoria with drug-related stimuli creates association
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8
Q

What evidence suggest there is a biological link between drug-related craving and relapse?

A
  • In both active and abstinent drug users. showing drug-related stimuli activates limbic regions usually associated with the effects of the drug
    • Strenght of craving related in cue-related limbic activity
    • Magnitude of activation predicts subsequent relapse

Suggests underlying mechanism

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9
Q

What is MA use associated with? What is a catch regarding this impairment?

A

Significant impairments in a range of cognitive domains

  • Verbal Memory
  • Processing Speed
  • Executive Function
    • Magnitutde of impairment is signficiant

Use behaviour (frequency, duration, quantity) does not predict level of impairment

  • Include genetic variation in suspectibility to MA toxicity
  • Impairment worse in older, men, and confounded by comorability
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10
Q

What is a key region responsible for emotion processing in the brain

A

Insula

  • Critical to craving of drugs, food, etc
  • Example of underlying biological/neural problem
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11
Q

What is the evidence for Dopamine Hypothesis in addiction

A

In people with low level of d2 receptors (closed star on the figure), the large drug-induced increases in DA result in optimal stimulation

  • Low D2 = Vulnerability to addiction
  • High D2 = Protective factor in siblins of drug dependent

Again, underlying biological processes

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12
Q

What is the genetic evidence for Dopamine hypothesis

A

Taq1A allele influences D2 density

  • 2 Copies = Reduced D2 receptors
  • Associated with hyodopaminergic state (low dopamine)
    • Benefits from external stimulation
    • Reinforcement (positive/negative) associated with dopamine stimulation is linked to drugs, giving it greater salience and increased desire to seek it
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13
Q

Evidence for Taq1A

A
  • People with Taq1A gene 2-5x more likely to develop drug dependence
  • Associated with poor response to treatment, with higher relapse
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14
Q

In inpulsive individuals, what is associated

A

Low D2

  • Giving small amphetamine results in greater D2 release
  • Impulse (Poor self-control) leads to enhanced dopaminergic stimulation
    • Elevated response associated with stronger desire for drug
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