W9: What is Addiction? Flashcards
Drug addiction is defined by… (3)
- Compulsion to seek out drug
- Loss of control in limiting intake of drug
- Negative emotions when access to drug is limited
What is not drug addiction? (2)
Occasional use of abusive drugs
Does not reliably lead to addiction
Types of drug use (sometimes leads to each other) - (3)
Occasional, controlled, or social use
Drug abuse or harmful use
Drug addiction (diagnosed in DSM-V + ICD-10)
Diagnosing addiction - DSM-IV
Categorised as substance abuse vs dependence
Diagnosing addiction - DSM-V (2)
Moving away from categories
Drug use is as a continuum from occasional use, abuse to addiction based on symptoms to categorise a person
Substance abuse disorder is what DSM-V uses to categorise
addiction
DSM-V Diagnosing criteria - criteria, severity, mild, moderate, servere
11 criteria for substance use disorders
Severity based on number of criteria someone meets
Mild = 2-3
Moderate = 4-5
Severe > 6 (above)
Substance use disorder and addiction
are same terms
Substance use disorder = addiction (2)
Levels of addiction can vary
Addiction is process from controlled to compulsive use
Addiction as a disease - quitting is not enough! (2)
Drugs have an impact on neural circuits in the brain
Neurochemical changes persist after abstinence ( 12% remain abstinent without treatment, 30% remain abstinent with treatment)
Who is at risk of drug addiction? (3)
Adolescents and emerging-adults
- 12-29 years
- Drugs change brain development
Different types of drugs of addiction (6)
- Opiates
- Cannabinoids
- Depressants
- Stimulants
- Hallucinogens
- Inhalants
Different types of drug of addiction - cannabinoids and hallucinogens (7)
Cannabinoids
- Marijuana
Hallucinogens
- LSD
- Psilocybin (mushrooms)
- Peyote
- DMT
Differenr types of drug of addiction - depressants, nicotine and caffeine and stimulants - (8)
Depressants
- Alcohol
Nicotine and Caffeine
Stimulants
- Caffeine
- Nicotine
- Amphetamines (e.g., meth)
- Cocaine
Differenr types of drug of addiction - opioids (most narcotices) and inhlants - (8)
Opioids (most narcotics)
- Heroin
- Codeine
- Morphine
Inhalants
- Nitrous oxide
- Aerosols
- Paint thinners
What about non-drug addiction? (7)
Similar behavioral symptoms as drug use
Compulsive and rewarding activities
- Sex/pornography
- Gambling
- Video games
- Exercising
- Tanning
Non-drug addictions are often diagnoised as
personality disorder or OCD
Non-drug addictions - DSM-5 addiction section focuses on
substance use with the expectation of gambling disorders
Perceptions of behavioural vs drug addiction (5)
Drugs addictions viewed as externally caused
Behavioral addictions viewed as internally caused
- Leads to stigma of those with behavioral addictions
- May not seek treatment or acknowledge their addiction
- May not feel motivated to attempt to change behavior
Graph shift from positive to negative reinforcement (2)
- Positive reinforcement addictive
- Switch positive to negative reinforcement to not feel bad as developing withdrawal
Stages of addiction (3)
- Binge/intoxication
- Withdrawal/negative affect
- Preoccupation/anticipation
Intoxication is the (5)
Immediate effects of drug or behavior
Often produce intense feelings of reward and impair:
- Behavior
- Cognition
- Physiology
Repeated intoxication dysregulates the reward system… (6)
Repeated intoxication dysregulates reward systems
Sensitivity to drug or behaviour develops (anticipatory reward)
Reward systems adjust thresholds for what is deemed rewarding
Tolerance develops for what is normally perceived as rewarding
- Typical, everyday behaviors no longer meet reward thresholds
- Only repeated use of drug or addictive behavior meets new threshold
Intoxication - why the shift in reward threshold? (4)
- Homeostasis occurs, assumes addictive behavior is CONSTANT
- Reward systems do not like overstimulation, so expectations adjust
- Now intoxication is what our body’s expect as the “new normal”
- Without presence of intoxication, reward systems are underwhelmed
Withdrawal (when we are not intoxicated)
occurs when (2)
cessation from drug use
physical dependence
Symptoms of withdrawal - (4) - opposite of what the drug is doing
Anxious
Restlessness
Nausea
Headaches
Symptoms of non-substance withdrawal
Anhedonia (inability to feel pleasure)
Symptoms of substance Withdrawal (4)
Typically opposite of drug’s effects
- Alcohol = anxiety
- Nicotine = depression
Can sometimes be fatal (e.g., depressants, opiates)
Withdrawal - more potenti stimulation is needed to feel reward (4)
Changes in reward neurotransmitter called dopamine…
Natural release of dopamine and number of receptors reduced
Body is now reliant on external stimulation for dopamine release!
So now that we are dependent on external stimulation…
Craving is the desire to use a drug or engage in rewarding behaviour (2)
Repeated intoxication restores “balance” to reward systems
Only way to achieve “new normal” without prolonged abstinence
Behavioural compulsions are
impulstivity linked to addictive behaviour
Addiction can be measured:
Emotional Stroop
Stroop effect (2)
Examines differences between automatic (reading) versus controlled (inhibition) processes in attention
State color of text, ignore the word presented
Emotional Stroop (3)
Participants sort the color of the word
Words are either neutral or relevant to a behavior/emotion - smoking, tobacco
Participants take longer to respond to word if it is relevant to them
Example of emotional stroop
Gross research (3) - emotional Stroop
- Adult male smokers randomly assigned to nicotine abstinent for 12 hours or smoking normally for same period of time
- Stroop task colour naming task (modified) asked to name colour of ink
- Absent smokers took significantly longer to colour-name words related to cigarette smoking (e.g., Lighter) than to colour name neutral words (e.g., Pennat) - assess craving
Attention bias - behavioural compulsions (3)
Tendency to focus on rewarding stimuli
Quicker and more intense processing of rewarding stimuli
Can assess these biases using dot-probe and emotional Stroop
