Week 4 Flashcards
What did the video on food addiction reveal? (2)
Chemicals are being created in labs to make food as irresistible as possible to make you hooked (or addicted) to the reward of the chemicals releasing dopamine and pleasure chemicals in the brain
The food industry is doing this on purpose to compete and make as much money as possible
What is food addiction? (3)
A specific adaptation to one or more regularly consumed foods to which a person is highly sensitive
Produces a pattern of symptoms descriptively similar to those of other addictive substances
Not formally recognized as an addiction but the idea has been around for a long time
What does the general public see as the cause of FA? (2)
Some people think it is about the act of eating
Others believe it is the ingredients that are chemically engineered to make the food impossible to resist and addictive
What are the parallels between FA and SUDs? (5)
There is an addictive substances that books our brains
Individual risk factors like family history, mental illness and biological factors
Environmental risk factors like capitalism and industries pushing the substance for their own benefit
Behavioral symptoms like cravings and continued use in spite of consequences
Neurobiological underpinnings like dopamine theory and loss of control
What is the Yale Food Addiction Study? (2) Why is it limited?
It was created in 2009 (lasting over 10 years) to study the severity of food addiction using a questionnaire
The questionnaire asked about items similar to the DSM 5 SUD criteria
Uses analogistic reasoning by assuming the behavior is already addictive, which means it might not look at other behaviors/causes
What are some of the eating habits the YFAS looks at? (8)
Control of eating
Eating more and longer than expected
Persistent desire/cravings
Failure to stop
Impairment to social/occupational/recreational activities
Use in the face of adverse consequences
Tolerance
Withdrawal
What was the result of the Yale study? (2)
They measured all the criteria and created a food addiction scale to measure FA
They also collected and analyzed studies that used the scale 10 years later to determine a prevalence
According to the YFAS, what is the prevalence of FA? (2) What does this demonstrate? (2)
The more people have other food related problems (obesity, eating disorders), the more likely they are to be diagnosed with FA
This is especially true for eating disorders involving binge eating components
Demonstrates that FA cannot be attributed to just chemically processed foods but also environmental/behavioral factors
This might indicate that it is an ED, not an addiction since it isn’t tied to a single substance
What is anorexia nervosa? (2)
Not eating enough food to a point that you are underweight, resulting in a restriction of energy
Body image concerns are central; they have an intense fear of gaining weight and their weight is inextricably linked to their self worth
There is a disturbance in their perception of their body (they think they are fat when they are underweight)
Focus on dietary and eating restrictions to maintain/fix body weight results to a point that they ignore every other factor in their life
What are the 2 sub types of AN?
Restricting type where they don’t engage in purging behavior and mainly focus on dieting, fasting and exercise
Binge-eating/purging type where they have recurrent episodes of binge eating and purging behavior
What is bulimia nervosa? (3)
Binge-eating episodes where one eats a lot of food in a 2 hour period with a complete lack of control during that time
Compensatory purging after in order to prevent weight gain and counter the effects of what they’ve just done (vomiting, laxatives, etc.)
Self-evaluating is also unduly influenced by body shape and weight
What is binge eating disorder? (4)
Long standing tendency to over eat due to loss of control, especially when they are unhappy, stressed and feeling other strong emotions as it can be a coping method
The over-eating leads to binge eating episodes in phases (they can go months without doing so or do it every day of the week) as it is dependent on what is going on in their life
They will try to diet/restrict after but will relapse eventually
Tends to last for years or even most of one’s life
What is a trans diagnostic model of EDs? (3)
Sees the over-evaluation of body shape and weight and control as the key parts of EDs, with other factors like events and mood playing into the never-ending cycle of binging, purgin and relapsing
All different EDs fit into this model and explains why people diagnosed with one are often diagnosed with others or develop them throughout their illness
Helps explain the connection between behaviors so treatment can address the root of the problem
What similarities are there between addiction and binge eating? (8)
Cravings or urges
Loss of control
Preoccupied with thoughts of the behavior
Use as coping
Denial of severity of the problem
Attempts to keep it secret
Persists in face of adverse effects
Repeated unsuccessful quit attempts
What are the dissimilarities between addiction and binge eating? (4)
Does not involve the consumption of particular foods
Strong drive to avoid the behavior and substance (food)
Fear of the behavior
Could just be co-occurrence
What are the different treatment approaches to FA/ED? (3)
Dependent on the perspective you take
FA perspective would focus on restricting those addictive food
ED perspective would look at treating the roots causes depending on the ED (body image, weight, coping with stress, moderating self-restraint)
What are the two ways of looking at food addiction?
Behavioral addiction to the act of food consumption
Substance addiction to an addictive agent in ultra-processed foods
What are opioids derived from?
Derived from the sap of the opium poppy plant
What is the history of opioid addiction? (3)
Used commonly throughout millenia as a painkiller and for other medicinal purposes like sedation without losing consciousness
Pleasurable effects led to widespread use for non-medicinal purposes in the 19th century
After the publication of Confessions of an English Opium Eater, which raved about the positive experiences taking opium for pleasure, it was destigmatized and brought mainstream in society
What is morphine? (3)
The major active chemical in opium that is 10 times more potent than straight opium
A scientist in 1803 found a process to separate morphine from opium
He named opium after the Greek god of dreams Morpheus due to the blissful dreamlike state it produced
What is heroin? (3)
A drug produced by chemically processing morphine to make it more potent
A British chemist in the late 1800s found a way to alter morphine into a new chemical, diacetylmorphine, which was twice as potent as morphine
Seen as giving you heroic and invincible properties, prompting it to be called heroin
When was opium first criminalized? What did this cause?
In the early 1900s, all these substances coming up prompted the US to create the Harrison Narcotics Act in an attempt to eliminate the non-medical use of opioids
This prompted the beginning of drug crimes
What is the legal status of prescription opioids in Canada? (4)
Classified as a Schedule I drug under the Controlled Drugs and Substances Act (CDSA)
Legal when prescribed by licensed practitioners and used by the person for whom it was prescribed
Illegal possession of opioids and double-doctoring (getting a prescription from multiple doctors without telling them) can result in years of imprisonment
Trafficking, importing, exporting and producing opioids can result in life imprisonment
What did the legal response to opioids do? (2)
Put the control of opioids completely in the hands of physicians and exclusively gave them to the power to prescribe based on medical need
This resulted in it being smuggled, increasing prices and the change in the kind of person who became addicted (lower-status men using the Black market)
What is the prevalence use of opioid use in Canada? (3)
Data from a non-profit in Ottawa
Self-report data shows an overall downward decline
Prevalence is not terribly high (only 10% for youth and 12-14% for adults and the general population)
How did opioid addiction develop? (3)
Appropriate prescribing of opioids is important for pain management and effective medical intervention for acute pain (not chronic pain)
However, since some people are at higher risk for addiction, physicians need to conduct a comprehensive assessment of risk factors before prescription opioids (it is on the doctor to mediate risk of addiction)
Problem is that physicians are not doing their homework by looking into the history of their patients in terms of addiction and risk factors and instead are mass prescribing opioids
What is fentanyl? (3)
A synthetic opioid like heroin that requires much less to achieve the same effect
It can be 100-100,000 times more powerful than morphine depending on the creation process
Carfentanyl is an even stronger synthetic opioid
How does fentanyl play into opioid addiction? (2)
Many people are being prescribed oxytocin and when the prescription runs out, they turn to the streets and illegal methods to get their fix
Problem is that street drugs are being cut with fentanyl, which cannot be evenly distributed and is way more dangerous, and they take them without knowing how strong it is and are overdosing and dying
How do opioids affect the brain? (2)
The body has natural opiates, which shuts down inhibitory transmitters in the brain to release dopamine
Opioids mimic this effect by binding to opiate receptors and turning off DA reception, flooding the brain with dopamine and feelings of sedation and wellbeing
How does opioids in the brain cause overdose? (2)
Activated opioid receptors in the brain can suppress or stop the breathing reflex and other vital functions
The main point of opioids is to depress the respiratory system and make breathing slower/easier but too much use can stop it completely, causing overdose and death
How did the epidemic of opioid addiction start?
Started in the clinic, not the streets, as doctors were mass prescribing opioids for things other than acute pain and short periods of time
What prompted the change in approach to opioid as treatment? (3)
In the 1990s, a pharmaceutical company called Purdue used two faulty studies in their mass marketing of oxycodone as this miracle cure
The retrospective studies, one of which was not looking at serious opioids or oxycodone and one that only looked at 38 people, were used to claim opioids were non-addictive
Purdue used these studies to market opioids to doctors, who took it at face value and mass prescribed it
What is the impact of the opioid crisis? (3)
It destroyed lives and communities
64,000 people died from drug overdose in 2016 and 42,000 were from opioid drug overdose
Most were accidental deaths from people consuming fentanyl without being aware of it
What is the response to the opioid crisis? (3)
Opioids are still some of the most valuable medications for physicians and not everyone who takes them will become addicted and die
Doctors need to be careful with how and who they are prescribing opioids, they need to do their homework
Also need to find alternatives for those at high risk of addiction
What are partial opiate agonists? (2) What are 2 examples?
New approaches to make prescription of opioids safer that combine opioids with others substances to produce lower levels of activity
Can also help with treatment and withdrawal as well as harm reduction
Example include buprenorphine patches (releases less pleasure at once to make them less addictive) and subxone (which combines buprenorphine and naloxone to reduce abuse liability as it regulates and control opioid use and uses naloxone if it is used improperly)
What is cannabis? What are the two main compounds?
A plant with over 400 compounds, 60 of which are psychoactive
The 2 main ones are THC and CBD
What is THC? (3)
The primary psychoactive substance/agent in cannabis
Produces psychedelic effects
Very potent in hashish which makes it the strongest compound
What is CBD? (2) How does it affect THC?
Non-psychoactive part of the plant
Does have some therapeutic benefits
The more CBD in the plant, the less the THC work because it actually counteracts it and dampens the effect
What did the Cannabis Act do? (3)
Legalized Cannabis in 2018
Came with a bunch of regulations and controls (can only purchase from authorized retailers, cannot import/export, can only possess 30g, illegal for youth, etc.)
Still made weed very accessible, with is available on every street corner
What is the prevalence of cannabis use in Canada? (4)
Has been steadily increasing over the 30 years before legalization
After legalization, it is even higher
Most common among 18-24 year olds while it is not increasing for youth
People usually either use it infrequently (once a month) or daily
How can we screen for CUD? (4)
The Cannabis Use Disorders Identification Test (CAUDIT)
A brief, 8 item screening measure that is used in epistemological studies most often
Modeled on AUDIT
Used to screen for people who might have a problem, not diagnose people with a CUD
What is the DSM criteria for CUD? (12)
Using large amounts
Desire or attempts to control or stop
Great deal of time spent using or obtaining or recording from CU
Failure to fulfill obligations
Social/daily functioning problems resulting from use, activities given up
Physically hazardous situations
Knowledge of harm
Tolerance
Withdrawal
Concurrence with mental health problems
Onset any time in life but often following adolescence
Pattern of use gradually increases over a long period of time
What is Cannabis Withdrawal? (2)
New to the DSM 5, every substance has a withdrawal component now
Psychological and physiological symptoms relating to withdrawal (mood, anxiety, pain, tremors, etc.)
What is the prevalence of cannabis addiction in Canada? (4)
6.8% of people have it over their lifetime, Only 1.3% in the past 12 months
That is a lot of people and it is important to give them help
Known sex difference with males much more likely to have addiction
The earlier you start using substances, the more likely you are to become addicted
What are the stats for risk of developing CA? (3)
1 out of 10 people who use cannabis
50% of people who use it daily or near daily
16% of people who start use during adolescence
What are biological risk factors of CA? (3)
Genetics plays a role as, according to twin studies, cannabis use, dependence and addiction has a genetic basis
Brain chemistry and the distribution of CB1 receptors
Brain reward pathway (THC mimics natural cannabinoid to bond to their receptors and release DA)
What are the psychosocial risk factors for CA? (2)
Coping skills, social skills, family relationships, self-esteem, mental health, etc.
A study on cannabis users used the CAUDIT and personality test to demonstrate that certain personality traits lead to motives for drug use that put people at risk of addiction
What psychosocial factors predict first onset of cannabis use? (8)
Men
Smoking or alcohol
Friends who consume cannabis
Low socioeconomic status
Poor relations to parents
ADHD and externalizing behaviors
Depression
Trauma exposure
What psychosocial factors impact the transition to CA? (6)
Early onset of use
Frequent use
Positive psychotropic effects of CU
Prior drug involvement
Concurrent mental disorders
Stressful and critical life events
How does a complex and multi factorial etiology view CUD? (4)
Cannot be fully accounted for by any one or even a few etiologies factors
Calls for the use of a biopsychosocial perspective to acknowledge there is no one single cause of pathway to addiction
Risk increases as the number of vulnerable conditions/experiences increases
Also must account for the buffering effects of protective factors
What are the mental health consequences of CUD? (2)
According to meta analyses, CU may be associated with increased risk for mood and anxiety disorders
There is also a dose-response relation between CU and risk of psychosis and schizophrenia (the use of higher potency cannabis is linked with an increased risk of psychosis symptoms and onset, especially when there is a family history of psychosis)
What are the cognitive consequences of CUD? (2)
Linked with memory impairment as THC is shown to impair memory as a result of reducing blood flow to the brain
These effects may be mediated by cannabinoid receptors in the hippocampus
