Wk 4 Substance Use Disorder Flashcards
Rewarding effect from drugs from large surges of
dopamine
Drugs mimic the regular response of dopamine but
greatly exceeds it
Dopamine surges disrupt
regular dopamine pathways (receptor down regulation)
Addiction is associated with deficits in the
prefrontal cortex
In drug addiction, dopamine transporters are
diminished
Loss of dopamine transporters can
be reversed with time
Risk factors for substance abuse disorder
Primarily environmental: aggressive behavior in childhood, poor social skills, lack of parental supervision, early drug experimentation, availability of drugs at kid’s school
Protective factos for substance abuse disorder
Good self control, parental monitoring and support, positive relationships, getting good grades, anti drug policies at schools
Some people are less likely to abuse drugs because they do not get the..
dopamine surges when abusing drugs
5 types of therapy for substance abuse disorder
CBT, contingency management/positive reinforcement, motivation enhancement therapy, family therapy, 12 step facilitation programs
Common medications used to treat opioid abuse
methadone, bruphenorpine, naltrexone (ER), lofexidine
Common medications used to treat nicotine abuse
NRT, bupropion, varenicline
Common medications to treat alcohol abuse
naltrexone, disulfiram, acamprosate
Crucial first step in treatment of drug abuse
medically assisted detoxification
Drug abuse treatment need to be tested for
HIV, Hep B and C, TB, endocarditis
Suboxone is a combination of
Naloxone and buprenorphine
If someone who takes opioids stops cold turkey they will experience withdrawal symptoms in
12-24 hours from last dose
Opioid withdrawal typically lasts
5-10 days
Opioid withdrawal peaks at
72 hours (day 3)
Symptoms of withdrawal opioid
flu-like, goose bumps, depression, intense cravings, anxiety
How to treat opioid withdrawal
supportive treatment
At 2 weeks past opioid withdrawal, physical symptoms have lessened but
there are psychological and emotional symptoms
At 1 month after opioid withdrawal
depression and cravings still linger
Benzo and alcohol have the same withdrawal symptoms… why?
They both work on GABA receptors
Methadone will not help
someone addicted to alcohol or bentos
Difference between benzo/alcohol withdrawal versus opioid withdrawal
Benzo and alcohol withdrawal can kill a person, while opioid withdrawal cannot
Signs and symptoms of withdrawal from benzos and alcohol
sleep disturbances, irritability, nausea, increased tension, weight loss, panic attacks, perceptual changes, sweating
Dangerous symptoms of alcohol and benzo withdrawal
seizures, hallucinations, delirium tremors, Wernicke’s encephalopathy
Delirium tremens
hallucination, disorientation, tachycardia, hypertension, fever, agitation, diaphoresis
Benzo withdrawal starts at
6-12 hours
Benzo withdrawal peaks at
2 WEEKS!
Alcohol withdrawal starts at
8 hours
Alcohol withdrawal peaks at
1-3 days and will taper off at about a week
For alcohol and benzos we will
taper them off, to prevent the dangerous side effects
Those with alcohol withdrawal require a
Vitamin b1 (thiamine) supplement
Why do alcoholics need a b1 supplement?
Long term alcohol use causes stomach inflammation inhibiting the vitamin b1 absorption
