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14 Cards in this Set
- Front
- Back
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Alcohol Dependence
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IS NOT RELATED TO QUANTITY!
3 domains over 12 months: Tolerance, spending more time searching for, trying to cut back, withdrawal, social/occ/rec effects |
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Addiction is a chronic disease? true/fase
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true
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Treatment types for alcohol dependence?
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AA meetings, individual counseling, CBT, pharmacodynamics. Treat withdrawal symptoms to prevent DT's
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What are alcohol's acute and chronic effects on brain reward pathways?
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ACUTE = ACTIVATION. Chronic use leads to changes and ultimately, CHRONIC = DISRUPTION of brain reward system
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Discuss how the addicted brain thinks in terms of salience, drive, memory, and control.
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Normally, control (behavioral inhibition = medial/dorsolateral pfc) inhibits one's drive (nuc.acc/vta = reward pathway). Other factors weak players. In addicted brain, memory (hippocampus) and their emotions (limbic system) drive salience (nuc.acc.) which overpowers and inhibits control and activates drive to use substance.
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What part of the brain can prevent salience-mediated relapse?
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PREFRONTAL CORTEX deals with REGISTERING CONFLICT BETWEEN GOOD/BAD. CONFLICT REGISTRATION = STOP SIGNAL.
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Can antagonists eliminate cravings?
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NOT in a chronic user! Cravings are stimulated in large part to memories and limbic inputs. ANTAGONISTS BLOCK EXPOSURE EFFECTS
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What drugs are used for alcohol dependence?
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Antabuse, Acamprosate, Naltrexone
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What is naltrexone?
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mu opioid receptor ANTAGONIST. Attenuates alcohol consumption. Alcohol affects overall activity of opioid peptides.
EFFECTIVENESS OF NALTREXONE IS INVERSELY PROPORTIONAL TO BASELINE LEVELS OF B-ENDORPHINS. more effective for people with low levels of B-endorphins...alcohol drinking is related to relative increases in b-endorphin levels. Genetic traits more responsive. |
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What are B-endorphins?
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endogenous opioid agonists. analgesic. people with low baseline levels generally at higher risk for alcoholism because increase in b-endorphin is dose-dependent w/ alcohol intake.
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What does naltrexone do?
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Decreases average number of haevy drinking days per month.
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What are Asp40 mutation and 118 A-G polymorphism in relation to alcohol use?
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mutations make less protein = fewer receptors (txn problems), bind b-endorphins w 3x more potency. G allele makes mu opioid receptor HYPORESPONSIVE. Greater cortisol release in patients with G polymorphism. Greater stimulation to alcohol AND GREATER RESPONSE TO NALOXONE/NALTREXONE.
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What is acamprosate?
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Acamprosate is an NMDA ANTAGONIST. Can reduce intensity of cue-induced, post-cessation cravings. Blocks c-fos. Suppresses withdrawal effects (increased glutamate and decreased DA)
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What is c-fos?
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C-fos is an immediate early gene associated with alcohol withdrawal.
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