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20 Cards in this Set
- Front
- Back
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What is tolerance? Is tolerance = addiction?
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takes a higher dose of the drug to achieve the same level of response achieved initially
development of tolerance is not addiction, although many drugs that produce tolerance also have addictive potential |
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Tolerance to drugs can be produced by several different mechanisms (3)
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1. Disconnect/uncoupling between intracellular signaling and receptor
2. Phosphorylation (biochemical change) of receptor 3. Receptor sequestration (internalization) |
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What is Physical Dependence?
Name some drugs that induce physical dependence. |
defined by the appearance of characteristic WITHDRAWAL SYMPTOMS when the substance is suddenly discontinued
Opiates, benzodiazepines, barbiturates, alcohol and nicotine induce physical dependence |
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What is Withdrawal? What are some examples? (3)
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characteristic signs and symptoms that appear when a drug that causes physical dependence is regularly used for a long time and then suddenly discontinued or decreased in dosage
Examples: - Delirium tremens - GI symptoms - Dysphoria |
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Where does withdrawal activate? What does it induce? What is withdrawal associated with?
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Commonly abused drugs activate nucleus accumbens, pleasure center, induces euphoria
Withdrawal therefore associated with dysphoria, activity at nucleus accumbens falls below normal levels - Associated with depression, anxiety, craving |
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What is Delerium tremens (DTs)?
What are some of the symptoms experienced? Occurs in __ - ___% alcohol dependent people ___ % fatal without treatment |
Example of withdrawal
Confusion, disorientation and agitation Hallucinations, formication (sensation of crawling upon skin) Tremors of extremities Anxiety, panic attacks, paranoia Occurs in 5-10% alcohol dependent people 35% fatal without treatment |
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When does withdrawal from heroin happen? What are some of the symptoms that are included?
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Begin 6-24 h post cessation of drug
Symptoms may include: sweating, malaise, anxiety, depression, persistent and intense penile erection in males (priapism), extra sensitivity of the genitals in females general feeling of heaviness, cramp-like pains in the limbs yawning, tears, sleep difficulties (insomnia) cold sweats, chills, severe muscle and bone aches nausea and vomiting, diarrhea |
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What is Psychological Dependence?
Addiction can in theory be derived from any _______ behaviour. Which system is addiction strongly associated with? |
dependency of the mind, and leads to psychological withdrawal symptoms (such as cravings, irritability, insomnia, depression, anorexia etc)
Addiction can in theory be derived from any rewarding behaviour, and is believed to be strongly associated with the DOPAMINERGIC system of the brain's reward system (as in the case of cocaine and amphetamines). |
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What is the Reward Pathway? - how is it activated?
What are the 3 major structures? What is the major NT? |
Activated by ‘rewarding stimulus’
Major structures: the ventral tegmental area (VTA), the nucleus accumbens, and the prefrontal cortex (dopamine pathway) Major neurotransmitters: dopamine |
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What is addiction?
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compulsive behavior, even when faced with negative consequences
behavior is reinforcing, or rewarding major feature of addiction is the loss of control in limiting intake of the addictive substance reward pathway may be even more important in the craving associated with addiction, compared to the reward itself |
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Compare 'tolerance', 'addiction' and 'physical dependence'.
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Tolerance is the body's physical adaptation to a drug: greater amounts of the drug are required over time to achieve the initial effect as the body "gets used to" and adapts to the intake.
Addiction is a primary, chronic, neurobiologic disease, with genetic, psychosocial, and environmental factors influencing its development and manifestations. It is characterized by behaviors that include one or more of the following: impaired control over drug use, compulsive use, continued use despite harm, and craving. Physical dependence is a state of adaptation that is manifested by a drug class specific withdrawal syndrome that can be produced by abrupt cessation, rapid dose reduction, decreasing blood level of the drug, and/or administration of an antagonist |
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Drug Rehabilitation - umbrella term - what does it include?
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includes processes of medical and/or psychotherapeutic treatment, for dependency on psychoactive substances such as alcohol, prescription drugs, and so-called street drugs such as cocaine, heroin or amphetamines.
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What does drug rehab address within the nature of drug dependency? (2)
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address twofold nature of drug dependency: physical and psychological dependency
Physical dependency involves a detoxification process to cope with withdrawal symptoms from regular use of a drug Psychological dependency attempts to teach the patient new methods of interacting in a drug-free environment |
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What medication is given as treatment for addiction to heroin + is an opiate receptor agonist?
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Methadone
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What medication is given as treatment for addiction to heroin and alcohol + is an opiate receptor antagonist?
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Naloxone
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What medication is given as treatment for addiction to heroin + is an mixed opiate receptor agonist and antagonist?
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Buprenorphine
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Methadone (Dolophine) - what is it used for?
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Synthetic opioid that binds with opiate receptors in the CNS, altering perception or and emotional response to pain
Used for relief of moderate to severe pain and for detoxification of opioid addicts Oral dosing stabilizes and reduces withdrawal symptoms |
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Rehab: Psychology (4 parts of the rehab)
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Reduced association with friends who use substance
Twelve step programs, examine change, habits associated with addiction Emphasis on permanent recovery process Emphasis on complete abstention, rather than moderation |
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What are 5 types of rehab?
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Residential treatment (in patient)
Outpatient Support groups Pharmacotherapies Counselling |
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What is harm reduction?
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main objective of harm reduction is to mitigate the potential dangers and health risks associated with the risky behaviours themselves
another objective of harm reduction is to reduce harm associated with, or caused by, the legal circumstances under which the behaviours are carried out |
