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57 Cards in this Set

  • Front
  • Back
What are 3 types of tolerance?
What is behavioral tolerance?
Learning how to handle being drunk
What is pharmacokinetic tolerance?
Faster metabolism
What is cellular tolerance?
Less effect on neurons
If it is pleasurable, the final common pathway of the drug usually involves _________
What pathways involve dopamine?
Pleasure and reward
What is the important brain center that sends impulses to activate the reward center?
The nucleus accumbens
How do drugs stimulate reward feelings?
By binding to dopamine receptors and preventing uptake of dopamine from the synapse.
What happens as a result of the body relying on drugs to maintain rewarding feelings?
The person can't feel positive reinforcement or pleasurable feelings of natural rewards.
What are the normal natural rewards?
food sex excitement and comfort
What are the important areas of the brain in reward pathways?
-Prefrontal cortex
-Nucleus accumbens
-Ventral tegmental area
How do addictive drugs activate the reward system in the brain?
By increasing dopamine transmission
What happens to rewarding behaviors with time?
They become conditioned and routine and controlled subconsciously.
Why are rewarding behaviors difficult to stop?
-Because patients aren't always aware of when they're initiated
-They're resistant to change
What are the 3 C's of addiction?
How does Alcohol dependence lead to violence?
It disinhibits aggressivity
How do Stimulants lead to violence?
By producing dose-dependent paranoia
What about opiates does/does not lead to violence?
Opiate seeking does lead to violence - but not the opiates themselves.
What long term effect does cocaine have on the brain?
It drastically reduces glucose utilization - metabolic activity - in the brain
Does a cocaine user's brain return to normal 100 days after stopping use?
No; there may be a little imporvement in brain activity, but not much.
What happens to the brain 2 weeks after people take ecstasy?
Serotonin is depleted and its uptake receptors on post synaptic neurons are reduced.
What changes can be seen in the brain 7 years after ecstasy use?
The serotonergic terminals may have regenerated somewhat, but their pattern of regrowth is sideways instead of normal.
What comorbid illnesses are seen at a much higher rate in female addicts?
Depression and PTSD
What are some risk factors for addiction?
-Young age of onset
-Childhood trauma
-Learning disorders
-Mental illness
What are 3 mental illnesses that are common risk factors for developing an addiction?
How are Social and Environmental factors mostly related to addictions?
They influence the initial use
How do we know social factors play a role in drug use?
Because there have clearly been epidemics
When was the marijuana epidemic?
When was the cocaine epidemic?
When was the crack epidemic?
Why aren't social factors as much of a component for continued use and substance dependence?
This becomes more dependent on individual vulnerability and psychopathology.
How is Biologic reinforcement a risk factor for substance dependence?
Depending on how good the drug makes one feel
What addictive drugs are NOT self-administered by rats?
How does Learning and Conditioning play a role in substance addiction?
By positively reinforcing the behavior - either physiologically or socially
For what 3 drugs is positive reinforcement especially important?
What is Operant conditioning?
Powerfully reinforced habit patterns - like when paraphernalia cues substance use
What is Classical conditioning?
Craving and euphoric recall when placed in a using setting
How does Negative reinforcement play a role in addiction?
By alleviating/removing a negative condition the behavior is reinforced.
For what drug addiction is Negative reinforcement a powerful etiologic factor?
What sex has a 4X higher incidence of alcoholism?
What are 4 psychodynamic and psychopathologic factors that are etiologic factors of addiction?
-Affective dysregulation
-Impulse control deficits
-Ego defects
-Family dynamics
Why do impulse control deficits may patients more susceptible to addictions?
Because they're more reliant on the reward
What family dynamics lend to developing an addiction?
-Multigenerational dependence
-Loss of parents
-Overprotective parents
-Cold/distant father
What drug usually causes positive reinforcement?
Which drug usually causes negative reinforcement?
How many americans need treatment for alcohol and/or other drug abuse in any year?
13-16 million
How many receive that care?
3 million
Is it illegal to be a drunk?
Is it illegal to injure a fetus by drinking?
Is it illegal to neglect children by drinking?
Is addiction a disability according to SSA?
According to Prochaska and DiClemente what are the 5 stages of change in addictive behavior?
1. Precontemplation
2. Contemplation
3. Determination
4. Action
5. Maintenance/Relapse
What type of therapy is their approach?
Motivational enhancement therapy
How is Motivational Enhancement therapy done?
By recognizing the patient's current stage, optimizing conditions to enhance the patient's efforts, and supporting intrinsic motivation.
What are the 5 motivational principles for motivational enhancement therapy?
1. Express empathy
2. Develop discrepancy
3. Avoid argumentation
4. Roll with resistance
5. Support self-efficacy
What is the model used most by residential centers?
12-step approach
What does the 12-step approach entail?
-Confrontation initially to break denial
-Emphasis on change and personal responsibility
-CONSEQUENCES for actions