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57 Cards in this Set
- Front
- Back
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What are 3 types of tolerance?
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-Behavioral
-Pharmacokinetic -Cellular |
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What is behavioral tolerance?
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Learning how to handle being drunk
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What is pharmacokinetic tolerance?
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Faster metabolism
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What is cellular tolerance?
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Less effect on neurons
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If it is pleasurable, the final common pathway of the drug usually involves _________
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Dopamine
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What pathways involve dopamine?
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Pleasure and reward
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What is the important brain center that sends impulses to activate the reward center?
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The nucleus accumbens
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How do drugs stimulate reward feelings?
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By binding to dopamine receptors and preventing uptake of dopamine from the synapse.
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What happens as a result of the body relying on drugs to maintain rewarding feelings?
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The person can't feel positive reinforcement or pleasurable feelings of natural rewards.
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What are the normal natural rewards?
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food sex excitement and comfort
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What are the important areas of the brain in reward pathways?
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-Prefrontal cortex
-Nucleus accumbens -Ventral tegmental area |
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How do addictive drugs activate the reward system in the brain?
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By increasing dopamine transmission
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What happens to rewarding behaviors with time?
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They become conditioned and routine and controlled subconsciously.
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Why are rewarding behaviors difficult to stop?
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-Because patients aren't always aware of when they're initiated
-They're resistant to change |
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What are the 3 C's of addiction?
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Control
Compulsion Chronicity |
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How does Alcohol dependence lead to violence?
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It disinhibits aggressivity
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How do Stimulants lead to violence?
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By producing dose-dependent paranoia
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What about opiates does/does not lead to violence?
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Opiate seeking does lead to violence - but not the opiates themselves.
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What long term effect does cocaine have on the brain?
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It drastically reduces glucose utilization - metabolic activity - in the brain
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Does a cocaine user's brain return to normal 100 days after stopping use?
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No; there may be a little imporvement in brain activity, but not much.
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What happens to the brain 2 weeks after people take ecstasy?
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Serotonin is depleted and its uptake receptors on post synaptic neurons are reduced.
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What changes can be seen in the brain 7 years after ecstasy use?
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The serotonergic terminals may have regenerated somewhat, but their pattern of regrowth is sideways instead of normal.
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What comorbid illnesses are seen at a much higher rate in female addicts?
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Depression and PTSD
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What are some risk factors for addiction?
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-Genetics
-Young age of onset -Childhood trauma -Learning disorders -Mental illness |
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What are 3 mental illnesses that are common risk factors for developing an addiction?
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-Bipolar
-Depression -Psychosis |
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How are Social and Environmental factors mostly related to addictions?
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They influence the initial use
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How do we know social factors play a role in drug use?
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Because there have clearly been epidemics
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When was the marijuana epidemic?
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1970s
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When was the cocaine epidemic?
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1980s
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When was the crack epidemic?
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1990s
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Why aren't social factors as much of a component for continued use and substance dependence?
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This becomes more dependent on individual vulnerability and psychopathology.
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How is Biologic reinforcement a risk factor for substance dependence?
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Depending on how good the drug makes one feel
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What addictive drugs are NOT self-administered by rats?
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-LSD
-marijuana |
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How does Learning and Conditioning play a role in substance addiction?
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By positively reinforcing the behavior - either physiologically or socially
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For what 3 drugs is positive reinforcement especially important?
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-Opiates
-Cocaine -Amphetamine |
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What is Operant conditioning?
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Powerfully reinforced habit patterns - like when paraphernalia cues substance use
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What is Classical conditioning?
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Craving and euphoric recall when placed in a using setting
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How does Negative reinforcement play a role in addiction?
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By alleviating/removing a negative condition the behavior is reinforced.
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For what drug addiction is Negative reinforcement a powerful etiologic factor?
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Benzodiazepines
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What sex has a 4X higher incidence of alcoholism?
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Men
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What are 4 psychodynamic and psychopathologic factors that are etiologic factors of addiction?
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-Affective dysregulation
-Impulse control deficits -Ego defects -Family dynamics |
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Why do impulse control deficits may patients more susceptible to addictions?
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Because they're more reliant on the reward
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What family dynamics lend to developing an addiction?
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-Codependence
-Enabling -Multigenerational dependence -Loss of parents -Overprotective parents -Cold/distant father |
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What drug usually causes positive reinforcement?
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Cocaine
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Which drug usually causes negative reinforcement?
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Opiates
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How many americans need treatment for alcohol and/or other drug abuse in any year?
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13-16 million
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How many receive that care?
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3 million
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Is it illegal to be a drunk?
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no
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Is it illegal to injure a fetus by drinking?
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yes
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Is it illegal to neglect children by drinking?
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yes
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Is addiction a disability according to SSA?
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no
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According to Prochaska and DiClemente what are the 5 stages of change in addictive behavior?
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1. Precontemplation
2. Contemplation 3. Determination 4. Action 5. Maintenance/Relapse |
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What type of therapy is their approach?
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Motivational enhancement therapy
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How is Motivational Enhancement therapy done?
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By recognizing the patient's current stage, optimizing conditions to enhance the patient's efforts, and supporting intrinsic motivation.
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What are the 5 motivational principles for motivational enhancement therapy?
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1. Express empathy
2. Develop discrepancy 3. Avoid argumentation 4. Roll with resistance 5. Support self-efficacy |
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What is the model used most by residential centers?
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12-step approach
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What does the 12-step approach entail?
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-Confrontation initially to break denial
-Emphasis on change and personal responsibility -CONSEQUENCES for actions |
