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59 Cards in this Set
- Front
- Back
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What is the biological explanation for substance misuse?
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The biochemical explanation for substance misuse is called the 'reward deficiency syndrome' which focuses on a deficiency in the dopamine system. Some individuals have a defective D2 dopamine receptor and lack dopamine receptors in the brains to produce pleasure naturally.
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What is it about a lack of dopamine receptors that results in a person self-medicating?
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The dopamine system is responsible for pleasure and positive emotions. Those suffering from reward deficiency syndrome are unable to produce a feeling of well-being and consequently often self medicate with substances that help raise the levels of 'feel good' chemicals in their system. These substances often include alcohol, nicotine, illegal drugs, etc. and thrill-seeking behaviours such as gambling, sex and internet pornography.
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How do most drugs work according to the biological explanation for substance misuse?
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Most drugs work by increasing the levels of dopamine present in the brain. For example, heroin works by slowing down the re-uptake of neurotransmitters so that dopamine messages stay active for longer, meaning the individual experiences pleasure from the drug. Without heroin, the levels of dopamine are too low for normal functioning and therefore more drugs are taken to restore levels of dopamine.
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According to the biological explanation for substance misuse, what does tolerance of drugs lead to?
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Tolerance leads to the need for increasing dose sizes to achieve the same effect. The drug causes either a reduction in the number of receptor sites or a reduction in the sensitivity of the drug. Therefore, more drugs are needed.
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Is there supporting evidence for the biological explanation for substance misuse?
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The existence of withdrawal symptoms in opoid users supports the biological approach as it demonstrates that the brain has become reliant on the drug to function normally. There is also a positive correlation between heavy use of drugs such as heroin and mental illnesses suggesting that drugs are causing biochemical changes in the brain. Furthermore, there is a growing body of genetic evidence suggesting that some people have a predisposition to drug misuse.
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How is the biological explanation for substance misuse reductionist and how may this have practical applications to society?
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It is mainly a reductionist approach as it is focusing on one explanation such as biochemistry and ignoring other explanations for drug use such as for social and cultural reasons. However, an advantage of this is that by focusing on just the action neurotransmitters, useful applications may be discovered which can change the biochemistry of the brain and ensuring the user does not need the drug, such as the development of methadone to treat heroin.
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Is there any refuting evidence for the biological explanation for substance misuse?
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They are not as successful as some other psychological approaches in explaining psychological dependence. For example, the learning approach can explain why coping without a drug is very distressing. Furthermore, it explains why people take the drug in the first place.
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What do learning explanations for substance misuse argue?
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Learning explanations argue that addiction is a behaviour, rather than a disease. It is possible to use operant conditioning to explain substance misuse, especially the concepts of positive and negative reinforcement for drugs.
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How is positive reinforcement linked to substance misuse?
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Drugs such as heroin that are injected or smoked pass very quickly into the brain and therefore almost have an instant effect - immediate positive reinforcement. It is particularly powerful as the user is learning the association between the drug taking behaviour and the positively reinforcing experiences of desired feelings.
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How can positive reinforcement explain why a user can be addicted to a drug even if they are aware of the unpleasant side effects?
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The risks of a damaged health after being addicted to drugs is long term, whereas the effects of positive reinforcement after the desired feelings are short term. Therefore, a heroin user is more powerfully affected by the immediate rewards that by the delayed consequences of withdrawal, imprisonment, or even death.
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How can negative reinforcement be used to explain substance misuse?
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Dependent users may be negatively reinforced to continue using the drug in order to avoid the unpleasant withdrawal symptoms such as nausea, anxiety and depression.
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Is there any supporting evidence for the learning explanation for substance misuse?
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Learning explanations such as operant conditioning are backed by many lab animal experiments which demonstrate that drugs do act as reinforcers. For example, rats in a Skinner box will learn to self-administer drugs.
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Is there any refuting evidence for the learning explanation for substance misuse?
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Findings from the biological approach refute the learning approach as it does not successfully explain the physical dependence on a drug as this needs an understanding of how neurotransmitters function.
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How is the learning explanation for substance misuse reductionist?
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The learning approach largely ignores cognitive processes and therefore cannot explain why some people would choose not to participate in drug use and importantly, cannot explain the concept of will power when a drug user choose to cease taking a drug.
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What is the aim of the Blattler et al's (2002) study?
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The aim of the study was to investigate the success of giving maintenance doses of heroin to heroin users who also use cocaine, in order to see the effects of the heroin maintenance programme on their cocaine use.
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What did Blattler's sample consist of?
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The main sample consisted of 266 patients (98 female and 168 male) who had all been using heroin for 18 months or more. They were all aged at least 20 years (mean age was 30 years), had made at least two unsuccessful attempts to treat their addiction and had given their informed consent. Potential participants were excluded if they were found to be dealing drugs. The study followed the group of heroin users in a naturalistic setting through at least 18 months on a treatment programme in six different clinics in Switzerland.
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What happened to the participants in Blattler's study?
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The participants were given maintenance foses of narcotics (all received heroin although some received methadone or morphine) and were supplied a mean dosage of 479mg daily, and this was self-injected under supervision. Participants were interviewed at intake and every six months, and urine tests for drug use were conducted on entry to the programme and randomly without warning. Participants were also required to attend psychosocial therapy, such as counselling and receive health care. They were also tested regularly for hepatitis and HIV.
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What were the main results of Blattler's study?
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When the programme first started, 84% of the participants reported using cocaine but by the end of the study, the number of cocaine users taking cocaine had dropped by more than 80%. Since the price of cocaine was stable throughout, the reduction in cocaine use was likely due to the programme rather than the drug availability. However, the programme had not worked for everyone, as 15 participants had increased the amount of cocaine used. The correlation between self-reported cocaine use and level found by urine was 0.66 and then 0.82 meaning participants had become more honest as the programme had progressed.
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How did Blattler conclude the study?
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It was concluded that heroin maintenance in a high monitoring situation does help to reduce cocaine use. It was also discovered that as cocaine use went down so did contact with the drug scene, sex industry and illegal income.
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What was the aim of Ennet et al's (1994) study?
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The aim of the study was to investigate the role of friendship groups and cliques in the smoking behaviour of adolescents.
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What did the main sample consist of in Ennet's study?
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The participants were students in the ninth grade (aged 14-15) in one area of the USA from 5 different schools. There were 1092 participants and they were interviewed twice in their own homes about their smoking behaviour. Data was collected using questionnaires.
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What were the participants asked in Ennet's study?
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The adolescents were asked to identify their 3 best friends and the data generated was weighted for whether friendships were one-way or two-way, with those identified as two-way (where both sides identified each other as friends) given greater weighting. The researchers also asked whether they smoked and this was cross checked by checking for carbon monoxide in their lungs.
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Which types of participants were discarded from Ennet's study?
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Friendships outside of school were discarded for practical reasons as was data from those adolescents who were not identified as clique members. Seven mixed-sex and eight mixed-race cliques were not analysed as these were said to be not typical of adolescent cliques. This left data from 42% of the original sample. A total of 87 cliques were available for analysis.
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What were the main results of Ennet's study?
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Of the 461 participants, 414 were non-smokers and 59 cliques were totally non-smoking. Just two cliques contained only smokers. The smoking rate among clique members at 11.1% was less than the 15.2% found overall in the school. There was a higher incidence of smoking in those who did not belong to a clique. Cliques rated as homogeneous (more similar to each other) were either all smokers or all non-smokers and the heterogeneous cliques included both types.
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How did Ennet conclude the study?
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The researchers concluded that the membership of cliques may contribute more to non smoking than to smoking, which differs from the common assumption that smoking is a consequence of peer group affiliation.
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What is heroin?
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Heroin (diamorphine hydrochloride) is an opiate (drugs derived from the opium poppy) and is a chemically altered form of morphine. Morphine is a powerful analgesisc and heroin is three times more powerful. The receptors to which opiates attach exist to receive input from endogenous (naturally occurring) opoids called endorphins. The key role of endorphins is to reduce the experience of pain and to provide positive reinforcement.
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What is the mode of action for heroin?
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Heroin acts by stimulating opoid receptors and mimics effects of endorphins. Heroin causes an increase in the amount of dopamine in the synapses. This massive release of endorphin activates the reward system and produces feelings of well being. One area of the brain where this action takes place is the nucleus accumbens.
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What are the effects of heroin?
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Heroin produces feelings of euphoria and the analgesic effect gives a feeling of calm and aches and pains will disappear. As heroin depresses most of the body's activity, breathing becomes slower and shallower, heart rate slows and the user feels sleepy and relaxed. The slowing of breathing is often responsible for deaths from overdosing.
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How can a person become tolerant of heroin?
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Because heroin swamps the brain with large amounts of the simulated neurotransmitters, a process called down regulation causes neurones to adapt their normal working state to function with high levels of the chemicals produced by taking heroin, and so they become less sensitive. More drug is therefore needed to have the same effect as previous encounters, and therefore the user has to up the frequency and/or amount of drug used to get the same hit.
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What happens when a person becomes dependent on heroin?
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Physical dependency develops very quickly and the user soon develops more severe withdrawal symptoms. Heroin becomes necessary for normal functioning as the neurones no longer fire when only the naturally occurring neurotransmitters are present as they have adapted to the high levels produced by the drug. The heroin user is driven to reproduce feelings of satisfaction and avoid discomfort associated with withdrawal. This can lead to being less concerned with maintaining contact with family and friends as their focus of life becomes finding the next fix.
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What are the withdrawal symptoms of heroin?
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Withdrawal symptoms start 6-12 hours after the last fix and symptoms peak after 26-72 hours. Most symptoms are over in a week. The first withdrawal symptoms are often feeling agitated and aggressive and the user alternates between feeling hot and cold (cold turkey). Breathing often becomes short and jerky and the user will wake up to cramps, vomiting, sweating, etc.
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What is methadone?
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Methadone is an opiate, like heroin or morphine but it cannot be injected so must be taken orally. It is a synthetic opiate which replaces heroin at the synapses and therefore reduces withdrawal symptoms of heroin users becase it occupies the user's opiate receptors.
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Why is methadone less dangerous than heroin?
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Because it is given orally rather than injected it is less dangerous than heroin. Methadone also lasts longer than heroin and therefore one daily dose can avoid the fluctuations experienced with heroin.
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How does a heroin addict receive methadone?
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After assessment which would include determining the level of methadone needed, the addict must visit a pharmacy/clinic to be given the required dose under supervision. They are allowed to take some advance doses home to self administer when the patient is deemed trustworthy.
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What happens when the treatment of methadone has stabilised?
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Once the treatment has stabilised, a process of detoxification is started. This involves slowly decreasing the amount of methadone needed, enabling the addict to cope with reduced intake without experiencing withdrawal.
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Is there any supporting evidence for methadone as a treatment for heroin dependence?
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Blattler demonstrated that drug treatment programmes can be used to reduce the use of cocaine. Similarly, Wodak reviewed studies for the use of methadone for heroin addiction and found that individuals tended to stay on the treatment more than if they were on other treatments.
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How is being treated with methadone effective?
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It enables the addict to break links with drug dealers and other drug users. Studies have also demonstrated that methadone maintenance programmes are successful in reducing crime and the spread of HIV. Furthermore, overdosing on methadone is much harder than doing so on other sources of opiates because it is swallowed and there is no risk of infection, such as catching hepatitis through dirty needles.
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Why is methadone ineffective?
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However, methadone treatment can be very time consuming as many patients need treatment for at least 2 years and this is costly. Also, not all addicts try to give up methadone completely. Once stable they continue to access methadone programmes and therefore may become addicted to the methadone.
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Overall, is methadone effective on its own?
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Studies suggest that methadone programmes are most successful when other psychosocial help is given, such as social support and encouraging the avoidance of people and places linked with their addiction.
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What is the mode of action for alcohol?
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Alcohol affects the function of neurotransmitters (a chemical released by nerve cells to send signals to other nerve cells), such as GABA and dopamine. Alcohol depresses activity in the brain by making GABA more effective, slowing down the speed with which messages are transmitted between neurones. GABA is an inhibitory neurotransmitter. It makes it more difficult for messages to be transmitted.
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What things are affected by the slowing down of neural activity, which is caused by alcohol?
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It can lead to a reduction of anxiety but also has a sedating effect on other functions such as moral and cognitive judgement, coordination and movement. Alcohol also triggers the dopamine reward system in some people which is why alcohol consumption is sometimes perceived as a pleasurable activity (fight or flight response).
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What are the main effects of alcohol?
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Low levels of alcohol can dilate skin blood vessels making the user feel warm and look flushed. Reactions slow down and at higher levels of alcohol, perception and speech are impaired. Reduced effectiveness of the inhibitory mechanism leads to initially, relaxed confident behaviour but can develop to exhibitionism and extreme behaviour.
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How do people become tolerant of alcohol?
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Because alcohol acts as a depressant, supressing the activity of cells in the brain, a process of upregulation kicks in to try and compensate for the presence of alcohol and return the brain to its normal working state. Alcohol consumption stimulates the body to produce an enzyme that breaks alcohol down more quickly and therefore the drinker will need to consume about 50% more to achieve the same effect.
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What are the effects of physical dependency on alcohol?
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It often leads to the alcoholic wanting to start drinking early in the day as they have withdrawal symptoms. The first drink usually alleviates the symptoms therefore increasing dependence. Alcoholics find it difficult to restrict their alcohol use as the need is constant.
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What are the effects of psychological dependency on alcohol?
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It is demonstrated by relief at finding a drink. Gaining alcohol is prioritised over other activities such as socialising, eating and hygiene. The user will be less concerned about personal issues and therefore may use the drug to cope with their problems.
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What are the main withdrawal symptoms of alcohol?
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Withdrawal symptoms often appear 8-12 hours after the last drink but this can take as long as a week. The symptoms include uncontrollable shakes, cramp, nausea, sweating, irregular heartbeat and vivid dreaming. Symptoms can last up to 48 hours. In people with a heavy addiction the effects of withdrawal are known as delirium tremens (high levels of activity in the brain). Unreated withdrawal is fatal in about a third of cases and even with early treatment about 5% of patients are likely to die.
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What can be used as a treatment for alcohol abuse?
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Aversion therapy is a form of behaviour therapy which can be used to eliminate or reduce alcohol misuse. An aversive (causing a strong feeling of dislike or disgust) is paired with alcohol to reduce this undesirable behaviour. The emetic drug (disulfiram) induces vomiting so that the patient associates alcohol with vomiting and it becomes a conditioned response.
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What is the 'Talk to FRANK' campaign?
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FRANK is a national drug education service jointly established by the Department of Health and Home Office in 2003. It is intended to reduce the use of both legal and illegal drugs by providing targeted and accurate informaion on drugs and alcohol, particularly to young people and their parents.
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Which types of services does FRANK provide?
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It is promoted through the televisiomn, radio and the internet but it also provides services for people who seek advice about drugs. This includes a website, a confidential telephone number, email, a confidential automated 'talk to FRANK' bot, and a service to locate counselling and treatment.
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How does the FRANK campaign attempt to do?
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The campaign attempts to effectively inform people about the dangers of drugs without alienating the users themselves by making drug users look too weak and undesirable. It is made to be accessible and appealing to young people whilst ensuring there are resources available for parents who can back up the messages of the campaign.
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How is information presented honestly in the FRANK campaign?
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The campaign is realistic about the effects of drugs without using fear evoking messages or being too humorous. The name FRANK was chosen as it sounded honest and straight-talking.
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Are there any studies to back up the FRANK campaign?
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The FRANK helpline shows that young people are accessing the campaign, as it receives an average of 2000 calls a day and the website is well used. Furthermore, studies have shown that the logo is well recognised by young people and their parents. In 2008, it was found that 89% of 11-21 year olds recognised the adverts and 82% knew about the website. Those who recognised it were also more likely to believe that drugs are risky compared to those who did not recognise the advert.
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How has the FRANK campaign been criticised?
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It has been argued that early on, the campaign focused too heavily on the harm associated with drugs such as heroin and cocaine, and that this had led to the assumption that cannabis was safe. Furthermore, people may change their health for reasons other than the campaign and therefore we cannot measure its effectiveness.
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What is substance misuse?
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Substance misuse refers to the intake of drugs in a quantity that impairs the physical or mental health of the user.
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What is a synapse?
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A synapse is the gap between two neurones across which a chemical signal is sent. Neurotransmitters are released by the neurone on one side of the synapse and then taken up by the neurone on the other side. It is through this process that messages are passed within the brain.
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What is tolerance?
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Tolerance refers to the state where a drug user often needs increased dosages over time in order to achieve the same effects as they did when first using the drug.
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What is physical dependence?
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Physical dependence refers to the need to keep taking drugs in order to avoid withdrawal symptoms. Continued use of the drug is required for normal functioning.
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What is psychological dependence?
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Psychological dependence refers to the need to keep taking druggs to produce psychological feelings of pleasure and to avoid the manifestation of cravings for the drug.
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What is withdrawal?
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Withdrawal refers to the symptoms produced by the body's response to the reduction, or removal of the drug it has become dependent on.
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