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PSY12 Addiction

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1Assessable Tasks
By the end of this lecture you will be able to:
• Describe the epidemiology and differences between recreational drug use and the diagnosis of addiction
• Describe the underlying mechanisms and site of action for commonly used recreational drugs
• Identify their main wanted/unwanted effects

[blank_start]OK[blank_end]
1. AOK
2Drugs ordered by overall harm scores and weights after normalisation (0–100) (Lancet, 2010)
1. [blank_start]Alcohol[blank_end] - 72/100
2. [blank_start]Heroin[blank_end] - 55/100
3. [blank_start]Crack Cocaine[blank_end] (smoked) - 54/100
4. [blank_start]Meth[blank_end] - 33/100
5. Cocaine - 27/100
6. Tobacco - 26/100

also cannabis - [blank_start]20[blank_end]/100, benzodiazepiones - [blank_start]15[blank_end]/100, methadone - [blank_start]14[blank_end]/100
1. AAlcohol
2. BHeroin
3. CCrack Cocaine
4. DMeth
5. E20
6. F15
7. G14
3DSM-5 Criteria for Substance Use Disorders:
The 11 criteria for substance use disorder are divided into four categories of behaviour related to the substance use:
1. impaired [blank_start]control[blank_end]
2. [blank_start]social[blank_end] impairment
3. [blank_start]risky[blank_end] use
4. pharmacological indicators ([blank_start]tolerance and withdrawal[blank_end]).
The severity of the substance use disorder is determined by the number of criteria the person meets:
Mild - [blank_start]2 or 3[blank_end] criteria
Moderate: [blank_start]4 or 5[blank_end] criteria
Severe: [blank_start]6[blank_end] or more criteria
Within the last 12-month period,
1. Acontrol
2. Bsocial
3. Crisky
4. Dtolerance and withdrawal
5. E2 or 3
6. F4 or 5
7. G6
4Probability of dependence when you have tried a drug once
[blank_start]Tobacco[blank_end] - 32%
[blank_start]Heroin[blank_end] - 23%
[blank_start]Cocaine[blank_end] - 17%
[blank_start]Alcohol[blank_end] - 15%
Stimulants - 11%
Anxiolytics and Cannabis - 9%
[blank_start]Analgesics[blank_end] - 8%
1. ATobacco
2. BHeroin
3. CCocaine
4. DAlcohol
5. EAnalgesics
5Speed of drug entry into brain dictates the intensity of the ‘high’.
1. AVerdadeiro
2. BFalso
6Tolerance
• Can and often occurs in the absence of [blank_start]dependence[blank_end] – reduced response after repeated administration
• Usually due to receptor/[blank_start]second messenger[blank_end] desensitization and [blank_start]down[blank_end]-regulation
• [blank_start]Cross-tolerance[blank_end] – repeated use of a drug in a given category confers tolerance to the drug being used AND others within the same pharmacological category.
• Metabolic or [blank_start]pharmacokinetic tolerance[blank_end] - increased metabolism requires increasing doses to produce the same pharmacological effect.
• [blank_start]Pharmacodynamic tolerance[blank_end] – increasing doses required to produce the same effect (learned behaviour)
1. Adependence
2. Bsecond messenger
3. Cdown
4. DCross-tolerance
5. Epharmacokinetic tolerance
6. FPharmacodynamic tolerance
7Neurocircuitry of impulsive-compulsive behaviuor:
• Associated with [blank_start]anticipation of the reward[blank_end] associated with drug, noy reward of drug
• Impulsivity and compulsivity are hypothetically drives that are “[blank_start]bottom[blank_end]-up,” ie controlled by suppression of higher drives.
1 - impulsivity comes from the [blank_start]ventral striatum[blank_end] (NAc)
2 - compulsivity comes from the [blank_start]dorsal striatum[blank_end]
3 - different areas of [blank_start]prefrontal cortex[blank_end] act “[blank_start]top[blank_end]-down” to suppress these drives.
1. Aanticipation of the reward
2. Bbottom
3. Ctop
4. Dventral striatum
5. Edorsal striatum
6. Fprefrontal cortex
8Addiction - shifts from [blank_start]impulsive to a compulsive[blank_end] drive, that comes with migration from [blank_start]ventral[blank_end] to [blank_start]dorsal[blank_end] circuitry. With chronic drug use, compulsivity develops, as the drive changes from [blank_start]seeking pleasure[blank_end] (impulsive) to seeking r[blank_start]elief from the withdrawal symptoms[blank_end] (compulsory) and anticipation of obtaining/consuming the drug.
1. Aimpulsive to a compulsive
2. Bventral
3. Cdorsal
4. Dseeking pleasure
5. Eelief from the withdrawal symptoms
9Choose the incorrect statement.
1. APsychotropics bypass neurotransmitters and directly stimulate receptors causing DA release and the high.
2. BWithdrawal of CNS depressants usually involves neuronal hypo-excitability with varying degrees of severity – anxiety, possible hallucinations, seizures etc.
3. CWithdrawal of CNS depressants causes significant activation of the autonomic nervous system: sweats, tremors, GI disturbances
4. DInhibition of the mesolimbic DA release commonly occurs in withdrawal
10Which of these is not a CNS stimulant/depressant?
1. ANicotine
2. BMethamphetamine
3. CCocaine
4. DCaffeine
5. EAlcohol
6. FBenzos
7. GOpioids
8. HCannabis
9. IHeroin

11Effects of Alcohol on reward:
Alcohol either acts directly upon µ [blank_start]receptors[blank_end] or releases endogenous opiates such as [blank_start]encephalin and endocannabinoids[blank_end].
It causes increased [blank_start]DA[blank_end] release in [blank_start]NAc[blank_end]. Reinforcing effects also theoretically mediated by enhancing [blank_start]GABA[blank_end] inhibition and reducing [blank_start]GLU[blank_end] excitation.

Factors Associated With Alcoholism
• Environmental Factors
1. family or peer [blank_start]group[blank_end] behavior
2. availability of other reinforcers (e.g. recreational resources)
3. job/educational opportunities
4. conditioned stimuli ([blank_start]environmental cues[blank_end] paired with drug use)
5. [blank_start]Cost/ease of availability[blank_end] of alcohol
• Host Factors - Genes:
1. + and - for alcohol (reduced gene expression for alcohol dehydrogenase reduced
sensitivity to alcohol phenotype in alcoholics);
2. Antisocial or [blank_start]anxious[blank_end] traits; risk-taking
3. Prior experience/expectations

Tx: Naltrexone on the [blank_start]VTA[blank_end] reduces reward.
Naltrexone - µ [blank_start]opiate antagonist[blank_end]: blocks [blank_start]pleasurable[blank_end] effects of alcohol, decreases cravings. [blank_start]Long acting benzodiazepines[blank_end] used to mediate ‘withdrawal’ over a few weeks to prevent symptoms like life threatening seizures.
1. Areceptors
2. Bencephalin and endocannabinoids
3. CDA
4. DNAc
5. EGABA
6. FGLU
7. Ggroup
8. Henvironmental cues
9. ICost/ease of availability
10. Janxious
11. KVTA
12. Lopiate antagonist
13. Mpleasurable
14. NLong acting benzodiazepines
12Cannabis - THC and cannabidiol
• ‘normal’ dose - sense of well-being, relaxation, friendliness, loss of [blank_start]temporal[blank_end] awareness, slows [blank_start]thought[blank_end] processes, impairs [blank_start]short[blank_end]-term memory
• ‘high’ doses - can induce [blank_start]panic, toxic delirium[blank_end] and rarely [blank_start]psychosis[blank_end]
• “[blank_start]amotivational syndrome[blank_end]” in frequent/heavy users characterized by the emergence of decreased drive and ambition, thus “amotivational.”
Cannabidiol = [blank_start]allosteric[blank_end] negative modulator of [blank_start]CB1 and CB2[blank_end], potentially used to treat addiction, anxiety, psychosis and epilepsy
1. Atemporal
2. Bthought
3. Cshort
4. Dpanic, toxic delirium
5. Epsychosis
6. Famotivational syndrome
7. Gallosteric
8. HCB1 and CB2
13Cannabinoids in the mesolimbic pathway:
• [blank_start]GABAergic[blank_end] interneuron feedback projections provide tonic [blank_start]inhibition[blank_end] of [blank_start]VTA dopaminergic[blank_end] neurons
• [blank_start]CB1[blank_end] receptors mediate marijuana’s reinforcing properties

Opioids in the mesolimbic pathway:
Act on [blank_start]opioid neurons[blank_end] which arise in the [blank_start]arcuate nucleus[blank_end] and project to the [blank_start]VTA and NAc[blank_end]. Opioids bypass the enkephalins and [blank_start]directly[blank_end] stimulate receptors causing [blank_start]DA[blank_end] release = high.

Nicotine & dopamine release:
Nicotine - full agonist at α4,β2 [blank_start]nicotinic[blank_end] receptors on [blank_start]DA neurons in the VTA[blank_end] – cause prolonged channel [blank_start]opening[blank_end] until desensitization → prolonged burst of action potentials and consequently [blank_start]prolonged DA release[blank_end]
1. AGABAergic
2. Binhibition
3. CVTA dopaminergic
4. DCB1
5. Eopioid neurons
6. Farcuate nucleus
7. GVTA and NAc
8. Hdirectly
9. IDA
10. Jnicotinic
11. KDA neurons in the VTA
12. Lopening
13. Mprolonged DA release
14The ‘amphetamines’
• Increase [blank_start]synaptic[blank_end] conc. of DA, by"
• inducing release of newly synthesized [blank_start]stores of intraneuronal DA[blank_end]
• and inhibiting NA, 5-HT and DA [blank_start]reuptake transporters[blank_end] and VMAT
• [blank_start]Methylphenidate[blank_end] is an uptake inhibitor only
• Methamphetamine - similar to cocaine but [blank_start]longer[blank_end] lasting effects with less euphoria, associated with [blank_start]schizophrenia[blank_end]-like psychosis
• Ecstasy - [blank_start]serotonergic[blank_end], dependence rare/debatable
1. Asynaptic
2. Bstores of intraneuronal DA
3. Creuptake transporters
4. DMethylphenidate
5. Elonger
6. Fschizophrenia
7. Gserotonergic
15The amphetamines ‘undesirable effects’
- change in [blank_start]structure and function[blank_end] of the human brain
- ability to cause [blank_start]cerebral and/or myocardial[blank_end] infarcts ([blank_start]dead[blank_end] tissue from oxygen deprivation)

Overdose treatment is with non-selective or [blank_start]Ca2+[blank_end] or ß-blockers, [blank_start]diazepam[blank_end] for seizures
1. Astructure and function
2. Bcerebral and/or myocardial
3. Cdead
4. Ddiazepam
5. ECa2+

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Descrição: O usuário eliminou as informações de disciplina Quiz sobre PSY12 Addiction, criado por Usuário eliminado em 14-10-2019.
Autor: Usuário eliminado
Idioma: English
Visualizações: 49
Histórico: Criado em 14 out 2019 · atualizado em 14 out 2019
Etiquetas: o usuário eliminou as informações de disciplina
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PSY12 Addiction

Perguntas do quiz (15)

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