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Addiction is characterized by what? - impulsive drug craving, seeking & use that persists
even in the face of negative consequences.
What parts of the brain are involved in the reward pathway? - the ventral tegmental area
(VTA), nucleus accumbens & pre-frontal cortex.
When activated by a rewarding stimuli, information travels from the VTA to the nucleus
accumbens and then up to the prefrontal cortex.
All drugs that lead to addiction increases: - dopamine in the ventral striatum.
Reinforcement of SUD results in what kind of sensations when a drug is abused? - "feel
good"
What sensations in SUD are experienced when the drug exit the body? - "feel bad"
Social rewards associated with drug use: - disinhibition, euphoric mood and anxiety
reduction.
Negative rewards from drug use are: - increased anxiety, dysphoria.
DA release in the reward center is further enhanced by the release of: - natural
morphine-like neurotransmitters called neuropeptides.
Define abuse: - Self-administration of any drug in a culturally disapproved manner that
cause adverse consequences.
Define Addiction: - A behavioral pattern of drug abuse characterized by overwhelming
involvement with the use of a drug (compulsive use), the securing of it's supply, and a high
tendency to relapse after discontinuation.
Define compulsivity: - Repetitive actions inappropriate to the situation that persist, that
have no obvious relationship to the overall goal, and often result in undesirable consequences,
behavior that results in preservation, in response in the face of adverse consequences.
Cross-tolerance: - The ability of one drug to suppress the manifestations of physical
dependence produced by another drug to maintain the physical dependent state.
,Dependence: - The physiological state of adaption produced by repeated administration
of certain drugs such as alcohol, heroin and benzos when they are abruptly discontinued, and
are associated with physical drug withdrawal distinct from the motivational changes of acute
withdrawal and protracted abstinence which is part of addiction.
Habit: - Responses triggered by environmental stimuli regardless of the current
desirability of the consequences. The condition response to a stimulus has been reinforced and
strengthened either by past experience with reward (positive reinforcement) or by omission of
an adverse event (negative reinforcement).
Impulsivity: - The tendency to act prematurely without foresight; actions which are
poorly conceived, prematurely expressed, unduly risky, or inappropriate to the situation.
Measured in 2 domains: the choice of a small, immediate reward over a larger, delayed reward,
or the inability to inhibit behavior to change the course of action or stop a response once it is
initiated.
Rebound: - The exaggerated expression of the original condition sometimes experiences
by patients immediately after cessation of an effective treatment.
Reinforcement: - The tendency of a pleasure-producing drug to lead to a repeated self-
administration.
Relapse: - The recurrence, upon discontinuation of an effective medical treatment, of the
original condition from which the patient suffered.
Tolerance: - When the body becomes less responsive to the drug with repeated
exposure.
Withdrawal: - Painful physical and psychological symptoms that follow discontinuation of
a drug.
What are some substances that can cause addiction? - Stimulants, nicotine, alcohol,
sedative-hypnotics, opioid, marijuana, hallucinogens and club drugs.
Addiction is characterized by: - compulsive drug craving, seeking, and use that persist
even in the face of negative consequences.
"Feel good" reinforcement is mediated by what pathways in drug abuse? - dopamine
"Feel bad: reinforcement is mediated by what pathway in drug abuse? - GABA
,DSM-5 criteria for substance abuse? - A maladaptive pattern of substance use leading to
clinically significant impairment or distress as manifested by 1 or more of the following,
occurring within a 12 month period:
1. Recurrent substance use resulting in failure to fulfill major role obligations at work, school or
home.
2. Recurrent substance use in situations in which it is physically hazardous (driving an
automobile, operating a machine when impaired).
3. Recurrent substance related legal problems.
4. Continued substance use despite having persistent or recurrent social or interpersonal
problems caused or exacerbated by the effects of the substance.
DSM-5 criteria for substance dependence: - A maladaptive pattern of substance abuse,
leading to a clinically significant impairment or distress, as manifested by 3 or more of the
following, occurring at any time in the same 12 month period.
1. Presence or tolerance to a drug.
2. Presence of withdrawal syndrome.
3. The substance is often taken in larger amounts or over a longer period than was intended.
4. There is a persistent desire or unsuccessful efforts to cut down on control substance use.
5. A great el of time is spent in activities necessary to obtain the substance, use the substance,
or recover from its effects.
6. Important social, occupational, or recreational activities are given up or reduced because of
substance use.
7. The substance use is continued despite knowledge of having a persistent or recurrent physical
or psychological problems that is likely to have been caused or exacerbated by the substance.
Define binge drinking: - 5 or more drinks on the same occasion during one or more days
in the past month.
Define heavy drinking: - 5 or more drinks on the same occasion 5 or more days in the
past month.
Define low risk drinking: - No more than 4 drinks on one occasion or 14 drinks per week
for men; no more than 3 drinks per day or 7 drinks per week for women.
, Signs of alcohol intoxication: - slurred speech, incoordination, unsteady gait, nystagmus,
impairment of inattention or memory, stupor or coma.
DSM-5 for alcohol intoxication: - 1. Recent ingestion of alcohol.
2. Clinically significant maladaptive behavior or psychological change that developed during or
shortly after alcohol ingestion.
3. Signs of alcohol intoxication as above.
4. The symptoms are not due to a general medical condition and are not better explained by
another mental disorder.
DSM-5 for alcohol withdrawal: - 1. Cessation of alcohol use that ahs been heavy and
prolonged.
2. 2 or more of the following, developing within several hours to a few days.
autonomic hyperactivity.
increased hand tremor
insomnia
nausea or vomiting
transient visual, tactile, or auditory hallucinations or illusions.
psychomotor agitation
anxiety
grand mal seizures
Alcohol withdrawal, delirium tremens: defined - 1. Considered medical emergency and
can result in death if untreated.
2. State of delirium usually peaks 2-3 days after cessation of reduction of prolonged heavy
drinking.
3. Symptoms include:
a. Autonomic hyperactivity (sweating, tachycardia, elevated BP)
b. Severe disturbance in sensorium.(disoriented)
c. Perceptual disturbances. (hallucinations)
d. Fluctuating level of consciousness.