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,Drugs and Behavior An Introduction to Behavioral Pharmacology 8th Edition hancock Test Ba
Chapter 3: How We Adapt to Drugs—Tolerance, Sensitization, and Expectation
Chapter Overview
In this chapter, we show how principles of traditional learning theory (classical and operant conditioning) can be applied
in order to understand behavioral pharmacological phenomena such as drug tolerance and withdrawal. Students are
presented with various mechanisms, both physiological and behavioral, that underlie the diminishment of a drug’s
effects with repeated use. That tolerance develops to the effects of a drug, and not to the substance itself, is an
important distinction for students to comprehend. Likewise, the conditioning of compensatory responses—physiological
changes that are opposite those produced by the drug itself—is an important concept that will aid students in
understanding why drug-associated cues can, in the absence of drug administration, elicit symptoms of withdrawal. The
concept of sensitization, or reverse tolerance, is also introduced in this chapter as preliminary background preparation
for a much broader discussion and application of sensitization to theories of addiction, covered in Chapter 5. This
chapter closes by revisiting the placebo effect, introducing the nocebo effect, and discussing the importance of
expectancy and context in mediating drug effects.
Chapter Outline/Notes
Drug tolerance is defined either as the decreased effectiveness (or potency) of a drug that results with repeated
administrations, or as the necessity of increasing the dose of a drug in order to maintain its effectiveness after
repeated administrations.
Tolerance to some effects of a drug may develop or dissipate rapidly, whereas others may develop or dissipate
slowly or not at all. This suggests that drug tolerance is the result of multiple mechanisms.
Cross-tolerance occurs when tolerance to one drug diminishes the effects of another.
Acute tolerance develops during a single drug-taking session, so that the perceived effects of a drug are diminished
as blood concentrations are falling compared to when blood concentrations were rising.
Pharmacokinetic tolerance arises from an increase in the rate or ability of the body to metabolize a drug, resulting in
fewer drug molecules reaching their sites of action. For the most part, pharmacokinetic tolerance is due to enzyme
induction—an increase in the level of an enzyme the body uses to break down the drug.
Pharmacodynamic tolerance arises from adjustments made by the body to compensate for an effect caused by the
continued presence of a drug. These adjustments are brought about through homeostasis—a process by which the
body attempts to maintain stability over fluctuation.
Tolerance develops only in a circumstance where a drug places a demand on an organism’s homeostatic
mechanisms; if the drug effect is of no biological or functional significance to the organism, tolerance will not
develop.
Behavioral tolerance arises from conditioned changes in behavior that compensate for the effects of a drug.
Withdrawal symptoms are physiological changes that occur when the use of a drug is discontinued or the dosage
reduced. They are thought of as expressions of the compensatory adjustment that homeostatic mechanisms have
made to the repeated effects of a drug.
Drug dependence is somewhat of an ambiguous term, as it has been used to refer to both the state in which
discontinuation of a drug causes withdrawal symptoms and the state in which a person compulsively takes a drug
(which is also often described as addiction).
Solomon and Corbit’s (1974) opponent process theory proposes that drugs of abuse stimulate an “A” process that
creates a euphoric (pleasant) a state, but that soon after, a compensatory “B” process is evoked that creates a
dysphoric (unpleasant) b state.
Visit TestBankDeal.com to get complete for all chapters
, Solomon and Corbit’s (1974) opponent process theory can be used to explain acute tolerance and hangover that
result from a single drug administration, as well as chronic tolerance and withdrawal symptoms that occur with
repeated drug administration.
Stimuli paired with drug administration will eventually come to elicit effects through classical conditioning
processes. Quite often, the effect that becomes conditioned is not that of the drug itself but of the physiological
responses triggered to oppose the unconditioned effects of the drug—that is, conditioned compensatory responses.
Conditional tolerance is dependent upon the presence of environmental cues predictive of drug administration.
These cues elicit conditioned compensatory responses that diminish the effects of the drug. In the absence of drug
administration, conditioned compensatory responses are expressed as conditioned withdrawal symptoms.
If a drug interferes with an organism’s ability to obtain reinforcement, behavioral tolerance will develop. If the
ability to compensate for the effect of a drug is not reinforced, tolerance may not develop. Similarly, tolerance to
some drug effects develops only if the organism is reinforced for demonstrating compensatory operant responding.
Sensitization is the increase in a drug’s effect with repeated administrations. It is often measured in terms of a drug’s
behavioral-activating effects. Like tolerance, sensitization can be conditioned to a particular environment and cross-
sensitization may occur across different drugs.
The placebo effect—the expectations individuals have regarding the effects of a drug—exerts great influence on the
drug experience. Brain regions and pathways have been identified that mediate this expectancy effect.
The nocebo effect is a placebo’s capacity to generate adverse side-effects. This stems from knowledge the individual
has pertaining to the negative effects of the particular drug being replaced by the placebo.
The context in which a drug is administered can influence its effects. This includes whether the individual self-
administers the drug or has no control over its delivery. The environment, whether familiar or novel, also modifies a
drug’s effects.
Multiple Choice Questions
3-1. Which of the following is an indicator of drug tolerance? Answer: E
a. A decrease in the effectiveness of a drug resulting from repeated administrations. Objective:
b. A decrease in the potency of a drug resulting from repeated administrations. Topic/Section:
c. The necessity to increase the dose of a drug in order to achieve the same effect after Tolerance
repeated administrations. Difficulty:
d. A shift to the right in a drug’s dose–response curve resulting from repeated Bloom’s level:
administrations.
e. All of the above are indicators of drug tolerance.
3-2. Tolerance to the various effects of a drug develops at different rates. This means that Answer: C
a. researchers cannot study tolerance using scientific protocols. Objective:
b. researchers cannot predict when drug tolerance will occur in an individual. Topic/Section:
c. there must be more than one mechanism responsible for the development of Tolerance
tolerance. Difficulty:
d. overdose deaths can be attributed to a sudden drop in the rate of tolerance Bloom’s level:
development.
e. eventually, all drug effects will show complete tolerance.
3-3. When she was a teenager, Joan fell off a horse and shattered her pelvis. She has been Answer: B
taking the opioid pain medication oxycodone ever since. Last week, Joan was in a car accident Objective:
, and the emergency-room physician administered morphine to treat Joan’s pain. What would Topic/Section:
you expect to have happened, in this case? Tolerance
a. Joan’s body is accustomed to opioid medications, and so the morphine would be a Difficulty:
highly effective pain reliever. Bloom’s level:
b. Joan’s body is accustomed to opioid medications, and so the morphine would be a
poorly effective pain reliever.
c. Joan’s body is unaccustomed to morphine, and so morphine would be a highly
effective pain reliever.
d. Joan’s body is accustomed only to oxycodone, and so that’s what the physician should
have administered to treat her pain.
e. Joan must not be taking her oxycodone as prescribed, otherwise she would not have
had any pain following the car accident.
3-4. Tolerance can develop to the effects of a drug during a single administration. This is Answer: A
known as Objective:
a. acute tolerance. Topic/Section:
b. cross-tolerance. Tolerance
c. chronic tolerance. Difficulty:
d. sustained tolerance. Bloom’s level:
e. Mithridatism.
3-5. When a drug effect is greater at a specific blood level when the concentration in the Answer: C
blood is rising, compared to at that same blood level when the concentration in the blood is Objective:
falling, this is called Topic/Section:
a. physiological tolerance. Tolerance
b. metabolic tolerance. Difficulty:
c. acute tolerance. Bloom’s level:
d. dispositional tolerance.
e. behavioral tolerance.
3-6. Mark is having a house party to celebrate landing a new job. He’s been drinking alcohol Answer: B
fairly steadily since early in the evening, and it is now 3:00 a.m. Mark’s friends are having Objective:
trouble hailing a cab, so Mark offers to drive them home. When they remind Mark that he’s Topic/Section:
had a lot to drink, he agrees that he was really drunk a couple of hours ago but says he feels Tolerance
pretty sober now. He suspects he can drive perfectly fine. What is likely happening to Mark? Difficulty:
a. Mark’s body has eliminated the alcohol from his system and he is now nearly sober. Bloom’s level:
b. Mark is showing acute tolerance to the subjective effects of alcohol.
c. Mark is showing cross-tolerance to the subjective effects of alcohol.
d. Mark is showing pharmacokinetic tolerance to the subjective effects of alcohol.
e. Mark is showing pharmacodynamic tolerance to the subjective effects of alcohol.
3-7. Tolerance that arises from an increase in the rate or ability of the body to metabolize a Answer: D
drug, resulting in fewer drug molecules reaching their sites of action, is known as Objective:
a. pharmacodynamic tolerance. Topic/Section:
b. physiological tolerance. Mechanisms of
c. cellular tolerance. Tolerance
d. pharmacokinetic tolerance. Difficulty:
e. All of a., b., and c. Bloom’s level:
3-8. Enzyme induction Answer: A
TEST BANK
,Drugs and Behavior An Introduction to Behavioral Pharmacology 8th Edition hancock Test Ba
Chapter 3: How We Adapt to Drugs—Tolerance, Sensitization, and Expectation
Chapter Overview
In this chapter, we show how principles of traditional learning theory (classical and operant conditioning) can be applied
in order to understand behavioral pharmacological phenomena such as drug tolerance and withdrawal. Students are
presented with various mechanisms, both physiological and behavioral, that underlie the diminishment of a drug’s
effects with repeated use. That tolerance develops to the effects of a drug, and not to the substance itself, is an
important distinction for students to comprehend. Likewise, the conditioning of compensatory responses—physiological
changes that are opposite those produced by the drug itself—is an important concept that will aid students in
understanding why drug-associated cues can, in the absence of drug administration, elicit symptoms of withdrawal. The
concept of sensitization, or reverse tolerance, is also introduced in this chapter as preliminary background preparation
for a much broader discussion and application of sensitization to theories of addiction, covered in Chapter 5. This
chapter closes by revisiting the placebo effect, introducing the nocebo effect, and discussing the importance of
expectancy and context in mediating drug effects.
Chapter Outline/Notes
Drug tolerance is defined either as the decreased effectiveness (or potency) of a drug that results with repeated
administrations, or as the necessity of increasing the dose of a drug in order to maintain its effectiveness after
repeated administrations.
Tolerance to some effects of a drug may develop or dissipate rapidly, whereas others may develop or dissipate
slowly or not at all. This suggests that drug tolerance is the result of multiple mechanisms.
Cross-tolerance occurs when tolerance to one drug diminishes the effects of another.
Acute tolerance develops during a single drug-taking session, so that the perceived effects of a drug are diminished
as blood concentrations are falling compared to when blood concentrations were rising.
Pharmacokinetic tolerance arises from an increase in the rate or ability of the body to metabolize a drug, resulting in
fewer drug molecules reaching their sites of action. For the most part, pharmacokinetic tolerance is due to enzyme
induction—an increase in the level of an enzyme the body uses to break down the drug.
Pharmacodynamic tolerance arises from adjustments made by the body to compensate for an effect caused by the
continued presence of a drug. These adjustments are brought about through homeostasis—a process by which the
body attempts to maintain stability over fluctuation.
Tolerance develops only in a circumstance where a drug places a demand on an organism’s homeostatic
mechanisms; if the drug effect is of no biological or functional significance to the organism, tolerance will not
develop.
Behavioral tolerance arises from conditioned changes in behavior that compensate for the effects of a drug.
Withdrawal symptoms are physiological changes that occur when the use of a drug is discontinued or the dosage
reduced. They are thought of as expressions of the compensatory adjustment that homeostatic mechanisms have
made to the repeated effects of a drug.
Drug dependence is somewhat of an ambiguous term, as it has been used to refer to both the state in which
discontinuation of a drug causes withdrawal symptoms and the state in which a person compulsively takes a drug
(which is also often described as addiction).
Solomon and Corbit’s (1974) opponent process theory proposes that drugs of abuse stimulate an “A” process that
creates a euphoric (pleasant) a state, but that soon after, a compensatory “B” process is evoked that creates a
dysphoric (unpleasant) b state.
Visit TestBankDeal.com to get complete for all chapters
, Solomon and Corbit’s (1974) opponent process theory can be used to explain acute tolerance and hangover that
result from a single drug administration, as well as chronic tolerance and withdrawal symptoms that occur with
repeated drug administration.
Stimuli paired with drug administration will eventually come to elicit effects through classical conditioning
processes. Quite often, the effect that becomes conditioned is not that of the drug itself but of the physiological
responses triggered to oppose the unconditioned effects of the drug—that is, conditioned compensatory responses.
Conditional tolerance is dependent upon the presence of environmental cues predictive of drug administration.
These cues elicit conditioned compensatory responses that diminish the effects of the drug. In the absence of drug
administration, conditioned compensatory responses are expressed as conditioned withdrawal symptoms.
If a drug interferes with an organism’s ability to obtain reinforcement, behavioral tolerance will develop. If the
ability to compensate for the effect of a drug is not reinforced, tolerance may not develop. Similarly, tolerance to
some drug effects develops only if the organism is reinforced for demonstrating compensatory operant responding.
Sensitization is the increase in a drug’s effect with repeated administrations. It is often measured in terms of a drug’s
behavioral-activating effects. Like tolerance, sensitization can be conditioned to a particular environment and cross-
sensitization may occur across different drugs.
The placebo effect—the expectations individuals have regarding the effects of a drug—exerts great influence on the
drug experience. Brain regions and pathways have been identified that mediate this expectancy effect.
The nocebo effect is a placebo’s capacity to generate adverse side-effects. This stems from knowledge the individual
has pertaining to the negative effects of the particular drug being replaced by the placebo.
The context in which a drug is administered can influence its effects. This includes whether the individual self-
administers the drug or has no control over its delivery. The environment, whether familiar or novel, also modifies a
drug’s effects.
Multiple Choice Questions
3-1. Which of the following is an indicator of drug tolerance? Answer: E
a. A decrease in the effectiveness of a drug resulting from repeated administrations. Objective:
b. A decrease in the potency of a drug resulting from repeated administrations. Topic/Section:
c. The necessity to increase the dose of a drug in order to achieve the same effect after Tolerance
repeated administrations. Difficulty:
d. A shift to the right in a drug’s dose–response curve resulting from repeated Bloom’s level:
administrations.
e. All of the above are indicators of drug tolerance.
3-2. Tolerance to the various effects of a drug develops at different rates. This means that Answer: C
a. researchers cannot study tolerance using scientific protocols. Objective:
b. researchers cannot predict when drug tolerance will occur in an individual. Topic/Section:
c. there must be more than one mechanism responsible for the development of Tolerance
tolerance. Difficulty:
d. overdose deaths can be attributed to a sudden drop in the rate of tolerance Bloom’s level:
development.
e. eventually, all drug effects will show complete tolerance.
3-3. When she was a teenager, Joan fell off a horse and shattered her pelvis. She has been Answer: B
taking the opioid pain medication oxycodone ever since. Last week, Joan was in a car accident Objective:
, and the emergency-room physician administered morphine to treat Joan’s pain. What would Topic/Section:
you expect to have happened, in this case? Tolerance
a. Joan’s body is accustomed to opioid medications, and so the morphine would be a Difficulty:
highly effective pain reliever. Bloom’s level:
b. Joan’s body is accustomed to opioid medications, and so the morphine would be a
poorly effective pain reliever.
c. Joan’s body is unaccustomed to morphine, and so morphine would be a highly
effective pain reliever.
d. Joan’s body is accustomed only to oxycodone, and so that’s what the physician should
have administered to treat her pain.
e. Joan must not be taking her oxycodone as prescribed, otherwise she would not have
had any pain following the car accident.
3-4. Tolerance can develop to the effects of a drug during a single administration. This is Answer: A
known as Objective:
a. acute tolerance. Topic/Section:
b. cross-tolerance. Tolerance
c. chronic tolerance. Difficulty:
d. sustained tolerance. Bloom’s level:
e. Mithridatism.
3-5. When a drug effect is greater at a specific blood level when the concentration in the Answer: C
blood is rising, compared to at that same blood level when the concentration in the blood is Objective:
falling, this is called Topic/Section:
a. physiological tolerance. Tolerance
b. metabolic tolerance. Difficulty:
c. acute tolerance. Bloom’s level:
d. dispositional tolerance.
e. behavioral tolerance.
3-6. Mark is having a house party to celebrate landing a new job. He’s been drinking alcohol Answer: B
fairly steadily since early in the evening, and it is now 3:00 a.m. Mark’s friends are having Objective:
trouble hailing a cab, so Mark offers to drive them home. When they remind Mark that he’s Topic/Section:
had a lot to drink, he agrees that he was really drunk a couple of hours ago but says he feels Tolerance
pretty sober now. He suspects he can drive perfectly fine. What is likely happening to Mark? Difficulty:
a. Mark’s body has eliminated the alcohol from his system and he is now nearly sober. Bloom’s level:
b. Mark is showing acute tolerance to the subjective effects of alcohol.
c. Mark is showing cross-tolerance to the subjective effects of alcohol.
d. Mark is showing pharmacokinetic tolerance to the subjective effects of alcohol.
e. Mark is showing pharmacodynamic tolerance to the subjective effects of alcohol.
3-7. Tolerance that arises from an increase in the rate or ability of the body to metabolize a Answer: D
drug, resulting in fewer drug molecules reaching their sites of action, is known as Objective:
a. pharmacodynamic tolerance. Topic/Section:
b. physiological tolerance. Mechanisms of
c. cellular tolerance. Tolerance
d. pharmacokinetic tolerance. Difficulty:
e. All of a., b., and c. Bloom’s level:
3-8. Enzyme induction Answer: A
