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Lecture Eighteen
Drug Abuse I
| Question | Answer |
|---|---|
| What distinguishes use from abuse? | 1. Time spent using, getting the drug 2. Amount use 3. Situations - working, driving. 4. Recurrent problems |
| What are four key changes that have occurred over the last 200 years and are reasons why drugs abuse is more common now? Know what to say to discuss them!!! | 1. Chemical advances - in isolation of pure chemicals, synthetic compounds and chemical modification 2. Global availability 3. intervention of the hypodermic needle 4. Internet |
| Methamphetamine is a drug derived from ...? | Amphetamine |
| Amphetamine's general mechanism of action is...? so this is also methamphetamines mxn of action! | Primarily promotes the release of biogenic amines (DA, NE 5HT) |
| What is the mode of action of amphetamine's that is why it is taken recreationally? | Psychostimulant |
| Amphetamine is completely _____________?. What is an amphetamine derivative we learnt about briefly? | synthetic, MDMA (ecstasy - and how you need fancy lab equipment, high grade chemicals to make it) |
| Amphetamine derivatives such as methamphetamine have dose dependent effects. What are they? | Low dose is stimulant effect, med dose is psychedelic/enactogen effect, high dose is tremors, convulsions and death. |
| Methamphetamine is an amphetamine molecule with a methyl group attached. What is the implication of this? | The methyl group attached makes the molecule very lipothilic, make it go through the BBB and is very potent so you get very high |
| What do you need to make meth? | 1. Basic chemistry supplies and multiple cooking agents which are easily accessible. 2. Pseudoephedrine (main psychoactive base ingredient) |
| A key mode of action pseudoephedrine is? | Psychostimulant |
| What is methamphetamines mxn of action? | prompts massive release of DA, NE and 5HT |
| What is the key mode of action for methamphetamine? (the one that is why its used recreationally) | Psychostimulant |
| You need to recognise a few things about the drugs we abuse. What are these things? | - Not all drugs of abuse are illegal/illicit. -Some are legally obtainable (nicotine, alcohol have huge social costs) -Some are Rx obtainable. - u can get addicted to anything e.g. drug or behaviour (sex, gambling as similar brain circuitry is activated) |
| What are the five identified risk factors for drug use to segue into drug abuse? | 1. Early experimentation 2. Psychiatric Co-morbidity 3. Environment 4. Genetics 5. Availability |
| Explain the first identified risk for drug abuse | 1. Early experimentation - also called The Gateway Theory is when early drug use esp. cannabis serves as a gateway to future drug use. |
| Explain the second identified risk for drug abuse | 2. Psychiatric Co-morbidity - also called The Addiction Vulnerability Hypothesis where people with psychiatric disorders exhibit higher rates of drug abuse/addiction. Here accurate dual diagnosis is critical to know what is driving what |
| Explain the third identified risk for drug abuse | 3. Environmental - home, social, communities. So if in your home, others abuse drugs or if you live in a poor neighbourhood where this is common or you live in a country with a bad government |
| Explain the second identified risk for drug abuse | 4. Genetics - still controversial but some research shows that there is a difference in receptors in drug abusers versus non-drug abusers |
| Explain the second identified risk for drug abuse | 5. Availability - the more available drugs are, the more likely you are to abuse drugs. |
| What are the common defining features of drug ADDICTION that fit in with the common defining features of drug abuse? | Compulsive use (time), craving, binging (amount), continued use despite recognized negative consequences (problems) |
| What does drug addiction equal? | physical and psychological dependence on a chemical compound |
| What are the two key points when defining drug abuse for 476? | Won't stop, drugs are important |
| What are the two key points when defining drug addiction for 476? | Can't stop, drugs are #1 priority |
| Drug addiction is ______________. They know it is not good but they keep doing it | irrational |
| What is the best way to deal with drug addicts? | Demand reduction. - reducing the desire/demand for the drug using rehab and psychotherapy. Rather than sending them to prison as if it is irrational thinking then prison doesn't fix it |
| Drug addiction is a state of..... | pathological decision making |
| How did we traditionally define/identify drug addiction? | Focused on physical withdrawal symptoms - if person stopped taking drug and exhibited withdrawals then they are addicted. But people get withdrawals from drugs taken in hospital for weeks. |
| Because traditionally physical withdrawal symptoms were the focus of how to define/identify drugs, what was the focus of treatment at this time? | Detox - thought that if you get the person over the withdrawal period, then they should go back to normal. |
| How do we define/identify drug addiction NOW? | We now appreciate that drug reinforcement is the unifying feature of addiction - if you want a drug over and over, you are an addict. |
| We now appreciate that drug reinforcement is the unifying feature of addiction - if you want a drug over and over, you are an addict. How does this have implications for how you treat drug addiction? | You cannot just treat the withdrawal or do detox. You have to treat the psychological drive with psychotherapy. |
| Describe the positive reinforcement during life as a recovering addict | You still have memory of good feeling/highs associated with drug use. So this is positive reinforcement towards relapsing |
| Describe the negative reinforcement during life as a recovering addict | In recovery, person must adapt to state where drug is absent an this can be very bleak e.g severe boredom, anhedonia (no pleasure), depression.So this is neg. reinforcement towards relapsing |
| Describe the contextual reinforcement during life as a recovering addict | Contexual cues such as friends (who you used to get high with) can UNKNOWINGLY spark cravings. This suggests that the brian forms strong, salient, and long-lasting associations.You need to separate your new life completely from your old life. |
| Describe the stigma reinforcement during life as a recovering addict | Being an "addict" is now part of your life story. Everyone knows you were an addict and you have to tell/explain to people you were an addict. This can lower self-esteem and be detrimental to recovery. It is a label with negative connotation/stigma |
| So how to we see a past drug addict now? | As a recovering addict (rather than a normal person) as they will always be dealing with psychological desires and contextual cues |
Created by:
alice476
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