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Addiction Final (Midterm)
Terms in this set (24)
Why Study addiction
It stimulates critical thinking
• It is prototypical modern "disease"
• It has intellectual "leverage:" to understand
addiction we must appreciate:
• The nature of genetic influences on behavior • General features of how the brain works
• General features of how drugs work • The role of values in behavior • Perhaps it forces us to clarify our own values
It provides a window into the nature of voluntary behavior
• It has a fascinating history • It is important
History of Addiction Rome
"Addiction" from ancient Rome to
the 16th century
• In Roman law an "addictus" was a person
who had been ordered by the court into servitude (usually because of debt).
• Over time, the domain of the "addictus"
expanded before settling down to its modern association with drugs (see OED, 1987):
- 1679 . . . He himself was addicted to a Trade. - 1660 . . . He was much addicted to civil Affairs. - 1703 . . . Much addicted to Merchandise
Addiction 17th century England
In 1609, an Englishman, Mr. Downame, describes persistent heavy drinking in the following terms: Addicts use alcohol as their vice to cope with life and thus are addicted to alcohol
Drugs and disease
In 1619, Robert Harris described habitual drunkenness
as this "Dropsilike disease."
In 1622, Samuel Ward writes of the "drunkard's disease," and in
1628, William Prynne notes that drunkenness is a
"dangerous dropsie and disease." ("Dropsie" was a
term for tuberculosis.) Moreover, it is pointed out that, also like today, it is a disease that has no cure and is spreading.
John Bury (1677) writes: drunkenness is a disease "so epidemical" that "all the Physicians in England
know not how to stop it.
DSM definition of addiction
The essential feature of Substance Dependence is a cluster of cognitive, behavioral, and physiological symptoms indicating that the individual continues use of the substance despite significant substance-related problems. There is a pattern of repeated self-administration that usually results in tolerance, withdrawal, and compulsive drug-taking behavior.
APA criteria of addiction
1.High level of drug use:
a. Tolerance b. Withdrawal
2.Continued use despite recognized adverse consequences: a. Health risks b. Loss of job c. Adverse social consequences
a. Takes more drug than intended b. Tried to stop or curtail use
Modification of the APA approach
Maintain the behavioral criteria that are actually used
• Drop the word "compulsive"
We can then study how addicts behave and test whether or not they are compulsive drug users or voluntary drug users
Basic facts of addiction
How to find out about a disorder
• The first step is descriptive: - Correlates of onset - Correlates of persistence
- Correlates of cessation
- Key natural history facts, such as duration
- Biological correlates - Treatment approaches
Drugs change the brain
Drugs alter consciousness
Consciousness and setting alter drug effects
Pharmacodynamics of drugs
Neuron is drug target Since neurons can't move Drug needs a way to get to neuron: the circulatory
Pharmacokinetics of drugs
Drugs enter the body They circulate through the body Act at specific sites Are eliminated from the body
Drugs and circulatory system
Oral and its challenges: lipid barriers, liver & kidneys (1st pass metabolism)
Inhalation: efficient and avoids 1st pass metabolism Intravenous: efficient and avoids 1st pass metabolism
Gets to the circulatory system by going through the:
Capillaries blood brain barrier lipid solubility: morphine/heroin
How do drugs leave the circulatory system?
Liver and kidneys transform drugs into less active more water soluble forms
Water soluble metabolites are excreted by kidneys
What determines drug effect?
time and concentration
- diffusion, metabolism, excretion all linked
How drugs act at site of action depend on properties of the neuron
The neuron is the fundamental unit of the nervous system
The neuron is the fundamental unit for behavior, mood, cognition---all things behavioral and psychological
Neurons complete 2 functions:
- reception of signals from outside world - Transmission of signals to other neurons and cells
Neurons have two properties that are essential to psychological phenomena and sharing, transmiting of informatio
each neuron is "excitable:" it can take one of two states as defined by its voltage
neurons can communicate with one another by means of biochemicals
Resting and action potential
The basis of these two states is the distribution of charged ions inside and outside of the neurons
At rest, the inside of the neuron is negative (- 70 mV)
At the peak of the action potential, the inside of the neuron is positive (approximately + 30 mV)
The difference is due to changes in the distribution of charged chemical ions inside and outside of the neuron
All thought, action and mood is mediated by the brain
The brain is a collection of an immense, number of interconnected neurons
Neurons are the working parts: they flash on or off
Thus: we can alter thought, action, and mood by altering neurons
Drugs act on neurons....
Drugs as neurons
Drug acts on neurons.
Neurons reflect individual history and current setting.
Thus drug effect depends on individual history and current setting.
How drugs work
How drugs work: some basic examples
Drugs that influence synthesis and storage of neurotransmitters:
L-Dopa: synthesis of dopamine to treat Parkinson's disease
aspirin: blocks prostaglandin synthesis---prostaglandins induce fever and pain)
reserpine: inhibits storage of dopamine, used to treat schizophrenia
Drugs that affect release of neurotransmitters: marijuana
Drugs that mimic endogenous neurotransmitters:
nicotine (acetylcholine) morphine (endorphin)
Drugs that block receptors:
1st generation anti-psychotic drugs (chlorpromazine---dopamine)
Drugs that affect duration of neurotransmitter/receptor bond: Prozac, cocaine.
Genes in this family provide instructions for making specialized proteins called endogenous ligands. A ligand is a protein that attaches (binds) to another protein called a receptor; receptor proteins have specific sites into which the ligands fit like keys into locks.
Neuroplasticity or brain plasticity refers to the brain's ability to CHANGE throughout life. The brain has the amazing ability to reorganize itself by forming new connections between brain cells (neurons)
- This could be important to study in addiction because as you use drugs your brain forms new associations. If you take a bunch of heroin you may only associate pleasure with receiving an overload to the opioid receptors. Etc.
Dopamine and reward theory
Reward theory: The theory that states that people like those whose behavior is rewarding to them or whom they associate with rewarding events. The correlation between reward theory and dopamine is that people continue to use drugs which release a surplus of dopamine because they realized that this brings them pleasure and they associate the drugs with feeling rewarded thus wanting to continue to use the drugs as much as possible so they always feel they are being rewarded.
Gene expression is the process by which information from a gene is used in the synthesis of a functional gene product. These products are often proteins, but in non-protein coding genes such as transfer RNA (tRNA) or small nuclear RNA (snRNA) genes, the product is a functional RNA. The process of gene expression is used by all known life - eukaryotes (including multicellular organisms), prokaryotes (bacteria and archaea), and utilized by viruses - to generate the macromolecular machinery for life.
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