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Study Guide
Chapter 8 - Drug Abuse, Dependence, & Addiction: 8. Describe some of the risk factors for developing drug addiction and some of the protective factors that may reduce risk. Risk Factors: Environmental factor is the occurrence of stress and the ability of the person to cope with stress. Significant comorbidity of drug abuse or addiction with various personality or mood disorders. Three different personality-related pathways to addiction I. Behavioral disinhibition II. Stress reduction III. Reward sensitivity Self-medication hypothesis predicts that individuals suffering from elevated anxiety should prefer alcohol and other sedative-anxiolytic drugs, whereas depressed individuals should seek out stimulant drugs such as cocaine or amphetamines. Genetic factors predispose individuals to exhibiting a variety of pathological characteristics involving drug use
Genetic differences in sensitivity or toxic responses to drugs of abuse Genetic variability in the liability to abuse substances
E.g., genetic factors may account for 73% of the variability in males in liability for alcoholism and 61% in female variability
Race
Whites have highest lifetime use of illicit drugs except crack and heroin Blacks have the highest rate of secondary problems (e.g., liver damage, cancer, etc) Hispanics have higher prevalence of alcohol Blacks have higher prevalence of heroin and crack
Sociological Factors; the strongest of which is the users selling of drugs, which is linked to
Drug availability Significant others labeling of the person as deviant Peer influence Early childhood deviance Poor school adjustment Weak family influence
Personality characteristics, such as the following, correlate with substance abusers (Marlatt et al., 1988)
sensation- or novelty-seeking traits history of antisocial behavior (e.g., nonconformity, acting out, and impulsivity)
Protective Factors:
An absence of the various risk factors described in the previous section will help protect against drug abuse or addiction Help maintain a stable abstinence in previously drug-abusing or addicted individuals.
Treatment (1)
If sufferer is dependent upon a legitimate prescription drug, he or she can be weaned off the drug slowly (assuming they recognize the problem and wish to stop the dependency) If the substance abuser doesnt recognize or want help, then coercion is an acceptable and/or effective means for getting the person treatment
Consequences will be allowed to occur if they dont (loss of job, legal action, etc.)
Treatment (2)
Deal with predisposing psychological and/or sociological factors which led to drug taking. Made
9. Why might the evaluation of drug-reinforcing properties in animals be valuable in the assessment of human experiences?
How do you determine if a drug has reinforcing properties, or is likely to become a drug capable of producing psychological dependence? One determines the degree to which an animal self-administers a drug
E.g., cocaine is self-administered to excess by rats, squirrels, monkeys, rhesus monkeys, pigtail macaques, baboons, dogs, and humans
Nonhuman animals will show many of the same aspects of substance abuse as humans.
Take more and more of it.
Animal Models
Devote a lot of time and energy to getting it. Continue taking it despite adverse consequences. Undergo a withdrawal syndrome if the drug is not available. Relapse in response to environmental or stressful cues or re-exposure.
Means we can address some of the same questions about human drug abuse by studying nonhuman subjects.
Has implications for the question: Is there an addictive personality?
10. Explain the mechanism that underlies the behavioral reinforcing properties of abused drugs. 11. Distinguish between context-specific tolerance and pharmacodynamic tolerance. Describe both. Context-specific tolerance (also called Behavioral tolerance) is demonstrated when tolerance occurs in the same environment in which the drug was administered, but tolerance is not apparent or is much reduced in a novel environment. Pharmacodynamic tolerance occurs when changes in nerve cell function compensate for the the continued presence of the drug. 3
Pharmacodynamic = functional = cellular-adaptive:
Neuronal receptors become desensitized through cellular changes so that the drug affects neurons less
12. The FDA approved the use of olanzapine (Zyprexa) in the treatment of schizophrenia (a few years ago). In general, what are the implications of this approval for psychiatrists in terms of what they may prescribe olanzapine for?
13. Controlled substances are categorized by the DEA into 5 schedules. What differentiates drugs placed into these schedules? Schedule I---Substances have no accepted medical use in the U.S., and have a high abuse potential. Ex: Heroin, LSD, mescaline, marijuana, THC, MDMA Schedule II---Substances that have a high abuse potential with sever psychic or physical dependence liability. Ex: opium, morphine, codeine, Ritalin, Demerol, cocaine, PCP Schedule III---Substances that have an abuse potential less than those in Schedules I and II, including compounds containing limited quanitities of certain narcotics and nonnarcotic drugs. Ex: paregoric, barbiturates Schedule IVSubstances that have an abuse potential less than those in Schedule III.Ex: Xanax, Valium, phenobarbital Schedule V- Substances that have an abuse potential less than those in Schedule IV, consisting of preparations containing limited amounts of certain narcotic drugs generally for antitussive and antidiarrheal purposes. 14. What changes take place after the chronic use of a drug of abuse that affects a persons ability to experience natural pleasurable experiences? According to the exposure model, chronic drug use leads to alterations in brain function that are responsible for loss of control and compulsive drug-seeking and drug-taking behaviors.
15. What happens when an addicted or recovering person is exposed to cues of drug use?
Craving is largely a conditioned response (CR) to powerful cues to use drugs, which the (recovering) addict may encounter e.g., people, places, things associated with drug use). Cues evoke powerful emotional memories of high, can trigger near-irresistible urges to use. Even in the absence of drugs, associated stimuli become capable of producing drug craving. Therefore, people recovering from addiction usually are advised to avoid friends and locations that have previously