Class 32 - Understanding Addiction

Class 32 - Addiction

• Addiction class plan for the day included learning models, treatment, and the big picture.
• A nasal spray, Narcan, was pictured, which contains 4mg.

Physical vs. Psychological Dependence

• Physical dependence involves brain changes requiring the drug for normal function.
• Psychological dependence involves emotional and mental processes associated with substance use disorder (SUD) development.

Physical Dependence

• Synaptic changes require the drug for normal function.
• Examples include addicted newborns and dopamine receptor density.

Psychological Dependence

• Emotional and mental processes relate to the drug itself or behavior.
• Behavioral addictions, without a substance, also show physiological changes.

Addiction as a Learned Behavior

• Learning how addiction occurs as a behavior.

Operant Conditioning and Drug Use

• How operant conditioning might be involved in drug use.

Conditioned Withdrawal

• Opioid users going through therapy were drug-free for months.
• When discussing drugs, withdrawal symptoms appeared.
• This shows evidence of psychological dependence.

Operant Conditioning and Drug Use

• How operant conditioning impacts drug use is noted.

Drug Opposite CR's

• Drug opposite CR is noted.

Conditioned Withdrawal

• Conditioned withdrawal is noted.

Conditioned Tolerance

• Conditioned tolerance is noted.

Drug-like CR's

• Drug-like CR's are noted.

Cue-Induced Wanting

• Neutral cues can trigger cravings for drugs.

Opioid-Related Deaths in Canada

• A graph shows opioid-related deaths in Canada over time, along with different scenarios and data sources.

Opioid-Related Deaths in Nova Scotia

• A table details confirmed and probable acute opioid toxicity deaths in Nova Scotia, from 2011 to 2022.

Goals of Treatment

• Stop using drugs.
• Promote healthier lifestyles (reduce stress).
• Decrease dependency (detox).
• End addiction.
• Coping skills and self-esteem.
• Social benefits—improve relationships and reduce legal problems.

Goal of Treatment

• Preventing a relapse back into drug abuse, especially if genetically susceptible.
• Psychological support beyond abstinence is needed.

Categories of Treatment

• Information and general health strategies (peer support, outreach services, needle exchanges).
• Drug cessation.
• Detoxification (getting through withdrawal).
• Drug substitution therapy (using safer drugs).
• Blocking or aversive drugs.
• After detoxification, reduce/eliminate reinforcing effects.
• Psychosocial therapy and support groups.

Blocking or Aversive Drugs

• Administered after detoxification.
• Blocking (antagonists) reduce drug effects.
• Reduce reinforcing effects (examples include naltrexone).
• Aversive agents create negative effects when the drug is used—punishment.
  • Example: Disulfiram.

Naltrexone

• Competitive antagonist at some opioid receptors.
• Reduces alcohol use and frequency for those taking it an hour before their dose.
• Reduces positively reinforcing effects from alcohol.
• Decreases heroin use and overdose risk.
• Reducing cravings takes a few weeks with both drugs.

Disulfiram

• A drug that causes unpleasant effects (hangover symptoms) when alcohol is consumed.

Drug Substitution Therapy

• The use of a safer drug to replace a problematic substance (heroin, nicotine).
• Example: Methadone (synthetic opioid agonist) for managing opioid dependence.
• Why this might be safer: Regulated supply, pure formulation, less likely to cause an overdose, combined with antagonists to lower the effect.

Drug Substitution/ Maintenance Therapy

• Methadone (synthetic opioid agonist).
• Nicotine patch (same compound without harmful toxins).
• Suboxone (buprenorphine—opioid agonist AND naloxone—opioid antagonist).
• Naloxone breaks down when taken orally.

Naloxone (Narcan)

• Non-selective and competitive opioid receptor antagonist.
• Used to treat heroin and other overdoses.
• Easy to use nasal spray (OTC in 2016).
• 46 Nova Scotians died from overdoses this year, as of an article's publication date.

Treatment Options

• Quitting cold-turkey is not very effective.
• Need to combat physiological and psychological dependencies.
• Need social support (groups and therapists).

Addiction Summary

• Drugs disrupt neurotransmission, creating physical and psychological dependencies.
• Treatment options for addiction and drug use.
• Social factors impact addiction (addressed in a future class).

Quiz Information

• A review quiz is scheduled for Wednesday by 10 am, on Moodle.

Explore the complexities of addiction in this quiz, covering both physical and psychological dependence, as well as the impact of learned behaviors. Learn about treatment models, the neurobiological changes associated with substance use, and the role of operant conditioning in addiction. Ideal for students studying addiction and its multifaceted nature.