Chapter 9

• Drugs change behavior through their effects on neuron activity at synapses.
• Agonists (and partial agonists) mimic neurotransmitters, antagonists block neurotransmitters, and other drugs affect neurotransmitter reuptake.
• Substance use disorder involves overwhelming drug use despite negative consequences.

Models of Addiction

• Biomedical models view dependence as a chronic disease causing abnormal physical functioning.
• Reward models propose that psychoactive drugs' pleasurable effects motivate repeated use by overstimulating the reward system.
• The "wanting-and-liking" theory suggests that "wanting" (craving) a drug becomes stronger over time, even if the person no longer "likes" (enjoys) its effects.
• The nucleus accumbens, a brain region involved in reward, motivation, and pleasure, plays a key role in addiction and reinforcement of behaviors.
• Common liability to addiction suggests that genetic, environmental, and psychological factors contribute to a general vulnerability to different types of addiction, rather than specific substances leading to further drug use.

Alcohol Use and Abuse

• Alcohol depresses the nervous system and impairs judgment.
• Genes, peer pressure, difficult home environments, and tension contribute to alcohol dependence.
• Behavioral undercontrol and negative emotions increase alcohol dependence risk.
• AUD is defined by daily alcohol needs, failed attempts to cut down, binge drinking, memory loss while intoxicated, and continued drinking despite health issues.
• Alcohol treatment starts with medically supervised detoxification.
• Counseling, psychotherapy, and support groups such as AA can help.
• Aversion therapy, causing nausea when alcohol is consumed, and antidepressants like Prozac, which reduce cravings, are pharmacological treatments for alcohol dependence.
• Fetal alcohol syndrome is a condition caused by prenatal alcohol exposure, leading to developmental, cognitive, and physical abnormalities in a child.
• At-risk drinking is a pattern of alcohol consumption that increases the likelihood of health problems, often defined by exceeding recommended limits for safe drinking.
• Blood alcohol level is the concentration of alcohol in the bloodstream, typically measured in grams per deciliter (g/dL), used to determine intoxication levels.
• Alcohol myopia is a cognitive effect of alcohol intoxication where focus is narrowed, leading to impaired judgment, reduced self-awareness, and an inability to consider long-term consequences.
• Behavioral disinhibition is a lack of restraint and impulse control, often leading to risky or socially inappropriate behavior, commonly associated with substance use.
• Alcohol expectancy effects refer to the influence of a person's beliefs about alcohol on their behavior and experience of intoxication, regardless of actual alcohol consumption.

Tobacco Use and Abuse

• E-cigarettes are battery-powered vaporizers that simulate smoking without burning tobacco, appearing safer.
• Vaping exposes users to harmful substances like formaldehyde, acetaldehyde (carcinogens), and toxic metal nanoparticles.
• Cigarette smoking is the most preventable cause of death in the Western world.
• Nicotine stimulates the body and induces physical dependence and withdrawal.
• Social pressures influence smoking initiation.
• Psychological, behavioral, social, and biological factors make it hard to quit smoking.
• The nicotine-titration model suggests long-term smokers smoke to maintain nicotine levels.
• Smoking prevention programs focusing on refusal skills before eighth grade may be most effective.
• Successful antismoking ads use culturally sensitive nonsmoking peer role models.
• No single treatment is most effective for quitting smoking, and most programs have high relapse rates.
• Modern treatments address psychological factors with relapse prevention and physical factors with nicotine replacement.

Marijuana

• Marijuana comes from Cannabis sativa, containing the hallucinogen THC (delta-9-tetrahydrocannabinol).
• THC affects mood, time perception, sensations, thinking, problem-solving, and memory.
• Marijuana use can negatively affect memory, language, and motivation, which is especially important during adolescence and emerging adulthood.
• Heavy THC use for 20+ years may cause damage.

Additional Information

• A gateway drug is a substance (e.g., nicotine, alcohol, or cannabis) that is believed to increase the likelihood of using more addictive or dangerous drugs in the future.
• Psychoactive drugs are substances that alter brain function, affecting mood, perception, consciousness, or behavior (e.g., caffeine, alcohol, nicotine, and illicit drugs).
• Dependence is a state in which a person requires a drug or behavior to function normally, often characterized by tolerance and withdrawal symptoms when the substance or behavior is discontinued.
• Withdrawal refers to a set of physical and psychological symptoms that occur when a person stops or reduces the use of a drug or addictive behavior after prolonged use.
• Drug potentiation is the increased effect of a drug when taken with another substance, often due to interactions that enhance its impact.
• Teratogens are substances or environmental factors (e.g., drugs, alcohol, infections) that can cause birth defects or developmental issues in a fetus during pregnancy.
• The blood-brain barrier consists of a protective network of blood vessels and cells that regulates the passage of substances between the bloodstream and the brain, preventing harmful toxins and pathogens from entering the central nervous system.
• Concordance rate indicates the probability that two individuals (often twins) will both exhibit a particular trait or condition, used in studies of genetics and heritability.
• Behavioral addiction involves a compulsive engagement in rewarding non-substance-related behaviors (e.g., gambling, gaming, or shopping) that leads to negative consequences like substance addiction.
• Behavioral undercontrol is a personality trait associated with impulsivity, risk-taking, and difficulty regulating behavior, often linked to substance use disorders.
• Negative emotionality is a tendency to experience negative emotions such as anxiety, depression, and anger, which can increase vulnerability to addiction.
• Behavioral activation is a therapeutic approach that encourages engagement in positive activities to counteract depression and improve mental well-being.
• Aversion therapy is a behavioral treatment that pairs undesirable behaviors (e.g., drinking, smoking) with unpleasant stimuli (e.g., nausea, electric shocks) to reduce their appeal.