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Questions and Answers
Which act established controls over the use of opiates and cocaine in the United States?
Which act established controls over the use of opiates and cocaine in the United States?
What was one of the consequences of the prohibition enacted by the 18th Amendment in 1920?
What was one of the consequences of the prohibition enacted by the 18th Amendment in 1920?
Which of the following substances is classified as Schedule 1 under the controlled substance schedule?
Which of the following substances is classified as Schedule 1 under the controlled substance schedule?
What does the 'disease model' of drug addiction primarily focus on?
What does the 'disease model' of drug addiction primarily focus on?
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Which amendment repealed the prohibition established by the 18th Amendment?
Which amendment repealed the prohibition established by the 18th Amendment?
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Which feature is NOT typically associated with substance use disorder?
Which feature is NOT typically associated with substance use disorder?
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The stages of addiction include which of the following?
The stages of addiction include which of the following?
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What does nicotine's addiction potential compare to in the context of substance use?
What does nicotine's addiction potential compare to in the context of substance use?
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What effect does the administration of glucocorticoid receptor antagonists have on alcohol consumption in rats?
What effect does the administration of glucocorticoid receptor antagonists have on alcohol consumption in rats?
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Which of the following has been shown to reduce cravings in individuals with Alcohol Use Disorder (AUD) when exposed to cues?
Which of the following has been shown to reduce cravings in individuals with Alcohol Use Disorder (AUD) when exposed to cues?
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What combination is identified as the most effective treatment for substance use disorders?
What combination is identified as the most effective treatment for substance use disorders?
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What is a common approach for treating opioid use disorders?
What is a common approach for treating opioid use disorders?
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Which medication is mentioned as potentially aiding withdrawal side effects from GHB?
Which medication is mentioned as potentially aiding withdrawal side effects from GHB?
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What is the primary benefit of using a Methadone Maintenance Program for individuals with opioid addiction?
What is the primary benefit of using a Methadone Maintenance Program for individuals with opioid addiction?
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How does Buprenorphine, when combined with naloxone in the form of Suboxone, help prevent abuse?
How does Buprenorphine, when combined with naloxone in the form of Suboxone, help prevent abuse?
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What is a significant risk associated with starting a Methadone Maintenance Program?
What is a significant risk associated with starting a Methadone Maintenance Program?
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What role does daily contact with program staff serve in a Methadone Maintenance Program?
What role does daily contact with program staff serve in a Methadone Maintenance Program?
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What is the primary function of the long-acting effects of methadone?
What is the primary function of the long-acting effects of methadone?
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What characterizes the impulsive stage of drug-taking behavior?
What characterizes the impulsive stage of drug-taking behavior?
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Which of the following factors is NOT associated with an increased risk of addiction?
Which of the following factors is NOT associated with an increased risk of addiction?
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In Koob and Le Moal's framework, what primarily motivates drug use in the compulsive stage?
In Koob and Le Moal's framework, what primarily motivates drug use in the compulsive stage?
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The Common Disease-Common Variant hypothesis suggests that:
The Common Disease-Common Variant hypothesis suggests that:
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Which personality variable is linked to increased vulnerability to substance use through stress reduction?
Which personality variable is linked to increased vulnerability to substance use through stress reduction?
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What methodological approach investigates chromosomal regions associated with addiction?
What methodological approach investigates chromosomal regions associated with addiction?
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Which of the following is a consequence of physical dependence on drugs?
Which of the following is a consequence of physical dependence on drugs?
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Which factor can contribute to the development of substance use disorder according to the self-medication hypothesis?
Which factor can contribute to the development of substance use disorder according to the self-medication hypothesis?
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What type of research focuses on specific genes involved in neuropsychiatric disorders?
What type of research focuses on specific genes involved in neuropsychiatric disorders?
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What effect does withdrawal symptomatology have on individuals struggling with addiction?
What effect does withdrawal symptomatology have on individuals struggling with addiction?
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What is a significant benefit of the new implantable option, Probuphine, for treating opioid dependence?
What is a significant benefit of the new implantable option, Probuphine, for treating opioid dependence?
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Which of the following accurately describes Naltrexone?
Which of the following accurately describes Naltrexone?
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What is the main purpose of the developing opioid vaccine?
What is the main purpose of the developing opioid vaccine?
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What role does counseling play in substance use treatment programs?
What role does counseling play in substance use treatment programs?
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What is a characteristic feature of contingency management in drug treatment?
What is a characteristic feature of contingency management in drug treatment?
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Which of the following statements about benzodiazepine treatment is accurate?
Which of the following statements about benzodiazepine treatment is accurate?
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Which neurotransmitter systems are being explored for potential treatments for cocaine and other psychostimulants?
Which neurotransmitter systems are being explored for potential treatments for cocaine and other psychostimulants?
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Which therapeutic approach aims to restructure thought processes to aid in addiction recovery?
Which therapeutic approach aims to restructure thought processes to aid in addiction recovery?
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Study Notes
Historical Context of Drug Use and Control
- Caffeine, morphine, tobacco, and THC are all derived from plants.
- The temperance movement led to the 18th Amendment (Prohibition), criminalizing drug use in 1920.
- Prohibition was repealed in 1933 with the 21st Amendment.
- The government started regulating drug commercialization with the Pure Food and Drug Act of 1906.
- The Harrison Act of 1914 controlled the use of opiates and cocaine.
- Heroin was initially marketed as a cough suppressant.
- The Marijuana Tax Act of 1937 banned non-medical cannabis use, overturned by the Supreme Court in 1969.
- The Controlled Substances Act of 1970 established the DEA and classified drugs into five schedules.
- Prohibition led to the rise of speakeasies and organized crime.
- The 19th Amendment granted women suffrage in 1920.
Understanding Drug Addiction
- The disease model of drug addiction remains influential in the treatment community.
- Drug laws may not effectively prevent drug use and sometimes contradict scientific evidence.
- Nicotine is more addictive than THC.
Defining Drug Addiction
- Addiction involves both physiological dependence (unpleasant withdrawal symptoms) and behavioral patterns (compulsive drug seeking due to cravings).
- Both remission (drug-free periods) and relapse (drug use despite negative consequences) are integral to the addiction cycle.
- Substance use disorder is characterized by a cluster of cognitive, behavioral, and physiological symptoms, including compulsive use despite negative consequences.
- Tolerance, a decrease in the threshold for stimulation, occurs in animals treated acutely.
Factors Influencing Addiction Development
- The immediate euphoria from drug use often outweighs the delayed negative effects.
- Most individuals cease using drugs before developing addiction, even with highly potent substances like heroin and cocaine.
- Physical dependence can contribute to continued drug use, particularly due to unpleasant withdrawal symptoms.
- Koob and Le Moal proposed a progressive model of drug-taking behavior:
- The impulsive stage is driven by the reinforcing effects of drugs.
- The compulsive stage is motivated by relief from withdrawal symptoms.
Development Stages: Physical Dependence and Conditioning
- Repeated drug use leads to physical dependence.
- Reduced drug levels in the system due to delayed access can trigger:
- Unconditioned withdrawal symptoms (UR).
- Conditioned withdrawal symptoms, including cravings (CR), associated with environmental stimuli.
Brain Changes and Genetics in Addiction
- fMRI studies show increased physiological responses related to drug craving in methamphetamine users, particularly in the ventral striatum, nucleus accumbens, and medial frontal cortex.
- Genetics plays a role in susceptibility to addiction, supported by twin and adoption studies, with heritability estimates ranging from 30% to 80%.
- Two genetic hypotheses explore the role of genetic variations in addiction:
- Common disease-Common variant hypothesis: a pool of risk-conferring alleles is present in the general population.
- Common disease-Rare variant hypothesis: genetic risk arises from rare mutations and genetic anomalies.
Research Approaches in Genetic Studies
- Candidate gene analysis focuses on genes linked to a particular disorder.
- Linkage analysis identifies chromosomal regions frequently associated with the disorder.
- Genome-wide association studies examine the entire genome to find associated alleles.
Psychosocial Vulnerability to Addiction
- Risk factors include young age, low education, non-white race, lack of employment, exhibiting conduct problems in childhood, and having substance-using friends.
- Stress and coping mechanisms play a crucial role, as do existing mental health conditions such as anxiety, mood disorders, and personality disorders.
Theories Explaining Substance Use
- Self medication hypothesis: stressful life events may trigger anxiety and mood disorders, leading to substance use as a coping mechanism.
- Shared etiology hypothesis: genetic and environmental factors increase risk for both addiction and other psychiatric disorders.
Personality Variables Influencing Addiction
- Behavioral disinhibition: substance use is linked to traits like impulsivity, antisociality, unconventionality, aggressiveness, and low levels of constraint and harm avoidance.
- Stress reduction: high scores on stress-related traits like reactivity, anxiety, and neuroticism indicate increased vulnerability to addiction.
- Reward sensitivity: drug abuse is associated with sensation seeking, reward seeking, extraversion, and gregariousness.
Familial and Socialcultural Influences
- Childhood maltreatment, the presence of violence, and low parental monitoring increase the risk of addiction.
- Socialcultural studies have shown elevated substance consumption in certain communities.
Stress Modulation and Addiction
- Glucocorticoid receptor (GR) signaling in the brain may play a role in compulsive alcohol consumption.
- Neurokinin 1 receptor (NK1R) antagonists, which block the neuropeptide substance P, have shown promise in reducing anxiety, alcohol consumption, and relapse.
Treatment Approaches and Their Effectiveness
- Combine: Combining medication and behavioral intervention proves to be the most effective approach to addiction treatment.
Specific Treatments:
- Inhalants: no specific treatment; standard approaches like CBT, 12-step programs, and social therapies are used.
- GHB: no specific treatment; high doses of benzodiazepines can help with withdrawal symptoms but relapse rates are high.
- Cannabis: most users do not become dependent; standard treatments like CBT, relapse prevention, etc. are employed, but relapse susceptibility is high.
- Opioids: often treated with a biopsychosocial model due to the multidimensional nature of chronic drug use.
- Detoxification is the first step, often assisted by longer-acting opioids like methadone.
- Clonidine, an alpha-2 adrenergic agonist, reduces norepinephrine (NE) activity in the locus coeruleus, helping to manage withdrawal symptoms.
- Electroacupuncture (EA) has shown promise in restoring prodynorphin mRNA levels in the spinal cord, hypothalamus, and periaqueductal gray (PAG) in rats, suggesting a potential role in reducing withdrawal symptoms.
Methadone Maintenance Program
- 長期置換療法としてメサドンを使用した、最も一般的な治療法
- メサドンは、強力なオピオイド依存症の治療に使用される、合成麻薬です。
- メサドンを服用することで、患者の体内の受容体に対するヘロインなどの薬物の作用を阻害し、治療の過程で離脱症状を軽減することで、患者の生活を改善することができます。
Buprenorphine (Buprenex)
- Partial opiod agonist used similarly to methadone but weaker effects and longer half-life.
- Available as Suboxone, containing antagonist naloxone.
- Implantable option, Probuphine, enhances compliance and prevents diversion.
- Lower risk of birth complications compared to methadone in treating pregnant women.
Opiod Antagonist (Naltrexone or Nalmefene)
- Opioid antagonists like naltrexone (Trexan) and nalmefene (Revex) are effective for their extended duration of action and minimal side effects.
Opioid Vaccine
- Under development to produce antibodies that bind to opioid molecules, preventing them from reaching the brain.
Non-Opioid Treatment Approaches:
- Counselling: helps patients identify environmental cues and develop coping strategies.
- Narcotics Anonymous (NA): a 12-step program for addiction recovery.
Benzodiazepines
- No specific treatment for benzo withdrawal.
- Flumazenil, a benzo antagonist, is used as an antidote for overdose but has no long-term efficacy.
Cocaine and Other Psychostimulants
- No currently licensed treatments.
- Exploration of lower-dose psychostimulants that increase dopamine (DA) transmission, similar to methadone maintenance.
- Research into other neurotransmitter systems like noradrenergic, serotonergic, glutamatergic, and GABAergic systems.
- Antibody treatment is being investigated.
Behavioral and Psychosocial Therapies
- Psychosocial treatment programs involve individual, group, and family counseling to educate users, promote behavioral change, and alleviate symptoms.
- CBT aims to restructure thought processes and train users to avoid high-risk situations and use positive coping mechanisms (relapse prevention therapy).
- 12-step programs like NA, AA, and CA.
- Contingency management plans emphasize that drug-taking is an operant response, reinforced by the drug itself. These plans work to replace drug use with alternative rewards or reinforcers.
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Description
Explore the historical background of drug use and regulation in America. This quiz covers key legislation, moments, and societal impacts related to drug use from the temperance movement to the establishment of the DEA. Test your knowledge on the evolution of drug laws and their implications.
