Addiction Class 32 Slides PDF

Class 32 – Addiction 2 Dec 2024 Plan for today: - Learning models - Treatment - Big picture  Physical vs. psychological dependence brain changes that emotional and mental require the drug for processes that are normal function associated with the...

Class 32 – Addiction 2 Dec 2024 Plan for today: - Learning models - Treatment - Big picture  Physical vs. psychological dependence brain changes that emotional and mental require the drug for processes that are normal function associated with the development of a SUD Physical dependence  Mouse party! https://learn.genetics.utah.edu/content/addiction/mouse /  Physical dependence synaptic changes that require the drug for normal function E.g. addicted newborns DA receptor density Psychological dependence emotional and mental processes that are associated with the drug or behaviour E.g. behavioural addictions without a substance (still see physiological changes) Addiction as a learned behavior How would operant conditioning be involved in drug use?  Conditioned withdrawal group therapy  opioid users drug free for months when talking about drugs, withdrawal symptoms emerged evidence for psychological dependence  Drug opposite CR’s  Drug opposite CR’s Conditioned Withdrawal  Drug opposite CR’s Conditioned Withdrawal Conditioned Tolerance  Drug opposite CR’s Conditioned Withdrawal Conditioned Tolerance Drug-like CR’s  Cue-induced wanting Neutral cues trigger drug craving Opioid-related deaths in Canada Public Health Agency of Canada https://www.canada.ca/en/health-canada/services/opioids/data-surveillance-research/ modelling-opioid-overdose-deaths-covid-19.html Opioid-related deaths in Nova Scotia https://novascotia.ca/opi What are the goals of treatment?  What are the goals of treatment? - Stop using drugs - Promote healthier lifestyles – reduce stress - Decrease dependency? Detox? - End addiction? - Coping skills, self-esteem - Social benefits  improve relationships, reduce legal problems hould the goal of treatment be abstinenc hould the goal of treatment be abstinenc vents slippery slope back to abuse d to casually use drugs if genetically susceptible to addiction ores psychological basis for a SUD port beyond abstinence is needed vs. sober Categories of treatment ormation & general health strategies peer outreach services, needle exchanges, PCPs, social workers, police ug cessation detoxification, get through withdrawal rug substitution therapy eplace substance with safer form ocking or aversive drugs fter detoxification, reduce/eliminate reinforcing effect ychosocial therapy, support groups, etc. [more in semester 2!]  Blocking or aversive drugs Administered after detoxification blocking = antagonist that reduces effect of drug reduce reenforcing effect e.g. naltrexone  Naltrexone competitive antagonist at some opioid receptors Alcohol reduces amount and frequency of drinking take an hour before, reduces positively reinforcing effects of alcohol Heroin decreases use and overdose risk Cravings take a few weeks to reduce with both  Blocking or aversive drugs Administered after detoxification blocking = antagonist that reduces effect of drug reduce reenforcing effect e.g. naltrexone aversive = negative effect when drug is used punishment! e.g. disulfiram  Disulfiram If in your system, you get sick when you drink alcohol! Instant hangover symptoms What type of operant conditioning is this? Drug substitution therapy Why is this safer?  Drug substitution/maintenance therapy Some examples - methadone  synthetic opioid agonist - nicotine patch  same compound w/ toxins removed  Drug substitution therapy Why is this safer? - regulated supply – formulation is pure - safer to acquire - less likely to lead to overdose - combine agonist with antagonist (to block further effect) - more gradual effect (due to oral administration) - reduce harmful compounds (nicotine patch vs cigarette)  Drug substitution/maintenance therapy Some examples - methadone  synthetic opioid agonist - nicotine patch  same compound w/ toxins removed - suboxone - buprenorphine  opioid agonist AND - naloxone  opioid antagonist - breaks down when taken orally  Naloxone (Narcan) non-selective and competitive opioid receptor antagonist used to treat heroin and other opioid intoxication events (overdoses) easy to use nasal spray (OTC in 2016) 46 Nova Scotians have died this year from opioid overdoses (as of Oct. 31) https://novascotia.ca/opioid/ Categories of treatment ormation & general health strategies peer outreach services, needle exchanges, PCPs, social workers, polic rug cessation detoxification, get through withdrawal rug substitution therapy replace substance with safer form ocking or aversive drugs after detoxification, reduce/eliminate reinforcing effect ychosocial – therapy, support groups, etc. [more in semester 2!]  Treatment options Quitting cold-turkey is not very effective – why not? Need to combat physiological and psychological dependencies Need social support Groups, therapists  Addiction summary Drugs disrupt neurotransmission Physical vs. Psychological dependence Conditioning and drug use Treatment options Social factors (next semester!) For Wednesday by 10 am Review quiz on Moodle