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Chapter 11: Addiction

In this Chapter…

  • Nicotine

  • Alcohol

  • Marijuana

  • Opiates

  • Psychostimulants

  • Club Drugs

Introduction

  • Drugs can alter the structure and chemical makeup of the brain

    • This produces a brain disorder called drug addiction

    • drug addiction/dependence: characterized by a pathological desire for drugs

      • drug seeking and taking behaviors occupy too much time

  • A key reason for drug use is that abused drugs produce feelings of pleasure and/or remove feelings of stress & emotional pain

  • Drugs produce pleasure by activating the reward system

    • This reward system is normally involved in the type of learning that helps us stay alive

    • It evolved to mediate pleasurable & motivating effects of natural rewards

    • When the reward makes pleasurable feelings, we learn to repeat the actions that got us the reward in the first place

  • Drugs alter the ways neurotransmitters carry messages from neuron to neuron in different ways:

    • Some mimic the neurotransmitters

    • Some block the neurotransmitters

    • Others alter the way neurotransmitters are released/inactivated

  • Brain regions involved with executive functions and judgment are changed by drugs

  • Factors in drug addiction:

    • Motivation for drug use

      • People who take drugs to get high are more likely to be addicted than people who use them as painkillers

    • Genetic susceptibility and environmental factors (stress, etc.)

    • Characteristics of drugs themselves

  • Tolerance: the progressive need for a higher drug dose to achieve the same effect

    • Varies person by person

Nicotine

  • Nicotine ats through the acetylcholine nicotinic receptor

  • Can act as a stimulant and depressant in the brain

  • Stimulates adrenal glands

    • Causes a “kick”

      • There’s a sudden release of glucose paired with an increase in blood pressure

  • Nicotine releases dopamine

  • Nicotine treatments relieve withdrawal symptoms, lower nicotine levels, totally eliminate one’s exposure to smoke

    • Bupropion: originally an antidepressant but approved for use as a nicotine addiction treatment

      • this was the first non-nicotine treatment

    • Varenicline: interacts with the acetylcholine nicotinic receptor and prevents nicotine from activating it

      • ends smoking

Alcohol

  • Genetic and environmental factors contribute to alcoholism

  • Cirrhosis: scarring of the liver

  • Ethanol: the active ingredient in alcoholic drinks

  • Alcohol acts as a stimulant in low doses & a depressant in high doses

  • Alcohol significantly alters behavior and mood

    • Too much alcohol causes heat loss and dehydration

  • Alcohol interacts with the GABA receptor

    • It calms anxiety, impairs muscle control, and delays reaction time

  • Higher doses of alcohol decrease the function of NMDA receptors

    • These receptors recognize neurotransmitter glutamate

  • Alcohol works by activating the endogenous opioid system

    • Susceptible individuals may feel an opioid-like euphoria from their own endorphins

    • Naltrexone: works by blocking opioid receptors

      • developed for opioid addiction but can also be used for these individuals

Marijuana

  • Distorts perception and alters sense of time, space, and self

    • Marijuana can also produce intense anxiety

  • Tetrahydrocannabinol (THC): the active ingredient in marijuana

    • Binds to cannabinoid receptors

      • Many of these receptors are in neurons responsible for coordinating movement

  • The hippocampus contains many receptors for THC

    • This causes intoxicated people have poor short-term memory and problems processing complex information

  • Cannabinoid receptors usually bind to natural neurochemicals called endocannabinoids (anandamide, etc.)

Opiates

  • Withdrawal symptoms of opiates

    • mild flu-like discomfort to severe muscle pain

    • stomach cramps

    • diarrhea

    • unpleasant mood

  • An increased amount of dopamine is released in the reward system → mimics the effects of endogenous opioids

    • Opiates reach the brain in 15 to 20 seconds

    • They bind to opiate receptors in brain regions involved in the reward system

    • They cause a brief rush of intense euphoria and then a couple of hours in a relaxed and contented state

  • Small doses of opioids can

    • relieve pain

    • depress breathing

    • cause nausea and vomiting

    • stop diarrhea

  • Large doses can make breathing shallow or even stop

  • Methadone: A long-acting oral opioid that keeps craving, withdrawal, and relapse under control

    • Most common opioid addiction treatment

    • Prevents withdrawal symptoms that can motivate continued drug use

  • Naloxone and Naltrexone: block opiate receptors so they don’t produce any pleasurable effects when taken

  • Buprenorphine: causes a weaker effect on receptors than methadone, creating a limited high

Psychostimulants

  • Includes cocaine and amphetamines

  • Crack/cocaine can

    • enter the brain in seconds

    • produce a rush of euphoria

    • bring about a feeling of power or self-confidence

  • Psychostimulants are greatly able to elevate dopamine in specific brain regions

    • Activating the nucleus accumbens causes the progressively increasing motivation to take drugs

      • This leads to addiction

  • Cocaine users often go on binges

    • Crash occurs after use

      • This crash is characterized by emotional and physical exhaustion as well as depression

  • Symptoms come from a shutdown in dopamine & serotonin function and a greater response in brain systems that reach to stress

  • Vaccines to produce antibodies to cocaine are in clinical trials

Club Drugs

  • Club Drugs include

    • ecstasy

    • herbal ecstasy

    • rohypnol (roofies)

    • GHB (gamma hydroxy-butyrate)

    • ketamine

  • Serious damage can occur from the use of some of these drugs

  • MDMA- 3, 4-methylenedioxymethamphetamine (“adam”, “ecstasy”, “XTC”)

    • Synthetic psychoactive drug, hallucinogenic and amphetamine-like properties

      • Problems are similar to those associated with the use of amphetamines & cocaine

  • Chronic ecstasy use causes long-term changes in brain areas of thought, memory, and pleasure

  • Rohypnol, GHB, and Ketamine are all CNS depressants

    • They are colorless, tasteless, odorless

    • They can be used by some in beverages and unknowingly ingested

  • Rohypnol can be lethal when mixed with alcohol and other depressants

  • GHB (Gamma hydroxy-butyrate): a drug that has been abused for euphoric, sedative, and body-building effects

  • Ketamine: a Central Nervous System depressant, hypnotic, and analgesic with hallucinogenic properties

    • Also used as a general anesthetic

AA

Chapter 11: Addiction

In this Chapter…

  • Nicotine

  • Alcohol

  • Marijuana

  • Opiates

  • Psychostimulants

  • Club Drugs

Introduction

  • Drugs can alter the structure and chemical makeup of the brain

    • This produces a brain disorder called drug addiction

    • drug addiction/dependence: characterized by a pathological desire for drugs

      • drug seeking and taking behaviors occupy too much time

  • A key reason for drug use is that abused drugs produce feelings of pleasure and/or remove feelings of stress & emotional pain

  • Drugs produce pleasure by activating the reward system

    • This reward system is normally involved in the type of learning that helps us stay alive

    • It evolved to mediate pleasurable & motivating effects of natural rewards

    • When the reward makes pleasurable feelings, we learn to repeat the actions that got us the reward in the first place

  • Drugs alter the ways neurotransmitters carry messages from neuron to neuron in different ways:

    • Some mimic the neurotransmitters

    • Some block the neurotransmitters

    • Others alter the way neurotransmitters are released/inactivated

  • Brain regions involved with executive functions and judgment are changed by drugs

  • Factors in drug addiction:

    • Motivation for drug use

      • People who take drugs to get high are more likely to be addicted than people who use them as painkillers

    • Genetic susceptibility and environmental factors (stress, etc.)

    • Characteristics of drugs themselves

  • Tolerance: the progressive need for a higher drug dose to achieve the same effect

    • Varies person by person

Nicotine

  • Nicotine ats through the acetylcholine nicotinic receptor

  • Can act as a stimulant and depressant in the brain

  • Stimulates adrenal glands

    • Causes a “kick”

      • There’s a sudden release of glucose paired with an increase in blood pressure

  • Nicotine releases dopamine

  • Nicotine treatments relieve withdrawal symptoms, lower nicotine levels, totally eliminate one’s exposure to smoke

    • Bupropion: originally an antidepressant but approved for use as a nicotine addiction treatment

      • this was the first non-nicotine treatment

    • Varenicline: interacts with the acetylcholine nicotinic receptor and prevents nicotine from activating it

      • ends smoking

Alcohol

  • Genetic and environmental factors contribute to alcoholism

  • Cirrhosis: scarring of the liver

  • Ethanol: the active ingredient in alcoholic drinks

  • Alcohol acts as a stimulant in low doses & a depressant in high doses

  • Alcohol significantly alters behavior and mood

    • Too much alcohol causes heat loss and dehydration

  • Alcohol interacts with the GABA receptor

    • It calms anxiety, impairs muscle control, and delays reaction time

  • Higher doses of alcohol decrease the function of NMDA receptors

    • These receptors recognize neurotransmitter glutamate

  • Alcohol works by activating the endogenous opioid system

    • Susceptible individuals may feel an opioid-like euphoria from their own endorphins

    • Naltrexone: works by blocking opioid receptors

      • developed for opioid addiction but can also be used for these individuals

Marijuana

  • Distorts perception and alters sense of time, space, and self

    • Marijuana can also produce intense anxiety

  • Tetrahydrocannabinol (THC): the active ingredient in marijuana

    • Binds to cannabinoid receptors

      • Many of these receptors are in neurons responsible for coordinating movement

  • The hippocampus contains many receptors for THC

    • This causes intoxicated people have poor short-term memory and problems processing complex information

  • Cannabinoid receptors usually bind to natural neurochemicals called endocannabinoids (anandamide, etc.)

Opiates

  • Withdrawal symptoms of opiates

    • mild flu-like discomfort to severe muscle pain

    • stomach cramps

    • diarrhea

    • unpleasant mood

  • An increased amount of dopamine is released in the reward system → mimics the effects of endogenous opioids

    • Opiates reach the brain in 15 to 20 seconds

    • They bind to opiate receptors in brain regions involved in the reward system

    • They cause a brief rush of intense euphoria and then a couple of hours in a relaxed and contented state

  • Small doses of opioids can

    • relieve pain

    • depress breathing

    • cause nausea and vomiting

    • stop diarrhea

  • Large doses can make breathing shallow or even stop

  • Methadone: A long-acting oral opioid that keeps craving, withdrawal, and relapse under control

    • Most common opioid addiction treatment

    • Prevents withdrawal symptoms that can motivate continued drug use

  • Naloxone and Naltrexone: block opiate receptors so they don’t produce any pleasurable effects when taken

  • Buprenorphine: causes a weaker effect on receptors than methadone, creating a limited high

Psychostimulants

  • Includes cocaine and amphetamines

  • Crack/cocaine can

    • enter the brain in seconds

    • produce a rush of euphoria

    • bring about a feeling of power or self-confidence

  • Psychostimulants are greatly able to elevate dopamine in specific brain regions

    • Activating the nucleus accumbens causes the progressively increasing motivation to take drugs

      • This leads to addiction

  • Cocaine users often go on binges

    • Crash occurs after use

      • This crash is characterized by emotional and physical exhaustion as well as depression

  • Symptoms come from a shutdown in dopamine & serotonin function and a greater response in brain systems that reach to stress

  • Vaccines to produce antibodies to cocaine are in clinical trials

Club Drugs

  • Club Drugs include

    • ecstasy

    • herbal ecstasy

    • rohypnol (roofies)

    • GHB (gamma hydroxy-butyrate)

    • ketamine

  • Serious damage can occur from the use of some of these drugs

  • MDMA- 3, 4-methylenedioxymethamphetamine (“adam”, “ecstasy”, “XTC”)

    • Synthetic psychoactive drug, hallucinogenic and amphetamine-like properties

      • Problems are similar to those associated with the use of amphetamines & cocaine

  • Chronic ecstasy use causes long-term changes in brain areas of thought, memory, and pleasure

  • Rohypnol, GHB, and Ketamine are all CNS depressants

    • They are colorless, tasteless, odorless

    • They can be used by some in beverages and unknowingly ingested

  • Rohypnol can be lethal when mixed with alcohol and other depressants

  • GHB (Gamma hydroxy-butyrate): a drug that has been abused for euphoric, sedative, and body-building effects

  • Ketamine: a Central Nervous System depressant, hypnotic, and analgesic with hallucinogenic properties

    • Also used as a general anesthetic