Addiction

What is addiction?

Repeated use of psychoactive substances leading to chronic intoxication, compulsion to use, difficulty stopping, and determination to obtain substances.

What are the characteristics of addictive substances?

Chemical compounds with intoxicating effects, rewarding effects, and potential harm with repeated use.

What are the three main classes of addictive substances?

1. Stimulants (e.g., cocaine) - energize and excite; 2. Depressants (e.g., heroin) - inhibit and relax; 3. Hallucinogens (e.g., LSD) - cause hallucinations and delusions.

Why are psychoactive substances used?

They provide a rewarding effect (euphoria), create cravings, and lead to loss of control over use.

How does abuse differ from addiction?

Abuse can be stopped and does not involve psychological dependence, while addiction involves compulsive use and dependence.

What is the first criterion for diagnosing alcohol use disorder?

Alcohol is often taken in larger amounts or over a longer period than intended.

What is the second criterion for diagnosing alcohol use disorder?

There is a persistent desire or unsuccessful efforts to cut down or control alcohol use.

What is the third criterion for diagnosing alcohol use disorder?

A great deal of time is spent in activities necessary to obtain alcohol, use it, or recover from its effects.

What is the fourth criterion for diagnosing alcohol use disorder?

Craving, or a strong desire or urge to use alcohol.

What is the fifth criterion for diagnosing alcohol use disorder?

Recurrent alcohol use resulting in failure to fulfill major role obligations at work, school, or home.

What is the sixth criterion for diagnosing alcohol use disorder?

Continued alcohol use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by alcohol.

What is the seventh criterion for diagnosing alcohol use disorder?

Important social, occupational, or recreational activities are given up or reduced because of alcohol use.

What is the eighth criterion for diagnosing alcohol use disorder?

Recurrent alcohol use in situations that are physically hazardous.

What is the ninth criterion for diagnosing alcohol use disorder?

Alcohol use continued despite knowledge of having a persistent or recurrent physical or psychological problem likely caused or exacerbated by alcohol.

What is the tolerance criterion for diagnosing alcohol use disorder?

A need for markedly increased amounts of alcohol to achieve intoxication or a diminished effect with continued use.

What is the withdrawal criterion for diagnosing alcohol use disorder?

Withdrawal is manifested by either the characteristic withdrawal syndrome for alcohol or using alcohol to relieve or avoid withdrawal symptoms.

What defines early remission in alcohol use disorder?

None of the criteria have been met for at least 3 months but less than 12 months after previously meeting full criteria.

What defines sustained remission in alcohol use disorder?

None of the criteria have been met at any time during a period of 12 months or longer after previously meeting full criteria.

What are the signs of alcohol intoxication?

1. Slurred speech; 2. Incoordination; 3. Unsteady gait; 4. Nystagmus; 5. Impairment in attention or memory; 6. Stupor or coma.

What are the criteria for diagnosing alcohol intoxication?

Recent ingestion of alcohol, significant behavioral or psychological changes, and specific signs or symptoms developing during or shortly after use.

What is the first criterion for alcohol withdrawal?

Cessation of (or reduction in) alcohol use that has been heavy and prolonged.

What are some symptoms that may develop after cessation or reduction of alcohol use?

Symptoms include autonomic hyperactivity, increased hand tremor, insomnia, nausea or vomiting, hallucinations, psychomotor agitation, anxiety, and generalized tonic-clonic seizures.

How are the severity levels of alcohol withdrawal symptoms categorized?

2-3 symptoms: mild, 4-5 symptoms: moderate, 6 or more symptoms: severe.

What are some risk factors for addiction?

Risk factors include environment (peer pressure), trauma, easier access to substances, genetic variations, heightened emotions (anxiety), loneliness, and other psychological disorders.

What are examples of behavioral addictions?

Examples include gambling, gaming, eating, and sex.

What is a key characteristic of drug reinforcement compared to natural reinforcers?

Drugs deliver more immediate rewards and are more salient than natural reinforcers.

What is the Medical Model of addiction?

It views addiction as a disease characterized by compulsive drug use and relapsing behavior, suggesting that addicts have little or no control.

What role does the dopamine/reward system play in addiction?

Addiction involves neuroadaptive changes that affect the dopamine system, leading to reduced dopamine receptors and impaired control.

What is a criticism of the Medical Model of addiction?

It may take away responsibility from addicts and does not fully account for neuroplasticity or the fact that many addicts quit without assistance.

What does the Moral Model of addiction propose?

It sees addiction as a choice characterized by voluntary behavior, influenced by genetic predisposition and social concerns.

What is the Theory of Rational Addiction?

It suggests that addiction is a specific pattern of rational choices, questioning why it appears different from ordinary behavior.

What is the significance of the Prefrontal Cortex in addiction?

Decreased activation in the Prefrontal Cortex is associated with impaired control and inhibition in addicts.

What is the relationship between dopamine levels and pleasurable experiences?

Increased levels of dopamine are common to most forms of pleasurable experiences, not just drug use.

How do most addicts eventually recover from addiction?

Many addicts recover without professional help, often due to moral or social concerns, and most quit by their mid-30s.

What is the impact of drug use on motivational reward systems?

Drug use subverts the rewarding properties of natural reinforcers, leading users to perceive a drug-free life as lacking pleasure.

What are transient symptoms that may occur during alcohol withdrawal?

Transient visual, tactile, or auditory hallucinations or illusions may occur.

What is the criteria for clinically significant distress in addiction?

The signs or symptoms must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

What is the importance of understanding environmental factors in addiction?

Environmental factors like peer pressure can significantly influence the risk of developing addiction.

How does genetic variation influence addiction risk?

Genetic variations can increase an individual's risk of developing addiction.

What is the role of anxiety in addiction risk factors?

Heightened emotions, such as anxiety, can contribute to an increased risk of addiction.

What is the significance of neuroadaptive changes in addiction?

Neuroadaptive changes caused by drug use can lead to a different brain state, impacting behavior and control.

What is the concept of 'maturing out' in addiction recovery?

'Maturing out' refers to the phenomenon where many addicts recover as they age, often without professional help.

What are the peculiar features of addictive behavior related to consumption?

They derive from the incentives that arise when a good has lagged effects, where consumption is both for immediate enjoyment and an investment for future enjoyment.

How do some consumers approach their consumption of addictive goods?

Some consumers find that the best consumption plan is to gradually increase consumption to ever higher levels, leading to addiction.

What paradox do drug users face regarding their happiness and consumption?

Drug users may be unhappy, but they would be even more unhappy if they were prevented from consuming their addictive drug.

What factors contribute to differences in addictive behavior among individuals?

Differences in time preferences, available choice sets, or uncertainty.

What are the potential outcomes of consuming addictive goods?

Addictive goods can be beneficial or harmful.

What is a key characteristic of harmful addictions?

Current consumption reduces future baseline welfare and increases the future value of the addictive good itself.

What does operant conditioning suggest about behavior?

All behavior is a function of environmental consequences.

What is the Law of Effect in the context of behavior?

Behavior leads to a consequence, which in turn increases or decreases the likelihood of that behavior.

How does drug use relate to positive and negative reinforcement?

Drug use increases in strength and frequency due to positive reinforcement from hedonic effects and negative reinforcement by alleviating withdrawal symptoms.

What happens to behavior when negative effects of drug use increase?

Behavior continues even when negative effects increase above the positive effects.

What are the three principles regarding preferences in decision-making?

1. Preferences are dynamic; 2. There is more than one way to frame options (local vs global); 3. Individuals always choose the best option.

What does the incentive-sensitization theory of addiction propose?

Addictive behavior is largely due to neuroadaptations from repeated drug use, leading to hypersensitivity in the nervous system.

What is the phenomenon of Sensitization in addiction?

It refers to drug-induced changes in the nervous system that enhance the incentive salience attributed to drug-related stimuli.

How does repeated drug use affect the perception of drug-associated stimuli?

It makes drug-associated stimuli more attractive and able to control behavior.

What brain system is involved in craving related to addiction?

The mesotelencephalic system, including the striatum and nucleus accumbens.

What is the difference between wanting and liking in the context of addiction?

Wanting refers to the desire for a substance, while liking refers to the pleasure derived from it.

What are the two systems described in the dual pathway model of addiction?

Type I System (Compulsive/Impulsive) is short-term and automatic, while Type II System (Control/Reflective) is rational and controlled.

What characterizes the Type I System in addiction?

It is emotional, associative, automatic, non-intentional, fast, and effortless.

What characterizes the Type II System in addiction?

It involves rational decision-making, controlled processes, and is intentional, slow, and effortful.

What cognitive processes are involved in addiction?

Hyperactive impulsive system, changes in associative networks, attentional bias, automatic associations, and dysfunctional reflective system.

What role does negative reinforcement play in addiction?

It involves using substances to prevent or reduce withdrawal symptoms or negative states.

What is the role of dopamine in positive reinforcement theory?

Dopamine gives the reward resulting in reward-seeking behavior.

What is the relationship between the quality of the high and the intensity of abuse?

There is no correlation between the quality of the high and the intensity of abuse.

Can behavior related to drug abuse be both voluntary and compulsive?

Yes, behavior can be voluntary, chosen, and compulsive at the same time.

What assumption does positive reinforcement theory make about decision-making?

It assumes that our decision-making system is divisible.

What happens when divisions in decision-making stabilize and cause failures?

They create compulsive patterns that may be very difficult to override by intentional effort alone.

What is a normative reason for compulsion into drug abuse?

To avoid negative social effects.

What biological factors trigger addiction?

Emotions triggered by biological factors can lead to addiction.

What are some behavioral treatments for addiction?

Cognitive Behavioral Therapy (CBT), Contingency Management (CM), and Motivational Interviewing.

What does Cognitive Behavioral Therapy (CBT) aim to change?

It aims to change patterns of thinking related to coping and dealing with emotions.

What is Medication Assisted Treatment (MAT)?

A treatment approach that combines medication with behavioral therapies.

What is the purpose of Alcoholics Anonymous (AA)?

To aid those with a Substance Use Disorder (SUD) through regular meetings encouraging abstinence.

How many AA groups exist worldwide?

Over 120,000 AA groups across 180 countries.

What is the significance of the 2nd step in the Twelve-step facilitation?

It involves believing that a power greater than oneself could restore sanity.

What does the 12th step of the Twelve-step facilitation entail?

Having had a spiritual awakening as a result of working the steps.

What is the dropout rate for SUD treatments?

Dropout rates average approximately 30%.

How effective is Twelve-step facilitation compared to other behavioral treatments?

It has been found to be just as effective as other established behavioral treatments, except for continuous abstinence and remission, where it outperforms them.

What is the focus of 'Psychedelics in Recovery'?

It offers a space for people in AA/Twelve-step facilitation looking to integrate classic psychedelics into their recovery.

Can psychedelics help with addiction?

This is a question explored in the context of recovery, but further research is needed.

What are the characteristics of experiences often described as 'self-transcendent' when using LSD and psilocybin?

They are characterized by a sense of unity, sacredness, ineffability, transcendence of time and space, and deeply felt positive mood.

What are some lasting benefits associated with the use of LSD and psilocybin?

Improved well-being in healthy volunteers, reduced anxiety in people with life-threatening illness, reduced depression, and improvements in substance use disorders.

How do LSD and psilocybin interact with the serotonin system?

They act as agonists on the serotonin system.

What are considered classic psychedelics?

Psilocybin, LSD, mescaline, dimethyltryptamine (DMT), and ayahuasca.

What are the physiological effects of classic psychedelics?

They are extremely low in physiological toxicity, non-addictive, and typically induce mild, transient physiological changes like modest increases in blood pressure and heart rate.

What risks are associated with the use of classic psychedelics?

Cardiac events in those at high cardiovascular risk, destabilization of individuals with psychotic disorders or predisposition, and high levels of anxiety or dangerous behavior while under the influence.

What evidence exists regarding the use of psychedelics in treating psychiatric disorders?

There is evidence suggesting they could be beneficial in treating various psychiatric disorders, including substance use disorders (SUDs) across a wide variety of substances.

What correlation has been found in clinical studies regarding psychedelics and treatment outcomes?

A moderate to strong correlation between treatment outcomes and the level of mystical experience reported by participants.

How might psychedelics be helpful in relation to Alcoholics Anonymous (AA)?

They may be helpful in combination with AA, which relies on a spiritual experience.

What is the evidence supporting the use of psychedelics for treating Alcohol Use Disorder (AUD)?

There are many studies supporting the effective use of psychedelics to treat AUD.

What is known about the effects of psychedelics on Nicotine use?

There have been few studies on the effect of psychedelics on nicotine use.

What have studies shown regarding psychedelics and long-term abstinence from substances?

Studies show strong effects and high numbers of long-term abstinence.

What preliminary effects have studies shown regarding psychedelics and Opioid and Cocaine use?

Studies have shown preliminary positive effects with numbers of 30-40% of abstinence after a year.

What considerations should be taken into account when using psychedelics for treatment?

They should only be used in controlled settings, and there are ethical concerns about combining spiritual beliefs with medical fields.

What is the current state of evidence regarding the use of psychedelics in medical settings?

There is only one known trial of this method, indicating a lack of extensive evidence.

What safety regulations are mentioned in relation to the use of psychedelics?

Other medical concerns and safety regulations need to be considered.