Substance Use Disorder - Svennson

Drug Abuse

harmful or hazardous use of psychoactive substances

Drug misues

use of drug for a purpose not consistent with legal or medical guidelines

Drug Dependence

The inaibility of an individual ot function normally in the absence of a drug both phsyically an nd pscyhologically

Tolerance definition

The body’s ability to adapt or acclimate to a drug over time. A larger dose is required to achieve desired effects due to progressive decrease in responsiveness

Withdrawal definition

Symptoms that occur due to abrupt discontinuation of drug

Recognize the key DSM-5 criteria for diagnosis of substance use disorder. Difference between DSM IV and DSM V

SUD is at least 2 critierias and severe SUD is at least 6 criterias. DSM V eliminated legal problems as a criteria but added craving

What are the five theories for drug use? What is good to know about these models

Self-medication model, brain disease model, developmental and learning model, accumulation model, and social contagion model. These models are not mutually exclusive

Describe the general trends in drug overdose death over time

drug overdose deaths from opioids, cocaine, and psychostimulants have been increasing exponentially indicating an opioid crisis and drug abuse crisis

What is more important than biology when determining harmful drug use?

Socioeconomic factors

Shortcomings of the Self-Medication Hypothesis for Addiciton

Over 90% of heroin addicts demonstrate the same accumualte drug use history and there is no meaningful difference in drug choice among addicts with different mental health diagnosis

Role of mesolimbic dopamine system in sustaining drug use

Dopaminergic projections from VTA to nucleus accumbens and prefrontal cortex

The destruction of the glutamate projection into the VTA causes what?

Reduced cocaine and morphine reward

mGluR5 KO mice showed what

reduced cocaine reward

What is the effect of NMDA antagonist in the glutamate pathway?

blocks acquistiion of reinforcement learning

What can cause relapse when speaking about the roles of glutamate in sustaining substance use?

intra NAcc AMPA injection may cause relapse

What controls glutamate activity in the amygdala?

Dopamine

What are the shortcomings of the Dopamine Reward Hypothesis for Addiction

Lack of relatinoship between dopamine releasea and addiction liability. Lack of ability of dopamine modulators to treat addiction. While dopamine reward is operational for all who use drugs recreationally, few become addicted. Addictive behavior observed with drugs is not associated with euphoria