Theories of Addictive Behaviors/Preclinical SUD Medication Evaluation

brain disease model of addiction (BDMA)

theorizes that addiction is the most severe, chronic stage of substance use disorder, in which there is a substantial loss of self-control as indicated by compulsive drug taking despite the desire to stop as a result of neurobiological changes

rationale of BDMA

-no one chooses to be addicted to a drug, implying that the person can't control their behavior or be held accountable

-addiction is a chronic disease that can't be treated (correlation between changes in the brain's structure and function and addiction)

-addiction has genetics components

positive reinforcing, negative reinforcing

drug use is initially driven by the _____ effects of drugs, but after escalating/compulsive usage is driven more by the _____ effects of relief of withdrawal symptoms

cons of BDMA

-spontaneous remittance can increase as a function of time since onset of dependence (addiction is not always chronic and relapsing or developmentally-limited)

-suggests that addiction is deterministic and driven by compulsion (no free will)

behavioral theory of addiction

theorizes that addiction is a behavioral disorder marked by repeated use despite destructive consequences and difficulty quitting despite the desire to stop as a result of persistent craving and/or continuous excessive use

primrose path theory

the latent costs of substance abuse are initially hidden and the benefits of each instance of addictive behaviors are more immediate than the costs so the individual is in a paradoxical situation of knowing how to act in their interest (global) but failing to do so when the occasion actually arises (local)

Herrnstein-Prelec theory

the local utility of consumption and non-consumption of an addictive commodity decreases as a function of increasing addiction, but the local utility of consumption is higher than the utility of non-consumption (local utility of drug use is higher than not using drugs)

overall utility decreases as a function of increased consumption less rapidly than the local utility of non-consumption so overall utility is relatively skewed towards consumption in an addict compared to someone who is sober

Becker-Murphy theory

similar to Hernnstein-Prelec theory, but non-consumption has a steeper rate of decline in utility as a function of increasing addiction compared to local consumption of the addictive commodity

cons to behavioral theory of addiction

can only discover and identify constants and variables pertaining to the specific behavior; can't discover the internal mechanisms underlying these constants and variables

BDMA rebuttal to behavioral theory

-behavior always has a physiological basis

-all experiences cause changes in the brain

-addictive behavior requires some conscious deliberation in whether to emit the behavior

BDMA treatment

treating addictive behavior requires medical intervention to treat the brain; although, medications alone are ineffective in treating SUD

behavioral theory treatment

treating addictive behavior requires the addict to change their patterns of thought and behavior; combining with medications is more effective

3 ways to study addiction theories

-extended/intermittent drug self-administration access

-pair drug intake with punishment

-drug vs non-drug choice procedures

extended/intermittent access SA

used to study compulsive, uncontrollable use/using larger amounts than intended

escalating intake

extending access in rats, but usually not NHPs, can lead to _____ for some drugs, but not others

punishment

used to study drug use despite negative consequences

drug vs non-drug choice procedures

used to study drug use to forgo other activities

3 principles of preclinical SUD candidate medication evaluation

-decreases in drug SA are sustained during chronic treatment

-decreases in drug SA occurs over a range of doses

-decreases in drug SA are behaviorally selective

potency shift

a decrease in SA of a single dose of a drug caused by a candidate medication could result from a _____, so it is necessary to test a candidate medication across a range of doses to better characterize the candidate's effects on drug SA

general behavior (behavioral selectivity)

all drugs will depress behavior at high enough doses, but candidate medications must depress SA behavior at doses that do not depress _____

choice procedures

one way to determine behavioral selectivity of a candidate medication