Addiction

Addiction

defined as a chronic, relapsing brain disorder characterized by compulsive drug seeking and use despite adverse consequences

I-RISA Model

explains that SUDs are driven by [1] a reduced ability to stop drug-seeking behaviors and [2] an exaggerated focus on drug-related cues

Hypofrontality

 low frontal metabolism that may contribute to the loss of control seen in addiction

Dually-Diagnosed/Co-occurring Disorders (COD)

 two or more illnesses (one mental health & one substance use) with no cause-and-effect relationship

Neonatal Abstinence Syndrome (NAS)

a group of withdrawal symptoms that happens when a baby is exposed to drugs before birth

Orbitofrontal Cortex (OFC)

executive functions such as decision-making, rewards, and problem solving located in the prefrontal cortex

Dorsal Anterior Cingulate Cortex (dACC)

tracks actions and errors

Substance Use Risk Profile Scale (SURPS)

developed to identify four personality dimensions associated with risk for substance abuse

4 Substance Use Risk Profiles

Hopelessness/Introversion, Anxiety Sensitivity, Impulsivity, Sensation Seeking

Antisocial Behavior

an early pattern is the strongest and most reliable indicator of substance abuse disorder

Gene-Environment Correlation (Passive)

children inherit both their genes and their home environment from their biological parents

Diathesis Stress Model

explains a disorder is caused by a predisposition and stress

Adverse Childhood Experiences (ACEs)

traumatic events from childhood

Opioids

chemical compounds that are not derived from natural plant matter. they are synthesized in the lab

Synthetic (Man-Made) Opioids

fentanyl and methadone are two examples of…?

Opiates

chemical compounds extracted from natural plant matter (ex: morphine, codeine)

Semisynthetic (Chemically Modified) Opiates

heroin and oxycodone are two examples of…?

Drug Enforcement Administration (DEA) Drug Schedules

things that make drugs are put into five schedules

Schedule I

no currently accepted medical use and high potential for abuse

Schedule I Drugs

heroin, LSD, and cannabis are examples of..?

Schedule II

high potential for abuse, dangerous and may lead to severe dependence

Schedule II Drugs

cocaine, meth, fentanyl, and opioids are examples of…?

Schedule III

moderate to low potential for dependence

Schedule III Drugs

tylenol with codeine and ketamine are examples of…?

Schedule IV

 low potential for abuse and low risk of dependence

Schedule IV Drugs

xanax and valium are examples of…?

Schedule V

lowest potential for abuse

Schedule V Drugs

Robitussin is an example of…?

Iatrogenic Addiction

induced in a patient by a treatment

First Epidemic (1898)

Bayer corporation developed and marketed a “safer alternative to morphine” as a cough medicine

Second Epidemic (1914-1970’s)

waves before and after WW2 affecting inner-city minorities, leading to Harrison Narcotic Act of 1914

Harrison Narcotic Act of 1914

served as the official end to unregulated opioids and the beginning of the federal war on drugs

Third Epidemic (1991-Present)

most overdose deaths due to over-prescribing, unethical marketing by Purdue Pharma framing OxyContin as “safer” due to false “12-hour formula”

Pseudoaddiction

claims addiction-like behaviors meant pain was “untreated” and higher doses were needed

Opioid Use Disorder (OUD)

at least 2 of the following within one year: (loss of control, risky use, social/vocational problems,pharmacological/physical symptoms)

Endogenous Opioids

natural painkilling peptides our bodies naturally produce

Endogenous Opioids

endorphins and mu receptors are examples of…?

Disinhibition Model

explains how individuals fail to restrain impulses, leading to risk-taking, antisocial behavior, or addiction

GABA Neurons

where mu-opioid receptors are located

Mu-Opioid Receptors

opioids bind to these

GABA

what is being inhibited (lessened) during opioid binding

Nucleus Accumbens

where dopamine firing increases during opioid receiving

Mu-Opioid Receptors

found everywhere opioids act

Acute Withdrawal Syndrome

initial withdrawal pains, gastrointestinal distress, and anxiety

Post-Acute Withdrawal Syndrome (PAWS)

lingering psychological symptoms (lasts 6 months-1 year)

Clinical Opiate Withdrawal Scale (COWS)

11-items rating common signs of opiate withdrawal and how to monitor these symptoms to see the severity of withdrawal

Agonists

replace opioid actions by binding to receptors and producing biological responses

Agonist

Methadone is an…?

Partial Agonists

bind to receptors but elicit partial functional responses

Partial Agonists

Suboxone is an…?

Antagonists

completely block responses and prevent agonists from binding to that site

Antagonist

Naltrexone is an…?

Supervised Injection Sites

designated, medically supervised facilities where people can consume pre-obtained illegal drugs safely

Heroin-Assisted Treatment (HAT)

is a medical program that prescribes pharmaceutical-grade heroin (diacetylmorphine) to people with severe, long-term opioid addiction who have not been helped by standard treatments (first seen in Switzerland)