addictions

shared characteristics of health-compromising behaviours

adolescent vulnerability, image and peer culture, reinforcement, gradual development, predicted by conflict and stress

addiction

a chronically relapsing disorder characterized by compulsion to seek and take the drug, loss of control in limiting intake, and continued use despite consequences

maladaptive addiction

behaviour that interferes with the user’s life in a harmful way

route of administration

method used to ingest the drug, alters rate of drug absorption and blood levels

set

user’s state of mind at the time of drug use

setting

physical environment at the time of drug use

cravings

an insistent search for an activity, distinctive feature of addictions

effect of repeated exposure

alters neural receptors to be more responsive to addiction-related stimuli, disrupts prefrontal cortex

tolerance

decrease in effect as addiction develops, is learned behaviour

withdrawal

body’s reaction to drug absence, drug relieves symptoms through negative reinforcement

economic cost of drugs

more than 38.4 billion dollars per year

alcohol and mortality

involved in over 50% of traffic deaths and homicides, 30% of suicides, about 20% of all deaths linked to substances

mesocorticolimbic dopamine system

includes frontal cortex, nucleus accumbens, ventral tegmental area, and substantia nigra

dopamine release

altered in the ventral tegmental area by addictive substances

factors in substance use disorder

genetic predisposition, prenatal and childhood environment, sensitivity to intoxication, stress response

alcoholism risk in sons of alcoholics

over 60% chance, often experience less intoxication from moderate drinking

ethanol

alcohol produced by fermentation of sugars by yeasts, dies at 15% concentration

fetal alcohol spectrum disorders (fasd)

caused by alcohol crossing placenta, leads to birth defects like facial abnormalities and learning disabilities

major effects of alcohol

impaired coordination, perception, memory, brain and organ damage, high blood pressure

alcohol withdrawal stage 1

starts 6–12 hours after last drink, includes anxiety, agitation, insomnia, sweating

alcohol withdrawal stage 2

occurs 24 hours or up to 3 days later, includes hallucinations, disorientation, panic attacks

alcohol vulnerability factors

anxiety, family history, high cortisol response, novelty seeking, low sensitivity, sociocultural factors

tobacco and death

leading preventable cause of death, about 50,000 deaths per year, 2/3 smokers die

nicotine effects

stimulates fatty acid release, raises heart rate and blood pressure, linked to breast cancer

nicotine

colourless, highly toxic alkaloid from tobacco, addictive

nicotine withdrawal symptoms

cravings, irritability, anxiety, concentration issues, restlessness, hunger

chippers

long-term smokers who smoke less than 5 cigarettes a day, do not develop dependency but do develop tolerance

dual reinforcement model

nicotine acts as primary reinforcer and enhances other reinforcers through conditioning

primary drives

hunger, thirst, sex, desire to alter consciousness

psychological reasons for drug use

to explore unconscious, resolve conflict, escape boredom, impulsivity

family model of addiction

addiction affects all members, linked to poor parenting, trauma, boundary issues

self-medication model

drug use as purposeful attempt to manage pain, psychological issues, or personality traits

social learning theory

drug use is socially acquired and maintained by cues, reinforcers, cognition, and modeling

developmental-genetic model

addiction results from genetic and environmental interaction, includes epigenetic and temperament changes

genetic risk factors

primary (family history), secondary (comorbid disorders), tertiary (other polymorphisms)

treatment options

alcoholics anonymous, cbt, motivational interviewing, antabuse, detox, behavioural interventions

antabuse (disulfiram)

causes sickness after drinking alcohol to create negative association

detoxification

uses benzodiazepines to manage withdrawal symptoms, often with psychosocial rehab

nicotine treatment

includes nicotine replacement therapy, bupropion, and varenicline