oct 7 D&B

Dispositional (Metabolic) Tolerance: Refers to the body's increased ability to metabolize drugs over time, reducing their effects.
Acute (Session) Tolerance: Refers to the rapid decrease in drug effects during a single session of drug use.
Chronic (Functional) Tolerance: Develops with repeated drug use, shifting dose-response curves to the right, indicating decreased sensitivity to the drug's effects.

Role of Classical Conditioning: Drug administration can be seen as a classical conditioning event where pre-drug cues condition the body to anticipate drug effects (Unconditioned Stimulus, UCS) leading to compensatory responses (Unconditioned Response, UCR).
Pre-drug Cues: Cues that occur before drug use that become associated with drug effects and lead to homeostatic responses in anticipation of the drug.

Definition: Tolerance is contingent upon the presence of familiar pre-drug cues. If these cues are absent, conditioned compensatory responses won't occur, leading to decreased tolerance.
Real-Life Implications: Cues can be external (location, people) or internal (emotional states), impacting how tolerance develops in individuals.
Evidence from Studies: Studies indicate that situational specificity is consistent across drugs and contexts, showing greater tolerance when re-exposed to specific cues previously associated with drug effects.

Mechanism of Tolerance: Experienced users can tolerate higher doses of opiates without experiencing lethal effects due to developed tolerance against respiratory depression.
Loss of Tolerance: If a user finds themselves in an unfamiliar situation without those pre-drug cues, they may experience fatal overdoses upon consuming what would be a lethal dose for a non-tolerant user.
Studies on Overdose: Animal studies show that experienced animals exposed to lethal doses in drug-predicting contexts survived, while those exposed in neutral contexts succumbed.

Test Design: Animals are conditioned with drug cues paired with drug administration, then tested with saline in the presence or absence of cues to observe response.
Expected Outcomes: Animals expecting morphine but receiving saline show heightened pain sensitivity (hyperalgesia), indicating the homeostatic restorative response exists.

Craving Activation: Treatment insights from people in recovery reveal cravings and urges relate directly to exposure to pre-drug cues, such as certain settings or emotional triggers associated with past usage.
Controlled Experiences: Studies measure physiological responses to cues and establish that seeing drug-relevant cues elicits cravings, indicating the powerful role of environmental contexts.

Acute Withdrawal: Characterized by physiological symptoms appearing when a user stops using drugs, typically peaking between 72-96 hours.
Post-Acute Withdrawal Syndrome (PAWS): Prolonged symptoms that arise even after acute withdrawal subsides, leading to cravings and urges triggered by situational cues.

Homeostasis Disruption: Withdrawal symptoms generally oppose drug effects, as neurotransmitter systems reset post-drug elimination. For alcohol:
- Glutamate System Upregulation: Alcohol suppresses glutamate; withdrawal increases glutamate activity, leading to symptoms like tremors, confusion, and seizures.

Desensitization to Cues: Treatment involves exposing individuals to drug cues without the drug to weaken associations and decrease cravings.
Real-Life Application: Treatment can involve simulated scenarios where clients confront cues linked to drug use in a controlled environment to help reduce reliance on the drug.

Identifying Triggers: Successful treatment requires understanding which cues trigger cravings in individuals to devise strategies for managing cravings effectively.
Cyclic Nature of Treatment: Many users undergo repeated cycles of detox and treatment due to their inability to manage cravings triggered by cues in their environments.