a. positive vs. negative reinforcement b. tolerance vs. sensitization c. drug classes einforcement
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2 Drug Abuse (chapter 18) 1. Definitions iti a. positive vs. negative reinforcement b. tolerance vs. sensitization c. drug classes 2. Neural Mechanisms of Re einforcement a. mesolimbic dopamine system b. cellular mechanisms 3. Treatment of Drug Abuse a. diagnosis b. detoxification c. relapse and recovery
3 Drug Abuse (chapter 18) 1. Definitions iti a. positive vs. negative reinforcement b. tolerance vs. sensitization c. drug classes 2. Neural Mechanisms of Re einforcement a. mesolimbic dopamine system b. cellular mechanisms 3. Treatment of Drug Abuse a. diagnosis b. detoxification c. relapse and recovery
4 OPERANT CONDITIONING Positive Reinforcement: Increase in responding that results when an appetitivee reward is presented after a response occurs. Negative Reinforcement: Increase in responding that results when an aversive stimulus is removed after a response occurs. Punishment: Decrease in responding that results when an aversive stimulus is presented after a response occurs.
5 Drug Self-Administration
6 Conditioned Place Preference CS- context US- drug
7 Drug Abuse (chapter 18) 1. Definitions iti a. positive vs. negative reinforcement b. tolerance vs. sensitization c. drug classes 2. Neural Mechanisms of Re einforcement a. mesolimbic dopamine system b. cellular mechanisms 3. Treatment of Drug Abuse a. diagnosis b. detoxification c. relapse and recovery
8 Repeated Exposure to Drugs Tolerance: Decrease in the effect of a drug when given repeatedly at a constant dose. Can be due to either pharmacokinetic or pharmacodynamic changes. Sensitization: Increase in the effect of a drug when given repeatedly at a constant dose. Physical Dependence: Upo on cessation of drug exposure, a rebound withdrawal syndrome is evident.
9 Conditioned Drug Tolerance
10 Drug Abuse (chapter 18) 1. Definitions iti a. positive vs. negative reinforcement b. tolerance vs. sensitization c. drug classes 2. Neural Mechanisms of Re einforcement a. mesolimbic dopamine system b. cellular mechanisms 3. Treatment of Drug Abuse a. diagnosis b. detoxification c. relapse and recovery
11 1. Sedative-hypnotics Nonbarbiturates e.g., meprobamate, methaqualone Barbiturates t short-acting e.g.., thiopental intermediate-acting e.g., pentobarbital long-acting e.g., phenobarbital Benzodiazepines eg e.g., diazepam Antipsychotics phenothiazines i e.g., chlropromazine butyrophenones e.g., haloperidol atypicals e.g., clozapine Alcohol
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13 2. Stimulants Antidepressants ti tricyclics MAO inhibitors SSRIs Catecholamine mimetics amphetamine, co caine, methamphetamine Caffeine Nicotine
14 DAT binding sites in monkey brain
15 3. Opiates Natural morphine heroin, codeinee Synthetic methadone meperidine (De emerol) oxycodone (Oxycontin) hydrocodone ( Lortab)
16 Opium poppy plant
17 Opiate Receptors in Rat Brain
18 4. Hallucinogens Natural mescaline, psilocybin Synthetic lysergic acid diethylmide (LSD) Miscellaneous marijuana volatile solvents phencyclidine (PCP)
19 What is this?
20 Cannabinoid Receptors in Rat Brain
21 Drug Abuse (chapter 18) 1. Definitions iti a. positive vs. negative reinforcement b. tolerance vs. sensitization c. drug classes 2. Neural Mechanisms of Re einforcement a. mesolimbic dopamine system b. cellular mechanisms 3. Treatment of Drug Abuse a. diagnosis b. detoxification c. relapse and recovery
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23 In vivo Microdialysis
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27 Drug Abuse (chapter 18) 1. Definitions iti a. positive vs. negative reinforcement b. tolerance vs. sensitization c. drug classes 2. Neural Mechanisms of Re einforcement a. mesolimbic dopamine system b. cellular mechanisms 3. Treatment of Drug Abuse a. diagnosis b. detoxification c. relapse and recovery
28 Cellular Cascade Effects of Repeated Morphine Exposure 1. Up-regulation of camp pathway -due to increased protein kina ase A (PKA) -phosphorylates ion channels 2. Increased CREB (camp resp ponse element-binding protein) -CREB is transcription factor in nucleus which alters gene expression -also due to increased protein kinase A (PKA) 3. Increased glutamate transmission may also occur
29 Drug Abuse (chapter 18) 1. Definitions iti a. positive vs. negative reinforcement b. tolerance vs. sensitization c. drug classes 2. Neural Mechanisms of Re einforcement a. mesolimbic dopamine system b. cellular mechanisms 3. Treatment of Drug Abuse a. diagnosis b. detoxification c. relapse and recovery
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33 Warning Signs of Teen Substance Abuse Physical Fatigue, repeated health complaints, red and glazed eyes, and a lasting cough. Emotional Personality change, sudden mood changes, irritability, irresponsible behavior, low selfesteem, poor judgment, depression, and a general lack of interest. Family Starting arguments, breaking rules, or withdrawing from the family. School Decreased interest, negative attitude, drop in grades, many absences, truancy, and discipline problems. Social problems New friends who are less interested di in standard dhome and school activities, ii problems with the law, and changes to less conventional styles in dress and music.
34 What is Addiction? A psychological or physiological over dependence of an organism on a drug or action. Mainly associated with the label for a form of substance-uscases in which there has been long-term abuse and loss of disorder, it is used only for control leading to impaired so ocial and/or occupational functioning. The specific drug or action involved is usually specified e.g. alcohol abuse, amphetamine abuse.
35 DSM-IV Diagnoses and Codes, Alphabetical Listing 305 Alcohol Abuse Alcohol Dependence 303 Alcohol Intoxication 291 Alcohol Intoxication Delirium Alcohol Withdrawal 291 Alcohol With drawal Delirium Alcohol-Induced Anxiety Disorder Alcohol-Induced Mood Disorder Alcohol-Indu l ced dpersisting Amnestic Disorder Alcohol-Induced Persisting Dementia Alcohol-Induced Psychotic Disorder, With Delusions Alcohol-Induced Psychotic Disorder, With Hallucinations Alcohol-Induced Sexual Dysfunction Alcohol-Induced Sleep Disorder Alcohol-Related Disorder NOS
36 Drug Abuse (chapter 18) 1. Definitions iti a. positive vs. negative reinforcement b. tolerance vs. sensitization c. drug classes 2. Neural Mechanisms of Re einforcement a. mesolimbic dopamine system b. cellular mechanisms 3. Treatment of Drug Abuse a. diagnosis b. detoxification c. relapse and recovery
37 Detoxification Medical intervention 1. Treat withdrawal, e.g., benzodiazepine 2. Treat secondary sy ymptoms HIV hepatitis endocarditis diti cirrhosis 3. Diagnosis and treatt psychiatric disorders depression anxiety 4. Drug maintenance methadone buprenorphine naltrexone disulfiram (Antabuse)
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39 Ro (alcohol antagonist at GABA A receptor)
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42 Drug Abuse (chapter 18) 1. Definitions iti a. positive vs. negative reinforcement b. tolerance vs. sensitization c. drug classes 2. Neural Mechanisms of Re einforcement a. mesolimbic dopamine system b. cellular mechanisms 3. Treatment of Drug Abuse a. diagnosis b. detoxification c. relapse and recovery
43 Recovery Psychosocial Intervention 1. Family support 2. Job skills training 3. Semi-structured residential facility 4. Psychotherapy 5. Narcotics Anonymou us and Alcoholics Anonymous
-- No equivalent DSM-IV code disorders 303 Alcohol dependence syndrome -- No equivalent DSM-IV code 303.9 [0-3]*
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Substance Use Disorder Covered Diagnoses ICD-9 DSM-IV Alcohol Use Disorders 291 Alcohol-induced mental -- No equivalent DSM-IV code s 303 Alcohol syndrome -- No equivalent DSM-IV code 303.9 [0-3]* Other
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