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
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
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.
Drug Self-Administration
Conditioned Place Preference CS- context US- drug
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
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.
Conditioned Drug Tolerance
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
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
2. Stimulants Antidepressants ti tricyclics MAO inhibitors SSRIs Catecholamine mimetics amphetamine, co caine, methamphetamine Caffeine Nicotine
DAT binding sites in monkey brain
3. Opiates Natural morphine heroin, codeinee Synthetic methadone meperidine (De emerol) oxycodone (Oxycontin) hydrocodone ( Lortab)
Opium poppy plant
Opiate Receptors in Rat Brain
4. Hallucinogens Natural mescaline, psilocybin Synthetic lysergic acid diethylmide (LSD) Miscellaneous marijuana volatile solvents phencyclidine (PCP)
What is this?
Cannabinoid Receptors in Rat Brain
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
In vivo Microdialysis
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
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
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
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.
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.
DSM-IV Diagnoses and Codes, Alphabetical Listing 305 Alcohol Abuse 303.9 Alcohol Dependence 303 Alcohol Intoxication 291 Alcohol Intoxication Delirium 291.81 Alcohol Withdrawal 291 Alcohol With drawal Delirium 291.89 Alcohol-Induced Anxiety Disorder 291.89 Alcohol-Induced Mood Disorder 291.11 Alcohol-Indu l ced dpersisting Amnestic Disorder 291.2 Alcohol-Induced Persisting Dementia 291.5 Alcohol-Induced Psychotic Disorder, With Delusions 291.3 Alcohol-Induced Psychotic Disorder, With Hallucinations 291.89 Alcohol-Induced Sexual Dysfunction 291.89 Alcohol-Induced Sleep Disorder 291.9 Alcohol-Related Disorder NOS
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
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)
Ro 15-4513 (alcohol antagonist at GABA A receptor)
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
Recovery Psychosocial Intervention 1. Family support 2. Job skills training 3. Semi-structured residential facility 4. Psychotherapy 5. Narcotics Anonymou us and Alcoholics Anonymous