PSYCH 333 1nd Edition Lecture 19 Outline of Last Lecture I Substance Use Disorder II Alcohol III Cannabis IV Opioids Outline of Current Lecture II Amphetamines methamphetamines III Theories and Treatment Current Lecture Amphetamines Methamphetamines o Psychological Wakefulness alertness Euphoria increased self esteem Nervousness anxiety paranoia Confusion o Physiological ANS arousal Headaches Insomnia Dizziness Formication and other parathesias Bugs crawling on your skin o How do they work Increases dopamine in the neural reward pathway Blocks reuptake of dopamine and norepinephrine Norepinephrine Frontal lobe functioning Attention alertness Dopamine Pleasurable effects o Effects of cocaine Similar to amphetamines Greater euphoria These notes represent a detailed interpretation of the professor s lecture GradeBuddy is best used as a supplement to your own notes not as a substitute Increased sexual desire o How does cocaine work Blocks reuptake of dopamine Increased dopamine in the synapse Strongest effect in neural reward pathway and basal ganglia Uncontrolled motor movement o Effects of stimulants Intoxication Changes in heart rate rhythm Pupillary dilation Changes in blood pressure Sweating chills Nausea vomiting Decrease appetite weight loss Psychomotor agitation retardation Muscle weakness Respiratory depression Confusion coma Seizures Withdrawal Fatigue Vivid dreams Insomnia hypersomnia Increased appetite weight gain Psychomotor retardation agitation Irritability Theories and Treatment o Biological theories genetics Runs in families Higher concordance rate in MZ twins Non specific Heritability of tolerance Alcohol dehydrogenase o Neurobiology of addiction Neural reward pathway Drugs of abuse stimulate the same pathway as primary reinforcers sex food Drugs stimulate this pathway more intensely than natural rewards Dopamine projections from VTA to nucleus accumbens and PFC Neuroadaptation With repeated substance use seek out substance at the expense of natural rewards Drug use perceived as basic need Liking want opioid pathways vs craving need dopamine pathways Allostatic model homeostasis Tolerance Desensitization in the brain to the effects of the substance Down or up regulation of receptors neurotransmitters Withdrawal Takes time to change allostatic setpoint Opposite symptoms due to the down up regulation in the brain Relapse Cues triggers for cravings Down regulated reward system anhedonia o Biological treatments Antabuse disulfiram Causes vomiting nausea when alcohol is ingested Drug antagonists Naltrexone suboxone also partial agonist Treatments to reduce cravings Naltrexone acamprosate burpropion nicotine Drug replacement Methadone nicotine patches gum o Psychological theories Mood alteration Positive and negative reinforcement Expectancies about drug alcohol use Positive expectations lead to greater use Negative expectation are protective to a point Personality factors Neuroticism Impulsivity o Psychological treatments Cognitive behavioral therapy Reinforce drug abstinence punish drug use Psychoeducation Address beliefs about alcohol use Relapse prevention Motivational interviewing Treatment modalities Group psychotherapy Court mandated vs voluntary Treatment of comorbid disorders o Other treatments Inpatient rehabilitation detox Often required for alcohol withdrawal due to potentially lethal side effects Controlled environment 12 step programs AA NA etc Social and emotional support Predicts greater likelihood of staying sober Good adjunctive treatment o Psychosocial factors Cultural norms regarding substance use Availability of the substance Family use environment Earlier use related to greater abuse addiction Family discord Social setting peer group One of the strongest predictors of use Media representation o Prevention Mixed results for effectiveness DARE doesn t work Social skills and resistance training may work esp for girls Family interventions Training families to talk about drugs alcohol Regulation of advertisements Campaign against tobacco use has been one of the most effective public health initiatives Psychoeducation to correct beliefs about use