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Chapter 7

Chapter 7 Reading Notes.pdf

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Camie Condon

READING NOTES Chapter Seven: Drug Use and DrugAddiction Evolutionary Considerations • Years of research have told us that drugs allow people to co-opt a system or systems ◦ “Co-opt” means to activate the system by using drugs • What is that system or systems? ◦ The main system is the reward pathway system, the dopaminergic system or simply the dopamine system ▪ Sometimes referred to as the pleasure-seeking system • Researchers have argued that the dopaminergic system provides pleasure and helps focus attention on those events that produce reward ▪ It is activated when we take risks while exercising control • e.g.) Mountain climbing ▪ Today, the dopaminergic system exists as a system that provides pleasure when we eat and do all those things that are adaptive ▪ This system emerged to sustain life is the system that also promotes and sustains drug addition Some Basic Terms and Concepts Drug Addition: The World Health Organization Definition • The WTO has defined drug addition as “a state of periodic or chronic intoxication produced by repeated consumption of a drug” Substance Abuse • Substance abuse refers to the tendency to use substance to excess – either more than prescribed by a doctor or more than the person can handle without physical and psychological ill effects Psychoactive Drugs • Apsychoactive drug affects mood, consciousness, or both • Because a drug can alter psychological functioning, people tend to use and abuse it Dependency • Adrug that produces addiction has altered normal body functions to such a degree that further doses of the drug are required to maintain a state of normal well-being ◦ This state of drug dependency is generally assumed to be physiological, even though the main symptoms associated with the absence of the drug are often psychological Tolerance • People often need to use increasing amounts of a particular drug to obtain the same psychological effects ◦ This is generally referred to as tolerance Solomon's Opponent Process Model of Tolerance • Solomon noted that a person who experiences an increase in positive affect is likely to experience a sharp increase in a negative affect a short time afterward ◦ Similarly, an increase in negative affect is likely to be followed by a sharp increase increase in positive affect ◦ He argues that the human is designed so that whenever affect departs from a baseline, an opponent process is triggered to return the person to baseline ◦ It is strengthened by use and weakened by disuse ◦ The initial affective reaction will be shortened and the opponent affective reaction will grow stronger (because it tends to increase in strength each time it is triggered) ▪ Therefore, for people to experience the same effect of the drug, they need to take larger amounts Withdrawal • Withdrawal refers to the physiological and psychological symptoms that follow the cessation of drug use/ intake • Research has suggested that part of the motivation for the continued use of drugs is to avoid the negative symptoms or states that occur when people stop using drugs ◦ People often use drugs as a form of self-medication Craving • Craving refers to the strong desire to ingest a drug or drugs and the preoccupation with obtaining and ingesting a drug or drugs ◦ It is used in two related contexts: ▪ Pre-consummatory and consummatory phases of drug use • The term consummatory is often used to emphasize the idea that ingesting a drug is goal-directed activity • Those who prefer a state of high intoxication exhibit behaviour that is characterized by repeated ingestion of a drug until level desired is reached ▪ Relapse • They no longer have withdrawal symptoms, so what motivates their behaviour? ◦ What drug users report is that they relapse because of a strong craving ◦ Relapse is a psychological problem rather than a physical one • Preoccupation refers to the narrowing or focusing of attention and thought about how to obtain a drug and the pleasure of ingesting that drug ◦ This preoccupation can result in the neglect of other important activities such as job, family, friends Why People BecomeAddicted Approach and Avoidant Motivation • Kolb: There are two types of people who take drugs: ◦ The hedonist takes drugs to obtain a euphoric effect ◦ The psychoneurotic takes drugs to obtain relief from anxiety ▪ We are designed quickly to learn reactions that will take us out of the threatening state A Motivational Model • People are inclined to use drugs to regulate mood and people drink for to distinct reasons: ◦ To enhance positive emotional experiences (e.g., to feel more friendly or caring) ◦ To reduce a negative mood – a coping mechanism (e.g., anxiety) • According to this model, people who use drugs to cope with negative experiences (for avoidant reasons) are more likely to have drinking problems • One possible reason for the maturing-out process – people's tendency to use fewer drugs as they get older – could be that drugs gradually lose their motivational impact when they fail to fulfill users' expectations The Initial Motivation to Use Drugs The Biological Component • To assess whether drugs is linked to our biology, researchers have examined the correlations between drug use and temperament ◦ Mood Temperament ▪ Mood is generally conceptualized as a continuum from negative affect to positive affect ▪ Evidence indicates that cigarette smokers tend to be more anxious and neurotic (negative affect) • This is consistent with the hypothesis that people use drugs to manage moods ◦ Activity Temperament ▪ Activity temperament is conceptualized as a continuum from low activity – represented by individuals who pursue more sedentary pursuits – to high activity – represented by individuals who tend to be restless and who frequently move around and can't sit still ▪ When we are confronted by new stimuli, the brain automatically becomes aroused to process it • Once the new information has been processed, the brain relaxes • Thus, to maintain momentary arousal at an optimal level, the hyperactive child must continually seek out new stimulation • Most drugs that people use tend to increase arousal ◦ Therefore, hyperactive children are more likely to use drugs than are normal children ◦ Novelty-Seeking Temperament ▪ Novelty seeking is one aspect of sensation seeking ▪ One reason that sensation seekers find drug use so reinforcing is that their low levels of the enzyme monoamine oxidase allow them to experience greater affect than do people with high levels of monoamine oxidase The Learned Component • The general argument is that children with certain temperaments, such as high activity, experience greater anger and helplessness in problem solving situation ◦ Therefore, they might be more inclined to use drugs as a method of dealing with these emotions • One reason they might be less inclined to use drugs might be that they have learned to cope better with the environment ◦ As a result, experience fewer feelings of anger and helplessness • Some who show an increase in drug use may be due to their temperaments ◦ Some children gravitate toward a social network of nonnormative peers, which provides initial access to alcohol and tobacco and social reinforcement for their use The Cognitive Component • Self-control (or generalized self-regulation ability) is an important predictor of success, also related to drug use ◦ Children with poor self-control also lacked coping skills and, consequently, experienced more anger and helplessness ◦ Perceptions of self-control are negatively related to temperaments such as activity and negative mood ◦ After extended periods of time or effort resisting an underlying habit or urge, the ability to exert self-control lessens or fatigues ▪ e.g.)Asmoker might find that after successfully resisting the tendency to “light up” during the work day, he can no longer resist the urger when offered a cigarette Why DrugsAreAddictive • Most drugs activate the dopaminergic system ◦ Within the limbic system is a pathway (reward pathway) that rums from the ventral tegmental area (VTA) through the nucleus accumbens to the prefrontal cortex ▪ Dopamine release in either the nucleus accumbens or the prefrontal cortex is produced by all the misused drugs • (heroin, cocaine, marijuana, alcohol and nicotine) • Unlike most events, which activate the system only momentarily, drugs often keep the system active for long periods by interfering with the normal process of degradation or re-uptake ◦ Degradation refers to the process whereby enzymes break down the neurotransmitter into more basic elements so that they can be re-synthesized to create new neurotransmitters ◦ Re-uptake refers to a process by which neurotransmitters released at the synapses are reabsorbed into the synapse and stored for later release ◦ What the additive drugs typically do is interfere with the process of degradation and re-uptake, and as a result, dopamine concentrations at the synapses increase far beyond what they would normally be ◦ The main consequence is that the reward pathway remains active for long periods of time, allowing users to experience euphoria for long periods of time Heroin and Morphine The Biological Component • Heroin is often the preferred drug of many drug addicts because it stimulates the release of abnormally high amounts of dopamine and stimulates other systems that seem to complement the use of heroin • Morphine is the same drug, but less preferred because of “drug efficacy” ◦ Heroin is in a form (lipophilic) that allows it to enter the brain much faster than morphine can Endorphins: Natural Opioids of the Brain • The body manufactures its own opiates, called endorphins (endogenous morphine) ◦ Two opiate-linked peptide neurotransmitters that interact with the same receptors as morphine does ▪ Met-enkephalin ▪ Leu-enkephalin ◦ These two chemicals block substance P and have been implicated in the relief of pain • The pituitary gland produces two hormones with opiate-like effects: ◦ Beta-endorphin ◦ Dynorphin ▪ Collectively, these are known as endorphins ▪ In addition to killing pain, they remove symptoms of stress • Heroin acts at the same sites as the natural opioids, but because heroin has greater efficacy, it appears to be able to “hijack” the system ◦ It produces an exaggerated response Psychological and Social Needs and the Power of Opioids • Dole states “most animas cannot be made into addicts” ◦ This suggests that the drug itself is not the cause of addiction • Aresearch prog
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