Addiction

Question 1

___-___% of addiction predisposition and risk is attributable to genetic factors.

Answer 1

40-60%

Question 2

What are some of the most common environmental factors associated with drug use?

Answer 2

• Low socioeconomic class
• Poor parental support
• Drug availability

Question 3

Substance Use Disorder (SUD) is characterized by the presence of two criteria occurring within a twelve month period. What are these criteria?

Answer 3

• Use results in failure to fulfill roles at work, school, or home
• Use in situations where it is physically hazardous
• Continued use in spite of social or interpersonal problems
• Tolerance
• Withdrawal
• Substance taken in larger amounts or over longer period than intended
• Unsuccessful efforts to cut down use
• Great deal of time devoted to obtaining substance
• Important activities are given up because of use
• Use is continued despite knowledge of having problem
• Cravings or strong desires to use substance

Question 4

What are the severity specifiers in relation to substance use disorder?

Answer 4

• Mild: 2-3 criteria
• Moderate: 4-5 criteria
• Severe: 6 or more criteria

Question 5

(T/F) If criteria 4 (tolerance) and 5 (dependence) are present in an individual with SUD, they have physiological dependence.

Answer 5

True.

Question 6

What areas of the brain are involved in inhibitory control and delayed gratification?

Answer 6

• Prefrontal cortex (PFC)
• Anterior cingulate gyrus (ACG)

Question 7

What areas of the brain are involved in motivation and drive?

Answer 7

• Orbitofrontal cortex (OFC)
• Subcallosal cortex (SCC)

Question 8

What areas of the brain are involved in reward and salience?

Answer 8

• Nucleus accumbens (NAc)
• Ventral tegmental area (VTA)

Question 9

What areas of the brain are involved in memory and learning?

Answer 9

• Hippocampus
• Amygdala

Question 10

What receptor changes can be seen using imaging in an individual who abuses a substance?

Answer 10

Lower number of dopamine receptors

Question 11

Motor reaction in substance abusers is (faster/slower) due to changes in the dopamine pathways of the brain.

Answer 11

Slower

Question 12

Memory function in substance abusers is (increased/decreased) due to changes in the dopamine pathways of the brain.

Answer 12

Decreased

Question 13

Nicotine is most often metabolized to ___________.

Answer 13

Cotinine

Question 14

Bupropion may be used in smoking cessation. What is its mechanism of action?

Answer 14

• Dopamine reuptake inhibitor
• Nicotine antagonist

Question 15

Varenicline may be used in smoking cessation. What is its mechanism of action?

Answer 15

• Varenicline is a partial agonist at α4β2 nicotinic acetylcholine receptors.
  
  • It acts to blunt the rewarding effects of nicotine.

Question 16

What is a specific caution when prescribing varenicline?

Answer 16

• Can worsen psychiatric symptoms already present in patient
  
  • May cause suicidal ideation, nightmares, irritability
• DO NOT mix with nicotine replacement (patches, gum, etc)
  
  • Can mix with Bupropion

Question 17

It is recommended to use evidence-based cessation treatments in patients who (are/are not) willing to try to quit smoking.

Answer 17

Are willing to try

Question 18

It is recommended to use a brief intervention in smoking habits to treat patients who (are/are not) willing to try to quit smoking.

Answer 18

Are not willing to try

Question 19

In which patients is Bupropion contraindicated in?

Answer 19

• Patients with eating disorders (due to electrolyte abnormalities)
• Small risk of seizure

Question 20

What are the functions of the dopamine pathways?

Answer 20

• Reward (motivation)
• Pleasure, euphoria
• Motor function (fine tuning)
• Compulsion
• Preservatoin

Question 21

What are the functions of the serotonin pathways?

Answer 21

• Mood
• Memory processing
• Sleep
• Cognition