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Health and medicine
Course: Health and medicine > Unit 9
Lesson 6: Drug abuse and drug addictions- Drug abuse and drug addiction
- Overview of psychoactive drugs
- Psychoactive drugs: Depressants and opiates
- Psychoactive drugs: Stimulants
- Psychoactive drugs: Hallucinogens
- Routes of drug entry
- Drug dependence and homeostasis
- Reward pathway in the brain
- Tolerance and withdrawal
- Risk factors for drug use and drug abuse
- Substance use disorders
- The development of substance use - Why do people use legal and illegal substances?
- Why do some people but not others develop substance use problems?
- Treatments and triggers for drug dependence
- How does substance use develop into substance abuse
- Drug use prevention - school programming and protective factors
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Treatments and triggers for drug dependence
Created by Carole Yue.
Want to join the conversation?
- I find it funny she says marijuana is addictive when it is actually proven to be not addictive just thought I would point that out(0 votes)
- Marijuana can be emotionally/psychologically addictive. Many people self-medicate for anxiety disorders and similar using marijuana, and they find it difficult/impossible to quit even if the use of the drug has dramatic consequences (jail, job security). While marijuana may not be chemically/physiologically addicting (and because it does work on opioid receptors as well as cannabinoid receptors, the scientific community is still divided over that claim), there are definite addictive qualities in persons who are at high risk for developing substance abuse problems. Denial of addictive properties is often used to rationalize the behavior, but might be limiting for those who feel they might have a problem and feel unable to speak about it or seek help.(160 votes)
- effects of tobacco addiction treatment 2:26
Isn't prevent "release" of dopamine and preventing "re-uptake" of dopamine really contrasting ideas?
One increases concentration of dopamine in the synaptic cleft, while the other reduces concentrations of dopamine. Why would a treatment want to have both of these effects?(17 votes)- Not quite.
If Dopamine isn't taken back up and left in the synaptic cleft, it will become degraded.(6 votes)
- Re-uptake has been frequently mentioned in these videos but not explained. May someone please provide an explanation? I thought neurotransmitter re-uptake means that the neuron has receptors that "collect" the excess molecules for future transportation across the synapse. Am I on the right track?(5 votes)
- You've pretty much got it. Just keep in mind that re-uptake refers to the action of the Presynaptic neuron. While in the synapse, NT's can either be degraded or subject to re-uptake. Many presynaptic neurons will re-uptake the NT's and 'recycle' them for future use. (Imagine how much energy we would have to expend to synthesize NT's if they were ALL degraded- A lot). Re-uptake also helps us regulate how much of a particular NT is present in the synapse and transmitting signals.(8 votes)
- Can one become addicted to methadone, the treatment drug, instead of the original drug? 1:17(3 votes)
- Yes, methadone is still an opioid. People use this to recover because it is not as strong as less addictive but this is still an opioid so there are addictive traits. Being an EMT I see lots of heroin overdoses with equal methadone overdoses. I do see a few people on methadone for its actual purpose to treat their heroin addiction but very rarely. (EMT/Pre-Med)(9 votes)
- It seems that if group meetings (like AA) require that the participant surrender to a higher power, they would be inherently religious. If so, how can judges require that an individual go to AA as part of a treatment/punishment plan? Put a different way: let's say that an atheist was an alcoholic and was being sentenced for a drunk driving or assault or some other alcohol-related charge. The judge says that they can either go to AA or go to jail. It seems as though the atheist would be correct to say that attending AA would be a violation of his or her religious freedom (his or her freedom not to believe in a higher power). How do the courts deal with cases such as these? Are there any secular alternatives to treatment programs that would give non- religious individuals the same opportunities? Please note that I am not saying that programs like AA are incorrect in their approach- I'm simply wondering if it is appropriate to require that an individual complete a program that requires the belief in a higher power in order to avoid jail time.(4 votes)
- 12-step programs like A.A. suggest (not require) that participants surrender to a higher power, but the higher power does not have to be a conventional religious being. Out of Western tradition, many participants choose one from religion, but others (there are also plenty of agnostics and atheists in these programs) choose something else (like their group as a whole or even an inanimate object as a higher power). The point is to get the addicted person to admit that he or she is not in control of everything and that admission of this is what it takes to get the ball rolling so that he or she can begin to recover. Many 12-step program adherents insist that their program is "spiritual, not religious".(4 votes)
- Can someone explain all of the types of therapies besides the cognitive behavioral therapy? Is there a video for that because all of those therapy types appear on the MCAT(4 votes)
- CBT is based on the theory that thoughts drive emotions which drive behaviors. So, to curb problematic behaviors, therapists work on the behavior patterns, thought processes, and emotions that drive them.
https://www.apa.org/ptsd-guideline/patients-and-families/cognitive-behavioral.pdf
https://www.apa.org/ptsd-guideline/patients-and-families/cognitive-behavioral(1 vote)
- Atwhen she describes "nicotine receptors" being acted upon by the medication to prevent dopamine reuptake, does this mean that the term "nicotine receptors" is analogous to "dopamine receptors"? 2:16(2 votes)
- My Psychology professor said Alcoholics Anonymous wasn't all that effective. I've read other studies saying that only about 5-10% will actually permanently avoid relapse, and only about half not relapsing within 5 years.(2 votes)
- At, how does preventing the release or re-uptake of Nicotine helps in smoking cessation? 2:26(1 vote)
- how do we find out what type of therapy ( inpatient and outpatient) does a person need(1 vote)
Video transcript
- [Voiceover] Drug addiction
is a medical problem, and just like other
psychological diseases, it has both physiological
and psychological components. So it makes sense that
treatments for drug addiction would address both physiological and psychological sides of the problem. For serious addictions,
hospitalization might be needed as the person goes through withdrawal both to make sure they
don't hurt themselves, and to help their body get used to operating without the drugs. This initial period of separating
the addict from the drug is called 'detoxification'. It's when you kind of try to flush out all the toxins from your body. Some medications are
used during that stage to help with the basic
symptoms of withdrawal like vomiting, nausea, pain, et cetera. This is important but
sometimes strong addictions require strong medications
to help break the cycle of addiction in addition to
addressing those symptoms. For example, let's consider opiates. Remember opiates, such as heroin, act at the neural receptor
site for endorphins to reduce pain and give
people a sense of euphoria, which is a highly addicting sensation. A medication called methadone,
which is an opioid agonist, activates the opioid receptors, but it acts much more slowly,
so it dampens the high. The benefit here is
that it reduces cravings and eases withdrawal symptoms. Also, if the person
does take heroin again, then they won't be able
to experience the high because all the receptors are
already taken with methadone. So like many other
pharmacological treatments that we'll talk about, methadone has been shown
to be more effective when it's combined with
behavioral therapy. So we'll talk more about
the different behavioral or psychological therapies
in just a minute. But we're gonna go over a
couple other medications first. For stimulants like tobacco, medications replace the
effects of nicotine, which is the primary addictive
ingredient in tobacco. Now you do this by either
delivering low levels of nicotine through a patch, or lozenge, or something, or they deliver chemicals that act on nicotine
receptors in the brain. In this case, the medication
either prevents the release, or the re-uptake of dopamine, which is the neurotransmitter that sends the reward signal to the brain. These medications help
reduce cravings, primarily. For alcoholics, medications work by blocking the receptors
involved in the rewarding effects of drinking and craving for alcohol. They can also help reduce
symptoms of withdrawal, such as anxiety, insomnia, and dysphoria, which is just a bad feeling,
the opposite of euphoria. Preventing symptoms of withdrawal is more than just making it
easier on the patient physically because these symptoms are often similar to the initial conditions
that drove the person to the drug in the first place. So it's important, even from
a psychological perspective, to prevent a relapse during
this critical early stage by minimizing those negative symptoms. As we mentioned before, behavioral treatments are
also an important component of treating drug addiction. In-patient treatments require
residents in a hospital or other treatment facility. Out-patient treatments
mean that the patient can live at home or wherever and then just come in
for therapy or meetings. Most behavioral treatments can happen in either of those settings, so it just depends on
what's best for the patient. Cognitive behavioral therapy, or CBT, is another type of psychological treatment for drug addiction, and has been used
successfully with patients addicted to alcohol, marijuana, cocaine, methamphetamines, and nicotine. As the name suggests, CBT addresses both the cognitive
and behavioral components of the addiction. Patients learn to recognize
problematic thought patterns and develop more positive thought patterns and coping behaviors. They also learn to anticipate
problematic situations. Say, for an alcoholic, going to a party where
there would be alcohol, would be a problematic situation. And self-monitor for cravings so that they can apply their
coping strategies early. Maybe go to a different party, or go to dinner with a friend
instead of going to the party. Fortunately, research shows
that the skills people learn in CBT last after the therapy ends, which is very important. We want long-lasting treatments. Another type of behavioral treatment is motivational interviewing, sometimes called motivational
enhancement therapy, and this type of therapy
involves working with the patient to find intrinsic motivation to change. It's considered a very
focused, very goal-directed type of therapy, because
it tends to involve very few sessions with a therapist, and it can be a doorway
for the patient to engage in another treatment program such as group meetings or CBT. Group meetings such as
"Alcoholics Anonymous" or "Narcotics Anonymous", or any of those, can help recovering
addicts support each other and realize they're not alone. These meetings are often
part of a 12-step program which help people go through
the process of recovery. I'm not gonna list all 12 steps, but they can be broken down
into three main categories. The first is acceptance, which means that you
acknowledge your addiction is a chronic-progressive disease that you can't control on your own, so you have to admit the problem. Second category would be 'surrender', meaning you have to give yourself over to a higher power, and
accept the help offered through that power and through the group. The third category is active involvement in meetings and activities
which could include helping other recovering addicts. So becoming a sponsor to
someone new to the group. Even though the steps
are generally sequential, most groups acknowledge
that people may revisit certain steps repeatedly over time. There's plenty of evidence showing these 12-step programs are helpful
in treating alcohol addiction and early evidence
suggests that it's useful for other types of addiction as well. Those just haven't been
around quite as long. Sometimes there are
parallel group meetings for families of recovering addicts, which can help people in the addict's life understand the problem and
help them help their loved one. So that's really important as well. When we're talking about therapy, it's important to consider
the idea of relapse, which is when a recovering
addict may slip up and take illegal drugs again. Relapse depends more on
the addictive potential of the drug that they were using and the environmental triggers they're currently experiencing
than anything else. More addictive substances
make relapse more likely, as does encountering anything
that a recovering addict used to associate with
his or her addiction. This is why it can be so hard sometimes for people to stay clean. If they go through the treatment, it seems successful, but then they go right back
into the same apartment, same group of friends, same situations that kind of got them into that mess, then it's very likely that those cues will trigger a relapse. This is part of why CBT can be helpful. It can teach people how
to anticipate and avoid situations that would lead to a relapse.