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Brainpower
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Neurotransmitter regulation of mesolimbic reward
Addiction
•Addiction
•Behavior pattern characterized by continued use of a psychoactive substance despite physical,
psychologic, or social harm
•Boston Collaborative Drug Study
•12,000 hospitalized patients taking opioids
•4 patients became abusers
•Probable that behaviors reflect tendencies existing before patients entered hospital, not due to
opioids received in hospital
•2 theorized population groups
•Individuals prone to drug abuse - estimate 8% of population
•Individuals not prone to drug abuse - estimate 92% of the population
,How Addicting are Different Substances?
Stimulants
Cocaine
•Extracted from leaves of coca plant
•CNS effect similar to that of amphetamines
•Two forms used by abusers:
•Cocaine
•"Crack"
•Can produce local anesthesia, vasoconstriction, and cardiac stimulation
Cocaine
•Cocaine
•Cocaine hydrochloride
•White powder
•Diluted for sale
•Taken intranasally
•Cocaine base: Commonly called "crack"
•Heated for use
•Taken by IV injection
Cocaine
•Chronic toxicity
•Intranasally: Atrophy of the nasal mucosa and loss of sense of smell
•Extreme cases: Necrosis and perforation of the nasal septum
•Injury to the lungs can occur from smoking cocaine base
•Use during pregnancy
, Cocaine
•Tolerance, dependency, and withdrawal
•Treatment of cocaine addiction
•Anti Cocaine vaccine - in development
•Removes cocaine before it reaches the brain
•Current research
•Naltrexone - stimulant addiction
•Buprenorphine - cocaine/opioid addiction
•Naltrexone/Buprenorphine - cocaine addiction not on opioids
•
Methamphetamines
•Amphetamines, Methylphenidate
•In abuse, usually taken orally, snorted, smoked, or IV
•The faster the drug's entry into the brain, the stronger are its reinforcing effects
•Also called "ice" or "crystal meth"
•Form of dextroamphetamine
•Smoked, snorted, or inserted into rectum
•Effects
•Arousal, euphoria, sense of increased physical strength and mental capacity
•Hallucinations, psychotic state, sympathomimetic actions
•
Methamphetamines
•Adverse cardiovascular effects
•Hypertension
•Angina pectoris
•Dysrhythmias
•Cerebral and systemic vasculitis and renal failure, stroke
•Vasoconstriction can be relieved with an alpha-adrenergic blocker (for example, phentolamine)
•Cardiac stimulation can be reduced with a mixed alpha and beta blocker (for example,
labetalol)
Methamphetamines
•Other adverse effects
•Significant weight loss
•Fetal effects
•"Meth mouth"
•Tolerance, dependency, and withdrawal
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