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Summary Notes Risk behavior lecture 4
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College 4 - Risk behaviorThe neuroscience of substance addiction.
Brain Changes is Substance Addiction: William James, 1890 quote: “We are
spinning our own fates, good or evil… The drunken Rip Van Winkle… excuses
himself for every fresh dereliction by saying, ‘I won’t count this time!’ → with
repeated substance use it becomes more and more difficult to restrain from
usage.
What is substance addiction?
Substance: not necessarily drugs only. Substances include tobacco and alcohol as well.
Substance Addiction: A substance-related chronic relapsing (brain) disorder characterized
by compulsive substance use. 9 out of the 11 criteria from the DSM5 are about loss of
control, the last two are tolerance and withdrawal. → also are effects of drugs use
without addiction. Biggest challenge for addicts is not necessarily quitting, but
remaining abstinent.
Relapse often precipitated by craving: an overwhelming desire to experience the effects of
the substance. Craving persists after discontinuation of use, outlasts withdrawal symptoms.
Craving can be provoked by:
- Substance,
- Substance-associated cues (paraphernalia, ‘scene’),
- Stress
View of Addiction: History.
Moral model (1800-present): people are the problem (addicts are weak that have no
control)
- solve the problem by incarceration
Pharmacological model (1920-present): substance is the problem
- solve the problem by prohibition
, Learning model (1975-present): addiction is learned (learned behaviour, and it can be
changed). Taught us a lot about the brain reaction to cues.
- solve the problem by cognitive behavioural therapy, cue exposure
Brain disease model (1990-present): substances use changes brain function.
- solve the problem by behavioural therapy, pharmacotherapy
- Dopamine D2 receptors and brain glucose metabolism (in the prefrontal cortex but
also in the rest of the brain) are rapidly less active in the brain of an (cocaine) addict
then in the brain of a control person.
From usage to addiction
- Choice that people have is to use a substance, they don’t choose to get addicted to
it/they don’t plan to become addicted.
- Substances abundantly available.
- Substance use is inherently human - or mammalian. Deeply anchored in our brain,
there has never been a civilization without substance use. (It being religiously,
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