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Stress and Addiction
Published in Hanna Pickard, Serge H. Ahmed, The Routledge Handbook of Philosophy and Science of Addiction, 2019
The shift from normal healthy desire to drug craving with increased levels of drug use is also associated with changes in limbic, striatal and cortical brain systems. For example, changes in hypothalamic pituitary adrenal (HPA) axis responses, altered and blunted amygdala response to fear/threat-potentiated startle in heavy drinkers compared with light social drinkers, and autonomic imbalances in sympathetic/parasympathetic systems have been reported with increased drug use. A number of studies have assessed neural changes associated with the drug-craving state with correlations to subjective drug craving and to drug use/relapse. Brief exposure to cocaine cues, known to increase drug craving in cocaine-dependent (CD) individuals, increased activity in the amygdala and regions of the frontal cortex, and with gender differences reported in amygdala activity and the frontal cortex response in cocaine-dependent individuals. Cue-induced craving for nicotine, methamphetamine and opiates also activate regions of the prefrontal cortex, amygdala, hippocampus, insula and the VTA.
Narcotic Addiction
Published in Mark S. Gold, R. Bruce Lydiard, John S. Carman, Advances in Psychopharmacology: Predicting and Improving Treatment Response, 2018
Mark S. Gold, Charles A. Dackis, A. L. C. Pottash, R. Bruce Lydiard
The power of the psychological and physiological entrapments of opiate addiction is demonstratd by the addict’s decision to remain in the hazardous drug environment even after tolerance develops and opiates no longer produce as much euphoria. In fact elements of the drug environment can themselves lead to conditioned abstinence symptoms.5’ Just as Pavlov’s dogs began to salivate after hearing a bell which had been associated with feeding, addicts often experience abstinence symptoms and craving upon exposure to elements of the drug environment. Seeing buildings where drugs were bought, smelling burning matches, or meeting drug-using friends can precipitate strong urges and abstinence symptoms even in detoxified patients. This classical conditioning further fortifies the addictive process and has specific treatment ramifications. Since merely the presence of the environment is potent enough to induce drug craving and withdrawal symptomatology, patients attempting to achieve a drug-free state must actively limit access to both drugs and conditioned elements of the drug environment. This requires hospitalization initially, on the most concrete level, but later patients are taught to terminate friendships with addicts, move from old neighborhoods, and change jobs if drug exposure is present. Otherwise, the force of conditioned abstinence symptoms will often lead the patient back into addiction. In addition, the use of the long-acting opiate blocker, naltrexone, if available, reduces the lure of opiates by eliminating the positive reinforcement of opiate-induced euphoria.
Diagnosis in the Addictions I: Conceptual Problems
Published in Howard Shaffer, Barry Stimmel, The Addictive Behaviors, 2014
Milton Earl Burglass, Howard Shaffer
Attempting to overcome this confusion, the 1981 WHO Memorandum proposes the term neuroadaptation, the nature of which is that’ ‘if drug administration is stopped or the drug displaced from its site of action, a withdrawal syndrome is observed.“28 Importantly, this reformulation does not require that the withdrawal syndrome be aversive. It allows for a range of responses to the syndrome, from indifferent to intensely dysphoric. It also allows for, but does not require, drug-seeking behavior to alleviate withdrawal dysphoria. Research has shown that drug-seeking behavior in withdrawal is not a necessary consequence of the physiologic effects of the withdrawal syndrome. Rather, the appearance of such behavior depends upon the complex interaction of the physiologic effects with various characteristics of the individual (e.g., attributions and past experiences) and of the social setting. Once experienced and linked by various processes of learning, withdrawal phenomena may be amplified or dampened by the individual's emotional states and can even come to be evoked by internal or external (environmental) stimuli long after the last drug use. Stimulus-evoked withdrawal effects may be associated with thoughts about the drug or by subjective drug craving.30
Linalool attenuates acquisition and reinstatement and accelerates the extinction of nicotine-induced conditioned place preference in male mice
Published in The American Journal of Drug and Alcohol Abuse, 2021
The current pharmacological approaches for drug and substance addiction aim to modulate or prevent the effects of the drug at sites of action in the body by decreasing three important aspects; abstinence syndrome, craving, and relapse (8,78). Among the pharmacological therapies that are frequently utilized to decrease abstinence symptoms, few can decrease the drug craving, and they are also rarely effective in blocking relapse (79). Therapeutic approaches for the treatment of nicotine addiction are decreasing the three main critical perspectives: craving, relapse, and withdrawal syndrome (14). Different phases of the CPP test imitate actual clinical situations like acquisition for craving, extinction for withdrawal, and reinstatement for relapse. Extinction and relapse, just like the development of drug dependence, are major points in drug addiction and principal problem in the treatment of drug abuse (1,36). Varieties of stimuli can enhance craving and later vulnerability to relapse during subsequent detoxification (37). Nevertheless, various experimental and clinical researchers explained that re-exposure to the drug (priming) in situations is a very critical factor linked to reinstatement behavior both human addicts and animals (36,37). In this study, linalool reduced the development of nicotine acquisition, reinstatement, and accelerated extinction.
Integrating DATA 2000 waiver training into undergraduate medical education: The time is now
Published in Substance Abuse, 2021
Elly Riser, Leigh Ann Holterman, Sanchit Maruti, John R. Brooklyn, Stephen G. DeVoe, Bradley J. Tompkins, Jacqueline Drouin, Halle G. Sobel
The United States faces a public health crisis due to opioids that claims more lives per year than the AIDS epidemic at its peak. Over 72,000 people in this country died from drug overdose in 2017; the majority involving opioids.1 Additionally, the intersection of the opioid epidemic and the Coronavirus Disease 2019 (COVID-19) pandemic has led to a rise in overdose deaths. Emerging evidence shows 40 states experienced an increase in opioid-related fatalities since the COVID-19 pandemic began,2 yet these deaths are preventable and substance use disorders are treatable. Medications for opioid use disorder (MOUD), including buprenorphine products, significantly improve outcomes for people with opioid use disorder (OUD). These medications decrease drug craving and illicit opioid use,3,4 increase treatment retention,5,6 and are associated with reducing overdose deaths and all-cause mortality.7,8 Despite the known benefits of MOUD as an evidence-based treatment, stigma and limited access to treatment remain barriers to care.
Addictive behaviors and craving during the COVID-19 pandemic of people who have recovered from substance use disorder
Published in Journal of Addictive Diseases, 2020
Questionnaire examining drug craving and the reasons for feeling the craving. The craving questionnaire consisted of three parts: (a) two questions examining craving before and after the outbreak of the pandemic, coded from 1 = Not at all to 5 = Very much; (b) statements based on the Mannheimer Craving Scale (MaCS, 2009), asking participants to estimate their craving based on 12 questions (for example, “How much of your time when you are not taking addictive drugs is occupied by ideas, thoughts, impulses, or images related to consumption?” and “How frequently do these thoughts occur?”); answers were provided on a 5-point scale, denoting increasing intensity of craving; Cronbach's alpha for the questionnaire was 0.94; (c) questions developed for the present study concerning the reasons for feeling the craving, for example, boredom, loneliness, and financial stress; participants were given a choice of 11 options and could select more than one.