Addiction Science
This chronic condition is characterized by compulsive substance use despite harmful consequences, impaired control over use, and changes in motivation and reward.
What is substance use disorder/addiction?
Sweating, tremor, anxiety, nausea, insomnia, and agitation are common examples of this process that occurs when the body has adapted to a substance and the substance is reduced or stopped.
What is withdrawal?
Name the three FDA-approved medications commonly used to treat opioid use disorder.
What are methadone, buprenorphine, and naltrexone?
PAWS stands for this.
What is Post-Acute Withdrawal Syndrome?
A person says, “I don't even enjoy getting high anymore, but I feel like I have to use just to feel normal.” This phenomenon reflects the brain's adaptation to repeated substance exposure and is closely related to this concept.
What is dependence?
Runny nose, gooseflesh, muscle aches, diarrhea, abdominal cramping, yawning, and dilated pupils are particularly associated with withdrawal from this drug class.
What are opioids?
This medication is a partial opioid agonist and can reduce opioid cravings and withdrawal while producing less opioid effect than a full agonist.
What is buprenorphine?
Name three symptoms that may occur during prolonged recovery after the acute withdrawal phase.
What are sleep problems, irritability, anxiety, low mood, difficulty concentrating, fatigue, cravings, or emotional instability?
A person has been abstinent for several months but suddenly experiences an intense urge after smelling alcohol at a restaurant. This demonstrates that cravings can be triggered by these environmental stimuli.
What are conditioned cues/triggers?
Which withdrawal syndrome is particularly dangerous because severe cases can involve seizures, delirium, autonomic instability, and potentially life-threatening complications?
What is alcohol withdrawal?
Which alcohol-use-disorder medication can cause an unpleasant physical reaction if alcohol is consumed?
What is disulfiram(Antabuse)?
A person says, “I've been sober for 45 days. Why am I still having cravings?” What is the most accurate response?
What is recovery involves ongoing brain and behavioral adaptation; cravings can persist after acute withdrawal and can be triggered by stress, cues, emotions, or memories?
Use → Trigger → Craving → Thought → Behavior
Trigger → Thought → Craving/urge → Behavior → Consequence
Someone repeatedly tells themselves, “I can use just once,” despite having relapsed every time they have attempted controlled use. This thinking pattern is an example of what type of cognitive distortion?
What is minimization/rationalization?
A patient says, “I'm detoxed now, so there's no way I can overdose.” Why is this statement dangerous?
What is loss of tolerance can increase overdose risk if the person returns to a previously tolerated amount?
A patient taking an opioid medication says, “I'll take some heroin on top of this because the medication isn't working fast enough.” What is the major safety concern with combining opioids and other central nervous system depressants?
What is increased risk of respiratory depression and overdose?
A patient has stopped using opioids and is experiencing anxiety, sweating, abdominal discomfort, diarrhea, muscle aches, and intense cravings. They ask why they feel physically sick even though the drug is no longer in their system. Explain the basic mechanism.
What is neuroadaptation/dependence—the nervous system has adapted to the presence of the substance, and removing it produces an imbalance that manifests as withdrawal?
A patient says, “My medication helped me feel better, so I don't need it anymore.” What are three reasons they should discuss stopping it with their treatment team first?
Stopping suddenly can cause withdrawal, return of symptoms, rebound symptoms, or increased relapse risk, depending on the medication.