Behavioral Science

140 Deja Review: Behavioral Science
What pathway is involved in the
chemical rewards of drug use?
The “dopamine reward pathway” is
thought to play a large role—it projects
from the ventral tegmental area (VTA) to
the nucleus accumbens.
What factors affect how quickly and • Route of administration: The faster
to what magnitude the chemical
through the blood-brain barrier,
rewards are felt after ingestion
the greater the euphoria and higher
of a drug? likelihood of addiction (eg, IV >
smoking > oral [pills])
• Chemical composition of the drug
(increasing purity → increased and
faster effects)
• Genetic differences between people
(relates to receptor stimulation)
• Associated stimuli (ie, drug
paraphernalia, other conditional
stimuli)
What are the three important
observations about withdrawal
that Himmelsbach made?
What are the four central tenets
that must be addressed in order
to successfully treat drug dependence?
How should withdrawal symptoms
be prevented/treated during
detoxification?
1. There is a common association
between tolerance and a specific
withdrawal syndrome.
2. The nature of the withdrawal
syndrome is opposite to the
acute effects of the drug.
3. The withdrawal syndrome is most
intense when the drug leaves the
brain rapidly.
1. The positive reinforcements/reward
effects of the drug must be reduced.
2. The negative reinforcements
(withdrawal symptoms) must be
treated, either by giving a substitute
drug or by symptomatically treating
the effects of drug removal.
3. Detoxification—complete removal
of the drug of dependence from the
patient’s system.
4. Relapse prevention by reducing the
desire for the drug or by reducing
cravings for the drug.
Withdrawal symptoms may be
prevented/treated by administering
a substitute drug with a similar effect
(eg, methadone for heroin,
benzodiazepines for EtOH), or treating
the withdrawal symptomatically
(eg, treating diarrhea and
GI symptoms).