summer 2023 week 4 response

Response 1

you did an excellent post this week with your explanations.  I found this topic to be very interesting especially the medications used to help with abuse and withdraw symptoms. I found an interesting article opioid abuse and it was estimated that over 4 million people in the United States are prescribed opioids each year and two-six% will develop substance abuse from taking these medications (Pergolizzi et al., 2019).  Although the percentage seems low but the number of people taking those medications is very high so as providers we have to offer alternatives, keep track of the number of pills prescribed and educate on the risks of taking these medications. The article also stated that close to 20% of patients taking opioids do not receive treatment for abuse and continue on with the medications because of the withdraw symptoms, this makes it essential providers to monitor patients on these medications for signs of abuse and step in early (Pergolizzi et al., 2019).

 

Another article of interest I found was in regards to memory in substance abuse that a patient experiences.  Memory of withdraw symptoms and feelings intensify as the addiction continues and this plays a major role in the patient not wanting to discontinue the medication.  This process was defined as memory consolidation. This process takes place in the brain, in areas including the amygdala and is caused by release of stress hormones.  There is still more research needed but the use of cue exposure therapy during active withdraw may be better than using it when the patient is no longer dependent on the drug due in part to memory consolidation (Baidoo et al., 2020).

 

References

 

Baidoo, N., Wolter, M., & Leri, F. (2020). Opioid withdrawal and memory consolidation.

 

          Neuroscience & Biobehavioral Reviews, 114, 16-24.

 

Pergolizzi Jr, J. V., Raffa, R. B., & Rosenblatt, M. H. (2020). Opioid withdrawal symptoms, a

 

          consequence of chronic opioid use and opioid use disorder: Current understanding and

 

         approaches to management. Journal of clinical pharmacy and therapeutics, 45(5), 892-903.

 

 

Response 2

 

Thank you, Jasmin, for the great discussion on substance use disorder. I agree that manifestations of substance abuse and addiction include: an increased desire to consume alcohol or use drugs, an inability to stop using drugs or alcohol, consuming alcohol or taking drugs under challenging circumstances (e.g., drinking and driving), and relationship changes. When individuals have substance use disorder, they may have an increased desire to take substances that they were previously. Besides, they may also have increased cravings, making them take the substance even when in dangerous circumstances, such as driving. Similarly, these individuals may find it hard to control the substance. I would also like to add that a provider may observe other physical features: bloodshed eyes, sudden weight loss, unusual breath or body smell, slurred speech, and impaired coordination (Jones, 2019). If the patient exhibits the said features, they may have substance use disorder.

I also agree that alcohol and drug addiction can interfere with your brain’s capacity to create dopamine normally and regulate pleasure responses. In other terms, the mechanism of action in addiction underlies the limbic cortico-striatal neural networks of the brain. When individuals become exposed to drugs, they develop a progressive neurobiological adaptation that makes them lose control over drug-seeking habits. This, in turn, leads to addiction or substance use disorder (Piantadosi et al., 2017). Drugs such as methadone, buprenorphine, or naltrexone have been effective in substance use disorders. I would, however, like to add that apart from the medications, individuals can consider motivational interviewing. The approach help individuals identify challenges associated with substance use and develop patient centers strategies to manage it.

References

Jones, A. W. (2019). Alcohol, its analysis in blood and breath for forensic purposes, impairment effects, and acute toxicity. Wiley Interdisciplinary Reviews: Forensic Science, 1(6), e1353.

Piantadosi, P. T., Yeates, D. C., Wilkins, M., & Floresco, S. B. (2017). Contributions of basolateral amygdala and nucleus accumbens subregions to mediating motivational conflict during punished reward-seeking. Neurobiology of learning and memory, 140, 92- 105.

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