Deck 4: Epidemiology and Neurobiology of Addiction

Question 1

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5)requires that patients diagnosed with mild substance abuse disorder must:

A)have a comorbid anxiety disorder.
B)have comorbid depression
C)exhibit two to three symptoms.
D)exhibit at least four specific symptoms.

Answer 1

C

Question 2

Recent evidence from the National Survey on Drug Use and Health suggests that drug use is _____ among teenagers and is _____ for individuals in their fifties.

A)moderate; decreasing
B)lowest; declining
C)highest; increasing
D)highest; falling

Answer 2

C

Question 3

Heroin is an example of a drug on Schedule:

A)I)
B)II.
C)III.
D)IV.

Answer 3

A

Question 4

Survey evidence suggests that __________ is the most widely abused drug in the United States.

A)marijuana
B)methamphetamine
C)heroin
D)cocaine

Question 5

The reward circuit of the brain involves neurons originating in the:

A)nucleus accumbens (NAc).
B)ventral tegmental area (VTA).
C)amygdala.
D)hippocampus.

Question 6

Evidence from the National Survey on Drug Use and Health suggests that approximately _____ percent of the population have used an illicit drug or abused psychotherapeutic medication in the past month.

A)1
B)5
C)9
D)15

Question 7

Schedule V substances have a _____ potential for abuse and consist of substances containing small quantities of certain _____.

A)high; opiates
B)moderate; hallucinogens
C)low; sedatives
D)low; opiates

Question 8

In addition to dopamine,a second population of cells within the VTA containing _____ are also important in the reward circuit.

A)serotonin
B)glutamate
C)histamine
D)GABA

Question 9

Schedule II drugs:

A)have a high potential for abuse.
B)are not prescribed in the United States.
C)have a low potential for psychological dependence.
D)are rarely prescribed outside the United States.

Question 10

Among patients with a lifetime schizophrenia diagnosis,approximately _____ percent meet the criteria for substance abuse.

A)10
B)25
C)50
D)70

Question 11

Schedule V drugs:

A)consist of drugs containing large amounts of opiates.
B)involve substances with high potential for abuse.
C)have a high potential for physical dependence.
D)involve substances containing limited amounts of opiates.

Question 12

For patients with a lifetime diagnosis of bipolar disorder,approximately _____ percent meet the criteria for substance abuse or dependence.

A)25
B)50
C)75
D)90

Question 13

The reward circuit in the brain involves the neurotransmitter:

A)serotonin.
B)norepinephrine.
C)acetylcholine.
D)dopamine.

Question 14

Between related expenses and lost productivity,the estimated cost of drug use in the United States is more than _____.

A)half a billion dollars
B)a billion dollars
C)half a trillion dollars
D)a trillion dollars

Question 15

Schedule I drugs:

A)have minimal potential for abuse.
B)are not currently used for medical treatments in the United States.
C)have some potential for abuse.
D)are commonly prescribed to treat pain.

Question 16

In 2016,__________ caused the sharpest increase in drug-related deaths.

A)heroin
B)methamphetamine
C)cocaine
D)fentanyl

Question 17

The DSM-5 classifies substance abuse and substance dependence as:

A)Substance Abuse Disorder.
B)Substance Use Disorder.
C)Substance Dependence Disorder.
D)Substance Diagnostic Disorder.

Question 18

The pathway between the ventral tegmental area (VTA)and the _____ is critical for the addiction process because lesions to this pathway eliminate addiction.

A)amygdala
B)substantia nigra (SN)
C)prefrontal cortex (PFC)
D)nucleus accumbens (NAc)

Question 19

A drug company is developing a new drug,ligabamax,which it plans to market to treat chronic pain.Initial tests,however,suggest that the drug has high potential for abuse.Given this information,one might conclude that this drug would be placed on Schedule _____ once it has been approved for use.

A)I
B)II
C)III
D)IV

Question 20

Drugs are considered controlled substances and they are placed on five schedules as stipulated by the Controlled Substances Act (CSA).Accordingly,their placement on a schedule is based on all of the following criteria EXCEPT:

A)What is the abuse potential of the drug?
B)What is the possibility of the development of dependence when the drug is abused?
C)Does the drug have a currently accepted medical use within the United States?
D)What is the side effect profile of the drug?

Question 21

Depressants of the central nervous system are thought to _____ dopamine by inhibiting _____.

A)increase; GABA
B)increase; glutamate
C)decrease; norepinephrine
D)decrease; serotonin

Question 22

Evidence suggests that chronic drug use causes the brain of abusers to be _____ responsive to natural reinforcers,and _____ responsive to the presence of drugs with respect to dopamine transmission.

A)less; less
B)less; more
C)somewhat; less
D)more; somewhat

Question 23

An important change that appears to commonly develop in the brain of chronic drug users is:

A)a higher metabolic rate in the frontal lobe.
B)a lower metabolic rate in the frontal lobe.
C)a higher firing rate of neurons in the nucleus accumbens.
D)lower overall activity in the ventral tegmental area.

Question 24

Evidence suggests that an important variable in relapse for those previously addicted to a drug is:

A)how long the person abused the drug.
B)how frequently the drug was used.
C)dose.
D)stress.

Question 25

Nicotine is thought to be addictive because it:

A)enhances influx of calcium into the presynaptic cell.
B)enhances binding of dopamine at the postsynaptic receptor.
C)blocks the reuptake and transport of dopamine.
D)stimulates the release of dopamine.

Question 26

The pleasurable effects associated with drugs of abuse and "natural addictions" (e.g.,overeating)are thought to involve effects on:

A)the GABAergic system.
B)glutamate.
C)the dopaminergic system.
D)serotonin.

Question 27

Long-term drug use is thought to produce:

A)cortical "hyperfrontality."
B)cortical "hypofrontality."
C)mesolimbic hyperactivation.
D)mesolimbic hypoactivation.

Question 28

The brain reward circuit involves neurons projecting from the _____ to the _____.

A)ventral tegmental area; nucleus accumbens
B)prefrontal cortex; ventral tegmental area
C)amygdala; nucleus accumbens
D)nucleus accumbens; ventral tegmental area

Question 29

Following drug use and abuse,the frontal lobes appear to become _____ active and _____ responsive to natural reinforcers.

A)more; more
B)less; more
C)more; less
D)less; less

Question 30

Neuroimaging suggests that when compared to nondrug users,cocaine addicts have a(n)_____ receptors.

A)decreased number of dopamine (D₂)
B)increased number of dopamine (D₂)
C)decreased number of GABA
D)increased number of GABA

Question 31

Chris has become dependent on cocaine.This suggests that there may be _____ dopamine being released from the _____ onto the nucleus accumbens.

A)decreased; frontal lobe
B)decreased; hippocampus
C)increased; amygdala
D)increased; ventral tegmental area

Question 32

Research shows that chronic stimulation of the VTA-NAc (ventral tegmental area-nucleus accumbens)pathway:

A)causes the reward system to be hyperresponsive to drug stimulation resulting in continued addictive behavior.
B)results in an up-regulation of dopamine receptors in the system.
C)impairs the pathways so that naturally rewarding stimuli are not an enjoyable.
D)damages the system so that vesicles are unable to store adequate amounts of dopamine.

Question 33

Research indicates that long-term,chronic exposure to any of several drugs of abuse will _____ the dopamine reward pathway,resulting in this pathway becoming _____ responsive to naturally rewarding stimuli.

A)impair; less
B)impair; more
C)activate; less
D)activate; more

Question 34

Cocaine blocks dopamine _____ in neurons of the _____ following release.

A)reuptake/transport; VTA
B)reuptake/transport; nucleus accumbens
C)release; hippocampus
D)release; amygdala

Question 35

Some evidence suggests that people could be prone to addiction because of:

A)increased dopamine receptor expression.
B)higher levels of D₂ receptors.
C)higher levels of GABA receptors.
D)lower levels of D₂ receptors.

Question 36

All of the following brain structures are intimately involved in addictive behavior,EXCEPT the:

A)orbitofrontal cortex.
B)ventral tegmental area.
C)hippocampus.
D)hypothalamus.

Question 37

Research suggests a strong correlation between the pleasurable sensations associated with drugs and the:

A)number of dopamine receptors present on cells in the VTA.
B)amount of GABA in the nucleus accumbens.
C)number of dopamine transporters that are blocked.
D)amount of calcium that enters the cell.

Question 38

People are thought to develop addictive behaviors because of:

A)a moral failing as a human being.
B)lower D₂ levels.
C)higher D₂ levels.
D)decreased activity in the dopamine system.

Question 39

Chronic drug use causes natural rewards (e.g.,food,sex)to become _____ pleasurable; drug associated cues result in _____ dopamine levels.

A)more; increased
B)less; increased
C)more; decreased
D)less; decreased

Question 40

Opioids:

A)stimulate GABA release.
B)inhibit GABA release.
C)act indirectly on neurons in the amygdala to alter dopamine levels.
D)act directly on neurons in the VTA to stimulate dopamine release

Question 41

Addiction results from _____ to drugs of abuse as well as hypersensitivity to _____.

A)hyposensitivity; depressive stimuli
B)hyposensitivity; environmental stressors
C)hypersensitivity; environmental stressors
D)hypersensitivity; depressive stimuli

Question 42

Evidence suggests that increased responsiveness of _____ population of receptors may be particularly important in addiction.

A)glutamate
B)GABA_A
C)kainate
D)AMPA

Question 43

Paul has become addicted to heroin; probably the most well-established pharmacological intervention for his addiction is:

A)the use of antagonists.
B)partial agonist substitution treatments.
C)agonist substitution treatments.
D)targeting nondopaminergic neurotransmitter systems.

Question 44

All of the following represent novel approaches to the treatment of addiction EXCEPT:

A)deep brain stimulation.
B)improving control of the prefrontal cortex.
C)faith-based and religious approaches.
D)targeting cAMP as a final common pathway for all addictions.

Question 45

Vaccines have been developed to treat addiction to all of the following substances EXCEPT:

A)cocaine.
B)alcohol.
C)nicotine.
D)heroin.

Question 46

Addiction appears to alter _____ receptors.

A)NMDA
B)AMPA
C)NMDA and mGluR5
D)AMPA and mGluR5

Question 47

The protein,_____,pushes glutamate out of the glial cell,while _____ carries glutamate into the glial cell.

A) $\Delta$ FosB; BDNF
B)BDNF; $\Delta$ FosB
C)xCT; GLT-1
D)GLT-1; xCT

Question 48

The learned associations in drug abuse appear to involve:

A)dopamine.
B)glutamate.
C)GABA.
D)histamine.

Question 49

Research evidence suggests that all of the following variables result in relapse to drug use EXCEPT:

A)stress.
B)drug cues that have been conditioned during use.
C)reexperience with the drug.
D)glutamate hyporeactivity.

Question 50

Evidence from human neuroimaging and animal experiments suggest that addictive drugs produce a more intense response in the _____ synapses that connect the frontal lobe with the VTA.

A)dopaminergic
B)GABAergic
C)glutamatergic
D)serotonergic

Question 51

Downstream neurons connecting frontal lobe structures with the nucleus accumbens (NAc)and the VTA use _____ as their primary neurotransmitter.

A)dopamine
B)glutamate
C)GABA
D)serotonin

Question 52

Buprenorphine is a(n)_____ treatment for _____ addiction.

A)partial agonist; opiate
B)agonist; opiate
C)agonist; cocaine
D)antagonist; nicotine

Question 53

Drug craving is thought to be associated with:

A)increased glutamatergic reactivity.
B)upregulation of dopamine receptors.
C)downregulation of GABA receptors.
D)decreased GABAergic reactivity.

Question 54

Blood levels of _____ were found to be significantly increase in opiate-dependent patients.

A) $\Delta$ FosB
B)GLT-1
C)xCT
D)mGluR5

Question 55

Research indicates that nerve fibers connecting the frontal lobe with the reward circuit involve:

A)dopamine.
B)GABA.
C)glutamate.
D)serotonin.

Question 56

Antabuse has been used successfully to treat alcohol as well as _____ addiction.

A)opiate
B)nicotine
C)cocaine
D)methamphetamine

Question 57

A very common approach for treating drug addiction involves:

A)targeted application of an antagonist.
B)agonist substitution.
C)partial agonist substitution.
D)targeted GABAergic treatments.

Question 58

_____ is an antagonist often used to treat opiate addiction.

A)Naltrexone
B)Flumazenil
C)Nalboxone
D)Antabuse

Question 59

Probably the most well-established pharmacological intervention for opioid and nicotine addiction is:

A)the use of antagonists.
B)partial agonist substitution treatments.
C)agonist substitution treatments.
D)targeting nondopaminergic neurotransmitter systems.

Question 60

Acamprosate has been used to treat _____ addiction.This pharmacotherapy works as a _____.

A)alcohol; GABA antagonist
B)opiod; glutamate antagonist
C)cocaine; GABA agonist
D)nicotine; glutamate agonist