Basic Neurobiology of addiction
Watch the following video (23 minutes)
Watch this video as well (2 min animated run through of the reward system)
Read the following article
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4065474/
Review SAMHSA’s Alcohol use Facts and Resources here:
https://www.samhsa.gov/sites/default/files/alcohol-use-facts-resources-fact-sheet.pdf
Quiz:
1. What is the highest anticipated amount of dopamine in an individual without a substance
abuse disorder on their very best day? 100 nanograms
2. Methamphetamine can raise the dopamine levels up to _10__ times their normal
amount.
3. System of the brain responsible for reward. Dopamine pathway
4. This system includes what two other important parts associated with reward? Ventral
tegumental area and nucleus accumbens. increasing this Neurotransmitter may assist in
cravings; Serotonin Pathway. likewise depletion of this neurotransmitter can lead to
cravings. Dopamine Pathway
5. Which medications can raise Dopamine in the nucleus accumbens for patient with SUD?
Buprenorphine and methadone.
6. Alcohol significantly impacts this inhibitory neurotransmitter: GABA Pathway
7. This screening tool can be used to determine the presence of hazardous drinking SBIRT
is a comprehensive, integrated Public Health approach to deliver early intervention and
treatment.
Case:
JR is a 52 year old recently divorced male who comes to your clinic for the first time following
discharge from an inpatient psychiatric hospital. You will be managing his care on an outpatient
basis. Over the last several months since the divorce, he has been drinking alcohol in greater
quantities, and just prior to hospitalization was drinking roughly 24 beers per day, as he noticed
it was taking more and more alcohol to ‘not feel anything anymore’. His daughter noticed his
drinking and urged him to seek help, but he had previously declined. JR’s daughter came to visit
and JR made a comment about shooting himself, so she contacted her local crisis center. He
was hospitalized for 5 days. While hospitalized, he was given a diagnosis of severe alcohol use
disorder as well as a non-specific mood disorder. He was prescribed the following medications:
Depakote DR 500 mg PO BID
Ativan 1 mg PO TID
Ambien 10 mg PO QHS
JR comes to your outpatient clinic stating that he is feeling great on his current regimen. He
states that his relationship with his daughter has improved. Upon discussion of his other current
treatments, you learn that he is not involved in any other treatment aside from medication
management.
Please answer the following questions in an essay format (minimum 500 words). Provide at
least one journal article reference in your response:
1. What education would you provide to JR regarding his current treatment
regimen?
2. What adjunctive or additional treatments would you suggest in JR’s case?
3. Would you make changes to JR’s regimen? If so, what/why?
I would find out how much he knows about the medications that he is currently taking,
why he is taking them and the possible side-effects that could occur. I would make sure
that he is aware of the possiblity of becoming dependent on the ativan and the ambien. I
would offer education if needed so that he would fully understand his medication
regimen. I would also ask if he is being compliant with the medication regimen and the
importance of not mixing alcohol due to the possiblity of interactions.
The adjunctive therapy that I would offer him would be Cognitive Behavior Therapy for
him and his daughter. I would support his decisions and provide him with different
options for therapy. I would begin to develop the theraupeutic relationship so that we
could discuss his feelings and goals and find out the ways he plans to accomplish them.
I would not make any changing in his regimen at this time but I would inform him of the
possibilities of becoming dependent on the ativan and the ambien and defer the
conversation to the next visit.
Bradley, K.A. and Kiviahan, D. R., (2014). Bringing Patient Centered Care to Patients
with Alcohol Use Disorders. Retrieved from https://www.ncbi.nim.nih.gov
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The post JR is a 52 year old recently divorced male who comes to your clinic for the first time following discharge from an inpatient psychiatric hospital. You will be managing his care on an outpatient basis. Over the last several months since the divorce, he has been drinking alcohol in greater quantities, and just prior to hospitalization was drinking roughly 24 beers per day, as he noticed it was taking more and more alcohol to ‘not feel anything anymore’. His daughter noticed his drinking and urged him to seek help, but he had previously declined. JR’s daughter came to visit and JR made a comment about shooting himself, so she contacted her local crisis center. He was hospitalized for 5 days. While hospitalized, he was given a diagnosis of severe alcohol use disorder as well as a non-specific mood disorder. He was prescribed the following medications: appeared first on Apax Researchers.