Path to Dependence

How does dependence develop?Why does it happen to some people and not others?

Start with first experience First drug experience

Rewarded by Positive Reinforcement

Unrewarded or Punished

Continue use Stop use

Role of learning From the very first encounter, see

the effects of learning. Learning plays a critical role in

psychological dependence. “craving for repeated or compulsive

use of a drug because its effects are deemed pleasurable.”

Learning and behavior Learning can be used to modify

behavior. Behaviorism was the first scientific

paradigm for psychology. JB Watson, BF Skinner Principles widely applied at home,

school and workplace. And on the road: seatbelt use

Safer to wear seatbelts. Well-known that

seatbelts save lives. Usage varies greatly. 51% in Mass 91% in Calif 78% in CT Required in CA but

only suggested in MA

External to internal control

Forced or encouraged. Not wearing seatbelt

might lead to punishment.

Wearing reinforced by others and by vehicle.

Put them on as a matter of habit.

Internalized.

Punishment and reinforcement. “Click it or ticket” Threat of punishment. Random checks. Car comes with

warning buzzers. Stop if you buckle up. Reinforces wearing.

Environment controls behavior

Extrinsic motivation. External rewards and punishments. Praise increase likelihood I’ll

participate. Criticism decrease the likelihood. Principles of operant conditioning at

work.

Effects on behavior Reinforcement Leads to an

increase in behavior.

Punishment Leads to a

decrease in behavior.

Types of reinforcement Positive

reinforcement: behavior leads to

reward.Negative

reinforcement: behavior removes pain or anxiety

Ex: take pill for headache

Types of punishment

Goal of punishment is a decrease in unwanted behavior.

Behavior leads to unpleasant outcome (Type I) or takes away something pleasant (Type II)

Add to Take away from

Pleasant

Unpleasant

Rewards and punishments

Add to Take away from

Pleasant Positive reinforcement

Type II punishment

Unpleasant Type I punishment

Negative reinforcement

Problems with punishment Negative feelings towards person

giving punishment. Physical or psychological pain. Escalate in severity. Situational: substitute teacher

syndrome. Less likely to internalize.

Initial use punished What might be present in the

individual or the environment to make the initial use unpleasant?

Psychological characteristics. Medical concerns. Moral or religious beliefs. Family background. Other possibilities?

Reasons to remember Guest turns down the offer of a

drink. Proper response from host? Push even further. Grill guest about reasons. Remember some of reasons for

individual choice. 1/3 US adults don’t drink at all.

Reward leads to increase use.

Frequent use

Body and brain adaptation

Dependence Tolerance

Increase use to maintain effect

Psychological and Physical

Dependence

Psychological Physical

Abstinence causes withdrawal and rebound

Abstinence causes craving

Sensitivity to triggers

and

Physical withdrawal

Withdrawal and rebound

Escape pain of withdrawal by taking drug (negative reinforcement

Avoid withdrawal by continuous use (avoidance learning)

Anti-social and/or criminal behavior to protect supply.

Understanding compulsion

Getting hooked. Beginning single hook (positive

reinforcement). Escape withdrawal (negative

reinforcement). Avoid withdrawal (avoidance). High-jacked brain thru learning.