The Brain: Understanding Neurobiology Through the Study of Addiction by National Institute of Health. - HTML preview

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their quality of life.

Medical Uses of Addictive Drugs

It is well known that otherwise safe medications can turn harmful if abused or taken without

prescription or supervision. The other side of this coin is that many drugs of abuse are themselves,

or have been found to contain, active ingredients that can be therapeutic. A good example is

morphine. During the Civil War, doctors gave morphine to wounded soldiers to relieve the pain of

injuries. Doctors didn’t realize how addictive injected morphine was until many soldiers became

addicted to the drug.2 Morphine addiction became known as “soldiers’ disease.” Today, morphine

is a valuable medicine to relieve pain when administered with the appropriate medical supervision.

Patients in hospitals receive morphine to ease their pain after surgery and during cancer and burn

treatment. Very few of these patients become addicted to morphine even though they may take it

for extended periods of time.

Another drug that has received considerable attention for its potential medical benefits is

marijuana. Television and newspaper reports periodically present stories on the use of marijuana

by terminal cancer or AIDS patients to ease their discomfort and pain. Following up on such

anecdotal evidence, several scientific studies have been able to corroborate at least some of

the claims about marijuana’s beneficial effects on appetite, nausea, and certain types of pain.

However, marijuana’s addictive properties and its usual delivery by smoke inhalation—which

exposes the lungs to many toxic chemicals—make it an unappealing candidate for medications

development. Rather, it is likely that our understanding of the biology of marijuana’s active

ingredients, such as tetrahydrocannabinol (THC), will lead to improved medications for a variety

of conditions, ranging from obesity and addiction to neuropathic pain in multiple sclerosis (MS)

patients, chronic pain in advanced cancer patients, nausea, and wasting syndrome.11

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Student Lesson 4

The Brain: Understanding Neurobiology Through the Study of Addiction

The risk of becoming addicted to prescription pain medications is minimal

in patients who are treated on a short-term basis; however, the risk for

those with chronic pain is less well understood. Some studies have shown

that those most vulnerable to becoming addicted to prescription pain

medications have a history of psychological disorders, prior substance

abuse problems, or a family history of these disorders. Pain management

for patients who have substance abuse disorders is particularly challenging

for the medical profession. However, these patients can still be successfully

treated with opioid pain medications, although they may need to be

admitted to a treatment or recovery program and monitored closely if

controlled substances are prescribed for pain.

In the 1970s, news media reported the use of marijuana and heroin by

soldiers who were serving in Vietnam. Combat stress, the easy availability

of drugs, and the relaxation of taboos against drug use at the time all

contributed to the prob lem. Although many soldiers did have drug problems

while in Vietnam, 95 percent were not addicted to drugs after they returned

to the United States.12 This illustrates the profound effect that environmental

circumstances can have on drug taking and drug addiction.

In addition, scientists are working to identify genetic factors that contribute

to drug abuse and addiction. Studies of identical twins indicate that as much

as half of an individual’s risk of becoming addicted to nicotine, alcohol, or

other drugs depends on his or her genes. Recent technical advances in DNA

analysis have enabled researchers to untangle complex genetic interactions

by examining a person’s entire genome at once. A series of studies has

identified a certain variant in the gene for a nicotinic receptor subunit

that more than doubles the risk for addiction among smokers, as well as

increasing their vulnerability to lung cancer and peripheral arterial disease.

Animals as Research Models

Why do scientists study the brains of laboratory animals? Scientists use

ani mals in research studies because the use of humans is either impossible

or unethical. For example, when scientists investigate the effects of drugs

of abuse on brain function, either the question they are asking cannot be

answered in a living human or it would be inappropriate to give a person

the drugs.

The use of animals as subjects in scientific research has contributed to

many important advances in scientific and medical knowledge. Scientists

must ana lyze the goals of their experiments in order to select an animal

species that is appropriate. Scientists often use fruit flies ( Drosophila

melanogaster) when they want to learn more about genetics. However,

fruit flies are not a very good model if a scientist is investigating muscle

physiology or behavior; a mouse may be a better model for those

experiments. Although scientists strive to develop nonanimal models

for research, these models often do not duplicate the complex animal or

human body. Continued progress toward a more complete under standing

of human and animal health depends on the use of living animals.

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Guidelines for the Use of Animals in Scientific research

Scientists who use animals as research subjects must abide by federal policies that govern the use

and care of vertebrate animals in research. The Public Health Service established a policy that

dictates specific requirements for animal care and use in research. This policy conforms to the

Health Research Extension Act of 1985 (Public Law 99-158) and applies to all research, research

training, biological testing, and other activities that involve ani mals.13 The principles for using

and caring for vertebrate animals in research and testing are as follows:

• The transportation, care, and use of animals should be in accordance with the Animal Welfare

Act and other applicable federal laws, guidelines, and policies.

• Procedures involving animals should be designed with consideration of their relevance to

human or animal health, the advancement of knowledge, or the good of society.

• The animals selected should be of an appropriate species and quality and the minimum number

required to obtain valid results. Methods such as mathematical models, computer simulation,

and in vitro biological systems should be considered.

• Procedures should minimize discomfort, distress, and pain to the animals.

• Procedures that may cause more than momentary or slight pain should be performed with

appropriate sedation, analgesia, or anesthesia.

• Animals that would suffer severe or chronic pain or distress that cannot be relieved should be

painlessly killed.

• The living conditions of animals should be appropriate for the species. The housing, feeding,

and care of animals must be directed by a veterinarian or a trained, experienced scientist.

• Investigators who work with animals must be appropriately qualified and trained for

conducting procedures on living animals.

• Exceptions to any of these principles must be reviewed and approved by an appropriate

committee prior to the procedure.

• An Institutional Animal Care and Use Committee (IACUC) oversees all animal use in each

institution where ani mal research is conducted. The IACUC must give approval for the research

plan and species to be used. IACUCs include both scientists and nonscientists from outside the

institution. Nonscientists are often representa tives of humane organizations.

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Student Lesson 4

The Brain: Understanding Neurobiology Through the Study of Addiction

Web-Based Activities

In Advance

Activity

Web Component?

1

No

2

No

3

No

4

No

5

Yes

Photocopies

For the class

For each student

1 transparency of Master 4.4, 1 copy of Master 4.1, Data for Rat

Playing the Game

Self-administration Experiment

1 transparency of Master 4.5, 1 copy of Master 4.2, Worksheet for

Who Is Addicted?

Rat Experiment Data

1 copy of Master 4.3, Evaluating

the Experiment

1 copy of Master 4.6, Long-Term

Effects of Drugs on the Brain (only

if not using the Web-based version)

Materials

Activity

Materials

Activity 1

none

Activity 2

colored pencils, overhead projector, transparency

playing cards (one deck for each group of

Activity 3

3 students; see Preparation section), overhead

projector

Activity 4

overhead projector

Activity 5

computer

Preparation

Gather decks of playing cards for use in Activity 3. Each group of three

students can share one deck of cards. Separate the face cards (jacks,

queens, and kings) and place them in one pile. Place the aces and number

cards in another pile.

Arrange for students to have access to computers for viewing the

minidocumentary online in Activity 5.

98

Activity 1: How Does Drug Abuse Begin?

Procedure

1. Begin the activity by holding a class discussion. Ask students,

“What is a drug?” Write their answers on the chalkboard or on an

overhead trans parency. Give students the opportunity to present

differing views.

Content Standard F:

Students will respond with a variety of answers. Some will give

An individual’s mood

examples of illegal drugs, such as marijuana or cocaine, others may

and behavior may be

give the names of prescription medications. If so, prompt students

modified by substances.

to think about a definition for the word drug. Some students will

describe a drug either as an illegal substance that harms a person’s

health or as a chemical that a person takes to treat a disease or

illness. At this point, based on students’ knowledge, both

definitions are correct.

Several terms will be introduced in this lesson. It is very important

to use these terms according to the definitions provided.

2. Write the following definitions for drug and medication on the

board or transparency and inform students that, for this discussion,

you will use the terms according to the following definitions.

• A medication is a drug that is used to treat an illness or

disease accord ing to established medical guidelines.

• A drug is a chemical compound or substance that can alter

the structure and function of the body. Psychoactive drugs

affect the function of the brain, and some of these may be

illegal to use and possess.

3. If the students didn’t do this in the previous question, ask them

to con sider examples for both medications and drugs. List each

response in the proper category as a medication or a drug.

According to these definitions, all medications are drugs, but not all

drugs are medications. This module uses the word “drug” to refer to

psychoactive drugs, or drugs of abuse. Drug abuse refers to the use of

illicit drugs or to the inappropriate use of a legal drug or substance,

such as alcohol, nicotine, prescription drugs, or inhalants.

Societal and political factors sometimes influence into which category

a sub stance falls. Alcohol and nicotine (tobacco) are drugs that are

illegal to use and possess if the individual is below legal age, but not

for adults to possess and use responsibly. Also, inhalants (paints,

glues, and sprays, for example) are not illegal to possess when they

are used for their intended purposes. However, they are drugs when

used improperly to alter brain function.

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Student Lesson 4

The Brain: Understanding Neurobiology Through the Study of Addiction

Some students will raise the idea that medications can also be drugs

if they are used inappropriately. For example, overuse of a prescription

medication, such as a sedative, is inappropriate and wouldn’t be

considered a medication in that case. Alternatively, students may

indicate that morphine is an illegal drug when used without medical

supervision, but is a valuable medicine when used appropriately in a

hospital, or at home, to relieve pain associated with various diseases.

Students may also propose that marijuana can be a medica tion to

relieve the pain that accompanies various diseases. (In some states,

marijuana is legal as a medication, but is illegal according to federal

law.) If students bring this up, point out to them that scientists need

to continue studying marijuana or its active ingredients to determine

if it may be effective as a medicine. Mari juana contains hundreds of

chemical compounds; the effects of most of these compounds in the

body are unknown. Marijuana also poses many problems outside of

the brain—for the lungs, for example, because it is usually smoked.

Use this as an opportunity to inform students that scientific research

is being done to determine whether marijuana or other cannabinoid-

based medications are more effective than other medicines (see the

Back ground Information section).

4. Ask students to respond to the question, Why do people start

abusing drugs?

Students may provide a wide range of answers to this question

including peer pressure, experimentation, boredom, or fun. Some

students may also respond that people take drugs to escape from

life’s pressures.

Activity 2: Drug Abuse Is Voluntary; Addiction Is

Compulsive

Content Standard A:

1. For this activity, students will work in groups of four. Before you

Mathematics is essential

have stu dents divide into their small groups, set the stage for the

in scientific inquiry.

activity. Tell stu dents they will be analyzing data from experiments

Content Standard A:

using rats. For the experiments, each rat was placed in a cage with

Scientists rely on

two levers that the rat could press. If the rat pressed the food lever, a

pellet of food was released. If the stimulus lever was pressed, the rat

tech nology to enhance

received an injection or an electrical stimulus.

the gathering and

manipula tion of data.

Students may ask what substance was injected in response to the

Content Standard C:

press of the stimulus lever. Tell students that the answer to that

Organisms have

question will be revealed during the activity.

behav ioral responses

to inter nal changes

and to external stimuli.

Content Standard F:

An individual’s mood

and behavior may be

modified by substances.

100

index-115_1.png

Figure 4.3 Diagram of a rat in a cage during a

drug self-administration experiment.

2. Give each student a copy of Masters 4.1, Data for Rat Self

administration Experiment, and 4.2, Worksheet for Rat Experiment

Data. Each student will graph on Master 4.2 the data for only one of the rats. Instruct the teams to decide which member will graph

the data for Rats A, B, C, and D. The students will plot the total

number of times that the rat presses the stimulus lever vs. time and

the total number of times that the rat presses the food lever vs. time.

The graph of the data for each rat will have two lines, one for the

stimulus lever and one for the food lever. Students can use a different

color of pencil for plotting each set of data, or they can use a solid line

and a dashed line to distinguish between the two graph lines.

3. After students have completed their graphs, give each student a

copy of Master 4.3, Evaluating the Experiment. Each student should share his or her graph with the other members of the group. Group

members then discuss the similarities and differences among the rats’

responses and answer the questions on Master 4.3.

4. When the groups are finished answering the questions, hold

a class discussion to ensure that each group has come to the

appropriate conclusions.

Sample Answers to Questions on Master 4.3

Question 1. Why do the rats press a lever the first time?

The rats initially press a lever while they are exploring the cage.

A rat may even press the lever by accident. Whether a rat presses

the food lever or the stimulus lever first is usually random.

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Student Lesson 4

The Brain: Understanding Neurobiology Through the Study of Addiction

Question 2. Compare the leverpressing behaviors of the four different

rats. Which rat pressed the stimulus lever the most? Which one pressed

the stimulus lever the least? Which rat pressed the food lever the most?

Which one pressed the food lever the least?

Rats A and C pressed the stimulus lever about the same number of

times and many more times than either Rat B or Rat D. Rats B and D

did not press the stimulus lever very many times, but they pressed the

food lever more times than Rats A and C did. Overall, Rats A and C

behaved similarly and Rats B and D behaved similarly.

Question 3. Rat A was injected with cocaine each time it pressed the

stimu lus lever. Can you use this fact to explain why Rat A behaved the

way it did?

The cocaine activated the reward system in the brain and caused the rat

to continue its stimulus-lever-pressing behavior. If necessary, remind

students that the reward system is the part of the brain stimulated by

drugs to cause feelings of pleasure.

Question 4. Based on the data you analyzed, do you think Rat B was

injected with cocaine when it pressed the stimulus lever? From what you

have learned so far in this unit, do you think Rat B was injected with a

different addictive drug when it pressed the stimulus lever? Why?

It appears that Rat B was not injected with cocaine when it pressed

the stimulus lever because its behavior was very different from Rat A.

If Rat B was injected with cocaine or another addictive drug, it should

display behavior similar to Rat A.

(Rat B actually received a saline injection when it pressed the

stimulus lever.)

Question 5. Do you think Rat C received cocaine when it pressed the

stim ulus lever? Why?

It is possible that Rat C received cocaine when it pressed the stimulus

lever because its behavior was very similar to that of Rat A. However,

you can not be sure that it was cocaine.

Question 6. Rat C did not receive an injection of cocaine when it pressed

the stimulus lever. When Rat C pressed the stimulus lever, it received a

mild electrical stimulation in the brain. On the basis of what you have

learned, can you predict what part of the brain was stimulated?

The reward system (ventral tegmental area or nucleus accumbens)

is the part of the brain stimulated. Stimulation in that area of the

brain caused the rat to continue pressing the stimulus lever.

102

Question 7. Rat D also received a mild electrical stimulation in the brain

when it pressed the stimulus lever. Do you think the same part of the

brain was stimulated in Rat D as was stimulated in Rat C? Why?

Rat D did not receive an electrical stimulation in the same part of the

brain that was stimulated in Rat C. If the same part of the brain, the

reward sys tem, was stimulated, Rat D should behave similarly to Rat C.

(Rat D received an electrical shock in the cerebellum, which is not part

of the reward pathway.)

Question 8. Why did Rats A and C press the stimulus lever more than

the food lever?

Rats A and C received a greater “reward” when they pressed the

stimulus lever than they did when they pressed the food lever.

Question 9. Why did Rats B and D press the food lever more than

the stim ulus lever?

Rats B and D received greater “reward” when they pressed the food

lever than they did when they pressed the stimulus lever.

Question 10. Why did the scientists who conducted this experiment

include Rats B, C, and D? How did the data from those rats help

scientists understand more about how cocaine acts in the brain?

Rats B, C, and D were used as controls in this experiment. Rat B

received a saline injection after pressing the stimulus lever. (The

cocaine that Rat A received was dissolved in a saline solution.)

Because Rat B’s behavior differed from Rat A’s beh