Course Syllabus
The Psychology of Addiction |
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Syllabus1420Fall15 Revised-1.pdf Psychology of Addiction PsycE-1420 Preliminary Syllabus* Harvard University Extension School Fall 2015
Instructors: Gene M. Heyman, Verna L. Mims Course website: https://canvas.harvard.edu/courses/4191 Addiction is studied at many levels, from how drugs affect neurons to how drugs affect society. Neural architecture and societal organization influence drug effects as well as bear the brunt of drug effects. This complexity is in part responsible for the conflicting views of the nature of addiction, with some arguing we should consider addiction a disease, much like heart disease or diabetes, and others arguing that drug use in addicts is a matter of choice. To understand addiction we also need to understand basic bio-psychological relations, such as how neurons work, heritability, and empirical laws of choice. Consequently, course readings include papers on these topics as well as papers on addiction. The course topics include (1) the characteristics of addiction as revealed in biographies, epidemiological studies, and ethnographies, (2) how drugs work (in a very schematic fashion), (3) role of heredity in behavior and alcoholism, (4) whether heroin is an “enslaving” drug, (5) the reward/dopamine explanation of cocaine addiction, (6) drug craving, (7) cigarette smoking, (8) marijuana (9) addiction as choice, (10) values as a determinant of drug use, and (11) drug policy. The readings are largely research studies published in scientific journals.
Required text
Recommended/optional text Additional reading course readings will be available on the course website, in the library, or in class handouts.
Grades Graduates: Exam 1: 20%, Exam 2: 30%, Quizzes: 20%, Papers 30% Quizzes
Papers
Key dates
Quiz dates
September 3 – Lecture 1 Introduction: Defining addiction, an overview of the topic, and course mechanics. “Addiction” identifies a self-destructive pattern of drug use. The popular understanding is that addiction is a compulsive, involuntary behavior. However, self-destructive behavior is not necessarily compulsive. Whether addictive drug use is voluntary or involuntary is an empirical question that can be scientifically tested. To answer it properly requires an objective definition of compulsivity and a sufficiently rich account of the determinants of drug use. This course offers insight into the nature of addiction based on objective definitions of voluntary and involuntary behavior, and the factors correlated with drug use. American Psychiatric Association (1994). Substance Dependence. In Diagnostic and statistical manual of mental disorders, (4th ed.) pp. 176-179. Washington, DC: Author. Burroughs, W. S. (1959). Deposition: Testimony concerning a sickness, xxxvii-xlii.
September 10 – Lecture 2 Neurons, drugs, psychopharmacology: Drugs achieve their effects by changing the way the brain normally functions. To understand these changes, we will cover how drugs reach their sites of action, receptor dynamics, psychopharmacology, and brain plasticity. How the nervous system works, selection. Pp. 92-103. McKim, W. A. (2013). Drugs and Behavior. Chapter 4: Neurophysiology, neurotransmitters, and the nervous system. Martin, S. et al. (1990). Effects of dominance rank on d-amphetamine-induced increases in aggression. Pharmacology, Biochemistry & Behavior, 37, 493-496.
September 17 – Lecture 3 Opiates, part 1: History, psychopharmacology, tolerance, and withdrawal. Heroin and morphine have been used in different forms, by different groups of people, for millennia. What makes using opiates so compelling that people continue to use it despite the dangers that are associated with its use? McKim, W. A. (2013). Drugs and Behavior. Chapter 11: Opioids. Fanselow, M. S. (1979). Naloxone attenuates rats’ preference for signaled shock. Physiological Psychology, 7, 70-74. Goldstein, A. (1980). Thrills in response to music and other stimuli. Physiological Psychology, 8, 126-129. Heyman, G.M., 2015. Opiate Use and Abuse, History of. In: James D. Wright (editor-in-chief), International Encyclopedia of the Social & Behavioral Sciences, 2nd edition, Vol 17. Oxford: Elsevier. pp. 236–242. Melzack, R. (1990). The tragedy of needless pain. Scientific American, 262, 27-33. *Martin-Soelch et al. (2001). Changes in reward-induced brain activation in opiate addicts. European Journal of Neuroscience, 14, 1360-1368. *Optional September 24 – Lecture 4 Opiates, part 2: Does heroin promote compulsive drug use? Heroin use in Vietnam was widespread, but what became of those soldiers when they returned home? Is addiction a chronic relapsing disorder? We use clinical, epidemiological, and ethnographic evidence to answer these questions. Brecher, E. (1972). Licit and illicit drugs. Boston: Little, Brown & Company. Why our narcotic laws have failed: Heroin as an addicting drug (pp. 64-89). Robins, L. et al. (1993). Vietnam veterans’ rapid recovery from heroin addiction: A fluke or normal experience? Addiction, 88, 1041-1954. Warner, L. A., Kessler, R. C., Hughes, M., Anthony, J. C. & Nelson, C. B. (1995). Prevalence and correlates of drug use and dependence in the United States. Archives of General Psychiatry, 52, 219-229. Zinberg, N. E., Harding, W. M., & Winkeller, M. (1977). A study of social regulatory mechanisms in controlled illicit drug users. Reprinted from Journal of Drug Issues.
October 1 – Lecture 5 Subjective aspects of drug use: Craving, intoxication, cognitive deficits. Why do some people experience craving and intoxication differently than others? What role does an individual’s experience of a drug’s subjective effects play in the likelihood that he or she will become addicted? Heyman, G. M. (2009). Addiction in the first person (Chapter 3). Addiction: A disorder of choice. Cambridge, MA: Harvard University Press. Preston, K. L. et al. (2009). Cocaine craving and use during daily life. Psychopharmacology, 207, 291-301. Shiffman, S., et al. (1997). A day at a time: Predicting smoking lapse from daily urge. Journal of Abnormal Psychology, 106, 104-116. Steele, C. M., & Josephs, R. A. (1990). Alcohol Myopia. American Psychologist, 45, 921-933. Wertz, J. M., & Sayette, M. A. (2001). A review of the effects of perceived drug use opportunity on self-reported urge. Experimental and Clinical Psychopharmacology, 9, 3-13.
October 8 – Lecture 6 Stimulants, reward, and dopamine. Why is cocaine so addictive? How does it differ from other addictive drugs? We will look at the differences and similarities between powder cocaine, crack, and other stimulants to understand why addiction to stimulants can be so difficult to break. McKim, W. A. (2013). Drugs and Behavior. Chapter 10: Stimulants. Lenoir, M., Serre, F., Cantin, L., & Ahmed, S. H. (2007). Intense sweetness surpasses cocaine reward. PLoS ONE, 2(8), e698. Nader, M. & Woolverton, W. (1991). Effects of increasing the magnitude of an alternative reinforcer on drug choice in a discrete-trials choice procedure. Psychopharmacology, 105, 169-174. *Gorelick. D. A. et al. (2005). Imaging brain mu-opioid receptors in abstinent cocaine users: Time course and relation to cocaine craving. Biological Psychiatry, 57, 1575-1582. *Toomey, R. et al. (2003). A twin study of the neuropsychological consequences of stimulant use. Archives of General Psychiatry, 60, 303-310. * Optional
October 15 – MIDTERM EXAMINATION
October 22 – Lecture 7 Alcohol, part 1. Introduction to alcohol and alcoholism. Selected topics will include the history of alcohol use, alcohol pharmacology and psychology, and genetic influences related to alcohol abuse. Does a genetic influence in alcoholism imply that it is a disease? McKim, W. A. (2013). Drugs and Behavior. Chapter 6: Alcohol. Schuckit, M. (1994). Low level of response to alcohol as a predictor of future alcoholism. American Journal of Psychiatry, 151, 184-189. Vaillant, G. E., & Milofsky, E. S. (1982). The etiology of alcoholism. American Psychologist, 37, 494-503. Waller, N. et al. (1990). Genetic and environmental influences on religious interests, attitudes, and values: A study of twins reared apart and together. Psychological Science, 1, 138- 142. *Watters, E. (2006). DNA is not destiny: The new science of epigenetics. Discover Magazine, November. *Optional
October 29 – Lecture 8 Alcohol, part 2. Treatment, recovery, and AA. How successful are treatments for alcoholism? Topics include the history of Alcoholics Anonymous and the theoretical basis its widespread use for treatment of alcoholism. Alcoholics Anonymous (1976). How it works. Alcoholics Anonymous (pp. 58-71). New York, NY: World Services, Inc. Tucker, J. A., Vuchinich, R. E., & Pukish, M. M. (1995). Molar environmental contexts surrounding recovery from alcohol problems by treated and untreated problem drinkers. Experimental and Clinical Psychopharmacology, 3, 195-204. Vaillant, G. E. (2003). A 60-year follow-up of alcoholic men. Addiction, 98, 1043-1051. Vaillant, G. E. (2005). Alcoholics Anonymous: Cult or cure? Australian and New Zealand Journal of Psychiatry, 39, 431-436.
November 5 – Lecture 9 Nicotine. Despite a concerted effort to dissuade people from smoking, millions of Americans continue to smoke cigarettes, and new users begin smoking every day. Why is nicotine sometimes considered the prototypical drug of abuse? Why is it so hard to stop smoking? Warburton, D. M. (1988). The puzzle of nicotine use. In M. Lader (ed.), The Psychopharmacology of Addiction (pp. 27-49). Westman, E., et al. (1996). Dissociating the nicotine and airway sensory effects of smoking. Pharmacology Biochemistry and Behavior, 53, 309-315.
November 12 – Lecture 10 Cannabis. Is marijuana addictive? Is it harmful? Topics include marijuana myths versus facts, an objective consideration of reasons to support and/or not support legalization of marijuana for medical or recreational use. McKim, W. A. (2013). Drugs and Behavior. Chapter 14: Cannabis. Fergusson, D. M. et al. (2006). Cannabis and psychosis. British Medical Journal. 332(7534), 172-175. Kandel, D. B., & Chen, K. (2000). Types of marijuana users by longitudinal course. Journal of Studies on Alcohol. 61(3), 367-378. Fried, P. A. et al. (2005). Neurocognitive consequences of marihuana—a comparison with pre-drug performance. Neurotoxicology and Tetratology, 27, 231-239. Meier, M. et al. (2012). Persistent marijuana users show cognitive decline from childhood to midlife. PNAS, August 27. *Fried, P. A. et al. (2005). Neurocognitive consequences of marihuana—a comparison with pre- drug performance. Neurotoxicology and Tetratology, 27, 231-239. *Gruber, A. J., Pope, H. G., Hudson, J. I., & Yurgelun-Todd, D. (2003). Attributes of long-term heavy cannabis users: A case-control study. Psychological Medicine, 33(8), 1415-1422. *Lyons, M. J. et al. (2004). Neuropsychological consequences of regular marijuana use: A twin study. Psychological Medicine, 34, 1239-1250. *Pope, H. (2002). Cannabis, cognition, and residual confounding. Journal of the American Medical Association, 287, 1172-1174. *Optional
November 19 – Lecture 11 Behavioral addictions and treatment issues for dual diagnosis. Couwenbergh, C. et al. (2006). Comorbid psychopathology in adolescents and young adults treated for substance use disorders. European Child & Adolescent Psychiatry, 15(6), 319- 328. Phillips, K. A. (2007). Addicted to Hair Pulling? How an Alternate Model of Trichotillomania May Improve Treatment Outcome. Harvard Review of Psychiatry. 15, 80-85. Potenza, M. N. (2006). Should addictive disorders include non-substance- related conditions? Addiction. Supplement 101, 142-151.
November 26 – THANKSGIVING BREAK
December 3 – Lecture 12 On the nature of reward and choice. Voluntary actions can produce undesirable outcomes. Ellingsen, T. & Johannesson, M. (2008). Anticipated verbal feedback induces altruistic behavior. Evolution and Human Behavior, 29, 100-105. Heyman, G. M. (2009). Chapters 5 & 6. Addiction: A disorder of choice. Cambridge, MA: Harvard University Press. Mendelson, J. et al. (1970). Tongue Cooling: A New Reward for Thirsty Rodents. Science, 170, 1418 -1421.
December 10 – Lecture 13 Pros and cons of current drug policy and should “values” play a role in the effort to reduce harmful drug use? Satel, S. (2007). In praise of stigma. In J. Henningfield, et al. (Eds.), Addiction Treatment: Science and Policy for the Twenty-first Century. John Hopkins University Press, pgs 147-151. Wilson, J. Q. (1990). Against the legalization of drugs. Commentary, 89, 21-28.
December 17 – FINAL EXAMINATION
* Nota bene: This is a preliminary syllabus. Some topics and readings may change.
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Course Summary:
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