Understanding Alcohol and Opiate Addiction Describe the diagnostic criteria for alcohol and opiate use disorder and discuss the underlying neural circuitry believed to be involved in this disorder. Please discuss mediation treatment options first-line treatments and the neurobiology behind how they work.

Purpose:

The purpose of required threaded discussions is an interactive dialogue among instructors and students to assist the student in organizing, integrating, applying, and critically appraising one’s knowledge regarding the nursing profession and selected area of practice. Scholarly information obtained from current sources as well as professional communication is required. The articles should have been published within the past 5 years and be peer-reviewed. In some cases, you will need to pull in content from the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

Application of information to advanced practice nursing experiences promotes the analysis and use of principles, knowledge, and information learned and related to real-life clinical situations. Interactive dialogue among instructors and peers fosters the development of a learning community as ideas, perspectives, and knowledge are shared.

Alcohol and Opiate Use Disorder: Diagnosis, Brain Effects, and Treatment

How Alcohol and Opiate Use Disorder Are Diagnosed

Alcohol Use Disorder (AUD) and Opiate Use Disorder (OUD) are diagnosed using the DSM-5 criteria. A person must meet at least two of the following symptoms within 12 months:

1. Drinking or using more than intended
2. Trying but failing to cut down
3. Spending a lot of time getting, using, or recovering from the substance
4. Strong cravings
5. Struggling with responsibilities due to substance use
6. Continued use despite relationship problems
7. Giving up important activities
8. Using in risky situations
9. Continuing despite knowing the harm
10. Needing more to get the same effect (tolerance)
11. Experiencing withdrawal symptoms when stopping

Severity Levels:

• Mild: 2–3 symptoms
• Moderate: 4–5 symptoms
• Severe: 6 or more symptoms

How These Disorders Affect the Brain

Both AUD and OUD change the brain’s reward system, which controls pleasure, motivation, and cravings. The key areas involved include:

• Ventral Tegmental Area (VTA): Releases dopamine (the “feel-good” chemical).
• Nucleus Accumbens (NAc): Reinforces substance use by creating a sense of reward.
• Prefrontal Cortex: Helps with decision-making but weakens with addiction, leading to poor self-control.
• Amygdala: Increases cravings and withdrawal symptoms.

Over time, alcohol and opioids disrupt normal dopamine levels, making natural rewards (like food and social interactions) less satisfying.

Treatment Options

Alcohol Use Disorder Treatments

1. Naltrexone (first-line) – Blocks opioid receptors in the brain, reducing alcohol cravings and pleasure.
2. Acamprosate – Helps restore brain balance, easing withdrawal symptoms.
3. Disulfiram – Causes an unpleasant reaction when drinking, discouraging use.recovery more manageable. APA