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Substance Use and the Brain. Susan Tapert, Ph.D. Alcohol Medical Scholars Program. Substance Use and the Brain. How is the brain affected long-term? Alcohol Marijuana Stimulants What can we do about this?. Substance Use and the Brain. How is the brain affected long-term? Alcohol
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Substance Use and the Brain Susan Tapert, Ph.D. Alcohol Medical Scholars Program
Substance Use and the Brain • How is the brain affected long-term? • Alcohol • Marijuana • Stimulants • What can we do about this? Copyright AMSP
Substance Use and the Brain • How is the brain affected long-term? • Alcohol • Marijuana • Stimulants • What can we do about this? Copyright AMSP
Drinking & Thinking • ~50% alcoholic adults show some problems: • Spatial skills • Planning • Learning and memory • IQ and language OK • Recovery • Much in 1st month • More in 1st year if sober Copyright AMSP
Problems when using and when sober Falling asleep Total sleep Sleep quality Affects memory and thinking Feeling unrested increases relapse risk Alcohol and Sleep Copyright AMSP
Brain Structure • Magnetic resonance imaging (MRI) • Safe • No injections • Shows small brain parts Copyright AMSP
Shrinkage: Ventricles Non-alcoholic Alcoholic Copyright AMSP
Shrinkage: Cerebellum Healthy Control Alcoholic Copyright AMSP
Brain Function • Functional magnetic resonance imaging (fMRI) • Safe • Movies of brain activity • Good resolution Copyright AMSP
Side View Brain Function Alcoholics vs. Healthy Controls Copyright AMSP
Volume Recovery 2 Years Later During Treatment Copyright AMSP
Substance Use and the Brain • How is the brain affected long-term? • Alcohol • Marijuana • Stimulants • What can we do about this? Copyright AMSP
Marijuana & Thinking • Modest problems in very heavy users • Learning and memory • Sustained attention • Impulsivity • Most recover after 1 month abstinent Copyright AMSP
Marijuana & Brain • No evidence of brain shrinkage • Altered brain waves related to attention • brain blood flow • brain response while learning Copyright AMSP
Substance Use and the Brain • How is the brain affected long-term? • Alcohol • Marijuana • Stimulants • What can we do about this? Copyright AMSP
Stimulants &Thinking • Motor skills • Planning • Switching tasks • Decision making • Working memory • Impulsivity • Learning and memory Copyright AMSP
Stimulants & Brain Structure • Volume reductions: • Cingulate • Hippocampus • No overall gray matter changes • Volume increase: • Subcortical areas Copyright AMSP
High blood flow Low blood flow Stimulants & Blood Flow Cocaine-dependent Healthy Control Gottschalk, 2001, Am J Psychiatry Copyright AMSP
Blood Flow Recovery High blood flow Non users Cocaine users, 10 days sober Low blood flow Cocaine Users, 100 days sober Copyright AMSP
Substance Use and Brain Summary: • Thinking problems • Tissue loss • Decreased blood flow • Altered brain response to task • Much recovery with abstinence Copyright AMSP
Substance Use and the Brain • How is the brain affected? • What can we do about this? Copyright AMSP
Implications • Inform patients • Develop better treatments Copyright AMSP