Addiction and the Brain

1. Addiction and the Brain

2. The Least You Need To Know: • Neurotransmitters (define) • reward pathway (define) • Old brain vs. New brain (general) • down-regulation (describe) • oops phenomenon (general) • drug use continuum (when addicted?)

3. Recap:Choice or Disease?

4. Substance Abuse: The Nation’s Number One Health Problem The costs of substance abuse in the United States, economically and physically, are staggering. Alcohol is the most economically costly at $166.5 billion, followed by smoking at $138 billion and drug abuse at $110 billion, the report said. Furthermore, of the more than 2 million deaths each year in the United States, one in four is attributable to alcohol, tobacco and illicit drug use. Robert Wood Johnson Foundation, 2006

5. “Drug Addiction is a Brain Disease”Alan Leshner, PhDNational Institute of Drug AbuseFormer Director

6. The Beginning of Brain Research Trepanized skulls 1848

9. Neurotransmitters: Chemical Messengers

10. Intro

11. The Big Two: • Serotonin: mood, emotion, sleep and appetite • Dopamine: pleasure and elation

12. Many drugs work by mimicking a naturally occurring neurotransmitter in the body.

18. Footshock Sucrose Cocaine Nicotine Alcohol Release of Dopamine in the Rat Nucleus Accumbens: Acute Administration 300 250 200 Dopamine (% Change) 150 100 50 0 60 120 180 240 Time (min) Kalivas, P. 2002

19. OLD BRAIN VS. NEW BRAIN

20. Increased Energy“It sustains and refreshes both body and brain...... in the same space of time more than double the amount of work could be undergone...” Sears, Roebuck, and Co. Consumers Guide, 1900 Euphoria“.....exhilarating andlasting euphoria.... You perceive increase in self-control and possess more vitality and capacity for work.”Sigmund Freud, 1884 Transition to Addiction Good to Bad Replace Natural Reward"A coke shot...it's like... Craving“I found I was taking money meant to buy presents for my children.” Paranoia“He thought he was being forcibly electrocuted and could see electric wires leading to his body.”

21. Oops Phenomenon • First use to Feel Good • Some continue to compulsively use because of the reinforcing effects • To Feel Normal • Changes occur in the reward system that promote continued use.

22. Something truly scary….? If you remember one thing about drugs….

23. National Institute on Drug Abuse, 2002; Monkey Brain

24. What is Down-Regulation? National Institute on Drug Abuse, 2000

25. PET/fMRI of Cocaine CravingChildress et al., 1999; Am.J.Psychiat

26. Relapse or Recidivism Why 8-9 out of 10? Or around 80-90%... Go back to using!

29. ‘Down’ in the Dumps Down-Regulation • Immediate effect of drug use is an increase in dopamine or NT’s • Continued use of drugs reduces the brain’s dopamine (or NT) production. • Because dopamine is part of the reward system, the brain is “fooled” that the drug has survival value for the organism. • The reward system responds with “drug seeking behaviors”

31. Imagine……

33. Abstinence DRUG USE CONTINUUM Experimentation Drug Use Drug Abuse Addiction

34. The face of addiction: http://www.youtube.com/watch?v=02ngAsHRg4A

35. Essential Questions • So…is addiction a Choice or disease? • How are depression and drug use related? • How does someone become an ‘addict?’