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Drugs and the Adolescent Brain

Drugs and the Adolescent Brain. Ken Winters, Ph.D. University of Minnesota winte001@umn.edu Treatment Research Institute kwinters@tresearch.org ASP Workshop 2005. Emerging Science: Teen Brains Are Still “Under Construction”. New insights about:

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Drugs and the Adolescent Brain

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  1. Drugs and the Adolescent Brain Ken Winters, Ph.D. University of Minnesota winte001@umn.edu Treatment Research Institute kwinters@tresearch.org ASP Workshop 2005

  2. Emerging Science: Teen Brains Are Still“Under Construction” • New insights about: • Why teenagers take risks and show poor judgment • How teenagers may be highly vulnerable to substance abuse • These findings can help parents, policy makers

  3. Adolescence is a period of profound brain maturation. • We thought brain development was complete by adolescence • We now know… maturation is not complete until about age 24!!!

  4. An Immature Brain = Less Brakes on the “Go” System

  5. Construction Ahead • Growth of the brain’s nerve cells (neurons) occurs through late childhood • 1,000,000,000,000,000 possible connections. • Around 11 – GIRLS; 12½ - BOYS: • Some of these connections are pruned off.

  6. Construction Ahead • When the pruning is complete, the brain is faster and more efficient. • But… during the pruning process, the brain is not functioning at full capacity

  7. Maturation starts at the back of the brain.. and moves to the front Construction Ahead Amygdala Judgment Emotion Motivation Physical coordination Sensory processing Prefrontal Cortex Nucleus Accumbens Cerebellum Notice: Judgment is last to develop!

  8. Age 24 Emotion Motivation Physical coordination, sensory processing Judgment Ahh… Balance, Finally!

  9. Implications of Arrested Development for Adolescent Behavior • Sensory and physical activities benefit from earlier “back of the brain” development • Complex, judgment-demanding thinking are compromised by later “front of the brain” development

  10. Implications of Arrested Development for Adolescent Behavior We can infer...…. • Preference for sensation seeking and physical activity • Poor planning and judgment • Minimal consideration of negative consequences • More risky, impulsive behaviors • Some evidence that being in a group accentuates impulsiveness

  11. Implications of Arrested Development for Drug Abuse Vulnerability Research Question Addressed in the Literature:Are adolescents more susceptible than adults to alcohol?4 lines of evidence

  12. Implications of Arrested Development for Drug Abuse Vulnerability 1. Evidence from epidemiological studies

  13. Percentages of Past Year Alcohol Dependence or Abuse Among Adults Aged 21 or Older, by Age of First Use (SAMHSA, 2004) Fewer Problems in Those Who Start Later % Age Started Drinking

  14. Alcohol Use Disorder in the Past Year by Age Group(SAMHSA, 2004) percent dependent or abusing past year

  15. Binge Alcohol Use in the Past Month by Age Group(SAMHSA, 2004) percent binge use past month Binge = 5+ drinks same occasion on at least one day in the past 30 days.

  16. Implications of Arrested Development for Drug Abuse Vulnerability Research Question Addressed in the Literature:Are adolescents more susceptible than adults to alcohol? • Evidence from the laboratory • Direct evidence can not obtained from human adolescents for ethical reasons. • Much of what is known from adolescent rat studies.

  17. Are adolescents more susceptible to alcohol than adults? 1. Epidemiological data Comparing adolescent and adult rats, both having no prior exposure to alcohol and matched on temperament…. 2. Adolescent rats are less sensitive to the sedative and motor impairment effects of intoxication. • more drinking before “signals to stop”

  18. Are adolescents more susceptible to alcohol than adults? 1. Epidemiological data 2. Adolescent rats are less sensitive to the sedative and motor impairment effects of intoxication. 3. Adolescent rats are more sensitive to the social disinhibition effects of alcohol. • greater social comfort from intoxication

  19. Are adolescents more susceptible to alcohol than adults? 1. Epidemiological data 2. Adolescent rats are less sensitive to the sedative and motor impairment effects of intoxication. 3. Adolescent rats are more sensitive to the social disinhibition effects of alcohol. #2 and #3 : May contribute to binge drinking and increased risk to alcohol dependence.

  20. Are adolescents more susceptible to alcohol than adults? 1. Epidemiological evidence 2. Adolescent rats are less sensitive to the sedative and motor impairment effects of intoxication. 3. Adolescent rats are more sensitive to the social disinhibition effects of alcohol. 4. Alcohol may produce cognitive disruptions in adolescents.

  21. 4. Human Data:Alcohol’s Effects (Brown, 2002; Wuethrich, 2001) • Adolescents with a history of extensive use…. Hippocampus volume (10%) brain activity during memory tasks converts information to memory • Not known if restoration or recovery will occur.

  22. Evidence in support that youth are highly vulnerable to the effects of alcohol SUMMARY 1. Greater rates of alcohol dependence 2. Reduced sensitivity to intoxication 3. Increased social disinhibition 4. Increased cognitive disruption

  23. INDIRECT evidence in support that youth are highly vulnerable to the effects of alcohol SUMMARY Neurodevelopment likely contributes to…. Risky, impulsive behavior Planning and judgment Ability to weigh consequences

  24. SUMMARY • Expect impulsivity, poor judgment, emotionality • “On second thought…” NOT in the repertoire • Parents must use THEIR judgment to protect teens • Parents must anticipate - kids can’t • Drugs, particularly alcohol, have different and more significant effects on teens • Drug experimentation is normal • BUT… can be dangerous

  25. Take Home Summary P= Promote activities that capitalize on the strengths of the developing brain A= Assist children with challenges that require planning R= Reinforce their seeking advice from adults E= Educateabout risk taking and negative consequences N= Never underestimate the effects of alcohol on the developing brain T= Tolerate the “oops” behaviors due to an immature brain

  26. POLICY IMPLICATIONS • Support services and programs that promote youth assets with neurodevelopment in mind • structure • adult supervision • recreation, music, realistic cognitive challenges • Re-visit age of majority/privilege? • 16 - emancipation • 16 - driving • 18 - gambling (some states/some games) • 18 - smoking

  27. THANK YOU!e-mail: winte001@umn.eduweb: www.tresearch.org

  28. Suggested Readings • www.thebrain.mcgill.ca/flash/index_d.html# Dubuc, B. (2004). The brain from top to bottom • www.drugabuse.gov/Published_Articles/ Leshner A. (2000). Oops. How casual drug use leads to addiction. National Institute on Drug Abuse, September, 2000. • Why do they act that way? : A survival guide to the adolescent brain for you and your teen Walsh, D. (2004). NY: Simon & Schuster. • What makes teens tick? Wallis, C. (May 10, 2004). NY: Time magazine. • The adolescent brain and college drinker: Biological basis of propensity to use and misuse alcohol. Spear, L. (2002). Journal of Studies on Alcohol, 14, pp. 71-81.

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