Your Brain on Drugs Presentation 8/13/08

1. Your Brain on Drugs Presentation 8/13/08 This is your Brain, this is your Brain on DRUGS, any Questions? YES LOTS! or Q Why do Youth Take Drugs? A BECAUSE THEY WORK ! So what can we do? Ira Sachnoff Tobacco and Alcohol Consultant, SFSUD

2. Highlights • What’s the teen environment • The adolescent brain • Reward System • Alcohol/Marijuana/Tobacco • Influencing our children

3. SFUSD Youth • Had a drink in the last 30 days HS MS 26 %10% • Used Marijuana in the past 30 days HS MS 15% 6% • Past 30 days Binged on Alcohol in the HS’s 18%

4. SFUSD Headlines 2008 • Did you know that according to a survey taken with over 12,000 SFUSD High School Students last year that: • 74% reported to HAVE NOT had a drink of alcohol in the past month. • 85% reported that they HAVE NOT used Marijuana in the past month. • 82% reported that they HAVE NOT Binged on Alcohol in the last month. • 91% reported that they believe that almost daily use or daily use of Alcohol is harmful. • Did you know that the use of Alcohol and Marijuana in the SFUSD is lower then the state averages? • While we are proud of these facts, we still are concerned and will always attempt thru education and outreach to lower these numbers every single year.

5. Adolescent Brain Adult Brain

6. Pruning • “USE IT OR LOSE IT”– Reading, sports, music, video games, x-box, hanging out—whatever a child/teen is doing—these are the neural synapses that will be retained • How children/teens spend their time isCRUCIALto brain development since their activities guide the structure of the brain

7. Neuroadaptation & HypofrontalityMemory Loss • Neuroadaptivity – Dulling of the pleasure center of the brain • Hypofrontality – Interference with the decision making area of brain • Memory loss – Damage to the hippocampus

8. Reward System • The reward system is responsible for seeking natural rewards that have survival value • seeking food, water, sex, and nurturing • Dopamine is this system’s primary neurotransmitter reward

9. Drugs Hijack the Brain’s Reward Circuitry • Immediate effect of drug use is an increase in dopamine • Continued use of drugs reduces the brain’s dopamine 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” • Craving occurs and, eventually, dependence. reward

10. Dopamine vs. SerotoninPleasure vs. Happiness • Dopamine produces a feeling of pleasure • Serotonin produces a feeling of well being • Difference between pleasure and happiness (short lived vs big picture) • Developing skills, interest, relationships, meaning (“getting a life”)

11. Anhedonia Pleasure Bored Interested “I feel negative” “I feel good” Pleasure Scale NORMAL RANGE Dysphoria Euphoria

12. The Pre Frontal Cortex Disease Adolescent dilemma: “ . . . want to be adults and they’re exposed to a semi-adult culture, but they don’t have the prefrontal cortex to regulate those adult behaviors . . . . They can’t apply emotional brakes.” “They have the passion and the strength but no brakes and they may not get good brakes until they are twenty-five.” (Giedd)

13. PreFrontal Cortex Parents’, therapists’ and our task: “Sometimes need to act as though they are their teenagers’ “frontal cortex . . . talking through possibilities and options. They have to function like a surrogate set of frontal lobes, an auxiliary problem solver.”

14. Are adolescents more susceptible to alcohol than adults? Most certainly YES • Reduced sensitivity to intoxication • Increased sensitivity to social disinhibitions • Greater adverse effects to cognitive functioning

15. What’s the big deal about kids drinking anyways??? • Have you ever seen a group of drunk teenagers? • Demeaning behaviors • Risk taking behaviors • Accidents • Teenage brain effects before 18 yrs old

16. Are you at Risk? Apply the bio-psycho-social model to yourself: Family history of addiction? Do you have a tendency to boredom or ADHD? Are you anxious or depressed? Have you suffered sexual trauma?

17. ADD and Drugs Prospective four-year study of 15 year-old boys. 75% Un-medicated ADD boys started abusing alcohol/drugs (N=19) 25% Medicated ADD boys started abusing alcohol/drugs (N=56) 18% (Controls) Non-ADD boys started abusing alcohol/drugs (N=137) 84% Risk Reduction when ADD treated with medications

18. Alcohol and Teenagers: • Date Rape – one to two-thirds of teen sexual assaults involve alcohol • 18% of Females/ 39% Males say it is acceptable for a boy to force sex if the girl is stoned or drunk • 40% of children who start drinking before age 15 will become alcoholics • In television 9 out of 10 drinkers are portrayed as having no effects or only positive outcomes from their alcohol consumption

19. Notes for alcohol • The alcohol industry • Extent of binge drinking in our culture • Integrated in society Alternatives to shifting gears, events, stress Modeling Power of delaying usage through age 18 Do we want to continue the level of pain and suffering alcohol has caused – look what we have done with cigarette smoking

20. For parents • I care, I see, I feel, Listen • Clear expectations and consequences • Communication & Monitoring • Integrity & Self Assessment – Modeling • Teen-proof your home

21. Prevention Factors • Supportive family (tuned in, time together, supervision, fair rules/boundaries) • Non using peers and role models – are we interested in really changing the culture? • Youth are connected (school, activities) • Social Skills (e.g. dancing) • Resiliency (coping with stress, celebration)

22. Our Own Self Assessment • Andrew Weil – Unhealthy relationship • Ignorance that the substance is a drug and what it does to the body • Loss of desired effect w/increasing frequency • Difficulty separating from the drug • Impairment of health or social function

23. Are you at Risk? Apply the bio-psycho-social model to yourself: Family history of addiction? Do you have a tendency to boredom or ADHD? Are you anxious or depressed? Have you suffered sexual trauma? Do you have an effective way to manage stress?

24. Are you in trouble? How can you tell if you are getting into trouble? Are you compulsive? Is use causing adverse consequences? Do you crave the drug? If so, when you crave the drug, can you talk yourself into using it, even when you had resolved to not use? When you have resolved not to use, do you find yourself using under known craving conditions: environment, withdrawal (bored, irritable, sleep disordered), anxiety or blue, or when you are stressed?

25. Are You an Addict? TRY THE “EXPERIMENT” Resolve not to use for 5 weeks. Go about your usual daily acivities. Put yourself around the drug and people using it.

26. Are You an Addict? AFTER 5 WEEKS Were you able to not use? Did you find your mind talking you into using? Did you struggle not to use? Were you able to have pleasure without using? Did you have problems with boredom, depression or anxiety?

27. Are you in trouble? How can you tell if you are getting into trouble? Are you compulsive? Is use causing adverse consequences? Do you crave the drug? If so, when you crave the drug, can you talk yourself into using it, even when you had resolved to not use? When you have resolved not to use, do you find yourself using under known craving conditions: environment, withdrawal (bored, irritable, sleep disordered), anxiety or blue, or when you are stressed?

28. What to do Get out of the using environment. Find alternative sources of pleasure. Work on balancing stress. Seek help for mental health issues and other personal stresses.

29. Process • Present a non-judgmental approach • Establish credibility (Honesty, Knowledge, Authenticity) • Stimulate discussion and serious thought • Art of weaving information (stealing of knowledge)

30. Strategies and ApproachesTalking with children in the classroom or individually Credibility – Believability plus influence Kids will listen, but even more, kids will consider and self reflect; look into what they already know and compare with new information. Example – THC Content

31. Strategies and ApproachesTalking with children in the classroom or individually • Brains are different • Not personal • Science based • Marsha’s experiment and the use of motivational interviewing • Not trying to convince • Teaching true decision making with a predetermined conclusion • Kids are sensitive to being manipulated • Use of their knowledge and past experience • Give balanced answers

32. Strategies and ApproachesTalking with children in the classroom or individually Honesty – They ask you if you ever used mostly to see if you are going to be honest; be real because the reality of the situation is that is what works.

33. Process • Present a non-judgmental approach • Establish credibility (Honesty, Knowledge, Authenticity) • Stimulate discussion and serious thought • Art of weaving information (stealing of knowledge)

34. Reaching Teenagers • Don’t shove this kind of information down their throat • No propaganda • Non-judgmental/ Fair and Balanced • Honest with integrity • Interactive • Honoring where they are and what they know • Let them steal the information • Authenticity

35. More to think about… • Various approaches for age and circumstance • What’s worked for you • Classroom settings, individuals, groups, SAP • Marijuana-Tobacco connection • Stages of change and Motivational Interviewing • Summation and conclusions

36. The Message • Non-Use is as Normal as Experimental Use • Use = Risk • Risk is not Evenly Distributed • Addiction is Real • Quality of Life can be diminished even without developing addiction; i.e., Seduction Vs Addiction • Motivations for Initial Vs Continuing Use are always different • DELAY, DELAY, DELAY