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Youth standing for freedom
from chemical slavery
Gilberto Gerra
Chief
Drug Prevention and Health Branch
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Political Declaration 2009Paragraph 22
Emphasize and facilitate health, productive and fulfilling alternatives
to the illicit consumption of drugs, which must not become accepted
as a way of life;
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a society under medication?a society under medication?
Benzodiazepine for math test anxietyCannabis for datingAmphetamine for workingEcstasy for dancingEnergy drinks for drivingKetamine for fantasyCocaine and Viagra for sexEfedrine and Growth Hormone for sportOxicodon for coping with stressHeroin for escaping realityRitalin for behavioural controlBrain enhancers for carrierAlcohol for relaxing and socializing
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Pharmaceutical Companies $
Narco-traffickers $
Alcohol producers $
Who is gaining?
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Health
Security
Mental health
Youth empowerment
Creativity
Innovative initiatives
Social-family cohesion
Responsibility accountability
At risk with substance usedisorders
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Who is interested in young people...
Less involved/engaged
Acritical
Sedated / anaffective
With reduced cognitive capacity
With reduced memory
Negativism....
Unable to dream the future
Dependent / conditioned ?????
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LancetAdverse health effects of non-medical cannabis use.
The health effects most likely to occur and to affect a large number of cannabis users:
Hall and Degenhardt, 2009
a dependence syndromeincreased risk of motor vehicle crashes
impaired respiratory function cardiovascular disease
adverse effects on adolescent psychosocial development and mental health
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Dunedin prospective study Dunedin prospective study
Regularly smoking cannabis in their teensand then stoppedRegularly smoking cannabis in their teensand then stopped
8 point less in IQ scale as adults8 point less in IQ scale as adults
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EcstasyEcstasy
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MacEwen C et al. (2008) A case of cocaine-induced basilar artery thrombosisNat Clin Pract Neurol doi:10.1038/ncpneuro0879
Figure 1 Brain CT scan in a patient with cocaine-induced basilar artery thrombosis
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Milton and Everitt, 2012
usurpation of emotional memory
Cocaine addicts brain is not activatedanymore by monetary rewardCocaine addicts brain is not activatedanymore by monetary reward
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Before andaftermethamphetamines ...
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Stigma and discrimination
To punish … To permit…
Denial
Not to share suffering
To ignore responsibility
To attenuate sense of guilt
Stigma and discrimination
To punish … To permit…
Denial
Not to share suffering
To ignore responsibility
To attenuate sense of guilt
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Drug addiction is often the result of an unwholesome social atmosphere in which those who are most exposed to the danger of drug abuse live
Resolution III, 1972 (amendments to 1961 Convention)
Drug addiction is often the result of an unwholesome social atmosphere in which those who are most exposed to the danger of drug abuse live
Resolution III, 1972 (amendments to 1961 Convention)
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A social atmosphere detrimental to physical, mental and moral well-being…
A social atmosphere detrimental to physical, mental and moral well-being…
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Temperament,personality traits
Insecure parent-child attachment
Neglect
Abuse
Stressful life events
Lack of bonding to family Affectionless
control
Excessiveprotection
Extreme poverty
Social exclusion
Exposure toviolence,displacement
Chaotic family Lack of
engagement in school
Peer pressureDrug availability:exposure to drugsand alcohol
Risk perception
PsychobiologicalVulnerability:
Synaptic functionEpigenetic changesBehavioural attitude
Mental health disorders
Pathogenesis of the disease
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EmotionalneglectEmotionalneglect AbuseAbuse
Adversechildhoodexperiences
Adversechildhoodexperiences
HouseholddysfunctionHouseholddysfunction
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Epigenetic effects of drugs
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Epigenetic mechanisms in drug addiction
Renthal and Nestler, 2009
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...andvulnerability
Exploring resilience...Exploring resilience...
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PBI
Paternal care
PBI
Maternal care
BDHIDirect
aggression
abstinent subjects
25,490,42
27,590,38
45.32.9
cocaine users LL-SL 5-HTT
genotypes
22,560.9
24.610.5
59.32.9
cocaine usersSS 5-HTTgenotypes
18.780.4
18.890.45
63.252.5
Perceived parenting behaviour in the childhood of cocaine users: relationship with genotype and personality traits
(Gerra et al., 2007)(Gerra et al., 2007)
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18
27
PARENTS CARE PERCEPTION
10% less risk
20% less risk
RISK % OF DRUG DEPENDENCE IN THE ADULT
PBI SCORE
90% less risk
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Proceedings of the National Academy of Sciences of the United States of America (PNAS), 2012
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short version (S) of the 5-HTTLPR
Zimmermann et al., 2009
insecure attachment
secure attachment
agreeable autonomy
hostile autonomy
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Resilience
Vulnerability
inequality PreventionPrevention
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Prevention of substance abuse reaching the most vulnerable
Prevention of substance abuse as a pillar of development and freedom
The commitment of the International CommunityThe commitment of the International Community
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long-term neurobiological changes associated with early stress can be modified by the quality of the subsequent care-giving environment
Kaufman and Charney, 2001
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Prevention of cardiovascular diseases -Poker of Aces
• No smoking
• No salt
• No cholesterol
• Physical exercise
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Give clearrules andappreciateyour childbehaviour
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Dreaming with children about future…
Rewarding their achievements
Teaching to accept limits and rules
Experiencing community cohesion and participation
Making them aware of progressive autonomy
Looking at life perspectives with hope
Proposing values and believes
Transmitting cultural identity
Dreaming with children about future…
Rewarding their achievements
Teaching to accept limits and rules
Experiencing community cohesion and participation
Making them aware of progressive autonomy
Looking at life perspectives with hope
Proposing values and believes
Transmitting cultural identity
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to change the trajectory of children at risk