What is Addiction?What is Addiction?

Addiction is a chronic relapsing condition Addiction is a chronic relapsing condition characterized by compulsive drug seeking characterized by compulsive drug seeking and abuse, in spite of negative health, and abuse, in spite of negative health, social and behavioral consequencessocial and behavioral consequences

Addiction is a brain diseaseAddiction is a brain disease Sustained drug abuse leads to changes in Sustained drug abuse leads to changes in

both the structure and function of the both the structure and function of the brainbrain

Neurons TalkingNeurons Talking

DopamineDopamine

Drug use activates the brain’s pleasure Drug use activates the brain’s pleasure pathwaypathway

Drug use causes dopamine levels to spike Drug use causes dopamine levels to spike highhigh

Brain remembers this and looks forward to Brain remembers this and looks forward to doing it againdoing it again

After spike dopamine levels go below After spike dopamine levels go below baseline baseline

Brain thinks it needs drug for survivalBrain thinks it needs drug for survival Person needs drug to feel normalPerson needs drug to feel normal

Dopamine Activity PET ScanDopamine Activity PET Scan

The end result: CravingsThe end result: Cravings

Our brains are wired to pursue natural Our brains are wired to pursue natural rewards (food, love, sex)rewards (food, love, sex)

Drug use begins to activate these Drug use begins to activate these same circuitssame circuits

This activation causes our brain to This activation causes our brain to crave the drugcrave the drug

These cravings become even stronger These cravings become even stronger than those for food and love.than those for food and love.

The Pre-frontal CortexThe Pre-frontal Cortex

Located in the front of the brainLocated in the front of the brain Allows us to weigh risks and consequencesAllows us to weigh risks and consequences Referred to as “The Seat of Sober Referred to as “The Seat of Sober

Thought”Thought” Pre-Frontal Cortex still developing in Pre-Frontal Cortex still developing in

teenagersteenagers

““What are the implications of this What are the implications of this information?”information?”

How Addiction is DiagnosedHow Addiction is Diagnosed

For a person to be diagnosed as an addict at For a person to be diagnosed as an addict at least 3 of the following symptoms must be least 3 of the following symptoms must be present:present:

1.1. Symptoms of toleranceSymptoms of tolerance

2.2. Symptoms of withdrawalSymptoms of withdrawal

3.3. Use of substance in large amounts or for longer then intendedUse of substance in large amounts or for longer then intended

4.4. The desire or attempt to reduce or control useThe desire or attempt to reduce or control use

5.5. Spending considerable time or effort to obtain the substanceSpending considerable time or effort to obtain the substance

6.6. A reduction in social, recreational or occupational activities A reduction in social, recreational or occupational activities because of drug usebecause of drug use

7.7. Continued use despite of health, social or economic problemsContinued use despite of health, social or economic problems

Who Becomes Addicted ?Who Becomes Addicted ?

Anyone can become addicted to drugs or Anyone can become addicted to drugs or alcoholalcohol

No single factor determines if a person will No single factor determines if a person will become an addictbecome an addict

Nature and nurture influence a person’s Nature and nurture influence a person’s risk for addictionrisk for addiction

Certain personality types and mental Certain personality types and mental health problems may make a person more health problems may make a person more susceptible to addictionsusceptible to addiction

Risk Factors for Addiction Having parents or immediate family members Having parents or immediate family members

who are/were addicted to drugs or alcoholwho are/were addicted to drugs or alcohol Being depressed or anxiousBeing depressed or anxious Other mental disordersOther mental disorders Experiencing trauma, such as physical or sexual Experiencing trauma, such as physical or sexual

abuseabuse Stressful life eventsStressful life events Conflict at homeConflict at home Exposure to drugs, or being pressured to use Exposure to drugs, or being pressured to use

themthem Using drugs or alcohol before the age of 15Using drugs or alcohol before the age of 15

Principles of Effective Principles of Effective TreatmentTreatment

Not one size fits allNot one size fits all

Needs to meet the needs of the individualNeeds to meet the needs of the individual

Must be long enoughMust be long enough

Counseling and behavior therapy are critical Counseling and behavior therapy are critical componentscomponents

Change people, places things Change people, places things ~What happens if ~What happens if they do they do not do this?not do this?

Effective TreatmentEffective Treatment continuedcontinued

Co-occurring disorders should be treatedCo-occurring disorders should be treated

Medications may be usedMedications may be used

Detoxification does little to change long Detoxification does little to change long term useterm use

Recovery can be a long term processRecovery can be a long term process

Be prepared for relapsesBe prepared for relapses

Routes of AdministrationRoutes of Administration

OralOral AdministrationAdministration--takentaken in through the in through the mouthmouth

InjectionInjection--drugdrug delivereddelivered with a with a hypodermic needlehypodermic needle

InhalationInhalation--substancesubstance isis smoked or huffedsmoked or huffed

AbsorptionAbsorption--drugdrug is is absorbed through the absorbed through the skinskin

Discussion QuestionsDiscussion Questions How does the route of How does the route of

administration affect administration affect the addictive the addictive properties of the properties of the substance ?substance ?

Can the route of Can the route of administration affect administration affect the risks of using the the risks of using the drug?drug?

Classification of Psychoactive Classification of Psychoactive DrugsDrugs

Stimulants- Stimulants- Cocaine, Methamphetamine, Cocaine, Methamphetamine, NicotineNicotine

Hallucinogens- Hallucinogens- LSD, PCPLSD, PCP MarijuanaMarijuana Depressants- Depressants- Alcohol, Barbiturates, Alcohol, Barbiturates,

Inhalants, Inhalants, Opioids- Opioids- Heroin, MorphineHeroin, Morphine Psycho-therapeutics- Psycho-therapeutics- Prozac, Haldol, Prozac, Haldol,

XanaxXanax

MarijuanaMarijuana The most widely used illegal drug in The most widely used illegal drug in

the USthe US

Dry shredded mix of flowers, stems Dry shredded mix of flowers, stems and leaves from the cannabis plantand leaves from the cannabis plant

Smoked as a cigarette or in a pipe Smoked as a cigarette or in a pipe most often.most often.

Active chemical in marijuana is Active chemical in marijuana is TTetra-hydrocannabinol etra-hydrocannabinol (THC) (THC)

Effects of MarijuanaEffects of Marijuana

Short TermShort Term Distorted Distorted

perceptionperception Difficulty thinking Difficulty thinking

and problem and problem solvingsolving

Loss of Loss of coordinationcoordination

Increased heart Increased heart raterate

Long TermLong Term Respiratory Respiratory

problemsproblems Negatively affect Negatively affect

cells that produce cells that produce dopaminedopamine

Fertility problemsFertility problems Emotional problemsEmotional problems Connected to further Connected to further

drug usedrug use Addictive propertiesAddictive properties

CocaineCocaine

Classified as a stimulantClassified as a stimulant Several routes of administrationSeveral routes of administration Extremely addictiveExtremely addictive Interferes with the re-absorption of Interferes with the re-absorption of

dopaminedopamine Often produces wild and erratic Often produces wild and erratic

behaviorbehavior

The Cocaine HighThe Cocaine High

Effects of CocaineEffects of Cocaine

Short Term EffectsShort Term Effects Mental alertnessMental alertness Increased Increased

energyenergy Increased heart Increased heart

rate/blood rate/blood pressurepressure

Increased Increased temperaturetemperature

Long Term EffectsLong Term Effects Number of Number of

dopamine dopamine receptors reducedreceptors reduced

Cardiovascular, Cardiovascular, respiratory and respiratory and neurological neurological complicationscomplications

Paranoid Paranoid psychosispsychosis

Cocaine Abuse…Putting Your Cocaine Abuse…Putting Your Life In Your Own HandsLife In Your Own Hands

Any use of crack or cocaine Any use of crack or cocaine can lead to death~ even the can lead to death~ even the first timefirst time

Alcohol and cocaine can Alcohol and cocaine can combine in a person’s liver to combine in a person’s liver to produce coca-ethyleneproduce coca-ethylene

MDMAMDMA

Also known as ecstasyAlso known as ecstasy Taken in pill formTaken in pill form Classified as a stimulantClassified as a stimulant Also acts as a psychedelicAlso acts as a psychedelic Affects neurons that use serotonin to Affects neurons that use serotonin to

communicatecommunicate

MDMA Health RisksMDMA Health Risks

Interferes with temperature Interferes with temperature regulationregulation

Similar physical risks as other Similar physical risks as other stimulantsstimulants

Long lasting psychological effectsLong lasting psychological effects Possible neurotoxicityPossible neurotoxicity Unknown drug purityUnknown drug purity Interferes with cognitive abilityInterferes with cognitive ability

AlcoholAlcohol

Classified as a depressantClassified as a depressant

Has complicated effects on the nervous Has complicated effects on the nervous systemsystem

The most commonly used and abused The most commonly used and abused psychoactive drugpsychoactive drug

17,602 people killed in alcohol related 17,602 people killed in alcohol related crashes in 2006crashes in 2006

Effects of AlcoholEffects of Alcohol

Short TermShort Term Impairs judgment and Impairs judgment and

coordinationcoordination Linked to a variety of Linked to a variety of

aggressive actsaggressive acts BlackoutsBlackouts HangoversHangovers

Long TermLong Term Brain DamageBrain Damage

Liver DisordersLiver Disorders

Heart DiseaseHeart Disease

CancerCancer

CIRRHOSIS OF THE LIVERCIRRHOSIS OF THE LIVER

Prescription Drug AbusePrescription Drug Abuse Over 20% of Over 20% of

Americans report Americans report misusing misusing prescription drugsprescription drugs

In 2005 598,542 ER In 2005 598,542 ER visits due to misusevisits due to misuse

Misuse of Misuse of prescription drugs is prescription drugs is illegalillegal

Classes of Commonly Classes of Commonly Abused Rx DrugsAbused Rx Drugs

OpioidsOpioids Central Nervous Central Nervous

System DepressantsSystem Depressants StimulantsStimulants

Dangers of Prescription Drug Dangers of Prescription Drug AbuseAbuse

Opioids can slow or stop breathingOpioids can slow or stop breathing Stimulant use associated with high Stimulant use associated with high

body temperature, irregular heart body temperature, irregular heart rate and seizurerate and seizure

CNS Depressants can cause seizures, CNS Depressants can cause seizures, slow heart rate and respiratory arrestslow heart rate and respiratory arrest

Do prescription drug abusers always Do prescription drug abusers always know what they are taking?know what they are taking?

MethamphetamineMethamphetamine

10 million people 12 years and older 10 million people 12 years and older abused Meth in 2005abused Meth in 2005

Meth is extremely addictiveMeth is extremely addictive Causes the brain to release Causes the brain to release

excessive amounts of dopamine.excessive amounts of dopamine. Crash after high often leads to Crash after high often leads to

increased useincreased use

Effects of Effects of MethamphetamineMethamphetamine

Short TermShort Term Violent BehaviorViolent Behavior AnxietyAnxiety ConfusionConfusion ParanoiaParanoia HallucinationsHallucinations DelusionsDelusions

Long TermLong Term Damage to nerves Damage to nerves

that produce that produce serotonin and serotonin and dopaminedopamine

Cardiovascular Cardiovascular system damagesystem damage

Difficulty feeling Difficulty feeling natural pleasurenatural pleasure