Documente Academic
Documente Profesional
Documente Cultură
ADDICTED MIND
by
• Characterized by:
– Compulsive Behavior
– Continued abuse of drugs despite negative consequences
– Persistent changes in the brain’s structure and function
Addiction is Like Other Diseases…
It is preventable
It is treatable
It changes biology
If untreated, it can last a lifetime
Decreased Brain Metabolism Decreased Heart Metabolism
in Drug Abuser in Heart Disease Patient
High
Low
Healthy Brain Diseased Brain/ Healthy Diseased Heart
Cocaine Abuser Heart
90
80
70
60
50
40
50 to 70%
50 to 70%
40 to 60%
30 to 50%
30
20
10
0
Drug Type I Hypertension Asthma
Addiction Diabetes
1.6%
1.6% CANNABIS
% in each age group who
1.4%
1.4% ALCOHOL
1.2%
1.2%
1.0%
1.0%
0.8%
0.8%
0.6%
0.6%
0.4%
0.4%
0.2%
0.2%
0.0%
0.0%
55 10
10 15
15 21
21 25
25 30
30 35
35 40
40 45
45 50
50 55
55 60
60 65
65
Age
Drugs of Abuse
Engage Motivation and
Pleasure Pathways
of the Brain
Drugs can be “Imposters” of
Brain Messages
Drugs Associated wth
Neurotransmitters
Why do people have “drugs of choice?”
• Dopamine - amphets, cocaine, ETOH
• Serotonin - LSD, ETOH
• Endorphins - opioids, ETOH
• GABA - benzos, ETOH
• Glutamate -ETOH
• Acetylcholine - nicotine, ETOH
(Marijuana )?
Movement
Motivation
Dopamine
Release
Recycle
Activate
Effects of Drugs on Dopamine Release
Amphetamine Cocaine
1100 Accumbens 400 Accumbens
1000
% of Basal Release
900
% of Basal Release
DA
300 DOPAC
800 DA HVA
700 DOPAC
600 HVA 200
500
400
300 100
200
100
0 0
0 1 2 3 4 5 hr 0 1 2 3 4 5 hr
% of Basal Release
Accumbens 0.5 mg/kg
% of Basal Release
Caudate 200
1.0 mg/kg
150 2.5 mg/kg
150 10 mg/kg
100
100
0
0 1 2 3 hr 0
0 1 2 3 4 5 hr
Time After Drug Time After Drug
Di Chiara and Imperato, PNAS, 1988
Science Has Generated Much
Evidence Showing That…
Saline Amph
Robinson & Kolb, Journal of Neuroscience, Volume: 1997
Functionally…
Dopamine D2 Receptors are Decreased by Addiction
Cocaine
Meth
Alcohol
Heroin
Control Addicted
Cognitive Deficits and D&A
• Memory problems – short-term loss
• Impaired abstraction
• Perseveration using failed problem-
solving strategies
• Loss of impulse control
These deficits are similar to
those with brain damage
Common Characteristics of
People Who are Addicted
• Unemployed or employed
• Multiple or no criminal justice contacts
• Difficulty coping with stress or anger
• Highly influenced by social peer group or a
loner
• Difficulty handling high-risk relapse
situations or craves excitement
More Common
Characteristics…
• Emotional and psychological
immaturity
• Difficulty relating to family
• Difficulty sustaining long-term
relationships
• Educational and vocational deficits
Why do Mental Illnesses and
Substance Abuse Co-occur?
• Self-medication
– substance abuse begins as a
means to alleviate symptoms of
mental illness
• Causal effects
– Substance abuse may increase
vulnerability to mental illness
• Common or correlated causes
– the risk factors that give rise to
mental illness and substance
abuse may be related or overlap
What Environmental
Factors Contribute to Addiction?
Stress
Early physical or sexual abuse
Witnessing violence
Peers who use drugs
Drug availability
Stress impairs our executive function,
which dampens our ability to resist
impulses. Chronic stress can increase
the reward responsiveness of our
brains. So if we are at all prone to
addiction, it's going to make us crave
palatable food or drugs even more. It
drives us to choose comfort foods,
whether unconsciously or with a strong
intention.
Recent studies pointing out the mind and body feedback loop when early
childhood stress and developmental disturbance may in turn lead to activation of
genes that cause oversensitivity to later stressful stimulus which sequentially leads
to greater susceptibility to physical health problems resulting in more stress that
may eventually develop into a more permanent pattern of chronic stress, mental
health problems, and/or long term physical health problems as result. They
explained the early life experience of the excessive and cumulative stress will lead
to compromised immune system and over the years, it will eventually manifest
itself in form of long term physical health problems and disease in adulthood such
as Diabetes and Cushing disease.
oocyte transcription/translation
postnatal
sensory stimulation,
maternal frequency & stability of care
behavior
Parental Experience
OFFSPRING Influences Offspring
DEVELOPMENT Development
Programming of Fetal Stress
Response
maternal fetal
risk of prematurity
lower birth weight
Stress
increased stress response
risk of depression & anxiety
Epigenetics
Early Brain
Environmental Physiology
Experiences Behavior
Our experiences or “nurture” can have long-
term effects on our brain and behavior
Early Brain
Environmental Physiology
Experiences Behavior
Our experiences or “nurture” can have long-
term effects on our brain and behavior
• Patients with physical and sexual abuse reported symptoms of temporal lobe damage
(specifically hippocampus and amygdala related) at a rate 113% higher than the control
group.
• Maltreatment before the age of 18 had greater impact than later abuse.
• Depression
• Aggression
• Low Self-Esteem
• Identity Confusion
• Difficulties in Interpersonal
Relationships
• Guilt
•Psychiatric Disorders in Addiction Treatment
•Two studies of Prevalence rates in addiction treatment settings had similar findings. Persons with
substance use disorders are also like to have mood and anxiety disorders.
In Social Context