Biological Basis of Addiction Christine Foster, LMSW Children’s Therapist

Effects of Substance Abuse: Conception – Age 11

Photo courtesy of Sterling Clarren, MD – Brain at 6 wks

Faces in Fetal Alcohol Syndrome

What we seeWhat we think What may be really going on What we can do ► Doesn’t follow rules ▪Noncompliance ▪Attention Seeking ▪Stubborn ▪Purposeful ●Difficulty translating verbal directions into action ●Cognitive deficit ♦ Check for understanding ♦ Repeat instructions ♦ Simplify tasks ► Repeatedly makes the same mistakes ▪Manipulative ▪Doing it on purpose ▪Willful ●Not able to link cause and effect ●Difficulty generalizing ♦ Provide assistance with organization ♦ Structure choices ► Poor social judgment ▪Attention Seeking ▪Poorly parented ▪Impulsive ●Not able to interpret social cues ●Desire to be liked ♦ Role play ♦ Identify safe external support/s ♦ Safety planning ► Easily agitated ▪Poor self control ▪Deviant ●Frustrated ●Disappointed ●Mental health issue ♦ Teach self advocacy ♦ Identify and practice coping techniques Texas Office for Prevention of Developmental Disabilities

Don’t Talk Don’t Trust Don’t Deal Don’t Feel

How do people get better from alcohol and drugs?

Effects of Substance Abuse: Ages Apoptosis = Pruning 200 billion to 100 billion

HYPOFRONTALITY: when Dopamine spikes the cortex actually shuts off

How do drugs & alcohol effect the brain during the pruning process?

Limbic System  Fight or Flight  Pleasurable Experiences: Dopamine

100% 150% 350% 1100% Dopamine Release

If you arrest here but stop using here Age 12

Arrested Development Effects  Stuck in psychosocial stage of development  10% Decrease in Hippocampus functioning (converts information to memory)  Increased social disinhibition  Risky, impulsive behavior  Poor planning & judgment  Little ability to weigh consequences

Developmental Age of Parents Parents with Fetal Alcohol SyndromeTeen ParentsParents with Arrested Development

Practical Applications Connect Client to Appropriate Service – Parent Coaching, Individual Therapy, In or Outpatient Treatment,12-step, ACA, Alanon Connect Child to Appropriate Service – Play Therapy, High Risk Classes, Individual or Family Therapy Teach Parents Executive Functioning Skills Teach Parents To Teach Executive Functioning Skills

Tools for Working with Families Play: A child’s work Patterned, Repetitive, Predictable & Rhythmic Praise Executive Functioning in Parents Teach Parents What To Say During Family Dinners Behavior Modification Contracts

Dopamine-Releasing Chemicals Alcohol & Sedative/Hypnotics Opiates/Opioids Cocaine Amphetamines Entactogens (MDMA) Entheogens/Hallucinogens Dissociants (PCP, Ketamine) Cannabinoids Inhalants Nicotine Caffeine Anabolic-Androgenic Steroids

Prefrontal Cortex Thinking: Executive Functioning 1.Abstract; conceptual understanding 2.Impulse Control 3.Problem-Solving 4.Decision-Making 5.Judgment 6.Emotion Regulation/Frustration Tolerance 7.Ability to Feel Empathy

References Califano Jr., Joseph (2009),How to Raise a Drug-Free Kid, The Straight Dope for Parents. Giedd. J. N. (2004).Structural magnetic resonance imaging of the adolescent brain. Annals of the New York Academy of Sciences, 1021, Spear, L. P. (2002). Alcohol’s effects on adolescents. Alcohol Health and Research World, 26 (4), Suggested Reading Dahl, R.E. & Spear, L.P. (Eds.) (2004). Adolescent brain development: vulnerabilities and opportunities. New York: Annals of the New York Academy of Sciences, Volume Dubuc, B. (n.d.).The brain from top to bottom. McGill University web site: Landreth, G. (2002). Play Therapy: The Art of the Relationship. Brunner Routledge. Nestler, E. J., & Malenka, R. C. (2004, March). The addicted brain. Scientific American, 290 (3), Underwood, N. (2009). The teenage brain: Why adolescents sleep in, take risks, and won’t listen to reason. The Walrus Magazine. Wallis, C. (2004, May 10). What makes teens tick? Time, 163, Walsh, D. (2004). Why do they act that way? A survival guide to the adolescent brain for you and your teen. New York: Free Press.