1 Drugs of Abuse Cindy Schaider, Executive Director Casa Grande Alliance 317 E. Cottonwood Lane

2 Agenda: Why people use drugs Impact of drug use on the brain Impact of drug use on the family Drug addiction and recovery Questions & comments welcome!

3 Why do people take drugs? To feel good To feel better (stress, anxiety, depression) To do better (athletic or cognitive performance) Curiosity, peer pressure, thrill seeking National Institutes of Health, US DHHS

4 Addiction Continued use despite negative consequences. The process:  Try a substance  Continue to use the substance  Deny that a problem exists  Lose control – unable to reduce or abstain

5 Addiction – why? Family influences (childhood environment) Genetics Personality traits Social and environmental factors (peer influences, emotional issues, high stress or conflict, etc.)

6 What is drug addiction? A chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences. It is considered a brain disease because drugs change the structure of the brain and how it works. These brain changes can be long-lasting and lead to harmful behaviors. National Institutes of Health, US DHHS

7 Brain basics

8 Brain basics: Limbic System Basic instincts are held in the Limbic system:  Sex  Food  Water  Child rearing Communication along the Brain Reward Pathway – exists to reward us for activities consistent with our survival Also responsible for our perception of emotion

9 Brain basics: Cortex Cerebral Cortex:  Processes sensory information  Thinking center Planning Problem solving Decision making Self control Receives info from limbic system, but does not send info to limbic system

10 Dopamine = transmitter

11 Brain damage from drug use There are 8 types of Neurotransmitters in the brain. Dopamine is responsible for  pleasure Without it = depression  Smooth muscle movement Without it = Parkinsonianism We are born with a static amount of dopamine for our lifetime. Drug use depletes it… will there be insufficient amounts for later years?

12 Brain effects The large release of dopamine produced by methamphetamine is thought to contribute to the drug's toxic effects on nerve terminals in the brain.

13 Dopamine response to stimuli

14 Pleasure = neuroadaptation By repeated creating a NEW source of pleasure (drugs) the brain adapts New protein is laid down in the brain that literally changes brain chemistry The user creates an additional BASIC SURVIVAL item in the limbic system – drug abuse Results in a need, not a preference This drives every choice the user makes

15 Frontal cortex damage The frontal cortex is a brain region that supports logical thinking, goal setting, planning, and self- control. Numerous MRI studies have documented that addictive drugs cause volume and tissue composition changes in this region and that these changes are likely associated with abusers’ cognitive and decision making problems. Closer to normal after 6 mos. abstinence

16 MRI-Methamphetamine reduces gray matter The yellow and red area in the central brain view indicates reduced gray matter density in the right middle frontal cortex (Kim et al., 2005).

17 Continued use is not voluntary A chemically induced need has a stronger hold on the brain reward pathway than even the 4 natural pre- programmed needs. Change is at the molecular level So… basic instincts have changed and are being overridden by the new drug desire Frontal cortex damage also present. HOWEVER: Users ARE responsible for their actions.

18 Impact on families Users blame the family – the family blames themselves Parents and siblings feel ashamed, frustrated, afraid, alone, hopeless The user feels ashamed, afraid, alone and hopeless and isolates from family Families are forced to self-protect: locks on bedroom doors, hiding valuables, orders of protection from the user

19 Impact on families CPS has to remove children from parents, and grandparents or other family often raise those children. Families are forced to self-protect: locks on bedroom doors, hiding valuables, orders of protection from the user Familial crime victims often do not report to police, out of shame and a misguided desire to protect the user.

20 Family response Denial:  “I shock myself with my ability to rationalize and tolerate things once unthinkable. The rationalizations escalate. He’s just experimenting. Going through a stage. It’s only marijuana. He gets high only on weekends. At least he’s not using hard drugs. At least it’s not heroin. He would never resort to needles. At least he’s alive.”

21 Family response Guilt and self-blame  Did I spoil him; was I too strict?  Did I give him too little attention; too much?  If only we had not divorced; moved; if only…. Recovery for the family  I didn’t cause it  I can’t control it  I can’t cure it

22 Recovery from addiction One-third of users will enter treatment one time, complete it, and never use again One-third will attempt recovery multiple times during their life and eventually get sober One-third will die in the midst of their addiction

23 Treatment and recovery Treatment is the initial process to reduce dependence upon the drug and introduce the user to cognitive restructuring Recovery is a life-long process of learning to live drug free Both are needed for successful sobriety Meth treatment process make take one year

24 Casa Grande Alliance Partnering for a safe and drug free community E. Cottonwood Lane, Suite A Casa Grande, AZ