1. Neurobiology of Addiction
Mark L. Carlson, MD, MPH
Cox Center for Addictions
October 11, 2018

2. etymology
Neuro from Greek νευρον meaning sinew or tendon

3. pathos
Greek for suffering

4. logos Heraclitus 535-475 BC A principle of order and knowledge
the stoic philosophers identified the term with the divine animating principle pervading the universe

5. Herophilus
325 to 255 BC
He was one of the first anatomist to differentiate nerves from blood vessels and tendons

6. Sagittal image of the brain

7. Forel Axis

8. Three Simple Parts to the Brain
Thinking part—cerebral hemispheres
Wanting part—limbic system
Breathing part--brainstem

9. Sagittal image of the brain with the Meynert Axis

10. “Neural science must continually confront certain fundamental questions. Is a particular mental process carried out in specific parts of the brain, or does it involve the brain as a whole? page 5 in Eric R. Kandel et al: Principle of Neural Science, Fifth edition, McGraw Hill Medical, New York, 2013

11. C-shaped Limbic structures
Cingulate gyrus, medial and longitudinal striae, indusium griseum, corpus callosum, fornix, stria terminalis, caudate nucleus, hippocampus, dentate gyrus, olfactory tract, habenular triangle, medullary stria

12. Nerve drawing by Santiago Ramon y Cajal

13. Camillo Golgi

14. Controversy
Reticular theory of Golgi
Neuron theory of Ramon y Cajal

15. resolution
We are talking about the synapse. This structure was not clearly seen until the development of the electron microscope in the 1950’s

16. Grand parts of humans

17. Body functions Instinct of self-preservation
Continuing of the human race

18. Soul Functions Thought and intellectual work—the brain
Feelings—the heart (more correctly the limbic system)
Desires—the will, but no body part is known to correspond to this function

19. Spirit functions The theological issues regarding conscience
Should not be overlooked

20. The synapse
This is where we can change our feelings by the addition of chemicals

21. But addiction is a choice
Electric thought experiment
1 mA—not perceptible, probable tingling sensation
3-5 mA—”Let go” current for an average child
7 mA—”Let go” current for an adult
20-50 mA—paralysis of respiratory muscles
Match the above with a worm, a bunny, a baby or yourself

22. What does it feel like to be in opioid withdrawal?
Very bad.