1. Addiction: A Treatable Brain Disease Amir H. Rezvani, Ph. D
Addiction: A Treatable Brain Disease Amir H. Rezvani, Ph.D. Professor of Psychiatry and Behavioral Sciences, Duke University March 1, 2019

3. No one is born an addict, but anyone with a brain can become one.

4. She said no, pass me a beer!

5. Cost and Scope of Addiction

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Why Do People Take Drugs
in the First Place?

7. . .

9. .

10. Testimony
“I can remember my first drink, I was only elven. I hated the taste., but I felt the glow and it worked. I would get sick as a dog and then swear on a stack of Bibles I would not do it again, but I kept going back. I got drunk because ………

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…..because I had a hole in my gut so big, and alcohol and then other drugs would fill the hole. They became the solution.”

12. Wanting-liking Theory

13. What do YOU think?
Addiction begins with a voluntary behavior, thus addicts should be able to quit by force of will!

14. Amazing Story of Phineas Gage

16. Hijacked Brain

17. Disease:
Any deviation from or interruption of the normal structure or function of any part, organ or system (or combination thereof) of the body that is manifested by a characteristic set of symptoms and signs and whose etiology, pathology, and prognosis may be known or unknown.
Dorland’s Medical Dictionary, 26th edition

18. Disease Model
Organ
Defect
Symptoms

19. Organ (pancreas) Defect (cell death) Symptoms (high blood sugar)
Diabetes
Organ (pancreas)
Defect (cell death)
Symptoms (high blood sugar)

20. Alcoholism
It is a primary, chronic disease with genetic, psychosocial and environmental factors influencing its development and manifestation. It is often progressive and fatal.
It is characterized by continuous or periodic impaired control over drinking, preoccupation with alcohol despite adverse consequences and distortion in thinking, most notably denial.

21. drug user environment Social status Age Potency Risk-taking “High”
Psychiatric state
Genetics
Potency
“High”
Cost
Side Effects
drug
user
Addiction
environment
SES=Socioeconomic Status
Peers
Parents
Attitudes
Opportunity

23. More Hugs = Less Drugs: Pair-bonding in Prairie Voles

24. Social Bonding
Social Bonding Decreases the Rewarding Properties of Amphetamine Through a Dopamine D1 Receptor-Mediated Mechanism.
The journal of Neuroscience 31:7960; 2011

25. Therapeutic Communities
Therapeutic Communities (TC) Triangle Residential Options for Substance Abusers (TROSA) (Durham, NC)

26. Did we learn anything from our addicted soldiers returning from Vietnam war?

27. Treatment Early prevention Multiple path to recovery
Drug alone is not enough
At least 90 days rehab
Holistic treatment is the best
Certain treatments work for certain drugs
Leverage can be good
Patient’s input very important
Relapse is part of the recovery process

28. Blocks & Barriers in Treatment
Denial (85% in denial)
Stigma
Anonymity
Terminology confusions
Physicians’ lack of proper training.

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30. More Hugs = Less Drugs

31. Thank you for your attention and have a lovely weekend!
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