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Substance Use and the Brain Susan Tapert, Ph.D. Alcohol Medical Scholars Program
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Copyright AMSP2 Substance Use and the Brain 1.How is the brain affected long-term? Alcohol Marijuana Stimulants 2.What can we do about this?
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Copyright AMSP3 How is the brain affected long-term? Alcohol Marijuana Stimulants What can we do about this? Substance Use and the Brain
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Copyright AMSP4 Drinking & Thinking ~50% alcoholic adults show some problems: –Spatial skills –Planning –Learning and memory IQ and language OK Recovery –Much in 1st month –More in 1st year if sober
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Copyright AMSP5 Alcohol and Sleep Problems when using and when sober –Falling asleep –Total sleep –Sleep quality Affects memory and thinking Feeling unrested increases relapse risk
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Copyright AMSP6 Brain Structure Magnetic resonance imaging (MRI) –Safe –No injections –Shows small brain parts
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Copyright AMSP7 Shrinkage: Ventricles Non-alcoholicAlcoholic
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Copyright AMSP8 Shrinkage: Cerebellum Healthy ControlAlcoholic
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Copyright AMSP9 Brain Function Functional magnetic resonance imaging (fMRI) –Safe –Movies of brain activity –Good resolution
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Copyright AMSP10 Brain Function Side View Alcoholics vs. Healthy Controls
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Copyright AMSP11 Volume Recovery During Treatment 2 Years Later
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Copyright AMSP12 How is the brain affected long-term? Alcohol Marijuana Stimulants What can we do about this? Substance Use and the Brain
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Copyright AMSP13 Marijuana & Thinking Modest problems in very heavy users –Learning and memory –Sustained attention –Impulsivity Most recover after 1 month abstinent
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Copyright AMSP14 Marijuana & Brain No evidence of brain shrinkage Altered brain waves related to attention brain blood flow brain response while learning
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Copyright AMSP15 How is the brain affected long-term? Alcohol Marijuana Stimulants What can we do about this? Substance Use and the Brain
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Copyright AMSP16 Stimulants &Thinking Motor skills Planning Switching tasks Decision making Working memory Impulsivity Learning and memory
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Copyright AMSP17 Stimulants & Brain Structure Volume reductions:Volume reductions: –Cingulate –Hippocampus –No overall gray matter changes Volume increase:Volume increase: –Subcortical areas
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Copyright AMSP18 Stimulants & Blood Flow High blood flow Low blood flow Healthy Control Cocaine-dependent Gottschalk, 2001, Am J Psychiatry
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Copyright AMSP19 Blood Flow Recovery Non users Cocaine users, 10 days sober Cocaine Users, 100 days sober High blood flow Low blood flow
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Copyright AMSP20 Substance Use and Brain Summary: Thinking problems Tissue loss Decreased blood flow Altered brain response to task Much recovery with abstinence
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Copyright AMSP21 How is the brain affected? What can we do about this? Substance Use and the Brain
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Copyright AMSP22 Implications Inform patients Develop better treatments
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