1. Terrence D. Walton, MSW, CSAC Pretrial Services Agency for the
Booze, Brains, and Behavior: The Psychopharmacology of Alcohol and Other Drug Use
Terrence D. Walton, MSW, CSAC
Director of Treatment
Pretrial Services Agency for the
District of Columbia
Psychopharmacology is the study of the effects of drugs on behavior.
There are two points I hope will be repeated through out this presentation and I would like you to keep them in mind during the course of the presentation.

2. Any substance that is consumed in order to alter mood, perception, and/or brain functioning

3. Areas of Concern
Intoxication
Damage
Withdrawal

4. Alcohol and Drug Use and Pretrial Services
Assessing Risk and Needs
Recommending Release Conditions
Returning to Court
Supervision Compliance
Pretrial Success or Failure

5. Mood Altering Chemicals: An Overview

6. Mood Altering Chemicals
Legal & Illicit
Street Drugs and Prescribed Drugs
Hard Drugs & Soft Drugs
Very Addictive & Less-Addictive
Natural and Synthetic
Stimulants
Depressants
Opioids
Cannabinols
Hallucinogens/ Dissociatives
Inhalants/ Deliriants/Other
The most useless part of any food label “all natural”

7. Important Factors Bottle to Blood to Brain Route of Administration:
Smoke
Sniff
Snort
Shoot
Swallow
The Blood Brain Barrier
Neurocompatibility

8. Abuse Potential Factors
Power (brain impact)
Popularity (acceptability)
Presence (accessibility)
Pay off (onset & intensity)
Persistence (length of high)
Patterns (of use)
Penalty (onset & intensity)
If you’re already hooked before the penalties kick in, then the addiction potential is greater.

9. Two Big Questions
Why do people do drugs?
Why can’t some people stop?

10. Use
Pleasure
Stimulation
Escape
Relief

11. Why Some Can’t Stop
Physiological Dependence
Psychological Dependence

12. Addiction
A medical condition characterized by impairment within both the brain’s reward and executive functions centers and resulting in compulsive, repetitive, self-destructive substance use

13. Exploring Physiological Dependence
Withdrawal
Tolerance

14. Another Big Question
What’s happening in the brain and body to cause this?

15. The Rebound Effect

16. Withdrawal
The brain adapts to the effects of substance use by over-releasing chemicals that produce the opposite effect. If the use stops abruptly, the over release of opposing chemicals continues for a period of time causing withdrawal symptoms.

17. Tolerance
Neuro-adaption (tolerance) occurs when neurons become less sensitive to the presence of a depressant or opiate as a result of the brain’s attempt to return to normal. For instance, in response to the presence of alcohol the brain may reduce the number of receptors available to detect alcohol.

18. Sensitization
Neuro-sensitization occurs when neurons become more sensitive to the presence of a stimulant. As a result, the neurons will only fully activate when the current reward is expected to be greater than the average of previous rewards (“reward prediction error”)

19. Exploring Psychological Dependence
To Cope with Life
To Feel Normal

20. What’s happening in the brain to cause psychological dependence?
A Final Big Question
What’s happening in the brain to cause psychological dependence?

21. Addiction
& the Brain

22. Neurochemistry: The Basics

23. Addiction is a Brain Disease
Any use causes acute and temporary changes and prolong use changes the brain in fundamental, destructive
and long lasting ways

24. How the Brain Works: Neurons & Neurotransmitters
Involved in all physical/emotional/ cognitive function
Metabolism, muscle movement, reflex
Mood, reactivity, emotions
Cognition, memory, etc.

25. Neuronal Receptor Activity
Affinity
Activation

27. Natural Rewards
FOOD
WATER
SEX
NURTURING
ACCOMPLISHMENT

28. Medial Forebrain Bundle
Prefrontal Cortex
Ventral
Tegmental Area
Nucleus Accumbens

29. Brain Effects from Chronic Substance Abuse

30. The Reward
Pathway
and
MACs

31. Un-Natural Rewards
Alcohol
and Other
Drug Use

32. How Drugs Work
Interact with neurochemistry
Results:
Feel Good – euphoria/reward
Feel Better – reduce negative feelings

33. Drug-Interacting Neurotransmitters
Dopamine – excitement & reward
Serotonin – feel – “normal”
Endorphin/Enkephalin – pain relief, reward, craving
GABA – lowers anxiety

34. About
Dopamine
Tone

35. Amount of dopamine produced
Length of time dopamine is available
Number of dopamine receptors

36. Behavior Pathways Rewarding behaviors can become routine
Obsessive, preoccupation, compulsion
“Subconscious” control of the behavior
Difficult to extinguish behaviors
Resistant to change

37. Delay Discounting Demand Elasticity
Brain Command Center
Delay
Discounting
Demand Elasticity

38. Effective Treatment Co-Occurring Disorders Cognitive Behavioral
Motivation
Enhance-ment
Relapse
Prevention
Medication
Assisted Treatment
Co-Occurring
Disorders

39. Related Pretrial Release Conditions
Report to court
Avoid criminal activity
Maintain employment
Maintain residence
Stay away from person or place
Report to pretrial agency in person or by phone
Drug testing
Avoid alcohol and illicit drug use
Participate in treatment as directed by …

40. The Brain and
Recovery

41. TerrenceDwalton@ gmail.com
Booze, Brains, and Behavior: The Psychopharmacology of Alcohol and Other Drug Use
gmail.com
Psychopharmacology is the study of the effects of drugs on behavior.
There are two points I hope will be repeated through out this presentation and I would like you to keep them in mind during the course of the presentation.