1. What is Addiction? Addiction is a chronic relapsing condition characterized by compulsive drug seeking and abuse, in spite of negative health, social and behavioral consequences Addiction is a chronic relapsing condition characterized by compulsive drug seeking and abuse, in spite of negative health, social and behavioral consequences Addiction is a brain disease Addiction is a brain disease Sustained drug abuse leads to changes in both the structure and function of the brain Sustained drug abuse leads to changes in both the structure and function of the brain

2. Neurons Talking

3. Dopamine Drug use activates the brain’s pleasure pathway Drug use activates the brain’s pleasure pathway Drug use causes dopamine levels to spike high Drug use causes dopamine levels to spike high Brain remembers this and looks forward to doing it again Brain remembers this and looks forward to doing it again After spike dopamine levels go below baseline After spike dopamine levels go below baseline Brain thinks it needs drug for survival Brain thinks it needs drug for survival Person needs drug to feel normal Person needs drug to feel normal

4. Dopamine Activity PET Scan

5. The end result: Cravings Our brains are wired to pursue natural rewards (food, love, sex) Our brains are wired to pursue natural rewards (food, love, sex) Drug use begins to activate these same circuits Drug use begins to activate these same circuits This activation causes our brain to crave the drug This activation causes our brain to crave the drug These cravings become even stronger than those for food and love. These cravings become even stronger than those for food and love.

6. The Pre-frontal Cortex Located in the front of the brain Located in the front of the brain Allows us to weigh risks and consequences Allows us to weigh risks and consequences Referred to as “The Seat of Sober Thought” Referred to as “The Seat of Sober Thought” Pre-Frontal Cortex still developing in teenagers Pre-Frontal Cortex still developing in teenagers “What are the implications of this information?”

7. How Addiction is Diagnosed For a person to be diagnosed as an addict at least 3 of the following symptoms must be present: For a person to be diagnosed as an addict at least 3 of the following symptoms must be present: 1. Symptoms of tolerance 2. Symptoms of withdrawal 3. Use of substance in large amounts or for longer then intended 4. The desire or attempt to reduce or control use 5. Spending considerable time or effort to obtain the substance 6. A reduction in social, recreational or occupational activities because of drug use 7. Continued use despite of health, social or economic problems

8. Who Becomes Addicted ? Anyone can become addicted to drugs or alcohol Anyone can become addicted to drugs or alcohol No single factor determines if a person will become an addict No single factor determines if a person will become an addict Nature and nurture influence a person’s risk for addiction Nature and nurture influence a person’s risk for addiction Certain personality types and mental health problems may make a person more susceptible to addiction Certain personality types and mental health problems may make a person more susceptible to addiction

9. Risk Factors for Addiction Having parents or immediate family members who are/were addicted to drugs or alcohol Having parents or immediate family members who are/were addicted to drugs or alcohol Being depressed or anxious Being depressed or anxious Other mental disorders Other mental disorders Experiencing trauma, such as physical or sexual abuse Experiencing trauma, such as physical or sexual abuse Stressful life events Stressful life events Conflict at home Conflict at home Exposure to drugs, or being pressured to use them Exposure to drugs, or being pressured to use them Using drugs or alcohol before the age of 15 Using drugs or alcohol before the age of 15

10. Principles of Effective Treatment Not one size fits all Not one size fits all Needs to meet the needs of the individual Needs to meet the needs of the individual Must be long enough Must be long enough Counseling and behavior therapy are critical components Counseling and behavior therapy are critical components Change people, places things ~What happens if they do not do this? Change people, places things ~What happens if they do not do this?

11. Effective Treatment continued Co-occurring disorders should be treated Co-occurring disorders should be treated Medications may be used Medications may be used Detoxification does little to change long term use Detoxification does little to change long term use Recovery can be a long term process Recovery can be a long term process Be prepared for relapses Be prepared for relapses

12. Routes of Administration Oral Administration - taken in through the mouth Oral Administration - taken in through the mouth Injection -drug delivered with a hypodermic needle Injection -drug delivered with a hypodermic needle Inhalation -substance is smoked or huffed Inhalation -substance is smoked or huffed Absorption -drug is absorbed through the skin Absorption -drug is absorbed through the skin Discussion Questions How does the route of administration affect the addictive properties of the substance ? How does the route of administration affect the addictive properties of the substance ? Can the route of administration affect the risks of using the drug? Can the route of administration affect the risks of using the drug?

13. Classification of Psychoactive Drugs Stimulants- Cocaine, Methamphetamine, Nicotine Stimulants- Cocaine, Methamphetamine, Nicotine Hallucinogens- LSD, PCP Hallucinogens- LSD, PCP Marijuana Marijuana Depressants- Alcohol, Barbiturates, Inhalants, Depressants- Alcohol, Barbiturates, Inhalants, Opioids- Heroin, Morphine Opioids- Heroin, Morphine Psycho-therapeutics- Prozac, Haldol, Xanax Psycho-therapeutics- Prozac, Haldol, Xanax

14. Marijuana The most widely used illegal drug in the US The most widely used illegal drug in the US Dry shredded mix of flowers, stems and leaves from the cannabis plant Dry shredded mix of flowers, stems and leaves from the cannabis plant Smoked as a cigarette or in a pipe most often. Smoked as a cigarette or in a pipe most often. Active chemical in marijuana is T etra- hydrocannabinol (THC) Active chemical in marijuana is T etra- hydrocannabinol (THC)

15. Effects of Marijuana Short Term Distorted perception Distorted perception Difficulty thinking and problem solving Difficulty thinking and problem solving Loss of coordination Loss of coordination Increased heart rate Increased heart rate Long Term Respiratory problems Respiratory problems Negatively affect cells that produce dopamine Negatively affect cells that produce dopamine Fertility problems Fertility problems Emotional problems Emotional problems Connected to further drug use Connected to further drug use Addictive properties Addictive properties

16. Cocaine Classified as a stimulant Classified as a stimulant Several routes of administration Several routes of administration Extremely addictive Extremely addictive Interferes with the re-absorption of dopamine Interferes with the re-absorption of dopamine Often produces wild and erratic behavior Often produces wild and erratic behavior

17. The Cocaine High

18. Effects of Cocaine Short Term Effects Mental alertness Mental alertness Increased energy Increased energy Increased heart rate/blood pressure Increased heart rate/blood pressure Increased temperature Increased temperature Long Term Effects Number of dopamine receptors reduced Number of dopamine receptors reduced Cardiovascular, respiratory and neurological complications Cardiovascular, respiratory and neurological complications Paranoid psychosis Paranoid psychosis

19. Cocaine Abuse…Putting Your Life In Your Own Hands Any use of crack or cocaine can lead to death~ even the first time Any use of crack or cocaine can lead to death~ even the first time Alcohol and cocaine can combine in a person’s liver to produce coca-ethylene Alcohol and cocaine can combine in a person’s liver to produce coca-ethylene

20. MDMA Also known as ecstasy Also known as ecstasy Taken in pill form Taken in pill form Classified as a stimulant Classified as a stimulant Also acts as a psychedelic Also acts as a psychedelic Affects neurons that use serotonin to communicate Affects neurons that use serotonin to communicate

21. MDMA Health Risks Interferes with temperature regulation Interferes with temperature regulation Similar physical risks as other stimulants Similar physical risks as other stimulants Long lasting psychological effects Long lasting psychological effects Possible neurotoxicity Possible neurotoxicity Unknown drug purity Unknown drug purity Interferes with cognitive ability Interferes with cognitive ability

22. Alcohol Classified as a depressant Classified as a depressant Has complicated effects on the nervous system Has complicated effects on the nervous system The most commonly used and abused psychoactive drug The most commonly used and abused psychoactive drug 17,602 people killed in alcohol related crashes in 2006 17,602 people killed in alcohol related crashes in 2006

23. Effects of Alcohol Short Term Impairs judgment and coordination Impairs judgment and coordination Linked to a variety of aggressive acts Linked to a variety of aggressive acts Blackouts Blackouts Hangovers Hangovers Long Term Brain Damage Brain Damage Liver Disorders Liver Disorders Heart Disease Heart Disease Cancer Cancer

24. CIRRHOSIS OF THE LIVER

25. Prescription Drug Abuse Over 20% of Americans report misusing prescription drugs Over 20% of Americans report misusing prescription drugs In 2005 598,542 ER visits due to misuse In 2005 598,542 ER visits due to misuse Misuse of prescription drugs is illegal Misuse of prescription drugs is illegal Classes of Commonly Abused Rx Drugs Opioids Opioids Central Nervous System Depressants Central Nervous System Depressants Stimulants Stimulants

26. Dangers of Prescription Drug Abuse Opioids can slow or stop breathing Opioids can slow or stop breathing Stimulant use associated with high body temperature, irregular heart rate and seizure Stimulant use associated with high body temperature, irregular heart rate and seizure CNS Depressants can cause seizures, slow heart rate and respiratory arrest CNS Depressants can cause seizures, slow heart rate and respiratory arrest Do prescription drug abusers always know what they are taking?

27. Methamphetamine 10 million people 12 years and older abused Meth in 2005 10 million people 12 years and older abused Meth in 2005 Meth is extremely addictive Meth is extremely addictive Causes the brain to release excessive amounts of dopamine. Causes the brain to release excessive amounts of dopamine. Crash after high often leads to increased use Crash after high often leads to increased use

28. Effects of Methamphetamine Short Term Violent Behavior Violent Behavior Anxiety Anxiety Confusion Confusion Paranoia Paranoia Hallucinations Hallucinations Delusions Delusions Long Term Damage to nerves that produce serotonin and dopamine Damage to nerves that produce serotonin and dopamine Cardiovascular system damage Cardiovascular system damage Difficulty feeling natural pleasure Difficulty feeling natural pleasure