and referral to treatment e pidemiology of substance use Lecture 11 substances affect the brain chemically structurally behaviorally the reward pathway drugs amp alcohol act on the reward pathway the same region activated by ID: 1034009
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1. screening, brief intervention, and referral to treatment epidemiology of substance useLecture 1.1
2. substances affect the brain{chemicallystructurallybehaviorally
3. the reward pathwaydrugs & alcohol act on the reward pathway, the same region activated by: eating sexdrinkingother pleasurable activities
4. chemical changes
5. the role of dopamineincrease in available dopamineresults in pleasurable feelings the behavior is reinforcedthe effect of previously pleasurable activities is blunted
6. substances that result in excess dopamine:alcoholheroin marijuanacocainenicotinedysfunction in dopamine system causes: mood disruptionsmemory difficultiesattention deficitsimpaired decision makingdopamine (cont’d)
7. non-drug userdruguser(National Institute on Drug Abuse, 2010)
8. tobacco userhealthy controlheavy alcohol userobese patientcocaine user(Volkow, 2001)healthy controlhealthy controlhealthy control
9. effects of alcohol userelease of:GABA – feelings of relaxation, wellbeingglutamate – feelings of being energized, excited, elated dopamine – pleasure endogenous opioids – reduction in pain, feelings of pleasure
10. glutamateendogenous opioidsGABAserotonin
11. healthy brainhealthy heartdiseased heartdiseased brain/cocaine userDecreased Brain Metabolism in Drug UserDecreased Heart Metabolism in Heart Disease Patient(National Institute on Drug Abuse, 2010)
12. structural changes
13. (National Institute on Alcohol Abuse & Alcoholism, 2004)healthy elderly personperson with Alzheimer’s diseaseheavy drinker
14. brain of heavy alcohol userbrain of healthy controlOscar-Berman, M., Valmas, M., Sawyer, K.S., Ruiz, S.M., Luhar, R., & Gravitz, Z. (2014). Profiles of impaired, spared, and recovered neuropsychological processes in alcoholism. In Pfefferbaum, A. & Sullivan, E.V. (Eds.), Handbook of Clinical Neurology: Alcohol and the Nervous System. Edinburgh: Elsevier (in press).
15. (National Institute on Alcohol Abuse & Alcoholism, 2004)control brainalcoholic brain
16. behavioral changes
17. classical and operant conditioningbehaviors that are rewarded are likely to be repeated
18. positive reinforcement
19. negative reinforcement
20. environmental cues
21. recovery
22. healthy braincocaine user (10 days abstinent)cocaine user (100 days abstinent)(National Institute on Drug Abuse, 2007)level of brain activity(low to high)
23. healthy controlmeth user(1 month of abstinence) meth user(14 months of abstinence) (National Institute on Drug Abuse, 2002)
24. debate over whether substance use should be deemed a ‘disease’ proponents: acknowledgment of physiological affects; comparison to other disease states opponents: emphasis on personal responsibility, choice, ability to change (empowerment)take away: substances affect the brain chemically and structurally “disease” – to be or not to be