Neuroscience in Prevention, Treatment and Recovery Carrie McKinley University of Missouri - Columbia My goals for this presentation •To provide a basic understanding of the neuroscience of addiction •To give insight on how neural processes manifest themselves physically •To explain the neurologically reinforcing properties of drugs of abuse First: Reinforcing Properties of Drugs • Our brains are programmed to have certain neurological responses in order to get us through every day and to teach us what is good for us. •Neurologically many things, including drugs, can be positively or negatively reinforcing. Positive reinforcement Negative Reinforcement • Occurs naturally when we are • Also occurs naturally when we do rewarded with something something and it takes away positive for a behavior or action. something bad • Example: Study hard and get a • Example: Eating to take away good grade hunger • Drugs of abuse do the same thing • Drugs of abuse also do this • Example: Snort cocaine and feel • Example: Drinking alcohol to take good away anxiety An introduction to neuroscience • Our brain is made up of millions of neurons. • These neurons serve special functions depending on their location in the brain. • Neurons communicate using chemicals called neurotransmitters • There are three major neurotransmitters related to drug abuse Dopamine GABA Glutamate Neurotransmitter manipulation • All drugs (THC, alcohol, Cocaine, Meth, Heroin) have an effect on the neurotransmitter dopamine. • All increase the amount of dopamine in the synapse • This increase in dopamine leads to the pleasurable effects associated with most drugs. • Repeated increases in dopamine levels lead to compensation by neurons. Compensation by neurons • When dopamine levels begin to neutralize the individual taking the drug begins to “lose” the high they experienced • If the individual chooses to use again then the dopamine level returns to being increased at the synapse • When an individual does this repeatedly, as with addiction, our neurons begin to compensate for the increased levels of dopamine. • Eventually the neurons production of dopamine gets altered as the neurons adapt to having constant high levels of dopamine in the synapse • There’s a down regulation of the amount of receptors on neurons to try and compensate for the amount of dopamine in the synapse • This results in tolerance and individuals using large quantities to get the same “effect” Brain pathways • Groups of neurons form different pathways in our brain • Drugs of abuse highjack the neurotransmitters in these pathways of the human brain • Every drug effects slightly different systems. • It is the manipulation of the neurotransmitters and neurons of these pathways that leads to a lot of the behaviors associated with drug addiction. Behavioral manifestations of neural changes • A result of these neural changes in the brain and dopamine pathways can be seen in conditioned place preference. • When an animal receives a dose of a drug in an environment and a placebo in another environment, the animal will chose to spend more time in the environment it received the drug in. • The opposite is true when an animal receives an adverse stimulus (shock) in one environment, the animal will spend less time where they experienced the adverse stimulus. • So then, how can we apply this to initial prevention and relapse prevention? Bean bag activity! Like Riding a Bike: Neuroscience in Prevention, Treatment and Recovery ACT Missouri Prevention Conference Missouri Champions of Prevention December 4, 2012 Lodge of the Four Seasons, Lake of the Ozarks Heather Harlan, Phoenix Programs, Inc. Certified Reciprocal Prevention Specialist Carrie McKinley, University of Missouri Cognitive Neuroscience Research/Center for Translational Neuroscience Learning Objectives • Why adolescent brains are more vulnerable to addiction • How substance use/abuse disrupts acquisition of skill sets necessary for adult function • How evidence-based prevention relates to teen brains and protective factors for substance use/abuse What do prevention, treatment and recovery have in common? ? ? ?? ? 12 Of course!!!!!!!!!! THAT makes sense! 13 Substance use disorders as well as prevention, treatment and recovery ALL made possible through reinforcers. 14 “Neuroscience for Dummies”—me Reward pathways= Roads in your brain 15 Human brain growing well in the mid-20’s Ages 5 20 Blue represents maturing areas of the brain Blue represents maturing portion of the brain. 16 90% of addictions begin during adolescence. Dr. Michael Dennis Chestnut Health Systems Illustration source: NIDA Age of first use matters Youth who begin drinking before age 15 are 4-5 times more likely to become alcohol dependent than those who wait until they are 21. --PIRE (Pacific Institute on Research and Development) 18 We know. . . . . . . Immature brains are more at risk. BUT . . . What’s happening neurologically? Think of the immature human brain as someone who is deciding where to build roads. Lights in the distance draw us on. “Where should I go?” “What actions/behaviors are advantageous to me?” A chemical reward in the brain tells us what actions/behaviors we should repeat and learn. Ordinary rewards we receive over and over teach us how to cope with life. Like flashlights on the dark horizon: Hungry-----eat Thirsty------drink Tired--------companionship Sad----------find comfort Better grades------study Bored-------rewarding pastimes Broke-------work Energy------exercise Stressed----relaxation Those repeated behaviors become our super highway reward pathways. When a young human brain experiences artificial rewards from alcohol or other drugs. . . It sets a youth on a different neurological path. How can you “un-experience” a strong chemical reward you did nothing to receive except to use/drink? How can you “un-see” a bright flashing light? Ordinary “rewards” can’t effectively compete. This creates a high risk for a neurological super highway to using/ drinking behavior—substance use/abuse/dependency. This is what makes the adolescent human brain so vulnerable to addictive chemicals. Skill SETS Adolescents need to acquire skill sets to be successful. Uh,what’s a skill set? Please repeat this with me: When I think of my brain There’s a lot at stake So I’m gonna learn how To make a good brain great. Now, please, repeat the little ditty from memory. Now, please stand add clapping pattern I will teach you with a with a partner. Now, please switch partners. Final time, everyone listen as we recite the verse and clap and say it together. Experience of a SKILL SET • First read the verse • Memorized it • Learned clapping pattern • Leaned to say it with a partner while clapping • Learned to accommodate different partners • Learned to listen and say it all together in unison. Neurons fired together Are Wired together. 40 Examples of other SKILL SETS Skill set Neurons fired together are wired together. Prevention, treatment and recovery: All depend on reward pathways that lead to acquisition of skill sets: Prevention, treatment and recovery: All depend on reward pathways that lead to acquisition of skill sets: Prevention: sufficient opportunities to learn coping skills to succeed and enjoy life. Treatment: strategic and extensive planning to avoid the “artificial rewards” of using while creating reward pathways to pro-social behaviors and coping skills. (not just STOP) Recovery: taking time to practice and strengthen reward pathways to successfully compete with artificial rewards. Neuroscience of Prevention, treatment and recovery: Like riding a bicycle. Sooooooooooooooo . . . .? How does evidence-based prevention relates to teen brains and protective factors for substance use/abuse? What are some evidence-based prevention efforts in your community/coalition? Discussion: What is happening to protect or develop brains using those interventions? Neuroscience of Prevention, treatment and recovery: Like riding a bicycle. Phoenix Programs, Inc. www.phoenixprogramsinc.org • Know us (I do a majority of posts) • “Like us” • Follow us. So you can become a member of the informed Community Speaker wishes to acknowledge: • Carrie McKinley, co-presenter • Phoenix Programs, Inc. • ACT MO • Preventionists and treatment counselors in MO and IL who have generously shared their wisdom and experience. Questions? Thank you for your kind attention and generous participation. Presented by Heather Harlan, Prevention Specialist Copy of this presentation available on request firstname.lastname@example.org 573-875-8880 x 2142 Funding for this project was provided in part by the Missouri Foundation for Health. The Missouri Foundation for Health is a philanthropic organization whose vision is to improve the health of the people in the communities it serves. A New Perspective in Prevention, Treatment and Recovery. For individuals. For families. For over 35 years.
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