From Neuron to Moron Making of an Addict

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From Neuron to MoronMaking of an Addict

• Safdar I. Chaudhary, MD
• Medical Director
• S'eclairer

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Additional Information other teaching /
educational resources

• You can reach Safdar I. Chaudhary, MD at the
  following
• Office 341 Story Road, Export, PA 15632
• Tel [phone]
• Email safdar3_at_gmail.com
• Web www.seclairer.com
• Fax [phone]

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Adolescent Substance Abuse

• Epidemiological data demonstrates continued
  increase in the incidence of substance use among
  youth.
• A decrease in the age at first diagnosis of
  substance use.
• An increase in the lifetime prevalence of
  substance use disorder in general population

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Leading cause of death among Adolescents

• Use of alcohol and other drugs is the leading
  cause of morbidity and mortality from motor
  vehicle accidents, suicidal behavior, violence,
  drowning and unprotected sexual activity.
• Source U.S. Department of Vital Statistics 1993.

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Normative Adolescent Behavior

• A phase of transition
• Biological and psychological maturations are
  completed
• The social roles of adulthood are increasingly
  assumed

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Adolescent normative behavior cont

• During the final stages of maturation
• Physical
• Psychological
• Sexual
• Working, driving,sexual activities and using
  alcohol and tobacco, are adult behaviors.

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Normative Behavior ? By age 18.

• 79.2 of youth in US have drunk alcohol, and 3.7
  drink alcohol daily ( Johnston et al.1996)
• 63.5 have smoked cigarettes and 13 smoke half
  a pack a day
• Marijuana used at least once in life times by
  44.9 of 18 years old.
• Inhalants 16.6 , Stimulants 15.3 ,
  hallucinogens 14.0 , Cocaine 7.9

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Pathological Behavior

• Initiation, Maintenance and Transition of
  Substance Use..
• Number of behavioral dispositions and
  environmental influences are predictive of age at
  initiation of drug use, drug use intensity and
  experience of negative consequences during
  adolescent

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Behaviors predictive of Substance Use

• Impulsivity
• Aggression
• Sensation seeking
• Low levels of striving to achieve
• Low levels of harm avoidance
• Inability to delay gratification
• Lack of religiosity
• Conduct disorder

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Environmental Factors

• Stressful life events
• Lack of support from parents
• Absence of normative peers
• Perception of high availability of drugs
• Social norms that facilitates drug use
• Relaxed laws and regulatory policies

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Adolescent a time of heightened Risk for
addictions

• Heavy use is often limited to the period of
  adolescence.
• Substance use does not invariably increase and
  lead to dependence
• Moderation or cessation may occur

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Gateway Theory According to Kandel ( 1982)

• Four stages of drug use.
• Beer or wine consumption
• Cigarette Smoking or hard liquor consumption
• Marijuana use.
• Other illicit drug use.

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A Recent Study by Golub and Johnson ( 1994)

• Marijuanas role as a gateway drug appears to
  have increased, and marijuana use nearly always
  precedes use of substances that have less
  normative attitudes ( e.g. heroin)

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Effective Programs

• Early Adolescence Prevention efforts should be
  directed at delaying onset and increase of drug
  use. ( Because drug use predicts future drug use)
• Ages 18- 21 years Peak lifetime period, Programs
  aimed at reducing risk factors during adolescence
  may have more beneficial long term effects.

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Psychiatric Comorbidity

• Conduct Disorder is commonly associated with
  adolescent substance use disorder.
• Rates of conduct disorder ranges from 50 to 80
  in adolescent patients with substance use
  disorder.
• Depression frequently precedes substance use.
• Adolescents who commit suicide are frequently
  under the influence of alcohol or other drugs at
  the time of suicide.