Drug Abuse

1
Bringing the Full Power of Science to Bear on

2
Addiction
Medical
Medical
Neurotoxicity AIDS, Cancer Mental illness
NEUROTOXICITY AIDS CANCERMENTAL ILLNESS
DRUGS
Economic
Social
Health care Productivity Accidents
Homelessness Crime Violence
3
4 Out of 10 U.S. AIDS Deaths Are Related to Drug
Abuse
4
Estimated Economic Cost to Society from Substance
Abuse and Addiction

• Illegal drugs 181 billion/year
• Alcohol 185 billion/year
• Tobacco 158 billion/year
• Total 524 billion/year

Surgeon Generals Report, 2004 ONDCP, 2004
Harwood, 2000.
5
What is Addiction? Addiction is A Brain Disease

• Characterized by compulsive behavior
• The continued abuse of drugs despite negative
  consequences
• A chronic, potentially relapsing disorder

6
Advances in science have revolutionized our
fundamental views of drug abuse and addiction.
7
used to be
8
Your Brain on Drugs Today
YELLOW shows places in brain where cocaine binds
(striatum)
Front of Brain
Back of Brain
Fowler et al., Synapse, 1989.
9

• Addiction is Like Other Diseases
• It is preventable.
• It is treatable
• It changes biology.
• If untreated, it can last a lifetime.

Decreased Heart Metabolism in Heart Disease
Patient
Decreased Brain Metabolism in Drug Abuser
Healthy Brain
Healthy Heart
Diseased Heart
Diseased Brain/ Cocaine Abuser
Research supported by NIDA addresses all of these
components of addiction
10
Addiction Involves Multiple Factors
11
Addiction Is A Developmental Disease
that starts in adolescence and childhood
1.8
1.8
TOBACCO
CANNABIS
1.6
1.6
ALCOHOL
1.4
1.4
1.2
1.2
1.0
1.0
in each age group who develop first-time
dependence
0.8
0.8
0.6
0.6
first
0.4
0.4
0.2
0.2
0.0
0.0
5
10
15
21
25
30
35
40
45
50
55
60
65
5
10
15
21
25
30
35
40
45
50
55
60
65
Age
Age
Age at
tobacco
,
alcohol
and
cannabis
dependence per DSM IV
National Epidemiologic Survey on Alcohol and
Related Conditions
, 2003.
National Epidemiologic Survey on Alcohol and
Related Conditions
, 2003.
12
Why Do People Take Drugs in The First Place?
To feel better To lessen anxiety worries fears de
pression hopelessness
To feel good To have novel feelings sensations ex
periences AND to share them
13
Why Do People Abuse Drugs?
Drugs of Abuse Engage Systems in the Motivation
and Pleasure Pathways of the Brain
14
Dopamine
movement
15
Drugs are Imposters of Brain Messages
16
The Neuron How the Brains Messaging System Works
Donald Bliss, MAPB, Medical Illustration
17
(No Transcript)
18
dopamine transporters
19
Natural Rewards Elevate Dopamine Levels
SEX
FOOD
200
200
NAc shell
150
150
DA Concentration ( Baseline)
100
100
of Basal DA Output
Empty
50
Box
Feeding
0
0
60
120
180
Female Present
Time (min)
Sample Number
Di Chiara et al., Neuroscience, 1999.
Fiorino and Phillips, J. Neuroscience, 1997.
20
(No Transcript)
21
Effects of Drugs on Dopamine Release
Di Chiara and Imperato, PNAS, 1988
22
But Dopamine is only Part of the Story
Other neurotransmitter systems are also affected

• Serotonin mood regulation, sleep
• Glutamate learning and memory

23
(No Transcript)
24
Science Has Generated Much Evidence Showing That
Prolonged Drug Use Changes the Brain In
Fundamental and Long-Lasting Ways
25
AND
We Have Evidence That These Changes Can Be
Both Structural and Functional
26
Structurally
NAC
Amph
Saline
Source Robinson Kolb, Journal of
Neuroscience, Volume 1997
27
Functionally
Dopamine D2 Receptors are Lower in Addiction
Cocaine
DA
DA
DA
DA
DA
DA
DA
DA
DA
DA
DA
DA
Meth
Reward Circuits
DA D2 Receptor Availability
Non-Drug Abuser
DA
DA
Alcohol
DA
DA
DA
DA
Heroin
Reward Circuits
Drug Abuser
Control
Addicted
28
Dopamine Transporters in Methamphetamine Abusers
Motor Task Loss of dopamine transporters in the
meth abusers may result in slowing of motor
reactions.
Normal Control
Memory task Loss of dopamine transporters in the
meth abusers may result in memory impairment.
Methamphetamine Abuser
Volkow et al., Am. J. Psychiatry, 2001.
29
Implication
Brain changes resulting from prolonged use of
drugs may compromise mental and motor
functions
30
Circuits Involved In Drug Abuse and Addiction
All of these must be considered in developing
strategies to effectively treat addiction