Causes of drug addiction ppt

drug abuse powerpoint backgrounds and neurobiology of drug addiction ppt and how to avoid drug addiction ppt
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Drugs, Brains, and Behavior The Science of Addiction Image: White Matter Fibers, Parietal Areas • www.humanconnectomeproject.orgThis publication is in the public domain and may be used or reproduced in its entirety without permission from NIDA. Citation of the source is appreciated. NIH Pub No. 14-5605 Printed April 2007 Revised February 2008, August 2010, July 2014CONTENTS Preface............................................................................................................................................................................ 1 Introduction.................................................................................................................................................................... 3 I. Drug Abuse and Addiction ........................................................................................................................................... 5 II. Preventing Drug Abuse: The Best Strategy................................................................................................................. 11 III. Drugs and the Brain................................................................................................................................................ 15 IV. Addiction and Health................................................................................................................................................ 21 V. Treatment and Recovery ............................................................................................................................................ 25 VI. Advancing Addiction Science and Practical Solutions............................................................................................... 29 References .................................................................................................................................................................... 31 I“Drug addiction is a brain disease that can be treated.” Nora D. Volkow, M.D. Director National Institute on Drug AbusePREFACE How Science Has Revolutionized the Understanding of Drug Addiction or much of the past century, scientists studying drug abuse labored in the shadows of powerful myths and misconceptions about the nature of addiction. When scientists began to study addictive behavior in the 1930s, people addicted to drugs were thought to be Fmorally flawed and lacking in willpower. Those views shaped society’s responses to drug abuse, treating it as a moral failing rather than a health problem, which led to an emphasis on punishment rather than prevention and treatment. Today, thanks to science, our views and our responses to addiction and other substance use disorders have changed dramatically. Groundbreaking discoveries about the brain have revolutionized our understanding of compulsive drug use, enabling us to respond effectively to the problem. As a result of scientific research, we know that addiction is a disease that affects both the brain and behavior. We have identified many of the biological and environmental factors and are beginning to search for the genetic variations that contribute to the development and progression of the disease. Scientists use this knowledge to develop effective prevention and treatment approaches that reduce the toll drug abuse takes on individuals, families, and communities. Despite these advances, many people today do not understand why people become addicted to drugs or how drugs change the brain to foster compulsive drug use. This booklet aims to fill that knowledge gap by providing scientific information about the disease of drug addiction, including the many harmful consequences of drug abuse and the basic approaches that have been developed to prevent and treat substance use disorders. At the National Institute on Drug Abuse (NIDA), we believe that increased understanding of the basics of addiction will empower people to make informed choices in their own lives, adopt science-based policies and programs that reduce drug abuse and addiction in their communities, and support scientific research that improves the Nation’s well-being. Nora D. Volkow, M.D. Director 1 National Institute on Drug AbuseMEDICAL SOCIAL ECONOMIC CRIMINAL JUSTICE The consequences of drug abuse are vast and varied and affect people of all ages.INTRODUCTION Why study drug abuse and addiction? buse of and addiction to alcohol, nicotine, and illicit and prescription drugs cost Americans more than 700 billion a year in 1,2,3 increased health care costs, crime, and lost productivity. Every year, illicit and prescription drugs and alcohol contribute to the 4,5 A death of more than 90,000 Americans, while tobacco is linked to an estimated 480,000 deaths per year. (Hereafter, unless otherwise specified, drugs refers to all of these substances.) People of all ages suffer the harmful consequences of drug abuse and addiction. z Babies exposed to drugs in the womb may be born premature and underweight. This exposure can slow the child’s intellectual 6 development and affect behavior later in life. z Adolescents who abuse drugs often act out, do poorly academically, and drop out of school. They are at risk for unplanned pregnancies, violence, and infectious diseases. z Adults who abuse drugs often have problems thinking clearly, remembering, and paying attention. They often develop poor social behaviors as a result of their drug abuse, and their work performance and personal relationships suffer. z Parents’ drug abuse often means chaotic, stress-filled homes, as well as child abuse and neglect. Such conditions harm the well- being and development of children in the home and may set the stage for drug abuse in the next generation. How does science provide solutions for drug abuse and addiction? Scientists study the effects that drugs have on the brain and on people’s behavior. They use this information to develop programs for preventing drug abuse and for helping people recover from addiction. Further research helps transfer these ideas into practice in our communities. 3I. DRUG ABUSE AND ADDICTION What is drug addiction? DECREASED BRAIN METABOLISM IN PERSON WHO ABUSES DRUGS ddiction is defined as a chronic, relapsing brain disease that is characterized by compulsive drug A seeking and use, despite harmful consequences.† It is considered a brain disease because drugs change the brain—they change its structure and how it works. These brain changes can be long-lasting, and can lead to the harmful behaviors seen in people who abuse drugs. Healthy Brain Diseased Brain/Cocaine Abuser DECREASED HEART METABOLISM IN HEART DISEASE PATIENT Addiction is a lot like other diseases, such as heart disease. Both disrupt the normal, healthy functioning of the underlying organ, have serious harmful consequences, and are preventable and treatable, but if left untreated, can last a lifetime. Healthy Heart Diseased Heart Source: From the laboratories of Drs. N. Volkow and H. Schelbert †The term addiction as used in this booklet may be regarded as equivalent to a severe substance use disorder as defined by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5, 2013). 5 LOW HIGH6 Why do people take drugs? In general, people begin taking drugs for a variety of reasons: z To feel good. Most abused drugs produce intense feelings of pleasure. This initial sensation of euphoria is followed by other effects, which differ with the type of drug used. For example, with stimulants such as cocaine, the “high” is followed by feelings of power, self-confidence, and increased energy. In contrast, the euphoria caused by opiates such as heroin is followed by feelings of relaxation and satisfaction. z To feel better. Some people who suffer from social anxiety, stress-related disorders, and depression begin abusing drugs in an attempt to lessen feelings of distress. Stress can play a major role in beginning drug use, continuing drug abuse, or relapse in patients recovering from addiction. z To do better. Some people feel pressure to chemically enhance or improve their cognitive or athletic performance, which can play a role in initial experimentation and continued abuse of drugs such as prescription stimulants or anabolic/androgenic steroids. z Curiosity and “because others are doing it.” In this respect adolescents are particularly vulnerable because of the strong influence of peer pressure. Teens are more likely than adults to engage in risky or daring behaviors to impress their friends and express their independence from parental and social rules. Courtesy: Vivian FelsenNo single factor determines whether a person will become addicted to drugs. 7 addiction show physical changes in areas of the brain that are If taking drugs makes people feel good or critical to judgment, decision making, learning and memory, better, what’s the problem? 7 and behavior control. Scientists believe that these changes alter When they first use a drug, people may perceive what seem to the way the brain works and may help explain the compulsive be positive effects; they also may believe that they can control and destructive behaviors of addiction. their use. However, drugs can quickly take over a person’s life. Why do some people become addicted to Over time, if drug use continues, other pleasurable activities drugs, while others do not? become less pleasurable, and taking the drug becomes neces- sary for the user just to feel “normal.” They may then compul- As with any other disease, vulnerability to addiction differs from sively seek and take drugs even though it causes tremendous person to person, and no single factor determines whether a problems for themselves and their loved ones. Some people may person will become addicted to drugs. In general, the more risk start to feel the need to take higher or more frequent doses, factors a person has, the greater the chance that taking drugs even in the early stages of their drug use. These are the telltale signs of an addiction. RISK AND PROTECTIVE FACTORS FOR DRUG ABUSE AND ADDICTION Even relatively moderate drug use poses dangers. Consider how Risk Factors Protective Factors a social drinker can become intoxicated, get behind the wheel Aggressive behavior Good self-control of a car, and quickly turn a pleasurable activity into a tragedy in childhood that affects many lives. Lack of parental Parental monitoring supervision and support Is continued drug abuse a voluntary Poor social skills Positive relationships behavior? Drug experimentation Academic competence The initial decision to take drugs is typically voluntary. However, Availability of drugs School anti-drug at school policies with continued use, a person’s ability to exert self-control can Community poverty Neighborhood pride become seriously impaired; this impairment in self-control is the hallmark of addiction. Brain imaging studies of people withChildren’s earliest interactions within the family are crucial to their healthy development and 8 risk for drug abuse. will lead to abuse and addiction. Protective factors, on RISK FACTORS the other hand, reduce a person’s risk of developing addiction. Risk and protective factors may be either envi- ronmental (such as conditions at home, at school, and in the neighborhood) or biological (for instance, a person’s genes, their stage of development, and even their gender n n Genetics Chaotic home and abuse n n Gender Parent’s use and attitudes or ethnicity). n n Mental disorders Peer influences n Community attitudes n Early use n Route of administration n Poor school achievement n Availability n Effect of drug itself n Cost What environmental factors increase the risk of addiction? z Home and Family. The influence of the home envi- ronment, especially during childhood, is a very impor- tant factor. Parents or older family members who abuse alcohol or drugs, or who engage in criminal behavior, can increase children’s risks of developing their own drug problems. What biological factors increase the risk of addiction? z Peer and School. Friends and acquaintances can have Scientists estimate that genetic factors account for between 40 and 60 percent of a an increasingly strong influence during adolescence. person’s vulnerability to addiction; this includes the effects of environmental factors Drug-using peers can sway even those without risk fac- on the function and expression of a person’s genes. A person’s stage of development tors to try drugs for the first time. Academic failure or and other medical conditions they may have are also factors. Adolescents and people poor social skills can put a child at further risk for with mental disorders are at greater risk of drug abuse and addiction than the general using or becoming addicted to drugs. population.9 z Method of Administration. Smoking a drug or injecting it into What other factors increase the risk of 9,10 a vein increases its addictive potential. Both smoked and injected addiction? drugs enter the brain within seconds, producing a powerful rush z Early Use. Although taking drugs at any age can lead to addiction, of pleasure. However, this intense “high” can fade within a few research shows that the earlier a person begins to use drugs, the minutes, taking the abuser down to lower, more normal levels. 8 more likely he or she is to develop serious problems. This may Scientists believe this starkly felt contrast drives some people to reflect the harmful effect that drugs can have on the developing repeated drug taking in an attempt to recapture the fleeting brain; it also may result from a mix of early social and biological pleasurable state. vulnerability factors, including unstable family relationships, exposure to physical or sexual abuse, genetic susceptibility, or mental illness. Still, the fact remains that early use is a strong indicator of problems ahead, including addiction.Addiction is a developmental disease— 10 it typically begins in childhood or adolescence. The brain continues to develop into adulthood ImAGeS OF bRAIN Dev eLOPmeNT IN HeALTHy CHILDReN AND TeeNS (AGeS 5–20) and undergoes dramatic changes during adolescence. AGeS 5 20 One of the brain areas still maturing during adolescence is the prefrontal cortex—the part of the brain that enables us to assess situations, make sound decisions, and keep our emotions and SIDE VIEW 11 desires under control. The fact that this critical part of an adolescent’s brain is still a work in progress puts them at increased risk for making poor decisions (such as trying drugs or continuing to take them). Also, introducing drugs during this period of development may cause brain changes that have profound and long-lasting consequences. Prefrontal Cortex TOP VIEW Blue represents maturing of brain areas. Source: PNAS 101:8174–8179, 2004.II. PREVENTING DRUG ABUSE: THE BEST STRATEGY Why is adolescence a critical time for preventing drug addiction? s noted previously, early use of drugs increases a person’s chances of developing addiction. Remember, drugs change brains—and this can lead to addiction and other serious problems. So, preventing early use of drugs or alcohol may go a long way in reducing A these risks. If we can prevent young people from experimenting with drugs, we can prevent drug addiction. Risk of drug abuse increases greatly during times of transition. For an adult, a divorce or loss of a job may lead to drug abuse; for a teenag- 12 er, risky times include moving or changing schools. In early adolescence, when children advance from elementary through middle school, they face new and challenging social and academic situations. Often during this period, children are exposed to abusable substances such as cigarettes and alcohol for the first time. When they enter high school, teens may encounter greater availability of drugs, drug use by older teens, and social activities where drugs are used. At the same time, many behaviors that are a normal aspect of their development, such as the desire to try new things or take greater risks, may increase teen tendencies to experiment with drugs. Some teens may give in to the urging of drug-using friends to share the experience with them. Others may think that taking drugs (such as steroids) will improve their appearance or their athletic performance or that abusing substances such as alcohol or MDMA (ecstasy or “Molly”) will ease their anxiety in social situations. A growing number of teens are abusing ® prescription ADHD stimulants such as Adderall to help them study or lose weight. Teens’ still-developing judgment and decision-making skills may limit their ability to accurately assess the risks of all of these forms of drug use. Using abusable substances at this age can disrupt brain function in areas critical to motivation, memory, learning, judgment, and behavior 7 control. So, it is not surprising that teens who use alcohol and other drugs often have family and social problems, poor academic perform- ance, health-related problems (including mental health), and involvement with the juvenile justice system. 11National drug use surveys indicate some children are 12 already using drugs by age 12 or 13. Can research-based programs The Drug Danger Zone: Most Illicit Drug Use Starts in the Teenage Years prevent drug addiction in 12 11.2% youth? 10.4% Yes. The term “research-based” means that 10 these programs have been rationally designed 16-17 based on current scientific evidence, rigor- 8.0% 18-20 8 ously tested, and shown to produce positive results. Scientists have developed a broad range of programs that positively alter the 6 14-15 balance between risk and protective factors 4.5% for drug abuse in families, schools, and communities. Studies have shown that 4 0.3% research-based programs, such as those 2.9% described in NIDA’s Preventing Drug Use 21-25 2 among Children and Adolescents: A 26 or Research-Based Guide for Parents, Older 12-13 Educators, and Community Leaders, can 0 Age Group significantly reduce early use of tobacco, Source: SAMHSA, Center for Behavioral Health Statistics and Quality, 13 alcohol, and illicit drugs. National Survey on Drug Use and Health, 2011 and 2012. Percentage of Past-Year Initiates among Those Who Have Never Used13 How do research-based prevention programs work? These prevention programs work to boost protective factors and eliminate or reduce risk factors for drug use. The programs are designed for various ages and can be designed for individual or group settings, such as the school and home. There are three types of programs: z Universal programs address risk and protective factors common to all children in a given setting, such as a school or community. z Selective programs target groups of children and teens who have factors that put them at increased risk of drug use. z Indicated programs are designed for youth who have already begun using drugs. Are all prevention programs effective in reducing drug abuse? When research-based substance use prevention programs are properly implemented by schools and communities, use of alco- hol, tobacco, and illegal drugs is reduced. Such programs help teachers, parents, and health care professionals shape youths’ perceptions about the risks of substance use. While many social and cultural factors affect drug use trends, when young people 14 perceive drug use as harmful, they reduce their level of use.n n Prevention is the best strategy 14 DRUG USe DeCReASeS WHeN DRUGS ARe PeRCeIv eD AS HARmFUL, AND v ICe v eRSA 12TH-GRADe STUDeNTS RePORTING PAST-mONTH 12TH-GRADe STUDeNTS RePORTING PAST-mONTH mARIJUANA USe AND PeRCePTION OF HARm, CIGAReTTe USe AND PeRCePTION OF HARm, 1975 TO 2013 1975 TO 2013 80 80 70 Perceived Risk of Harm n 70 Past-Year Use 60 Cigarette smoking among teens is at its 60 50 lowest point since Perceived Risk of Harm n NIDA began tracking 1/2 a pack+/day 40 50 it in 1975. But marijuana use has 30 increased over the 40 past several years as 20 perception of its 30 risks has declined. 10 0 20 Year Year Source: 2013 Monitoring the Future survey. University of Michigan, with funding from the National Institute on Drug Abuse. For more information on prevention, see NIDA’s most recent edition of Preventing Drug Use among Children and Adolescents: A Research- Based Guide for Parents, Educators, and Community Leaders at www.drugabuse.gov/Prevention/Prevopen.html. Percent PercentIII. DRUGS AND THE BRAIN Introducing the Human brain he human brain is the most complex organ in the body. This three-pound mass of gray and white matter sits at the center of all human activity—you need it to drive a car, to enjoy a meal, to breathe, to create an artistic masterpiece, and to enjoy everyday activi- T ties. In brief, the brain regulates your body’s basic functions; enables you to interpret and respond to everything you experience; and shapes your thoughts, emotions, and behavior. The brain is made up of many parts that all work together as a team. Different parts of the brain are responsible for coordinating and per- forming specific functions. Drugs can alter important brain areas that are necessary for life-sustaining functions and can drive the compul- sive drug abuse that marks addiction. Brain areas affected by drug abuse include: z The brain stem, which controls basic functions critical to life, such as heart rate, breathing, and sleeping. z The cerebral cortex, which is divided into areas that control specific functions. Different areas process information from our senses, enabling us to see, feel, hear, and taste. The front part of the cortex, the frontal cortex or forebrain, is the thinking center of the brain; it powers our ability to think, plan, solve problems, and make decisions. z The limbic system, which contains the brain’s reward circuit. It links together a number of brain structures that control and regulate our ability to feel pleasure. Feeling pleasure motivates us to repeat behaviors that are critical to our existence. The limbic system is activated by healthy, life-sustaining activities such as eating and socializing— but it is also activated by drugs of abuse. In addition, the limbic system is responsible for our perception of other emotions, both positive and negative, which explains the mood-altering properties of many drugs. 1516 z Neurotransmitters—The Brain’s Chemical Messengers How do the parts of the brain communicate? The messages are typically carried between neurons by chemicals The brain is a communications center consisting of billions of called neurotransmitters. neurons, or nerve cells. Networks of neurons pass messages back z Receptors—The Brain’s Chemical Receivers and forth among different structures within the brain, the spinal cord, The neurotransmitter attaches to a specialized site on the receiving and nerves in the rest of the body (the peripheral nervous system). neuron called a receptor. A neurotransmitter and its receptor oper- These nerve networks coordinate and regulate everything we feel, ate like a “key and lock,” an exquisitely specific mechanism that ensures that each receptor will forward the appropriate message think, and do. only after interacting with the right kind of neurotransmitter. z Neuron to Neuron z Transporters—The Brain’s Chemical Recyclers Each nerve cell in the brain sends and receives messages in the Located on the neuron that releases the neurotransmitter, trans- form of electrical and chemical signals. Once a cell receives and porters recycle these neurotransmitters (that is, bring them back processes a message, it sends it on to other neurons. into the neuron that released them), thereby shutting off the signal between neurons. To send a message, a brain Here’s how people communicate. Here’s how brain cells communicate. cell (neuron) releases a chemical (neurotransmitter) into the space (synapse) between it and the next cell. The neurotransmitter crosses the synapse and attaches to proteins (recep- tors) on the receiving brain cell. This causes changes in the receiving cell—the Transmitter Receptor Neurotransmitter Receptor message is delivered. Concept courtesy: B.K. Madras