exploring myths about addiction - environmental science · dependence = addiction alcohol...
TRANSCRIPT
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Produced by and for Hot Science - Cool Talks by the Environmental Science Institute. We request that
the use of these materials include an acknowledgement of the presenter and Hot Science - Cool Talks
by the Environmental Science Institute at UT Austin. We hope you find these materials educational
and enjoyable.
Dr. Carlton Erickson
November 16, 2001
Exploring Myths About Addiction
# 16
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Exploring Myths
About Addiction
Carlton Erickson, Ph.D.Director, Addiction Science Research and Education Center
College of Pharmacy, U.T.
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We have problems….
• Club drugs and marijuana are not addicting.
• Prozac and other antidepressant drugs are
addicting.
• Everyone who uses cocaine or heroin is
addicted.
• It takes a history of heavy smoking to produce
addiction to nicotine.
• Anyone who drinks too much, too often, is an
alcoholic.
Here are some myths:
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Movie about Alcoholism
Click here to view animation
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Movie about Addiction
Click here to view animation
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TWO CRITICAL DEFINITIONS*
* Based on the Diagnostic and Statistical Manual-IV (DSM-IV)
Abuse
Dependence
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ABUSE
• Intentional Overuse in cases of celebration, anxiety, despair, self-medication, or ignorance. Tends to decline with adverse consequences. (“a problem to solve”)
• Not a minor problem - produces a major socioeconomic impact in the nation
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DEPENDENCE
• Impaired Control over drug use, probably
caused by a dysfunction of the medial
forebrain bundle, “pleasure pathway”
(“a disease to conquer”)
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Addiction is impaired control
over use of the drug!
Dependence = Addiction
Alcohol Dependence = Alcoholism
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Determining whether
someone is an alcoholic or
drug addict is a
professional decision.
You should not
make that decision.
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A NINE MINUTE
COURSE IN
NEUROBIOLOGY
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The brain is made up of millions
of neurons that send information
across the brain with electrical
signals.
Click here to view animation
Neuron cell bodies
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These neurons are
separated by small
spaces called synapses.
Neural synapses
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Neurons communicate across
synapses by chemical signals
called neurotransmitters.
Click here to view animation
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A Detailed Look at a Neural Synapse
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Neurotransmitters in the
synapse
Neurotransmitters
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Inside the synapseSynapse
(the space
between two
nerves)
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Where cocaine works
Cocaine inhibits
the uptake of a
neurotransmitter
called dopamine.
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When neurotransmitter is not taken
out of the synapse, it causes more
stimulation than it normally would.
Click here to view animation
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Where amphetamines work
Amphetamines
increase the
release of
dopamine.
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The Pleasure Pathway
Pleasure Pathway
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Where drugs like Prozac work
Prozac inhibits
the uptake of a
neurotransmitter
called Seratonin.
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SOME PEOPLE MAY BE PRE-DISPOSED
TO ADDICTION
• Dopamine (DA)
• Serotonin (SER)
• Endorphins (END)
Certain people may have a functional deficiency in
one or more neurotransmitters that occur in the
pleasure pathway.
• Gamma-aminobutyric acid (GABA)
• Glutamate (GLU)
• Acetylcholine (ACh)
NEUROTRANSMITTERS OF “ADDICTION”
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ADDICTION IS A BRAIN CHEMISTRY
DISEASE!
1. Addicting drugs “match” a transmitter system that is not normal.
2. Abstinence is the first step in the total treatment process, in order to access the “wreckage of the past”.
3. Some people require a chemical to overcome the non-normal transmitter system. Evidence for is found in cases of methadone maintenance.
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GENETICS OF ALCOHOLISM
• What is passed from parent to child?
• “The tendency to become alcoholic is
inherited.”
Research on the Genetics of Alchoholism
• family, twin, and adoption studies
• the search for the genes
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SCIENTIFIC RATIONALE
BASED UPON GENETICS
transmitter synthesizing enzymes
transmitter breakdown enzymes
Receptors
neurotransmitter dysfunction in the pleasure pathway
impaired control
abnormal genes abnormal proteins
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Medial Forebrain Bundle
DEPENDENCE MODEL
• This is not a will power or poor judgment
disease.
• Impaired control is caused by brain chemistry
malfunction.
• Addicts need to drug to feel normal.
• Ultimate treatment must normalize
neurotransmitter function in the proper brain
area.
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REDUCING DRUG ABUSE
• make drugs harder to get (alcohol: age, taxes, supply)
• coerce or punish abusers
• educate to prevent first use
• increase adverse consequences
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REDUCING DRUG DEPENDENCE
• intervention for those in denial
• inpatient-outpatient-aftercare
• 12 steps (abstinence)
• relapse prevention therapy
• new medications to reduce craving (now) and fix abnormal genes (in the future)
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PHARMACOTHERAPIES FOR
CHEMICAL DEPENDENCY
• alcohol - naltrexone, acamprosate,
ondansetron
• nicotine - patches, gum, bupropion
(Zyban), new vaccine
• heroin - methadone, buprenorphine
• cocaine - many alleged (GVG?), new
vaccine
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SCIENCE PROPOSES
THAT
BEHAVIORAL
THERAPIES CHANGE
BRAIN CHEMISTRY!
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The Real Situation• we wrongly tend to think all drug problems
have a single solution
• we want to blame people for their affliction,
while not seeking real causes (ask: why do
they do that?)
• we hate what we fear or become angry at
people who act badly
• stigma, prejudice, and misunderstanding are
enormous
• addiction science is teaching us to become
more tolerant
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Acknowledgements
The following people and institutions provided
support to make this presentation possible.
The Environmental Science Institute
Nelson Guda
Jay Banner
The College of Pharmacy
The National Science Foundation
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Dr. Carlton K. Erickson
Carlton Erickson is interested in addiction science education,
performed through the dissemination of new research findings on
drug addiction in lay language. Primarily through lectures and slide
presentations to treatment professionals (alcohol and other drug
abuse counselors, social workers, mental health counselors, etc.)
and the “reachable public” (criminal justice workers, physicians,
nurses, pharmacists, dentists, clergy, and family members),
education is packaged in an easily-understandable form so that
new information can be transferred quickly to those who can use it.
He is also interested in teaching other researchers to communicate
their research results more effectively, and to motivate them to also
talk to nonscientific groups. Finally, the evaluation of such
information transfer is critical to its long-term effectiveness in
altering public opinion about addictions as diseases. Therefore he
is interested in learning behavioral change methods and theory,
attitudinal theory, and how to influence public opinion regarding
drug use, abuse, and dependence in our society.