national institute on drug abuse (nida) bringing the power of …€¦ · scientists have proof now...
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NationalInstituteonDrugAbuse(NIDA)
BringingthePowerofSciencetoBearonDrugAbuseandAddiction
LastUpdatedJanuary2007
https://www.drugabuse.gov
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TableofContents
BringingthePowerofSciencetoBearonDrugAbuseandAddiction
SectionI
SectionII
SectionIII
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SectionI
1:NIDAisdedicatedtobringingthepowerofsciencetobearondrugabuseandaddiction
TheNationalInstituteonDrugAbuse(NIDA)ispartoftheNationalInstitutesofHealthandisdedicatedtobringingthepowerofsciencetobearondrugabuseandaddiction.
Whenapersonfirstthinksabouttryingdrugs,itisusuallyavoluntarydecision.“MaybeIshouldseewhatit’slike...justthisonce,”youmightthink.Orafrienddaresyou.Oryoujustwanttofeelgoodorforgetyourtroubles.Mostdrugsofabuse-includingnicotine,alcohol,marijuana,cocaine,andheroin-activateapartofthebraincalledtherewardsystem,andthatmakesyoufeelgood.But
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justforalittlewhile.
Drugabusehasseriousconsequences.Themostseriousconsequenceisthatprolongeddrugusecanchangethebraininfundamentalandlong-lastingways.Eventually,itbecomesdifficulttodeerivepleasurefromothernormalactivities,suchassports,food,orsex.
Afterrepeateddruguse,youreachapointwhendecidingtousedrugsisnolongervoluntary.Scientistshaveproofnowthatdrugsliterallychangeyourbrain.It’sasifa“switch”goesoffinthebrain.Itisduringthistransformationprocessthatadrugabuserbecomesadrugaddict.
Addictionisachronicrelapsingdiseasecharacterizedbycompulsive,oftenuncontrollable,drugseekinganddruguseinthefaceofnegativeconsequences.Drugaddictsneedprofessionalhelpandtreatmenttohelpthemcopewiththesechangesandpossiblychangethebrainbacktonormal.
2:Thebrainisthemostcomplexorganinthebody
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Thebrainismadeupofacomplexnetworkofbillionsofnervecellscalledneurons,aswellasotherkindsofcells,allprotectedbythebonesoftheskull.Thetypicalbrainweighsonlyabout3pounds,butitisthesourceofmostqualitiesthatmakeyouwhoyouare.Neuronsinthebrainandspinalcordarepartofthenervoussystemandactasabody’s“CommandCentral.”
Thebrainisconstantlyactive,evenwhenweareasleep.Asamatteroffact,asleeporawake,thebrainrequires20percentoftheheart’soutputoffreshbloodand20percentoftheblood’soxygenandglucosetokeepfunctioningproperly.Glucoseisatypeofsugarthatisourbrain’sprimaryfuel.
Thebrainproducesenoughelectricalenergytopowera40-wattlightbulbfor24hours.That’salotofenergyforahumanorganalittlebiggerthanasoftball.
3:Howaneuronworks
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Neuronsareuniquebecausetheycansendinformationfromthebraintotherestofthebody.Yourbraincommunicateswiththerestofyourbodybysendingmessagesfromoneneurontothenextandultimatelytothemusclesandorgansofthebody.Neuronscanalsostoreinformationasmemories.
Typically,aneuroncontainsthreeimportantparts:acellbodythatdirectsallactivitiesoftheneuron;dendrites(thepartthatlooksliketreebranches),whichareshortfibersthatreceivemessagesfromotherneuronsandrelaythosemessagestothecellbody;andtheaxon,alongsinglefiberthattransmitsmessagesfromthecellbodytodendritesofotherneurons.Everymoment,messagesaremovingwithamazingspeedbackandforthfromneurontoneuron.Asamatteroffact,scientistsoftencomparetheactivityofneuronstothewayelectricityworks.
Aneuroncommunicateswithotherneuronsatspecialplacescalledsynapsesorsynapticclefts.Tosendamessage,aneuronreleasesachemicalmessenger,orneurotransmitter,intothesynapticcleft.Fromthere,the
Illustrationusedwithpermission,courtesyofLydiaV.KibiukandtheSocietyforNeuroscience
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neurotransmittercrossesthesynapseandattachestokeysitescalledreceptorsonthenextneuroninline.Whenneurotransmittersattachtothesereceptors,theycausechangesinsidethereceivingneuronandthemessageisdelivered.
Neuronscommunicatewitheachotherthroughanetworkofinterconnectedcellsthatscientistsarestilltryingtofullyunderstand.Scientistsdoknowthatthiscomplexcommunicationsystemwithinthebraincanbedisruptedbythechemicalsindrugs.Didyouknowthatmorethan400chemicalsareinamarijuanaleaf?Andover4,000chemicalsbesidesnicotineareintobacco!
4:Thebrainisyourbody
Yourbraincontrolsmorethanthewayyouthink.Thebraincontrolsourphysicalsensationsandbodymovements.Howweunderstandwhatwesee,hear,smell,taste,andtouch.Oursenseofbalanceandcoordination.Memory.Feelingsofpleasureandreward.Theabilitytomakejudgments.Whenwecatchafootball,dance,jog,speak,sing,laugh,whistle,smile,cry-that’sourbrainreceiving,processing,andsendingoutmessagestodifferentpartsofour
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body.
Whenwefeelgoodforwhateverreason-laughingwithafriendorseeingagoodmovieoreatingourfavoriteicecream-thebrain’srewardsystemisactivated.Aswesaidbefore,therewardsystemisthepartofthebrainthatmakesyoufeelgood.Therewardsystemisacollectionofneuronsthatreleasedopamine,aneurotransmitter.Whendopamineisreleasedbytheseneurons,apersonfeelspleasure.
Scientistshavelinkeddopaminetomostdrugsofabuse-includingcocaine,marijuana,heroin,alcohol,andnicotine.Thesedrugsallactivatetherewardsystemandcauseneuronstoreleaselargeamountsofdopamine.Overtime,drugsdamagethispartofthebrain.Asaresultofthisdamage,thingsthatusedtomakeyoufeelgood-likeeatingicecream,skateboarding,orgettingahug-nolongerfeelasgood.
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SectionII
1:Controlcentersinthebrainareaffectedbydruguse
Drugsofabusedisableordisruptimportantbrainfunctions.
Whensomeonesmokesmarijuana,forexample,thechemicalTHC(delta-9-tetrahydrocannabinol),themainpsychoactiveingredientinmarijuana,travelsquicklytothebrain.Wecanseetheareasofthebrain(indarkpink)whereTHCconcentrates.Let’sgobacktothepreviousimageandseetheareasofthebrainthatareaffectedbyTHC.
[PRESENTER:Pleasereturntothepreviousimageandpointouttheseareas.]
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YoucanseethatTHCbuildsupinareasthatcontrolthebody’smovements,balance,coordination,memoryandjudgmentabilities,andsensations.THCdisruptsyourbrain’sabilitytocontroltheseactivitiesaswellasyoucouldnormally.
2:Apositronemissiontomography(PET)scanner
Nowlet’stakealookinsideyourmind...OneofthetoolsthatscientistsusetoseetheeffectsofdrugsonthebrainiscalledpositronemissiontomographyoraPET[saytheword“pet”]scan.Similartoanx-ray,butmuchmoresophisticated,aPETscanisusedtoexaminemanydifferentorgansincludingtheheart,liver,lungs,andbones,aswellasthebrain.APETscanshowsmuchmorethanthephysicalstructureofboneandtissue.APETscanshowshowwell(orhowlittle)anorganisfunctioning.
UsingaPETscan,adoctororascientistcanseewhatisactuallyhappeningin
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aperson’sbrainandseetheeffectsofdrugs.ThePETscanshowsareasofthebrainthatareactiveandalsoareasthatareinactiveornotfunctioningatall.Typically,aPETscantakes1to2hourswiththepersonlyingcompletelystillsothatthePETimageswillbeclear.
Let’sseetheeffectsadruglikecocainehasonthebrain.
3:Thisisliterallythebrainondrugs
Whensomeonegets"high"oncocaine,wheredoesthecocainegointhebrain?Withthehelpofaradioactivetracer,thisPETscanshowsusaperson'sbrainoncocaineandtheareaofthebrain,highlightedinyellow,wherecocaineis"binding"orattachingitself.ThisPETscanshowsusminutebyminute,inatime-lapsedsequence,justhowquicklycocainebeginsaffectingaparticular
PhotocourtesyofNoraVolkow,Ph.D.Mappingcocainebindingsitesinhumanandbaboonbraininvivo.FowlerJS,VolkowND,WolfAP,DeweySL,SchlyerDJ,Macgregor,HitzemannR,LoganJ,BendreimB,GatleyST,etal.Synapse1989;4(4):371-377.
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areaofthebrain
Westartintheupperlefthandcorner.Youcanseethat1minuteaftercocaineisadministeredtothissubjectnothingmuchhappens.Allareasofthebrainarefunctioningnormally.Butafter3to4minutes[thenextscantotheright],weseesomeareasstartingtoturnyellow.Theseareasarepartofabrainstructurecalledthestriatum[stry-a-tum]thatisthemaintargetinthebrainboundandactivatedbycocaine.
Atthe5-to8-minuteinterval,weseethatcocaineisaffectingalargeareaofthebrain.Afterthat,thedrug'seffectsbegintowearoff.Atthe9-to10-minutepoint,thehighfeelingisalmostgone.Unlesstheabusertakesmorecocaine,theexperienceisoverinabout20to30minutes.
Scientistsaredoingresearchtofindoutifthestriatumproducesthe"highfeeling"andcontrolsourfeelingsofpleasureandmotivation.Oneofthereasonsscientistsarecuriousaboutspecificareasofthebrainaffectedbydrugssuchascocaineistodeveloptreatmentsforpeoplewhobecomeaddictedtothesedrugs.Scientistshopetofindthemosteffectivewaytochangeanaddictedbrainbacktonormalfunctioning.
4:Long-termeffectsofdrugabuse
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ThisPETscanshowsusthatonceaddictedtoadruglikecocaine,thebrainisaffectedforalong,longtime.Inotherwords,onceaddicted,thebrainisliterallychanged.Let’sseehow...
Inthisimage,thelevelofbrainfunctionisindicatedinyellow.Thetoprowshowsanormal-functioningbrainwithoutdrugs.Youcanseealotofbrainactivity.Inotherwords,thereisalotofyellowcolor.
Themiddlerowshowsacocaineaddict’sbrainafter10dayswithoutanycocaineuseatall.Whatishappeninghere?[Pauseforresponse.]Lessyellowmeanslessnormalactivityoccurringinthebrain-evenafterthecocaineabuserhasabstainedfromthedrugfor10days.
PhotocourtesyofNoraVolkow,Ph.D.VolkowND,HitzemannR,WangG-J,FowlerJS,WolfAP,DeweySL.Long-termfrontalbrainmetabolicchangesincocaineabusers.Synapse11:184-190,1992;VolkowND,FowlerJS,WangG-J,HitzemannR,LoganJ,SchlyerD,DeweyS,WolfAP.DecreaseddopamineD2receptoravailabilityisassociatedwithreducedfrontalmetabolismincocaineabusers.Synapse14:169-177,1993.
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Thethirdrowshowsthesameaddict’sbrainafter100dayswithoutanycocaine.Wecanseealittlemoreyellow,sothereissomeimprovement-morebrainactivity-atthispoint.Buttheaddict’sbrainisstillnotbacktoanormalleveloffunctioning...morethan3monthslater.Scientistsareconcernedthattheremaybeareasinthebrainthatneverfullyrecoverfromdrugabuseandaddiction.
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SectionIII
1:Drugshavelong-termconsequences
Hereisanotherexampleofwhatsciencehasshownusaboutthelong-termeffectsofdrugs.WhatthisPETscanshowsusishowjust10daysofdrugusecanproduceverydramaticandlong-termchangesinthebrainofamonkey.Thedrugintheseimagesisamphetamine,orwhatsomepeoplecall“speed.”Rememberthepreviousimageshoweduswhatthebrainofachroniccocaineabuserlookslike.Thisimageshowsuswhatusingadruglikeamphetaminecandoinonly10daystothebrainofamonkey.
Thisimagealsogivesusabetterideaofwhatmethamphetamine,adrugsimilar
PhotocourtesyofNIDAfromresearchconductedbyMelegaWP,RaleighMJ,StoutDB,LacanC,HuangSC,PhelpsME.Recoveryofstriataldopaminefunctionafteracuteamphetamine-andmethamphetamine-inducedneurotoxicityinthevervetmonkey.BrainRes1997Aug22;766(1-2);113-120.
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instructure,candotothebrain.Methamphetamineuseisbecomingincreasinglypopularincertainareasofthecountry.
Thetoprowshowsus,inwhiteandred,normalbrainactivity.Thesecondrowshowsusthatsamebrain4weeksafterbeinggivenamphetaminefor10days.Thereisadramaticdecreaseinbrainactivity.Thisdecreasedbrainactivitycontinuesforupto1yearafteramphetamineuse.Thesecontinuousbrainchangesoftentriggerotherchangesinsocialandemotionalbehavior,too,includingapossibleincreaseinaggressiveness,feelingsofisolation,anddepression.
2:Thememoryofdrugs
Thisimagedemonstratessomethingreallyamazing-howjustthementionofitemsassociatedwithdrugusemaycauseanaddictto“crave”ordesiredrugs.ThisPETscanispartofascientificstudythatcomparedrecoveringaddicts,whohadstoppedusingcocaine,withpeoplewhohadnohistoryofcocaineuse.The
PhotocourtesyofAnnaRoseChildress,Ph.D.
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studyhopedtodeterminewhatpartsofthebrainareactivatedwhendrugsarecraved.
Forthisstudy,brainscanswereperformedwhilesubjectswatchedtwovideos.Thefirstvideo,anondrugpresentation,showednatureimages-mountains,rivers,animals,flowers,trees.Thesecondvideoshowedcocaineanddrugparaphernalia,suchaspipes,needles,matches,andotheritemsfamiliartoaddicts.
Thisishowthememoryofdrugsworks:Theyellowareaontheupperpartofthesecondimageistheamygdala(a-mig-duh-luh),apartofthebrain’slimbicsystem,whichiscriticalformemoryandresponsibleforevokingemotions.Foranaddict,whenadrugcravingoccurs,theamygdalabecomesactiveandacravingforcocaineistriggered.
Soifit’sthemiddleofthenight,raining,snowing,itdoesn’tmatter.Thiscravingdemandsthedrugimmediately.Rationalthoughtsaredismissedbytheuncontrollabledesirefordrugs.Atthispoint,abasicchangehasoccurredinthebrain.Thepersonisnolongerincontrol.Thischangedbrainmakesitalmostimpossiblefordrugaddictstostaydrug-freewithoutprofessionalhelp.Becauseaddictionisabraindisease.
3:Amessagetoremember
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Wediscussedmanyimportantpointstoday.Twopoints,inparticular,Ihopeyouremember.Oneisthatdrugabuseandaddictionaffecteverysegmentofsociety.That’sallofus.Everyone.Notonepersonisimmunefromthediseaseofaddiction.
Theseimagestodaydemonstratethatthereareobservablechangesinbrainfunctionthattakeplacewhendrugsareused.Wesawthatthebrainsofaddictsaredifferentfromthebrainsofpeoplewhoarenotaddicted.Anditisdifficult,insomecasesimpossible,toreturnthebraintonormal.Scientists,likethosewhoworkattheNationalInstituteonDrugAbuse,areworkingtodeveloptreatmentstohelppeoplewhoareaddictedtodrugs.Buttreatment,likeaddiction,isacomplexissue.
4:Isitworththerisk?
CourtesyofPartnershipforaDrugFreeAmerica.
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Whatpercentageofpeoplewhoexperimentwithdrugswillbecomeaddicted?[Pauseforresponses.]Rightnow,sciencedoesn’thavetheanswertothatquestion.Theeffectsofdrugsonthebrainarestillbeingstudiedandexplored.
Andwhenwetalkaboutdrugs,wearenotjusttalkingaboutcocaineandmarijuanaandamphetaminesandinhalants.Nicotineishighlyaddictivetoo,and,formanypeople,soisalcohol.Forgetthestereotypeofadrugaddicthangingoutonadangerousstreetcorner.Anyonecangethookedondrugs-yourfriends,membersofyourfamily,yourneighbors.
Tryingadrugjustbecauseafriendsaysit’s“cool,”mightcostyoumuchmorethanyoubargainedfor.Soeverypersoninthisroomhastodecideforthemselves:Isitworththerisk?
Thegoodnewsis:Helpisavailable.
5:VisitNIDA
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We’vecoveredalotofgroundtoday.Bynoweveryonehereshouldhaveanideaofwhatdrugsdotoourbrain,buttheinformationwesharedtodayisjustabeginning.There’smuchmoretodiscoverabouthowthebrainworks.Takesometimeonyourowntolearnaboutthissubject.TheInternetisanexcellentplacetostart.
Tolearnmore,checkoutNIDA’shomepageontheWorldWideWebandseewhatyoucanfindoutaboutthelatestdiscoveriesaboutthebrainandhowitrespondstodrugs.
Forscientists,thebrainisunexploredterritorylikethesurfaceofMarsforthePathfinderexpedition.Itismyhopethatsomeofyouwillbecomescientistsinterestedinhowthebrainworks,sothatyoumighthelpusunderstandmoreaboutaddictionandhelpussolvethisproblem.
6:Haveyouchangedyourmind?
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Hereisourlastimage.Aswelookatside-by-sidePETscansofapersonwhohasneverusedcocainecomparedwithacocaineaddict,canyoutellwhichbrainismoreactiveandhealthy?Takeaguess.Yes,thebrainontheleftwithanabundanceofredisthehealthy,activebrain.
Withalittlebitofknowledgeaboutwhatdrugaddictionactuallyis,anyone-notjustneuroscientistsandneurobiologists-canseethechangesinbrainactivitycausedbydrugabuseandaddiction.ThePETscanswe’velookedattodayprovethat.
We’veseenthescientificfacts.We’velearnedthataddictionisabraindisease.Andwe’vealsolearnedthatscientistsaremakinggreatstridesindevelopingtreatmentsforaddiction.Therewillbenomagiccharmtomakeaddictiongoaway.Buteducatedandinformedwiththescientificfactsaboutwhatdrugscandotothebrain,weareeachinabetterpositiontodecidewhetherornottotakedrugsinthefirstplace.Giventhefacts,haveyouchangedyourmind?
PhotocourtesyofNIDA.IfYouChangeYourMind.Studentmagazine.NIHPublicationNo.93-3474,1993.
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