the adolescent brain - hfm prevention council … · impact: drugs and alcohol the adolescent brain...
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Impact: Drugs and Alcohol
THE ADOLESCENT BRAIN
HIGH RISK BEHAVIOR
AND ADDICTION
Michael Nerney and Associates
P.O. Box 93
Long Lake, NY, 12847-0093
Discoveries from Neuroimaging
fMRI
Diffusion Spectrum Imaging
SQUID Magnetometry
MEG Magnetoencephalography
NEW RESEARCH ON THE
ADOLESCENT BRAIN
CAT
PET
TDI
BRAIN IMAGING SYSTEMS
Genetics
Environment
Experiences
WHO IS AT RISK?
Codeine converted to Morphine
Metabolic function
Poor
Effective
Moderate
Ultra fast
P450 CYP2D6
Genetics
Environment
Exposure
A DISEASE OF THE BRAIN
WHO IS AT RISK?
Chemical Trigger for Puberty
Kisspeptin
Signal to Endocrine System
Production of New Hormones
Male/Female
DEVELOPMENTAL CHANGES
Pituitary Growth Hormone (PGH)
Physical Growth
Skeletal
Muscular
Head and Face
Self Esteem drop Spotlight phenomenon
ADOLESCENT HORMONES
Testosterone
Primary and Secondary Sex Characteristics
Estrogen
Primary and Secondary Sex Characteristics
ADOLESCENT HORMONES, CONT.
200 Billion Cells
Grey Matter
White Matter
Migration and Activation
Cell Migration
Benchmarks
WHY IS THIS BRAIN AT RISK?
THE BRAIN
Emotional Intensity
2 to 4 Times
More Frequent Change
Male/Female
Legitimate/Normal
WHY IS THIS BRAIN AT RISK?
CONT.
Emotional Intensity
Mirror, Mirror on the wall
A/A sites
Male/Female Brain Differences
WHY IS THIS BRAIN AT RISK?
CONT.
WHY IS THIS BRAIN AT RISK?
Emotional Intensity
What do I think?
How do I feel?
Risk/Reward in Change of
Appearance
Depression
Serotonin Synthesis
WHY IS THIS BRAIN AT RISK?
CONT.
GENDER DIFFERENCES
Problem Solving
Social/Emotional Crisis
The Crisis Chemical
THP
Emotional Support Essential
WHY IS THIS BRAIN AT RISK?
CONT.
Emotional Stressors
Social Bonding
Negative Emotions
Boredom
Money
RISK FACTORS, CONT.
Males
Older male siblings
Females
Early puberty
RISK FACTORS, CONT.
Family Dysfunction
#1 Risk Factor
Emotional and Learning
Disorders
School Failure
Social Isolation
RISK FACTORS
Seek drugs for:
Create positive effect in brain chemistry
Dopamine release in reward sites
Suppress negative emotions
Activation in specific sites
MOTIVATION FOR DRUG USE
Risk Taking
New Sites of Activity
Influence of Peers
Male/Female
WHY IS THIS BRAIN AT RISK?
CONT.
I SECOND THAT EMOTION
Social Bonding and Connecting
You got to have friends.
Like and Admire
CULTURAL AND ENVIRONMENTAL
INFLUENCES
Role Models
TV
Social Media
RISK TAKING
Kylie Jenner Challenge
RISK TAKING
RISKY BUSINESS
Alcohol treats
Pocket Shots
ALCOHOL: NEW PRODUCTS
Malt Beverages
Malt brewed beer
Sugars
Flavors
20 – 24 ounces
7 – 13% alcohol
ALCOHOL: NEW PRODUCTS, CONT.
IMPULSE CONTROL
PRDM2Down regulated
Disrupts impulse control
ECM-extracellular matrix
PNN-perineuronal nets
ALCOHOL IN COMBINATION WITH OTHER
DRUGS
Alcohol and Liver function
Liver Pathways
P 450
Busy signal, come back later
Enhance Primary Drug Effect
Boost the initial drug
Slow metabolism
Grapefruit juice
DRUG COMBINATIONS
Reduce Negative Side Effects
Minimize unpleasant effects
DRUG COMBINATIONS
Alleviate Withdrawal
Mask the withdrawal symptoms
Two separate systems
One system suppression
DRUG COMBINATIONS
ALCOHOL AND COCAINE
New Compound-Cocaethlyene
5 Times ½ Life
Cardiac arrest
ALCOHOL AND MARIJUANA
Popular combination
Cross fade
Which one first
Toxic effect
Impact on Brain
Two systems activated
Stimulatory – caffeine
Biphasic – alcohol
Harvard University study
“Wide Awake Drunk”
ALCOHOL AND CAFFEINE
Physical
Energized
Uncoordinated
30% drop in glucose uptake in motor cortex
30% drop in glucose uptake in visual cortex
Slower reaction time
ALCOHOL AND CAFFEINE: RISK FACTORS
High risk when operating any moving vehicle
Auto/motorcycle
32% of all crashes alcohol-related
Boat
60% of fatalities alcohol-related
Bike/skateboard
High risk:
Swimming
Heights
Parties
ALCOHOL AND CAFFEINE: RISK FACTORS
Behavioral
Sense of competence
Aggressive social interactions
Twice as likely to suffer physical injury
Twice as likely to get in fights
Twice as likely to be either a victim or a perpetrator of
sexual assault
ALCOHOL AND CAFFEINE: RISK
FACTORS, CONT.
ALCOHOL AND HEROIN
Robo-shots
Dextromethorphan
Opioid cough suppressant
Plus alcohol
Rapid and powerful intoxication
Motor control
Impulse control
Delusional
ALCOHOL: COMBINATIONS
Oxycontin
Vicodin
Roxanol
Opana
ALCOHOL AND
PRESCRIPTION PAIN MEDICATIONS
ALCOHOL AND NICOTINE
Reciprocal enhancement
By the numbers
Past and Present
Cancer and Cardiac
Duke University study
NMDA pathways
Adult brain
Calming effect
Adolescent brain
Biphasic – excitatory effect
It’s a party!
ALCOHOL: IMPACT ON ADOLESCENT
BRAIN
10% Loss of Volume in Prefrontal Cortex
Executive Function
Learning
Reasoning
LONG TERM OUTCOMES OF
UNDERAGE DRINKING AND DRUG ABUSE
10% Loss of Volume in Hippocampus
Memory
Motivation
Social Behaviors
LONG TERM OUTCOMES
BY THE NUMBERS
Drug Overdose fatalities in the US
152 per day 64,404 per year
Alcohol fatalities in the US.
241 per day 88,000 per year
ALCOHOL AND BAD BEHAVIORS
Homicide
Assault
Suicide
Males
A DAY AT THE BEACH
Spring, Summer, and Fall
Open water drownings
Male /Female
HIGH RISK
Driving
Swimming
Falls
Burns
Highest Risk for Females
Second Location
More bad outcomes
THE CABIN IN THE WOODS
NATIONAL CANCER INSTITUTE
Skin, Prostate, Pancreas, Breast, Liver,
Colon, Larynx, Esophagus
Dose Related
Cause Unknown
ALCOHOL RISK FACTORS
Age
Gender
Exposure
Amount
Medical Staff
Parents
School
Law Enforcement
PREVENTION
Unknowns
Cuts
Potency
HEROIN
Price
As low as $12
ON THE STREET
Routes of Administration
Snorting
Smoking
Injecting
IV, SC, IM
ROUTE OF ADMINISTRATION
Addiction
Infection
Overdose
RISK FACTORS
ROUTE OF ADMINISTRATION
MARIJUANA MARKETING: IT’S GOOD
FOR YOU
Lung function Joints, blunts, pipes, bongs
Vaporizers
Unknown herbal products
Damiana
Yerba Mate
Loaded Blunts Herbals plus smokable:
Marijuana
Heroin, H-Bomb
Cocaine, Coco Puffs
Methamphetamine, M&Ms
Ketamine, Klickums
Embalming Fluid, Water
MARIJUANA SUBSTITUTES:
RISKS
Physical
Mild mental stimulation
Body relaxation
Social/Emotional
Relaxation
Laughter
Behavioral
Disconnected
MARIJUANA SUBSTITUTES:
EFFECTS
Addiction
Anandamide influence
High potency – more activity in CB1 and CB2 sites
May lead to dependency and addiction
Tolerance
Withdrawal
Compulsion
Loss of Control
Continued Use Despite Consequences
MARIJUANA SYNTHETICS:
SIGNIFICANT RISKS
Marijuana candies
NEW PRODUCTS
Butane Hash Oil
Amber, Shatter, Ear Wax
NEW PRODUCTS: DABBING
Internalize new skills
Neural pathways and chemistry
How to learn
How to manage emotions
How to behave
SOCIAL, EMOTIONAL COGNITIVE
DEVICES
Brain Changes Related to Substance Abuse
Reward System Shutdown
Systemic Chemical Change
CREB
Embedded Emotional Memory
New Protein Activity
PKMzeta
CONCERNS
A Work in Progress
Stages of Adolescent Development
Emerging Adult Brain
The Long and Winding Road
WHY IS THIS BRAIN AT RISK?
CONT.
1. Reliability
2. Predictability
3. Faith
COMPONENTS OF TRUST
EFFECTIVE LANGUAGE FOR RISK
ASSESSMENT
Immediate
Social/EmotionalPhysical Appearance
Impact on Others
Validate Emotions
Social Bonding
Risk-Taking Opportunities
Crisis Support
Early Intervention
WRAP UP
Drug and Alcohol Use
Medicate for Feelings
Limited Practice Skills
No Life Skills
Social/Emotional
Relationship
Adult Brain
Less Fire Power
Harder Work
HIGH RISK BEHAVIORS