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NIDA. NATIONAL INSTITUTE ON DRUG ABUSE. Drug Abuse & Addiction. Bringing the Full Power of Science to Bear on. Addiction. Medical. Medical. Neurotoxicity AIDS, Cancer Mental illness. NEUROTOXICITY AIDS CANCER MENTAL ILLNESS. DRUGS. Economic. Social. Health care Productivity

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NIDA

NATIONAL INSTITUTE ON DRUG ABUSE

Drug Abuse

& Addiction

Bringing the

Full Power of Science

to Bear on


Addiction

Medical

Medical

Neurotoxicity

AIDS, Cancer

Mental illness

NEUROTOXICITY

AIDS

CANCERMENTAL ILLNESS

DRUGS

Economic

Social

Health care

Productivity

Accidents

Homelessness

Crime

Violence


4 Out of 10 U.S. AIDS Deaths Are Related to Drug Abuse


Estimated economic cost to society from substance abuse and addiction
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 General’s Report, 2004; ONDCP, 2004; Harwood, 2000.


What is addiction addiction is a brain disease
What is Addiction? Addiction:Addiction is A Brain Disease

  • Characterized by compulsive behavior

  • The continued abuse of drugs despite negative consequences

  • A chronic, potentially relapsing disorder



used to be views of drug abuse and addiction.


1-2 Min views of drug abuse and addiction.

3-4

5-6

6-7

7-8

8-9

9-10

10-20

20-30

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.


High views of drug abuse and addiction.

Low

  • Addiction is Like Other Diseases…

    • It is preventable.

    • It is treatable

    • It changes biology.

    • If untreated, it can last a lifetime.

Decreased Heart Metabolism inHeart Disease Patient

Decreased Brain Metabolism

inDrug Abuser

Healthy Brain

Diseased Brain/

Cocaine Abuser

Diseased Heart

Healthy Heart

Research supported by NIDA addresses all of these components of addiction


Addiction Involves Multiple Factors views of drug abuse and addiction.


Addiction Is A Developmental Disease views of drug abuse and addiction.

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.


Why do people take drugs in the first place

Why Do People Take Drugs in The First Place? views of drug abuse and addiction.

To feel better

To lessen:

anxiety

worries

fears

depression

hopelessness

To feel good

To have novel:

feelings

sensations

experiences

AND

to share them


Why Do People views of drug abuse and addiction.

Abuse Drugs?

Drugs of Abuse

Engage Systems in

the Motivationand

Pleasure Pathways

of the Brain


Dopamine
Dopamine views of drug abuse and addiction.

motivation

Reward& well-being

addiction

movement


Drugs are imposters of brain messages
Drugs are “Imposters” of views of drug abuse and addiction.Brain Messages


Dendrites views of drug abuse and addiction.

Axon

Cell body

(the cell’s life

Terminal

support center)

branches of

axon

Neuronal Impulse

Myelin

sheath

The Neuron: How the Brain’s Messaging System Works

Donald Bliss, MAPB, Medical Illustration


dopamine views of drug abuse and addiction.

transporters


15 views of drug abuse and addiction.

10

Copulation Frequency

5

0

Mounts

1

2

3

4

5

6

7

8

Intromissions

Ejaculations

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.


Effects of Drugs on Dopamine Release views of drug abuse and addiction.

COCAINE

AMPHETAMINE

Accumbens

1100

Accumbens

400

1000

900

DA

800

DA

300

DOPAC

700

DOPAC

HVA

% of Basal Release

HVA

600

% of Basal Release

500

200

400

300

100

200

100

0

0

0

1

2

3

4

5 hr

Time After Amphetamine

Time After Cocaine

NICOTINE

MORPHINE

250

Accumbens

250

Dose (mg/kg)

200

Accumbens

0.5

200

Caudate

1.0

2.5

150

% of Basal Release

10

150

% of Basal Release

100

0

1

2

3 hr

100

0

1

2

3

4

5 hr

0

0

0

1

2

3

4

5hr

Time After Nicotine

Time After Morphine

Di Chiara and Imperato, PNAS, 1988


But Dopamine is only Part of the Story views of drug abuse and addiction.

Other neurotransmitter systems are

also affected:

  • Serotonin: mood regulation, sleep

  • Glutamate: learning and memory


Science Has Generated Much views of drug abuse and addiction.

Evidence Showing That…

Prolonged Drug Use Changes

the Brain In Fundamental

and Long-Lasting Ways


AND… views of drug abuse and addiction.

We Have Evidence That

These Changes Can Be Both

Structuraland Functional


Structurally views of drug abuse and addiction.…

NAC

Amph

Saline

Source: Robinson & Kolb, Journal of Neuroscience, Volume: 1997


Functionally… views of drug abuse and addiction.

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


2.0 views of drug abuse and addiction.

1.8

1.6

1.4

1.2

Dopamine Transporter

Time Gait

Bmax/Kd

1.0

7

8

9

10

11

12

13

(seconds)

2.0

1.8

1.6

1.4

1.2

Delayed Recall

(words remembered)

1.0

16

14

12

10

8

6

4

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.

Volkow et al., Am. J. Psychiatry, 2001.

Methamphetamine Abuser


Implication: views of drug abuse and addiction.

Brain changes resulting from

prolonged use of drugs

may compromise

mental and motor functions


Circuits Involved In Drug Abuse and Addiction views of drug abuse and addiction.

All of these must be considered in developing strategies to effectively treat addiction


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