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Substance Use and the Brain. Susan Tapert, Ph.D. Alcohol Medical Scholars Program. Substance Use and the Brain. How is the brain affected long-term? Alcohol Marijuana Stimulants What can we do about this?. Substance Use and the Brain. How is the brain affected long-term? Alcohol

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substance use and the brain

Substance Use and the Brain

Susan Tapert, Ph.D.

Alcohol Medical Scholars Program

substance use and the brain2
Substance Use and the Brain
  • How is the brain affected long-term?
    • Alcohol
    • Marijuana
    • Stimulants
  • What can we do about this?

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substance use and the brain3
Substance Use and the Brain
  • How is the brain affected long-term?
    • Alcohol
    • Marijuana
    • Stimulants
  • What can we do about this?

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drinking thinking
Drinking & Thinking
  • ~50% alcoholic adults show some problems:
    • Spatial skills
    • Planning
    • Learning and memory
  • IQ and language OK
  • Recovery
    • Much in 1st month
    • More in 1st year if sober

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alcohol and sleep
Problems when using and when sober

Falling asleep

Total sleep

Sleep quality

Affects memory and thinking

Feeling unrested increases relapse risk

Alcohol and Sleep

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brain structure
Brain Structure
  • Magnetic resonance imaging (MRI)
    • Safe
    • No injections
    • Shows small brain parts

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shrinkage ventricles
Shrinkage: Ventricles

Non-alcoholic

Alcoholic

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shrinkage cerebellum
Shrinkage: Cerebellum

Healthy Control

Alcoholic

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brain function
Brain Function
  • Functional magnetic resonance imaging (fMRI)
    • Safe
    • Movies of brain activity
    • Good resolution

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brain function10

Side View

Brain Function

Alcoholics vs. Healthy Controls

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volume recovery
Volume Recovery

2 Years Later

During Treatment

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substance use and the brain12
Substance Use and the Brain
  • How is the brain affected long-term?
    • Alcohol
    • Marijuana
    • Stimulants
  • What can we do about this?

Copyright AMSP

marijuana thinking
Marijuana & Thinking
  • Modest problems in very heavy users
    • Learning and memory
    • Sustained attention
    • Impulsivity
  • Most recover after 1 month abstinent

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marijuana brain
Marijuana & Brain
  • No evidence of brain shrinkage
  • Altered brain waves related to attention
  •  brain blood flow
  •  brain response while learning

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substance use and the brain15
Substance Use and the Brain
  • How is the brain affected long-term?
    • Alcohol
    • Marijuana
    • Stimulants
  • What can we do about this?

Copyright AMSP

stimulants thinking
Stimulants &Thinking
  • Motor skills
  • Planning
  • Switching tasks
  • Decision making
  • Working memory
  • Impulsivity
  • Learning and memory

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stimulants brain structure
Stimulants & Brain Structure
  • Volume reductions:
    • Cingulate
    • Hippocampus
    • No overall gray matter changes
  • Volume increase:
    • Subcortical areas

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stimulants blood flow

High blood flow

Low blood flow

Stimulants & Blood Flow

Cocaine-dependent

Healthy Control

Gottschalk, 2001, Am J Psychiatry

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blood flow recovery
Blood Flow Recovery

High blood flow

Non users

Cocaine users, 10 days sober

Low blood flow

Cocaine Users, 100 days sober

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substance use and brain
Substance Use and Brain

Summary:

  • Thinking problems
  • Tissue loss
  • Decreased blood flow
  • Altered brain response to task
  • Much recovery with abstinence

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slide21

Substance Use and the Brain

  • How is the brain affected?
  • What can we do about this?

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implications
Implications
  • Inform patients
  • Develop better treatments

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