what I’d like to talk about today is the
biology of people doing purses clearly
as we think about building community the
community is under assault from the
other day I could get lots of slides
about my participants but the bottom
line to remember is that the opioid
crisis is the number one killer of
people under the age of 50 and last year
when people die drug overdose than from
cars or guns
come on so we have a problem to address
and one of those problems is that
community
unfortunately believes that that drug
engage through the world and that’s what
I’d like to address a bit a very simple
take-home lesson addiction is a brain
disease and it should be treated like a
disease not by definition it’s a chronic
relapsing disease a brain reward and
I’ll share with you some basic ideas
about the brain reward system but it’s
also a defect of motivation and memory
and circuitry that’s characterized by
drug craving and seeking and useless
fighting adverse outcomes in spite of
losing primitive
it’s a disease the reward pathways one
of the most primitive in development all
animals have a basic reward system that
pays attention to those things in your
environment and your life that are good
for the species that we enforce our
propagation so things like food and
water and ship insects are all
activating the same pathway in our brain
we notice structure to those athletes
we’ve characterized them they are
involved in monitoring they’re involved
in monitoring the environment paying
attention to it
remembering where we had that
pleasurable feeling so that we can do it
again and it’s involved in emotion
attention savings to the event so that
it has an impact for us the brain
structures are really well characterized
there are things like the mental
mental earlier you need to let the
nucleus accumbens the medial prefrontal
cortex but that’s the science so that we
understand what’s going awry and we have
ways to address that and we’re trying to
develop new ways addiction is a disease
of the brain it’s a biological problem
it’s not an immoral thing you don’t just
tell me addict
oh quit that heroin problem instead we
have to help those individuals
recognizing that it’s a disease we have
to bring all of the tools in our
armamentarium against helping that
individual overcome a change in their
brain that has set them up for continued
abuse community doesn’t recognize that
in many cases it’s a biological problem
might even I’ve been studying addiction
process now for over twenty five years
we’ve done a handle on some of the
things that are changing in the brain
and the brain is changing
it starts with casual use it might start
with the prescription of a develop an
opiate agonist for treating pain but
then the drug becomes abused it’s not
taken now to alleviate pain went away
Connie and the brain starts changing is
we’ll see in a minute and that leads to
dependence where you’re physically
depend
on board this is a pharmacologically
induced imprint you are changing the
brain and then perhaps are fortunate
enough for an intervention as we heard
earlier and you become clean and sober
and you end up in the wrong environment
where you’re getting environmental cues
that remind you of the problem remind
you of the joy of taking the drug or
stress comes into their life the loss of
a loved one divorce if you remember you
can escape that obtained by turning back
to the drug and then of course our
psychosocial effectiveness the flames
are up privately to relapse and in our
opinion that’s the main problem we can
incarcerate somebody we can intervene
with someone we can get them clean and
sober but made any bad art and so for
the last 15 or 20 years we’ve been
studying this persistent molecular
nutrient that occurs in the brain and
sets the individual up for relapse those
changes last the analogies for very long
periods of time of abstinence and that’s
why an alcoholic will frequently tell me
I’m an alcoholic
even though they’ve been clean and sober
for a long time because they know
they’re at risk for relapse falling back
into the darkness that is addiction
these data come from a friend of mine at
Wake Forest University Jeff Martin who
has a marvelous or having marvelous
model for getting brats to
self-administer heroin through an
intravenous port and they would perform
complex tasks to get Harry but in this
experiment what he did was to provide
them with unlimited access every day in
successive days and what you see is what
we observe in humans and that’s that the
dose escalates with time with each day’s
opportunity to select to self administer
of heroin but the brain is changing the
body is changing by driving our
attention to the y-axis
on the left hand side of the figure
that’s a logarithmic scale by the end of
30 days of self administration these
rats are taking 100 times more than they
took at the beginning in fact at 30 days
they’re tasting and taking doses of
drugs that would have killed that in 1
day 1 and hence we put the series
problem that the recovering manic when
they relapse with error or opiates and
gentlemen they’ll go back to taking what
they were taking
and we end up with a lethal overdose
you
biology of people doing purses clearly
as we think about building community the
community is under assault from the
other day I could get lots of slides
about my participants but the bottom
line to remember is that the opioid
crisis is the number one killer of
people under the age of 50 and last year
when people die drug overdose than from
cars or guns
come on so we have a problem to address
and one of those problems is that
community
unfortunately believes that that drug
engage through the world and that’s what
I’d like to address a bit a very simple
take-home lesson addiction is a brain
disease and it should be treated like a
disease not by definition it’s a chronic
relapsing disease a brain reward and
I’ll share with you some basic ideas
about the brain reward system but it’s
also a defect of motivation and memory
and circuitry that’s characterized by
drug craving and seeking and useless
fighting adverse outcomes in spite of
losing primitive
it’s a disease the reward pathways one
of the most primitive in development all
animals have a basic reward system that
pays attention to those things in your
environment and your life that are good
for the species that we enforce our
propagation so things like food and
water and ship insects are all
activating the same pathway in our brain
we notice structure to those athletes
we’ve characterized them they are
involved in monitoring they’re involved
in monitoring the environment paying
attention to it
remembering where we had that
pleasurable feeling so that we can do it
again and it’s involved in emotion
attention savings to the event so that
it has an impact for us the brain
structures are really well characterized
there are things like the mental
mental earlier you need to let the
nucleus accumbens the medial prefrontal
cortex but that’s the science so that we
understand what’s going awry and we have
ways to address that and we’re trying to
develop new ways addiction is a disease
of the brain it’s a biological problem
it’s not an immoral thing you don’t just
tell me addict
oh quit that heroin problem instead we
have to help those individuals
recognizing that it’s a disease we have
to bring all of the tools in our
armamentarium against helping that
individual overcome a change in their
brain that has set them up for continued
abuse community doesn’t recognize that
in many cases it’s a biological problem
might even I’ve been studying addiction
process now for over twenty five years
we’ve done a handle on some of the
things that are changing in the brain
and the brain is changing
it starts with casual use it might start
with the prescription of a develop an
opiate agonist for treating pain but
then the drug becomes abused it’s not
taken now to alleviate pain went away
Connie and the brain starts changing is
we’ll see in a minute and that leads to
dependence where you’re physically
depend
on board this is a pharmacologically
induced imprint you are changing the
brain and then perhaps are fortunate
enough for an intervention as we heard
earlier and you become clean and sober
and you end up in the wrong environment
where you’re getting environmental cues
that remind you of the problem remind
you of the joy of taking the drug or
stress comes into their life the loss of
a loved one divorce if you remember you
can escape that obtained by turning back
to the drug and then of course our
psychosocial effectiveness the flames
are up privately to relapse and in our
opinion that’s the main problem we can
incarcerate somebody we can intervene
with someone we can get them clean and
sober but made any bad art and so for
the last 15 or 20 years we’ve been
studying this persistent molecular
nutrient that occurs in the brain and
sets the individual up for relapse those
changes last the analogies for very long
periods of time of abstinence and that’s
why an alcoholic will frequently tell me
I’m an alcoholic
even though they’ve been clean and sober
for a long time because they know
they’re at risk for relapse falling back
into the darkness that is addiction
these data come from a friend of mine at
Wake Forest University Jeff Martin who
has a marvelous or having marvelous
model for getting brats to
self-administer heroin through an
intravenous port and they would perform
complex tasks to get Harry but in this
experiment what he did was to provide
them with unlimited access every day in
successive days and what you see is what
we observe in humans and that’s that the
dose escalates with time with each day’s
opportunity to select to self administer
of heroin but the brain is changing the
body is changing by driving our
attention to the y-axis
on the left hand side of the figure
that’s a logarithmic scale by the end of
30 days of self administration these
rats are taking 100 times more than they
took at the beginning in fact at 30 days
they’re tasting and taking doses of
drugs that would have killed that in 1
day 1 and hence we put the series
problem that the recovering manic when
they relapse with error or opiates and
gentlemen they’ll go back to taking what
they were taking
and we end up with a lethal overdose
you
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