Chemical Dependency, Neurobiology, and Addiction ARCO 502 … · 2019-08-20 · Chemical...

Chemical Dependency, Neurobiology, and Addiction 1

Light University Online

Chemical Dependency, Neurobiology, and Addiction

ARCO 502

Module 1



Module One

Table of Contents

Biological Aspects of Chemical Dependency & Addiction Michael Lyles, M.D. ....................................................................................................................................................... 3

CHEMICAL ADDICTION & ITS BIOLOGICAL ASPECTS



Description Dr. Michael Lyles describes the neurological factors and processes that occur in the brain during addiction and chemical dependency. He describes the complications of substance abuse and the protective variables that deter drug use and eventual addiction. Dr. Lyles also provides extensive attention to the actual biological and physiological responses to various substances.

Learning Objectives:

1. Describe the neurological complications associated with substance abuse.

2. Explain the relationship between substances of abuse and the reward

system in the brain.

3. Identify the functions of the key parts of the brain in relation to each element’s role in addiction.

Biological Aspects of Chemical Dependency & Addiction

VIDEO

Michael Lyle, M.D.



I. Prevalence of Addiction in America

A. 12.7 Million People have used an Illegal Drug in the Past Month B. 10 Million are Casual Users

C. 2.7 Million are Addicts D. 30-40 Million People in the Past Year E. “For I know that in me (that is my flesh) nothing good dwells; for to will is

present with me, but how to perform what is good I do not find. For the good that I will to do, I do not do; but the evil I will not to do, that I practice.”

Romans 7:18-19

F. “For I delight in the law of God according to the inward man. But I see another law in my members, warring against the law of my mind, and bringing me into captivity the law of sin which is in my members.”

Romans 7:22-23

G. “O Wretched man that I am! Who will deliver me from this body of death?” Romans 7:24



II. Why Do People Use Drugs?

A. To Feel Good

B. To Self-Medicate/Numb Feelings

C. To Perform Better

D. To Fit In

E. Curiosity

III. Risk Factors for Drug Abuse

A. Genetics (40-60% of Vulnerability)

B. Family Relationships

C. Drug using Peers or Friends

D. Environmental Stress

E. Poor Social Skills



F. Poor Spiritual “Skills”

G. Early Use

H. Method of Delivery

I. Past Experiences with Drug Use

IV. Protective Variables

A. Impulse Control & Self-Discipline

B. Positive Family Relationships

C. Supportive Parental Supervision

D. Positive Self-Esteem

E. Positive Peers



F. Values (Biblical Input)

G. Internalized Spiritual Relationship with God

V. Complications of Drug Abuse

A. Relapse/Overdose

B. Depression/Suicide

C. Increase in Cancer Rates

D. IV Drugs Hepatitis, Thrombophlebitis, Respiratory Infections/Blood Clots, Bacterial Endocarditis, HIV Infection

E. Stroke, Heart Attacks

F. Legal, Relational, Financial, Vocational Difficulties



G. Spiritual Separation Behold, the Lord’s hand is not shortened, that it cannot save; nor his ear heavy,

that it cannot hear. But your iniquities have separated you from your God; and your sins have hidden His face from you, so that He will not hear.

Isaiah 59:1-2

VII. Terminology

A. Addiction – A compulsive or obsessive drug usage with increased risk for relapse after stopping.

B. Tolerance – Reduced effect of a drug following repeated usage. C. Withdrawal – Either psychological or physiological reactions occurring when

the drug is stopped or reduced.

D. Cross-Tolerance/Dependency – The ability of one drug to suppress the withdrawal effects of another drug.

E. Reinforcement – The ability of the drug to promote repeated self-administration due to the feelings of pleasure one gets from taking the drug.



F. Relapse – The recurrence of the original symptoms after effective treatment has been suspended.

G. Substance Abuse (DSM IV) – Maladaptive Pattern of Drug Use within 12 Month Period with Three of the Following:

Failure to fulfill responsibilities

Using when physically dangerous

Legal problems related to use

Persistent social or interpersonal problems

Tolerance

Withdrawal

Increasing amounts used or longer periods of time than planned

Desire or efforts to reduce or stop use

Increased time spent obtaining, using or recovering from the drug

Activities of life given up or reduced

Continued despite knowledge of consequences



VII. Biology of the Brain and Addiction

A. Brain Terminology Neurotransmitters (6)

Serotonin

Dopamine

Endorphins

Norepinephrine

GABA

Synaptic Clefts (5)

Post-synaptic receptors (7)

Neuroplasticity: The system can change over time in response to drugs or stress

B. Pleasure/Reward System

Ventral Tegmental Area Nucleus Accumbens

Amygdala

Hippocampus

Locus Ceruleus

Medial Fascicular Bundle

Prefrontal Cortex



C. Ventral Tegmental Area Top of the brainstem

Center of the brain dopamine system

Also influenced by endorphins (opiate type)

Pleasurable activities stimulate the VTA to make dopamine in mild to moderate

amounts that the brain can handle (35 60 mph)

The dopamine is shipped to the nucleus accumbens via the medial fascicular bundle

D. Nucleus Accumbens (The Ventral Striatum)

Center of pleasure and reward: Natural highs felt when 35 60mph Drugs of Abuse highjack the system and speed up the Nucleus Accumbens to 100

mph

Stimulates the Nucleus Accumbens excessively (excitotoxicity) and causes “neuroplastic” changes with repeated exposures

Serotonin/GABA (inhibition/braking) are decreased

All accelerator with no brakes/steering

E. Hippocampus

Located in the temporal lobes Have two of them

Foundation of memory formation

The details and context of the memories

Works hand in hand with the amygdala



F. Amygdala

Center of emotional memory/learning Located in the temporal lobes

Involved in fear and pleasure

Imparts emotional “coloring” to memories, perceptions and behaviors

This “coloring” helps to “consolidate” memories and make them permanent

Reinforcement -- “It’s cool to go 100 mph; let’s do that again!”

G. Locus Ceruleus

Located in the brainstem Alarm center that goes off in response to stress and panic

Norepinephrine rich

Interacts with the entire brain/spinal cord

Acts like a spoiled child if it does not get its way – can generate a huge “fit” and

send 911 calls all over the body (part of the fight or flight response)

Reinforcement -- “It’s cool to go 100 mph; let’s do that again!”

H. Prefrontal Cortex

Center of executive functions Planning, motivation, decision-making, goals, consequences of actions, values

Connects to the VTA, nucleus accumbens

Tells it to stop it, this is not good



I. Normal Reward System

Pleasurable activity stimulates the VTA which stimulates the nucleus accumbens, which says this is great.

The amygdala and hippocampus remember what made this so great, so that we

can do it again later. The greater the pleasure, the stronger the memory.

The frontal lobe says enough is enough, you need to stop and resume the rest of your life.

J. Reward System with Drug-Mediated Pleasure

The VTA, nucleus accumbens, amygdala, and hippocampus are “stimulated to death” very quickly and for a brief period of time. With repeated exposures, the system loses its calibration and thinks the dopamine high is normal acquired drive.

The system really likes (thinks it needs) this and wants more now! If dopamine

fix is not given, the locus ceruleus goes crazy and calls 911 on everybody craving.

Serotonin and GABA are turned off and impulse controls are lost.

The frontal lobe tries to tell it to stop but the system is on autopilot. If the craving is strong enough, it will not stop until the drug is obtained.

This is what addiction looks like: The frontal lobe has lost control and the inmates are running the show.



K. Drugs of Abuse and Reward System

Nucleus accumbens directly stimulated by cocaine, amphetamines, opiates, and marijuana

VTA directly stimulated by alcohol, opiates, and nicotine

Locus ceruleus stimulated by nicotine, opiates, and alcohol

Hippocampus affected by nicotine, marijuana, and alcohol

L. Inmate Brain’s Natural “Pharmacy”

Endorphins (morphine, heroin, opioids) Anandamide (marijuana)

Acetylcholine (nicotine)

Dopamine (cocaine, amphetamines)

GABA (valium, xanax)



VIII. Addiction as a Brain Disease

A. Drugs of abuse mimic naturally occurring substances of the brain

B. Highjacks the systems and changes the hardwiring of the brain (neuroplasticity)

C. Creates “acquired drives” that fool the brain into thinking that drugs are needed like food, air and water compulsive craving/drug seeking

D. Negatively affects areas critical to judgment, decision-making, learning, and memory

E. Some of these changes can be permanent



Study Questions

1. According to Dr. Lyles, why do people use drugs?

2. Describe the primary risk factors for drug abuse.

3. Describe the complications of drug abuse.

4. Describe the neurological process of rewards and the difficulties in the system that occur following the introduction of substances of abuse.

5. Why does Dr. Lyles consider addiction to be a brain disease?

Chemical Dependency, Neurobiology, and Addiction ARCO 502 … · 2019-08-20 · Chemical...

Documents

Transcript of Chemical Dependency, Neurobiology, and Addiction ARCO 502 … · 2019-08-20 · Chemical...