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Neuroscience in Prevention,
Treatment and Recovery
Carrie McKinley
University of Missouri - Columbia
My goals for this presentation
•To provide a basic understanding of the neuroscience of addiction
•To give insight on how neural processes manifest themselves
physically
•To explain the neurologically reinforcing properties of drugs of
abuse
First: Reinforcing Properties of Drugs
• Our brains are programmed to have certain neurological responses in order to get us
through every day and to teach us what is good for us.
•Neurologically many things, including drugs, can be positively or negatively reinforcing.
Positive reinforcement
Negative Reinforcement
• Occurs naturally when we are
rewarded with something
positive for a behavior or action.
• Example: Study hard and get a
good grade
• Drugs of abuse do the same thing
• Example: Snort cocaine and feel
good
• Also occurs naturally when we do
something and it takes away
something bad
• Example: Eating to take away
hunger
• Drugs of abuse also do this
• Example: Drinking alcohol to take
away anxiety
An introduction
to neuroscience
• Our brain is made up of
millions of neurons.
• These neurons serve
special functions
depending on their
location in the brain.
• Neurons communicate
using chemicals called
neurotransmitters
• There are three major
neurotransmitters related
to drug abuse
Dopamine
GABA
Glutamate
Neurotransmitter
manipulation
• All drugs (THC, alcohol,
Cocaine, Meth, Heroin) have
an effect on the
neurotransmitter dopamine.
• All increase the amount of
dopamine in the synapse
• This increase in dopamine
leads to the pleasurable
effects associated with most
drugs.
• Repeated increases in
dopamine levels lead to
compensation by neurons.
Compensation by neurons
• When dopamine levels begin to neutralize the individual taking the
drug begins to “lose” the high they experienced
• If the individual chooses to use again then the dopamine level returns
to being increased at the synapse
• When an individual does this repeatedly, as with addiction, our
neurons begin to compensate for the increased levels of dopamine.
• Eventually the neurons production of dopamine gets altered as the
neurons adapt to having constant high levels of dopamine in the
synapse
• There’s a down regulation of the amount of receptors on neurons to
try and compensate for the amount of dopamine in the synapse
• This results in tolerance and individuals using large quantities to get
the same “effect”
Brain
pathways
• Groups of neurons form
different pathways in our
brain
• Drugs of abuse highjack
the neurotransmitters in
these pathways of the
human brain
• Every drug effects
slightly different systems.
• It is the manipulation of
the neurotransmitters
and neurons of these
pathways that leads to a
lot of the behaviors
associated with drug
addiction.
Behavioral manifestations of neural changes
• A result of these neural changes in the brain and dopamine
pathways can be seen in conditioned place preference.
• When an animal receives a dose of a drug in an environment and a
placebo in another environment, the animal will chose to spend
more time in the environment it received the drug in.
• The opposite is true when an animal
receives an adverse stimulus (shock) in one
environment, the animal will spend less
time where they experienced the adverse
stimulus.
• So then, how can we apply this to initial prevention and relapse
prevention?
Bean bag activity!
Like Riding a Bike:
Neuroscience in
Prevention, Treatment and Recovery
ACT Missouri Prevention Conference
Missouri Champions of Prevention
December 4, 2012
Lodge of the Four Seasons, Lake of the Ozarks
Heather Harlan, Phoenix Programs, Inc.
Certified Reciprocal Prevention Specialist
Carrie McKinley, University of Missouri Cognitive Neuroscience
Research/Center for Translational Neuroscience
Learning Objectives
• Why adolescent brains are more vulnerable to
addiction
• How substance use/abuse disrupts acquisition of
skill sets necessary for adult function
• How evidence-based prevention relates to teen
brains and protective factors for substance
use/abuse
What do prevention, treatment and
recovery have in common?
?
??
?
?
12
Of course!!!!!!!!!!
THAT makes
sense!
13
Substance use disorders as well as
prevention, treatment and recovery
ALL made possible through
reinforcers.
14
“Neuroscience for Dummies”—me
Reward pathways= Roads in your brain
15
Human brain growing well in the mid-20’s
Ages 5
20
Blue represents maturing areas of the brain
Blue represents maturing portion of the brain.
16
90% of
addictions
begin during
adolescence.
Dr. Michael Dennis
Chestnut Health
Systems
Illustration source:
NIDA
Age of first use matters
Youth who begin drinking before age 15
are 4-5 times more likely to become
alcohol dependent than those who
wait until they are 21.
--PIRE
(Pacific Institute on Research and Development)
18
We know. . . .
. . . Immature brains are more at risk.
BUT . . .
What’s
happening
neurologically?
Think of the immature human brain as someone
who is deciding where to build roads.
Lights in the distance draw us on.
“Where should I go?”
“What actions/behaviors are advantageous to
me?”
A chemical reward in the brain tells us what
actions/behaviors we should repeat and learn.
Ordinary rewards we receive over and over teach
us how to cope with life. Like flashlights on the
dark horizon:
Hungry-----eat
Thirsty------drink
Tired--------companionship
Sad----------find comfort
Better grades------study
Bored-------rewarding pastimes
Broke-------work
Energy------exercise
Stressed----relaxation
Those repeated behaviors become our
super highway reward pathways.
When a young human brain experiences artificial
rewards from alcohol or other drugs. . .
It sets a youth on a different neurological path.
How can you “un-experience” a strong chemical
reward you did nothing to receive except to
use/drink?
How can you “un-see” a bright flashing light?
Ordinary “rewards” can’t
effectively compete.
This creates a high risk for a neurological
super highway to using/ drinking
behavior—substance
use/abuse/dependency.
This is what makes the adolescent
human brain so vulnerable to
addictive chemicals.
Skill SETS
Adolescents need to acquire skill sets
to be successful.
Uh,what’s a
skill set?
Please repeat this with me:
When I think of my brain
There’s a lot at stake
So I’m gonna learn how
To make a good brain great.
Now, please, repeat the little
ditty from memory.
Now, please stand add clapping
pattern I will teach you with a
with a partner.
Now, please switch partners.
Final time, everyone listen as
we recite the verse and clap
and say it together.
Experience of a SKILL SET
•
•
•
•
•
•
First read the verse
Memorized it
Learned clapping pattern
Leaned to say it with a partner while clapping
Learned to accommodate different partners
Learned to listen and say it all together in
unison.
Neurons fired together
Are
Wired together.
40
Examples of other SKILL SETS
Skill set
Neurons fired together
are wired together.
Prevention, treatment and recovery:
All depend on reward pathways that
lead to acquisition of skill sets:
Prevention, treatment and recovery:
All depend on reward pathways that
lead to acquisition of skill sets:
Prevention: sufficient opportunities to
learn coping skills to succeed and enjoy life.
Treatment: strategic and extensive planning
to avoid the “artificial rewards” of using while
creating reward pathways to pro-social behaviors
and coping skills. (not just STOP)
Recovery: taking time to practice and
strengthen reward pathways to successfully
compete with artificial rewards.
Neuroscience of Prevention, treatment
and recovery:
Like riding a bicycle.
Sooooooooooooooo . . . .?
How does evidence-based prevention
relates to teen brains and protective
factors for substance use/abuse?
What are some evidence-based prevention
efforts in your community/coalition?
Discussion: What is happening to protect or
develop brains using those interventions?
Neuroscience of Prevention, treatment
and recovery:
Like riding a bicycle.
Phoenix Programs, Inc.
www.phoenixprogramsinc.org
• Know us
(I do a majority of posts)
• “Like us”
• Follow us.
So you can become a member of the informed
Community
Speaker wishes to acknowledge:
•
•
•
•
Carrie McKinley, co-presenter
Phoenix Programs, Inc.
ACT MO
Preventionists and treatment counselors in
MO and IL who have generously shared their
wisdom and experience.
Questions?
Thank you for your kind
attention and generous
participation.
Presented by Heather Harlan, Prevention Specialist
Copy of this presentation available on request
[email protected]
573-875-8880 x 2142
Funding for this project was provided in part by the Missouri
Foundation for Health. The Missouri Foundation for Health
is a philanthropic organization whose vision is to improve
the health of the people in the communities it serves.
A New Perspective in Prevention, Treatment and Recovery.
For individuals. For families. For over 35 years.