The Future of Treating Alcoholism: Framing the Key Research Questions
|
|
- Scot Hutchinson
- 8 years ago
- Views:
Transcription
1 The Future of Treating Alcoholism: Framing the Key Research Questions Kathleen A. Grant, Ph.D. President, Research Society on Alcoholism A Society of basic, clinical and translation researchers committed to addressing public health concerns related to alcohol abuse and dependence
2 RSA lecture series: 2006 Module #1 Module #2 Basics of Alcohol Action: Pharmacodynamics & Etiology of Alcohol Abuse & Alcoholism Metabolism Who becomes alcohol dependent & why? Arthur Cederbaum, Ph.D. Mount Sinai School of Medicine Cardiovascular Effects of Alcohol Sam Zakhari, Ph.D. NIAAA/NIH Effects of Alcohol on the Endocrine System Catherine Rivier, Ph.D. The Salk Institute Alcohol & Stress Stress & Drinking: What is the link? Rajita Sinha, Ph.D. Yale University Neurobiology of Alcoholism: Insights from the dark side of reward neurocircuitry George Koob, Ph.D. The Scripps Research Institute Diagnosis & Assessment of Alcohol Dependence Deborah Hasin, Ph.D. Columbia University Behavioral Treatments for Alcohol Dependence Allen Zweben, Ph.D. Columbia University Medications to Treat Alcoholism: Where WeÕve Been and Where WeÕreGoing Henry Kranzler, M.D. University of Connecticut Kenneth Sher, Ph.D. University of Missouri Alcohol & Genetics: Is your child at risk? Tamara Phillips, Ph.D. Oregon Health and Science University Alcohol-Related Brain Pathology If you drink your brain will shrink! Clive Harper, M.D. University of Sydney Effects of Alcohol on Cognitive Function Sara Jo Nixon, Ph.D. University of Kentucky Fetal Alcohol Spectrum Disorders Edward Riley, Ph.D. San Diego State University Alcohol and Adolescence Linda Spear, Ph.D. Binghamton University College Drinking Mark Goldman, Ph.D. NIAAA/NIH Alcohol Policy Thomas Greenfield, Ph.D. University of California, Berkeley
3 Key Questions in Alcohol Research Why do some people drink more than others? What are individual differences in drinking quantity and pattern? What contributes to problem drinking and dependence? Prevalence of Past-year DSM-IV Alcohol Dependence by Age - U.S. Drinkers 18 and older 14% 12% 10% 8% 6% 4% 2% 0% Age Grant and Dawson, NIAAA
4 Prevalence of DSM-IV Alcohol Use Disorder Diagnoses by sex and age Abuse Dependence Percent Men Women
5 DSM-IV Dependence Criteria Tolerance* Withdrawal* Using in larger amounts/over a longer time period than intended Persistent desire to cut down/control Great deal of time spent obtaining/using/recovering* Important activities given up/reduced* Continued drinking despite physical/psychological problems that are caused/exacerbated by alcohol* * These criteria are modeled well in animals, whereas terms in red text are human constructs
6 DSM-IV Abuse Criteria Failure to fulfill major role obligations Recurrent use in physically hazardous situations Recurrent alcohol-related legal problems Continued drinking despite social/interpersonal problems that are caused/exacerbated by alcohol Criteria for alcohol dependence not met
7 Comprehensive models of why people drink to excess and dependence Pharmacological Vulnerability Affect (mood) Regulation Negative affect regulation ( self-medication ) Positive affect regulation ( reward seeking ) Deviance/Disinhibition
8 Animal models help address the biological basis of traits found in human alcohol abuse and alcoholism Eventual Binger (16 drinks/day) Eventual non-binger Drinking behavior gulping drinks Brain imaging Sex differences Genetics
9 Selective breeding for high and low alcohol drinking preference Drinking preferences transfer across environments: An example of salience Water (ml/day) Ethanol intake (g/kg/day) Ethanol ( ml/day) g/kg/day Generations of breeding Ethanol concentration
10 Patterns of drinking show tolerance and attempts to cut down on alcohol consumption Tolerance (increased intake) over 4 months of drinking pellet etoh water One day out of 4 showing volitional cutting down on drinking drinks/day MONKEY 6888 BEC=181 mg/dl (3.42 g/kg) Session Time (hr) etoh water pellets Session Time (hr) Session Time (hr) 16-Jan 17-Jan 18-Jan 19-Jan
11 Alcohol co-opts normal brain processes that compel behaviors linked to survival Reinforcement Ventral pallidum Nucleus Accumbens Core Prefontal Cortex Impulsivity Ventral Tegmental Area Pleasure/ Positive Reinforcement Ventral Tegmental Area Basolateral amygdala Rats bred to prefer alcohol will inject alcohol directly into the brain (Posterior VTA) Raphe nucleus Hippocampus Extended amydala Central nucleus amydala Bed nucleus stria terminalis Nucleus Accumbens shell Anxiety/ Negative Reinforcement Dopamine Glutamate GABA GABA/CRF/NPY Dopamine/GABA/Opioid 5HT Adapted from Kalivas and Volkow (2005) Am J Psychiatry 162:
12 Potential molecular and neural pathways involved in excessive alcohol drinking have been identified and can be the target of new drug therapies Cholinergic Excitatory Input GLU Excitatory Input CB1-R AMPA NMDA Serotonin Modulatory Input CRF? DOPAMINE (D1, D2) Prefrontal cortex Amygdala Lateral septum Hippocampus GLU Excitatory Input CB1-R Enkephalin Inhibitory Input NIC-R GABA Inhib Input NIC-R Dopamine Neuron GABA Neuron Mu Opioid Receptors GABA Inhibitory feedback GABA Neuron CB1-R REINFORCEMENT Ventral Tegmental Area (VTA) Nucleus Accumbens (nacc)
13 Genes Contributing to Alcohol-Related Behaviors in both Rodents and Humans Gene a-synuclein BDNF Rodent QTG for alcohol preference (Liang et al., PNAS 2003) BDNF levels in the NAc are lower in P rats than NP rats (Yan et al., Brain Res. 2005) Human associated with alcohol dependence (Bonsch et al., Hum Mol Genet. 2005) association of val66met polymorphism with alcohol dependence & violence in males (Tsai et al., Neurosci Lett. 2005) NMDA NR1 CB1 CCK-AR 5-HTT Mutant mice show attenuated alcohol effects on behavior (Kiefer et al., Biol Psychiatry 2003) KO showed alcohol consumption (Hungund et al., J Neurochem 2003) KO showed alcohol consumption (Miyasaka et al., Alcohol & Alcohol 2005) Alcohol intake in KO mice (Kelai et al., Alcohol Alcohol 2003) the A allele is associated with type I alcohol dependence (Wernicke et al., Biol Psychiatry. 2003) 1359G/A polymorphism confers vulnerability to alcohol withdrawal (Schmidt et al., Drug Alc Dep. 2002) -81A/G polymorphism is Associated with alcohol dependence in a Japanese population (Miyasaka et al., Alcohol & Alcohol 2004) Associated with lower risk of binge drinking (Olsson et al., Mol Psychiatry 2005)
14 Alcohol has both stimulant and sedative effects: possible risk factor and drug therapy target The stimulant effects of alcohol are at lower doses than the sedative effects Light drinkers and alcohol non-prefering rats do not show stimulation after 2-3 drinks Arousal Index Light drinkers 2-4 drinks/week N=9 Heavy drinkers drinks/week N=9 0 Pre Pre Time (mins) DA GABA NMDA Activity (counts above/below saline control) * * * * P MALES (n=10) * p<0.05 * NP MALES (n=10) * * * Ethanol, g/kg body weight
15 Naloxone, over a wide range of doses, decreases alcohol but not water consumption in rats Naloxone Dose (mg/kg)
16 Stress is likely involved in relapse to drinking after a period of abstinence. Negative Mood-Induced Alcohol Craving Predicts Time to First Drink After Inpatient Treatment
17 Stress is likely involved in relapse to drinking after a period of abstinence. Animal Models are being developed to help understand this link and suggest possible therapeutic interventions Brain serotonin systems are involved stimulation of serotonin release blockade of serotonin receptors Brain Areas related to anxiety and conflict are involved nucleus accumbens bed nucleus of the stria terminalis
18 Stress Management is a Key Component of Effective Behavioral Treatments for Alcoholism Cognitive Behavioral Treatment focuses on stress management training Cognitive restructuring, problem solving skills 12-Step Facilitation targets increases social support AA, NA or other peer support programs Enlist family and friends Case management services - housing, employment, medical care New Approaches Gaining Attention: Mindfulness Meditation Desensitization techniques to decrease craving-related distress state. Enhancing attentional/memory abilities to increase prefrontal functioning. Increasing emotional distress tolerance skills.
19 Conclusion: Research can identify molecular and behavioral aspects of alcoholism for the development of drug and behavioral treatments Brain pathways and candidate genes for: Specific features of alcohol use disorder modeled in animals Transition from voluntary to involuntary drinking Importance of gene-environment interactions Access to alcohol Early childhood experiences Current stressful environments Sex Age relapse
Causes of Alcohol Abuse and Alcoholism: Biological/Biochemical Perspectives
Causes of Alcohol Abuse and Alcoholism: Biological/Biochemical Perspectives Neurobehavioral Aspects of Alcohol Consumption Source: Eighth Special Report to the U.S. Congress on Alcohol and Health Secretary
More informationDSM-IV Alcohol Dependence. Alcohol and Drug Abuse. Screening for Alcohol Risk. DSM-IV Alcohol Abuse
DSM-IV Alcohol Dependence Alcohol and Drug Abuse David Gilder, MD Division of Mental Health Scripps Clinic Alcohol Research Center The Scripps Research Institute 1.5.11 Three or more criteria, same 12
More informationPrevention & Recovery Conference November 28, 29 & 30 Norman, Ok
Prevention & Recovery Conference November 28, 29 & 30 Norman, Ok What is Addiction? The American Society of Addiction Medicine (ASAM) released on August 15, 2011 their latest definition of addiction:
More informationSource: National Institute on Alcohol Abuse and Alcoholism. Bethesda, Md: NIAAA; 2004. NIH Publication No. 04-3769.
Diagnosis and Treatment of Alcohol Dependence Lon R. Hays, MD, MBA Professor and Chairman Department of Psychiatry University of Kentucky Medical Center Defining the Standard Drink A standard drink = 14
More informationAddiction Neurobiology
Addiction Neurobiology Stephen Jurd University of Sydney Australia Richard W is sick Apology The site of pathology IF Addiction has a neurobiological basis THEN we should be able to: Define addiction AND
More informationSource: National Institute on Alcohol Abuse and Alcoholism. Bethesda, Md: NIAAA; 2004. NIH Publication No. 04-3769.
Diagnosis and Treatment of Alcohol Dependence Lon R. Hays, MD, MBA Professor and Chairman an Department of Psychiatry University of Kentucky Medical Center Defining the Standard Drink A standard drink
More informationEPIDEMIC 4.6 % OF INDIVIDUALS 18 25 USED PAIN RELIEVERS FOR NON-MEDICAL REASONS. 1.5 MILLION YOUNG ADULTS USED PAIN RELIEVERS IN THE PAST MONTH.
Drug Court EPIDEMIC In the 10 years (1997 2007) the per capita retail purchases of Methadone, Hydrocodone and Oxycodone in the United States increased 13-fold, 4-fold and 9-fold, respectively. 4.6 % OF
More informationNeurobiology of Reward and Addiction in the Vulnerable Brain. Alan I. Green, M.D. May 1, 2009
Neurobiology of Reward and Addiction in the Vulnerable Brain Alan I. Green, M.D. May 1, 2009 DSM-IV Substance Abuse Maladaptive pattern of substance use leading to significant impairment distress, as indicated
More informationNEUROPHARMACOLOGY AND ADDICTION CHRISTOPHER M. JONES, PHARMD, MPH
NEUROPHARMACOLOGY AND ADDICTION CHRISTOPHER M. JONES, PHARMD, MPH Disclosures This presentation does not represent the views of the US Public Health Service or the US Food and Drug Administration The majority
More informationAmerican Society of Addiction Medicine
American Society of Addiction Medicine Public Policy Statement: Definition of Addiction (Long Version) Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry.
More informationThe Addicted Brain. And what you can do
The Addicted Brain And what you can do How does addiction happen? Addiction can happen as soon as someone uses a substance The brain releases a neurotransmitter called Dopamine into the system that makes
More informationBrain Damage & Recovery: The Resilience of the Brain, Addiction Impact & Therapeutic Repair. Michael Fishman, MD Director of Young Adult Program
Brain Damage & Recovery: The Resilience of the Brain, Addiction Impact & Therapeutic Repair Michael Fishman, MD Director of Young Adult Program How Addiction Takes Hold Large & rapid upsurges in dopamine
More informationAlchemy -Neuroscience of Alcoholism
Neuroscience of Alcohol Addiction David W. Oslin, MD Associate Professor University of Pennsylvania, School of Medicine And Philadelphia, VAMC Hazelden Research Co-Chair on Late Life Addictions Introduction
More informationAMPHETAMINE AND COCAINE MECHANISMS AND HAZARDS
AMPHETAMINE AND COCAINE MECHANISMS AND HAZARDS BARRY J. EVERITT Department of Experimental Psychology, University of Cambridge Stimulant drugs, such as cocaine and amphetamine, interact directly with dopamine
More informationWhat Can Science Contribute to the Treatment of Alcoholism?
What Can Science Contribute to the Treatment of Alcoholism? George F. Koob, Ph.D. Director National Institute on Alcohol Abuse and Alcoholism National Institutes of Health Flow of Talk 1. Conceptual Framework
More informationAlcohol Overuse and Abuse
Alcohol Overuse and Abuse ACLI Medical Section CME Meeting February 23, 2015 Daniel Z. Lieberman, MD Professor and Vice Chair Department of Psychiatry George Washington University Alcohol OVERVIEW Definitions
More informationOverview. Unit 5: How do our choices change our brains?
Unit 5: How do our choices change our brains? Overview In the previous units, we learned about the neuron, synaptic transmission, and neuronal circuits. In this key culminating unit, we ll bring all of
More information12 Steps to Changing Neuropathways. Julie Denton
12 Steps to Changing Neuropathways Julie Denton Review the neurobiology of the brain Understand the basics of neurological damage to the brain from addiction Understand how medications and psychotherapy
More informationAddiction Medicine 2014
Addiction Medicine 2014 Update on Current/New/Anticipated Medications for Alcohol Use Disorders J.C. Garbutt, MD Department of Psychiatry and Bowles Center for Alcohol Studies School of Medicine, University
More informationDrugs and Teens: Current Facts and Recent Trends. Agenda. Adolescent development
Drugs and Teens: Current Facts and Recent Trends Cheryl Houtekamer Youth Addiction Services Calgary Agenda Adolescent Development Brain Development Adolescent Substance Use - Prevalence How does addiction
More informationUnderstanding Addiction: The Intersection of Biology and Psychology
Understanding Addiction: The Intersection of Biology and Psychology Robert Heimer, Ph.D. Yale University School of Public Health Center for Interdisciplinary Research on AIDS New Haven, CT, USA November
More informationThe Science of Addiction:
The Science of Addiction: Why it s a bad idea to turn to drugs in times of stress Regina M. Carelli, PhD Stephen B. Baxter Distinguished Professor Department of Psychology & Neuroscience The University
More informationAlcohol and Other Drug Use and Adolescent Brain Development
Alcohol and Other Drug Use and Adolescent Brain Development Ken Winters, Ph.D. Department of Psychiatry University of Minnesota winte001@umn.edu Prevention, Law Enforcement and Coalitions: Developing Lasting
More informationThe Relationship Between the Reward and Stress Systems and How They are Perturbed in Addiction
The Relationship Between the Reward and Stress Systems and How They are Perturbed in Addiction George F. Koob, Ph.D. Professor and Chair Committee on the Neurobiology of Addictive Disorders The Scripps
More informationIdentification, treatment and support for individuals with Alcohol & Drug Addiction in the Community
Identification, treatment and support for individuals with Alcohol & Drug Addiction in the Community Dr David Jackson Clinic Medical Officer The Hobart Clinic Association Drugs In tonight s context, drugs
More informationThe latest in addiction medicine: What every nurse needs to know
CNA Webinar Series: Progress in Practice The latest in addiction medicine: What every nurse needs to know Monica Gregory Nurse Practitioner, Crosstown Clinic December 4, 2014 Canadian Nurses Association,
More informationTHE BRAIN & DRUGS. Nebraska Training on Substance Abuse Prevention
THE BRAIN & DRUGS Nebraska Training on Substance Abuse Prevention Educational Service Unit 10 Building 76 Plaza Blvd., Kearney, NE 68848-0850 Tuesday, April 26th 2011 MODULE 2 1 Overview How does the brain
More informationSubstance Addiction. A Chronic Brain Disease
Substance Addiction A Chronic Brain Disease What you will Learn Addiction is a Brain Disease Understand the Structure and Pathways Associated with changes in the brain. Addiction is a Chronic Condition
More informationAlcohol Withdrawal Syndrome & CIWA Assessment
Alcohol Withdrawal Syndrome & CIWA Assessment Alcohol Withdrawal Syndrome is a set of symptoms that can occur when an individual reduces or stops alcoholic consumption after long periods of use. Prolonged
More informationThe Results of a Pilot of Vivitrol: A Medication Assisted Treatment for Alcohol and Opioid Addiction
The Results of a Pilot of Vivitrol: A Medication Assisted Treatment for Alcohol and Opioid Addiction James H. Barger, MD SAPC Medical Director and Science Officer Desiree A. Crevecoeur-MacPhail, Ph.D.
More informationNaltrexone and Alcoholism Treatment Test
Naltrexone and Alcoholism Treatment Test Following your reading of the course material found in TIP No. 28. Please read the following statements and indicate the correct answer on the answer sheet. A score
More informationThe Developing Brain, Adolescence and Vulnerability to Drug Abuse
Welcome. This presentation is for you to read and to use in your prevention work. We hope you will review it, learn from it and feel comfortable using it in presentations to colleagues that work in prevention,
More information1. According to recent US national estimates, which of the following substances is associated
1 Chapter 36. Substance-Related, Self-Assessment Questions 1. According to recent US national estimates, which of the following substances is associated with the highest incidence of new drug initiates
More informationADOLESCENT BRAIN DEVELOPMENT: IMPLICATIONS FOR DRUG USE PREVENTION. Jessie Breyer, B.A. & Ken C. Winters, Ph.D. Center for Substance Abuse Research
ADOLESCENT BRAIN DEVELOPMENT: IMPLICATIONS FOR DRUG USE PREVENTION Jessie Breyer, B.A. & Ken C. Winters, Ph.D. Center for Substance Abuse Research Department of Psychiatry, University of Minnesota & Mentor
More informationGenetic and Other Risk Factors for Alcoholism and Alcohol Abuse. Manzardo, Ch 11,12 Fingarette, pp 51-55
Genetic and Other Risk Factors for Alcoholism and Alcohol Abuse Manzardo, Ch 11,12 Fingarette, pp 51-55 Suggestive Trends 80% of alcoholics in inpatient treatment have close relative with an alcohol problem
More informationsubstance abuse and addiction are complex phenomena
Executive Summary 1 substance abuse and addiction are complex phenomena that defy simple explanation or description. A tangled interaction of factors contributes to an individual s seeking out, using,
More informationSeminar/Talk Calendar
Seminar/Talk Calendar Tuesday, February 3rd Dr. John Neumaier, Professor of Psychiatry and Pharmacology, University of Washington DREADDing Addiction Dr. Neumaier s laboratory is studying stress and addiction
More informationNovel Pharmacological Treatments for Gambling Addiction Brian L. Odlaug, MPH
Novel Pharmacological Treatments for Gambling Addiction Brian L. Odlaug, MPH Department of Public Health, Faculty of Health & Medical Sciences, University of Copenhagen, Denmark Disclosure Information
More informationObjectives. Addiction. Some terms. Some terms. Hierarchy of brain function 9/23/2011 PREGNANCY IN WOMEN WITH SUBSTANCE ABUSE: A DOORWAY TO CHANGE
Objectives PREGNANCY IN WOMEN WITH SUBSTANCE ABUSE: A DOORWAY TO CHANGE Discuss the physiology of addiction Identify barriers to care for women with substance dependence Develop techniques to encourage
More informationASSIGNMENTS AND GRADING
Instructor: Janet Menard Office: Craine- 431 Phone: 533-3099 Email: menard@queensu.ca Class Hours: Tuesdays 11:30 1:00 Friday 1:00 2:30 Office Hours: Mondays 1:00-2:00 Thursdays 3:30-4:30 (please notify
More informationOVERVIEW OF MEDICATION ASSISTED TREATMENT
Sarah Akerman MD Assistant Professor of Psychiatry Director of Addiction Services Geisel School of Medicine/Dartmouth-Hitchcock Medical Center OVERVIEW OF MEDICATION ASSISTED TREATMENT Conflicts of Interest
More informationHow To Understand How Alcohol Changes The Brain
U.S. Department of Health & Human Services National Institutes of Health National Institute on Alcohol Abuse and Alcoholism Num ber 77 Ap ril 2 00 9 NEUROSCIENCE: PATHWAYS TO ALCOHOL DEPENDENCE Why does
More informationChapter 9: Drug Abuse and Addiction
Chapter 9: Drug Abuse and Addiction Drug use and abuse- some history Drug addiction: Defining terms Physical dependence/ drug withdrawal Factors that influence development and maintenance of drug addiction
More informationTreatment of Opioid Dependence with Buprenorphine/Naloxone (Suboxone )
Treatment of Opioid Dependence with Buprenorphine/Naloxone (Suboxone ) Elinore F. McCance-Katz, M.D., Ph.D. Professor and Chair, Addiction Psychiatry Virginia Commonwealth University Neurobiology of Opiate
More informationDenormalizing Tobacco Use in the Behavioral Health Setting
Nassau County s 2 nd Annual Conference on Co-Occurring Disorders Denormalizing Tobacco Use in the Behavioral Health Setting Tony Klein, MPA, CASAC tklein@unityhealth.org Discussion Individuals with mental
More informationThe Brain, Behavior, and Addiction. Objectives. Advances in science have revolutionized our fundamental views of drug abuse and addiction.
The Brain, Behavior, and Addiction Flo Hilliard University of Wisconsin-Madison Division of Continuing Studies Objectives Progress of science in addiction studies Why it is a brain disease Changing our
More informationSlide 1: Introduction Introduce the purpose of your presentation. Indicate that you will explain how the brain basically works and how and where
Slide 1: Introduction Introduce the purpose of your presentation. Indicate that you will explain how the brain basically works and how and where drugs such as heroin and cocaine work in the brain. Tell
More informationUpdate and Review of Medication Assisted Treatments
Update and Review of Medication Assisted Treatments for Opiate and Alcohol Use Disorders Richard N. Whitney, MD Medical Director Addiction Services Shepherd Hill Newark, Ohio Medication Assisted Treatment
More informationBeroendemekanismer- ett beroende som andra?
Beroendemekanismer- ett beroende som andra? Neuroendokrina responser till spel om pengar Anna Söderpalm Gordh Dopamine and the Rewardsystem Studies in animal models have demonstrated that mesocorticolimbic
More informationRelationship Between Stress and Substance Use Disorders: Neurobiologic Interface
Relationship Between Stress and Substance Use Disorders: Neurobiologic Interface Kathleen Brady, M.D., Ph.D. Professor of Psychiatry Associate Dean of Clinical and Translational Research Medical University
More informationWHAT HAPPENS TO OUR BRAIN?
WORK DYNAMIC The final result of this session is the formulation of the questions that, within the activity of the Let s talk about drugs programme of the la Caixa Welfare Project, you will ask Dr. Rafael
More informationDrinking Patterns. Harmless Use At-Risk. Abuse. 4% Dependence. Financial Disclosures. Alcoholism: Recognition and Management.
Alcoholism: Recognition and Management Timothy W. Fong MD UCLA Addiction Psychiatry PRI-MED West Current Clinical Issues March 2014 Financial Disclosures Speaker Bureau Reckitt Benckiser Research Support
More informationIntroduction to Tolerance, Physical Dependence and Withdrawal
Introduction to Tolerance, Physical Dependence and Withdrawal Carrie G Markgraf, MD, PhD Safety Assessment Merck Research Laboratories 1 Overview Definitions Addiction, psychological dependence, physical
More informationDrugs, The Brain, and Behavior
Drugs, The Brain, and Behavior John Nyby Department of Biological Sciences Lehigh University What is a drug? Difficult to define Know it when you see it Neuroactive vs Non-Neuroactive drugs Two major categories
More informationAddressing Substance and Alcohol Use Prior to HCV Treatment
Addressing Substance and Alcohol Use Prior to HCV Treatment Glenn J. Treisman, MD, PhD The Johns Hopkins University School of Medicine Baltimore, Maryland Disclosure Information Dr Treisman has no relevant
More informationTolerance and Dependence
Tolerance and Dependence Drug Tolerance is a decrease in the effect of a drug as a consequence of repeated exposure. Change over repeated exposures. Different effects may show different tolerance. Tolerance
More informationTesting Mediators of Topiramate s Effects on Alcohol Use Using Ecological Momentary Assessment Methods
Testing Mediators of Topiramate s Effects on Alcohol Use Using Ecological Momentary Assessment Methods Robert Miranda Jr., Ph.D. Associate Professor of Psychiatry and Human Behavior Center for Alcohol
More informationAlcoholism In The Office SCOTT PAIST, III, M. D.
Alcoholism In The Office SCOTT PAIST, III, M. D. The Dopaminergic Mesolimbic System PFC= Prefrontal Cortex NA=Nucleus Accumbens VTA= Ventral Tegemntal Area A = Amygdala C = Caudate Nucleus The Limbic System
More informationhttp://nurse practitioners and physician assistants.advanceweb.com/features/articles/alcohol Abuse.aspx
http://nurse practitioners and physician assistants.advanceweb.com/features/articles/alcohol Abuse.aspx Alcohol Abuse By Neva K.Gulsby, PA-C, and Bonnie A. Dadig, EdD, PA-C Posted on: April 18, 2013 Excessive
More informationNeurobiology of Depression in Relation to ECT. PJ Cowen Department of Psychiatry, University of Oxford
Neurobiology of Depression in Relation to ECT PJ Cowen Department of Psychiatry, University of Oxford Causes of Depression Genetic Childhood experience Life Events (particularly losses) Life Difficulties
More informationDr. Joseph Frascella
Dr. Joseph Frascella WHY YOU CAN T JUST SAY NO : Combatting Drug Addiction is Harder Than You Might Think The frontal areas of the young brain develop last. Those do the more executive function the inhibitory
More informationWhat is Adolescence? Three Developmental Tasks. What is the science behind the teen brain? Rollercoaster Highs: Substance Abuse and Adolescence
Rollercoaster Highs: Substance Abuse and Adolescence Naomi Weinstein, MPH Center on Addiction and the Family Phoenix House 646-505-2061 nweinstein@phoenixhouse.org What is Adolescence? Period of time between
More informationAlcohol and Prescription opiate abuse: Responsibilities of Stakeholders to reduce the problem. Thomas Kosten MD
Alcohol and Prescription opiate abuse: Responsibilities of Stakeholders to reduce the problem Thomas Kosten MD Waggoner Chair & Professor of Psychiatry & Neuroscience Baylor College of Medicine Past-President,
More informationNeurobiology and Treatment of Alcohol Dependence. Nebraska MAT Training September 29, 2011
Neurobiology and Treatment of Alcohol Dependence Nebraska MAT Training September 29, 2011 Prior treatment episodes for persons starting treatment for alcohol dependence, 2009 Percent 50 45 40 35 30 25
More informationDual diagnosis: working together
Dual diagnosis: working together Tom Carnwath RCGP conference Birmingham 2007 DSM-IV & cocaine Cocaine intoxication Cocaine withdrawal Cocaine-induced sleep disorder Cocaine-induced sexual dysfunction
More informationAddictions: Why Don t They Just Quit?
Counseling Center of New Smyrna Beach 265 N. Causeway New Smyrna Beach FL 32169 Ph: 386-423-9161 Fax: 386-423-3094 Addictions: Why Don t They Just Quit? By Shane Porter One of the most frustrating issues
More informationDisclosure INTRODUCTION TO SUBSTANCE USE DISORDERS. Substances of Abuse. Substances of Abuse. Primary Substance Use Disorders
INTRODUCTION TO SUBSTANCE USE DISORDERS Disclosure Some slides courtesy of Dr. D. Charney Co-owner 38DTX private treatment center Ronald Fraser, MD, CSQP, FRCPC Assistant Professor McGill University Dalhousie
More informationRobert Walker, M.S.W., L.C.S.W., Assistant Professor University of Kentucky
The Neuroscience of Addiction Robert Walker, M.S.W., L.C.S.W., Assistant Professor University of Kentucky Center on Drug and Alcohol Research Why do we need the science on addiction i for community projects?
More informationNaltrexone for Opioid & Alcohol Use Disorders
Naltrexone for Opioid & Alcohol Use Disorders Reid K. Hester, Ph.D. Director, Research Division Behavior Therapy Associates, LLC Senior Science Advisor Checkup and Choices, LLC 505.345.6100 reidkhester@gmail.com
More informationThe Limbic System Theory of Addiction
The Limbic System Theory of Addiction The brain controls every aspect of a human being. From breathing to blinking, it runs the show. Most of how it operates, however, is on an automatic and unconscious
More informationThe concept of alcoholism and other drug dependency as
Understanding the Disease of Addiction Kathy Bettinardi-Angres, MS, RN, APN, CADC, and Daniel H. Angres, MD The disease of chemical dependency can be traced to neural pathways in the brain predating a
More information12-Step Recovery - Making Sense of Adolescent Neuropsychosis
NEUROPSYCHOLOGICAL EDUCATION AND THE 12 STEPS: RECLAIMING A VIABLE RECOVERY OPTION FOR ADOLESCENTS MAP Challenges to 12 Step Recovery History of 12 Step Recovery Overview of the 12 Steps Alternatives to
More informationContents. Acknowledgements List of abbreviations. xix xxi
Table of Preface Acknowledgements List of abbreviations page xv xix xxi Chapter 1. Introduction 1 1.1. Introduction 1 1.1.1. Neuroethics: the promises and perils of neuroscience research 4 1.2. Addiction
More informationThese changes are prominent in individuals with severe disorders, but also occur at the mild or moderate level.
Substance-Related Disorders DSM-V Many people use words like alcoholism, drug dependence and addiction as general descriptive terms without a clear understanding of their meaning. What does it really mean
More informationDrug and Alcohol Assessment
Drug and Alcohol Assessment Engagement the first step What is engagement? building a working relationship Showing that you care (do you?) Working towards mutually acceptable goals building rapport building
More informationScientific Facts on. Psychoactive Drugs. Tobacco, Alcohol, and Illicit Substances
page 1/5 Scientific Facts on Psychoactive Drugs Tobacco, Alcohol, and Illicit Substances Source document: WHO (2004) Summary & Details: GreenFacts Context - Psychoactive drugs such as tobacco, alcohol,
More informationThe neuroscience of depression: why does it matter? Dr Susan Mizen Exeter
The neuroscience of depression: why does it matter? Dr Susan Mizen Exeter Mark Solms and the Freudian Brain Neuroscience and the clinical features of depression Clinical features Anhedonia and decreased
More information7/29/2013. Pleasure Unwoven: An Adventure in Social Marketing. Choice vs. Disease. Kevin McCauley, MD Texas Behavioral Health Insistute July 2013
Pleasure Unwoven: An Adventure in Social Marketing Kevin McCauley, MD Texas Behavioral Health Insistute July 2013 Choice vs. Disease 1 PILOTS! HMH-363 Red Lions MCAS Tustin, CA 2 U.S. Navy Sober Living
More informationsimilar to other psychoactive drugs, drugs of abuse alter the
Basic Concepts 2 similar to other psychoactive drugs, drugs of abuse alter the brain s normal balance and level of biochemical activity. This can include mimicking the action of naturally occurring neurotransmitters
More informationNeurobiology of Nicotine Addiction
Neurobiology of Nicotine Addiction David McFadden, MD, MPH Mayo Clinic Nicotine Dependence Center Outline Addiction defined Nicotine absorption Nicotine neurophysiology Conditioning Cues Nicotine withdrawal
More informationMeasuring Addiction with DSM Criteria. May 20, 2014 Deborah Hasin, Ph.D. Columbia University
Measuring Addiction with DSM Criteria May 20, 2014 Columbia University Two Main Topics 1. DSM-5 definition of addiction and its empirical basis 2. PRISM-5 measure of DSM-5 addiction 2 DSM-IV Substance
More informationDependence and Addiction. Marek C. Chawarski, Ph.D. Yale University David Metzger, Ph.D. University of Pennsylvania
Dependence and Addiction Marek C. Chawarski, Ph.D. Yale University David Metzger, Ph.D. University of Pennsylvania Overview Heroin and other opiates The disease of heroin addiction or dependence Effective
More informationAlcohol and Health. Alcohol and Mental Illness
Alcohol and Mental Illness Adapted from Éduc alcool s series, 2014. Used under license. This material may not be copied, published, distributed or reproduced in any way in whole or in part without the
More informationCognitive Behavioral Interventions for Substance Abuse. Overview Presentation TASC Conference 2013. University of Cincinnati Corrections Institute
Cognitive Behavioral Interventions for Substance Abuse Overview Presentation TASC Conference 2013 University of Cincinnati Corrections Institute Curriculum Content, Format and Supporting Research Curriculum
More informationKaren Drexler, M.D. ALCOHOLISM AND DEPRESSION
Karen Drexler, M.D. for the DUMC Alcohol Awareness Task Force ALCOHOLISM AND DEPRESSION Overview What is major depression? What is alcohol dependence? Does depression lead to alcohol dependence? Does alcohol
More informationAlcohol Withdrawal. Introduction. Blood Alcohol Concentration. DSM-IV Criteria/Alcohol Abuse. Pharmacologic Effects of Alcohol
Pharmacologic Effects of Alcohol Alcohol Withdrawal Kristi Theobald, Pharm.D., BCPS Therapeutics III Fall 2003 Inhibits glutamate receptor function (NMDA receptor) Inhibits excitatory neurotransmission
More informationLESSON 5.7 WORKBOOK Is addiction a chronic disease?
DEFINITIONS OF TERMS Addiction is a disease idea that states drug addiction is no different from other chronic diseases, like diabetes and heart disease, and thus needs to be treated as a distinct medical
More informationMedication Assisted Treatment for Alcohol Use Disorders
Medication Assisted Treatment for Alcohol Use Disorders Jennie Wei, MD, MPH American College of Physicians New Mexico Chapter Scientific Meeting November 7, 2015 Objectives Define Alcohol Use Disorders
More informationAlcohol Abuse and Dependence in Native Americans
Alcohol Abuse and Dependence in Native Americans Its link to suicide and medication treatment options Addiction Psychiatrist Objectives Will discuss alcohol s role in suicide with the limited data we have.
More informationSC 215 FIGHTING DRUG ADDICTION WITH DRUGS. John Bush April 15, 2013
SC 215 FIGHTING DRUG ADDICTION WITH DRUGS John Bush April 15, 2013 ADDICTION A persistent, compulsive dependence on a behavior or substance Behavioral Compulsive shopping --Compulsive eating Compulsive
More informationWhile the individual patient, rather than his or her disease, is the appropriate
RESEARCH REVIEWS THE NEUROBIOLOGY OF OPIOID DEPENDENCE 13 N The Neurobiology of Opioid Dependence: Implications for Treatment Opioid tolerance, dependence, and addiction are all manifestations of brain
More informationYouth Drug Abuse and Addiction
Youth Drug Abuse and Addiction Ken Winters, Ph.D. Dept. of Psychiatry, U. of Minnesota winte001@umn.edu Summit on Prescription Drug Abuse in Georgia March 2, 2011 1. Epidemiology of Rx Abuse by Youth 4.
More informationSystematic Review of Treatment for Alcohol Dependence
Systematic Review of Treatment for Alcohol Dependence ALCOHOL ARCUATE NUCLEUS in Hypothalamus, pituitary Beta-endorphin Dynorphin Kappa receptor Nucleus Enkephalins accumbens Delta receptor (+) Mu receptor
More informationAlcohol, Stress and the Brain
Alcohol, Stress and the Brain George F. Koob, Ph.D. Professor and Chair Committee on the Neurobiology of Addictive Disorders The Scripps Research Institute La Jolla, California Koob GF, A Role for Brain
More informationAlcoholism, like addiction to other drugs, is a chronic, THE POTENTIAL OF NEUROSCIENCE TO INFORM TREATMENT. George F. Koob, Ph.D.
THE POTENTIAL OF NEUROSCIENCE TO INFORM TREATMENT George F. Koob, Ph.D. In the 40 years since the founding of the National Institute on Alcohol Abuse and Alcoholism (NIAAA), researchers have gained a better
More informationThe significant and escalating problem of PROCEEDINGS THE BIOLOGIC BASIS OF ALCOHOL DEPENDENCE * Bankole A. Johnson, MD, PhD ABSTRACT
THE BIOLOGIC BASIS OF ALCOHOL DEPENDENCE * Bankole A. Johnson, MD, PhD ABSTRACT Over the past decade, there has been growing interest in understanding the neuroscientific basis of alcoholism and in developing
More informationC. Chapman Sledge, MD, FASAM Chief Medical Officer. Nashville, TN
ANATOMY OF RELAPSE C. Chapman Sledge, MD, FASAM Chief Medical Officer Cumberland Heights Nashville, TN chapman_sledge@cumberlandheights.org 250 200 150 100 50 0 We're addicted to rehab. It doesn't even
More informationThe Neuropharmacology of Drugs of Abuse 3
The Neuropharmacology of Drugs of Abuse 3 rugs of abuse interact with the neurochemical mechanisms of the brain. Some of these interactions are directly related to the reinforcing properties of a drug,
More informationHarm Reduction Strategies to Address Anxiety and Trauma. Presented by Jodi K. Brightheart, MSW
Harm Reduction Strategies to Address Anxiety and Trauma Presented by Jodi K. Brightheart, MSW What would you diagnose a client with the following symptoms? Frantic efforts to avoid being abandoned by friends
More informationNAADAC Annual Conference 2013 Denormalizing Tobacco Use: Improving Quality of Care in Addiction Services
NAADAC Annual Conference 2013 Denormalizing Tobacco Use: Improving Quality of Care in Addiction Services Tony Klein, MPA, CASAC, NCACII tklein@unityhealth.org Discussion The tobacco industry enhanced the
More information