Terrence D. Walton, MSW, CSAC Director of Treatment Pretrial Services Agency for the District of Columbia

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1 Terrence D. Walton, MSW, CSAC Director of Treatment Pretrial Services Agency for the District of Columbia

2 1. Legal & Illicit it 1. Stimulants t 2. Street Drugs and Prescribed Drugs 3. Hard Drugs & Soft Drugs 4. Very Addictive & Less-Addictive 5. Natural and Synthetic 2. Depressants 3. Opioids 4. Cannabinols 5. Hallucinogens/ Dissociatives 6. Inhalants/ Deliriants/Other

3 Alcohol Barbiturates (sleeping pills) Benzodiazepines (nerve pills) Valium, Xanax, Nembutal

4 Death Seizure Agitation Disphoric Delirium Tremens Hangover Withdrawal Euphoric Relaxed Sleep Coma Death Overdose

5

6

7 The brain adapts to the effects of substance use by over-releasing chemicals that produce the opposite effect. If the use stops abruptly, the over release of opposing chemicals continues for a period of time causing withdrawal symptoms.

8 Neuro-adaption (tolerance) occurs when neurons become less sensitive to the presence of a depressant or opiate as a result of the brain s attempt to return to normal. For instance, in response to the presence of alcohol the brain may reduce the number of receptors available to detect alcohol.

9 Neuro-sensitization occurs when neurons become more sensitive to the presence of a stimulant. t As a result, the neurons will only fully activate t when the current reward is expected to be greater than the average of previous rewards ( reward prediction error )

10

11 1) Can a person be psychologically dependent without being physiologically dependent? 2) Can a person be physiologically dependent without being psychologically dependent?

12 Involved in all physical/emotional/ cognitive function Metabolism, muscle movement, reflex Mood, reactivity, emotions Cognition, memory, etc.

13 Affinity Activation

14 FOOD WATER SEX NURTURING ACCOMPLISHMENT

15 Prefrontal Cortex Nucleus Accumbens Ventral Tegmental Area

16 Brain Effects from Chronic Substance Abuse

17

18

19 Interact with neurochemistry Results: Feel Good euphoria/reward Feel Better reduce negative feelings

20 Dopamine excitement & reward Serotonin feel normal Endorphin/Enkephalin pain relief, reward, craving GABA lowers anxiety

21

22 1. Amount of dopamine produced 2. Length of time dopamine is available 3. Number of dopamine receptors

23 Rewarding behaviors can become routine Obsessive, preoccupation, compulsion Subconscious control of the behavior Difficult to extinguish behaviors Resistant to change

24

25 A medical condition characterized by impairment within the brain s reward center and resulting in compulsive, repetitive, selfdestructive behaviors

26 A rat chooses to drink 80 to 90 percent of its daily fluid as alcohol, and then three days later its down to 20 percent! Increased the level of some dopamine (D2) receptors and blocked activity of others (D3)

27

28 1) Working the Steps 2) Powerlessness 3) Higher Power 4) Surrender 5) Taking Inventory 6) Making Amends 7) Spiritual Awakening 8) The Rituals 9) The Slogans

29 l

The Addicted Brain. And what you can do

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