Presented by: Robert L. Smith, Ph.D. Clinical Psychologist / Addiction Specialist

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1 Presented by: Robert L. Smith, Ph.D. Clinical Psychologist / Addiction Specialist

2 DRUG ADDICTION IS A COMPLEX ILLNESS Human Brain

3 Functions of the Brain

4 Stimulants Cocaine. Amphetamine. Methamphetamine Depressants Alcohol, Xanax, Valium, Librium, Barbiturates Seconal, Amytal, Nembutal Cannabis / Marijuana Hallucinogens LSD, Ecstasy, mushrooms, mescaline, psilocybin

5 PCP phencyclidine Large animal tranquilizer/anesthetic, Inhalants Glue. Amyl nitrate, nitrous oxide, paint, paint thinner, gasoline Toluene Opiates Morphine, Codeine, Methadone, Fentanyl, OxyContin, Vicodin, Demerol, Percodan, Darvon, Heroin

6 Mood Swings Agitation, belligerence, aggressiveness Misperception Overreaction to minor provocation Paranoia, suspiciousness Memory impairment and Black-outs Hallucinations and/or delusions Confusion, delirium Impaired judgment Impulsivity, unpredictability

7 Agitation, irritability Depression Anxiety Intense craving for more substances Physical illness

8 During Intoxication or Withdrawal Delirium Amnesia ( Black-out ) Depression Anxiety Psychotic Disorder hallucinations and delusions Hallucinogen Persisting Perception Disorder - flashbacks

9 Depression Bipolar Disorder Posttraumatic Stress Disorder (PTSD) Psychosis Schizophrenia Schizoaffective Disorder

10 Personality Disorders Borderline Paranoid Narcissistic Schizotypal Schizoid Antisocial

11 Substance abuse often part of self-medication Substance abuse and mental illness exacerbate one another Treatment is effective only if both disorders are addressed

12 Attention Deficit / Hyperactivity Disorder Increased difficulty attending and concentrating Increased impulsivity Learning Disability Increased difficulty understanding social situations Borderline Mental Retardation Increased impairment in understanding written material, verbal instructions, problem-solving, decision-making

13 Substance Abuse Impulsivity Impaired judgment Difficulty making decisions Impaired problemsolving Limited planning and coping skills Frontal Lobe Damage Impulsivity Impaired judgment Difficulty making decisions Impaired problemsolving Limited planning and coping skills Inability to anticipate the consequences of actions

14 Misperception Overreaction Hallucinations Delusions Paranoia Black-out Example: Perceives lifelong friend as enemy and reacts with impulsivity and aggression due to methamphetamine induced paranoia

15 Resisting arrest Unable to knowingly waive Miranda rights Physically ill due to withdrawal Unable to remember due to black-out Example: Agitation, hallucinations, confusion at time of the arrest due to inhaling airplane glue

16 Unable to understand legal process or to assist in their defense due to drug induced psychosis hallucinations, delusions Withdrawal agitation, physical illness Example: Distorted perceptions and hallucinations at time of offense due to cocaine and confession is inaccurate Example: Manipulating confession by withholding treatment for withdrawal

17 Inability to appreciate wrongfulness of actions Example: Belief in Zachariah at time of the offense as a result of Schizoaffective Disorder and LSD

18 Substances change brain functioning misperception, confusion, difficulty concentrating, problems attending Substances change emotions distorted, exaggerated, depression, anger, fear, paranoia Substances change behavior difficulty making decisions, impulsive, reactionary, choices based upon misperceptions

19 Example: Rage reaction to sexual advance due to PTSD and methamphetamine intoxication. Example: Violent response to arrest for minor offense due to manic episode and alcohol and marijuana abuse Example: Accomplice to murder due to Borderline Personality Disorder and alcohol and Xanax abuse.

20 National Institute of Mental Health (NIMH) National Institute of Drug Abuse (NIDA) National Institute of Alcoholism and Alcohol Abuse (NIAAA) Substance Abuse and Mental Health Services Administration (SAMHSA)

21 Robert L. Smith, Ph.D. Clinical Psychologist / Addiction Specialist Mailing Address: St. Andrews Westlake, Ohio Phone: Fax:

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