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Eighth Edition

Part I: Current Science of Addiction,

Relapse & Recovery: Dispelling The Stigmas

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Evolution of our Human Brain: Spinal Cord to

Diencephalon to Mammalian-Meso Cortex to Neo

Cortex

Fish 500 mya

Reptiles 300 mya

Amphibians 315 mya

Mammals 220 mya

Primates 65 mya Hominids 5 mya

Earth 4.5 Billion Years, Life from 4 Billion Years

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CNS Addiction Pathway

Survival/Reinforcement Circuit

Control Circuit

GO!

STOP!

Our Brain’s Go & Stop Switch

Stop Switch

Go

Switch

Brains Addiction Pathway

Blum K. et al. (2014)

Glucose metabolism in Prefrontal Cortex & Cingulate Gyrus

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Stop Switch

Go

Switch

Control Circuitry

Reasoning, Impulse Control, Temporal Processing, Planning, Judgment

Medial PFC = Value

Lateral PFCs = Costs

or consequences

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Limbic Area

• Role: Drive Generation (SURVIVAL)

• Intervention: Pharmacotherapy

Prefrontal Cortex

• Role: Executive Function

• Intervention: Counseling

Prefrontal

Cortex

Nucleus

Accumbens

Arcuate

Nucleus Ventral

Tegmental

Area

Brain Reward Pathways

Dopamine

Opioid Peptides

Glutamate

Courtesy of Dr. John Hart, Portland, Oregon

Similar Findings: Bando, Kenneth et al.

Am. J. of Psychiatry, 168(2):183-192, 2011

Courtesy of Paulus, M.P.; Tapert, S.F.;

and Schuckit, M.A. l NIDA, Archives of

General Psychiatry, 62(7), 2005

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© Magal Mondin and Daniel Choquet, CNRS, Universite Bordeaux 2

All Addiction Memories are processed as emotional

memories via the amygdala, these are faster and

have a more powerful influence on Behavior than

hippocampal working memories

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Courtesy of Max Planck Institute of Neurobiology

Prefrontal

Cortex

Nucleus

Accumbens

Arcuate

Nucleus Ventral

Tegmental

Area

Brain’s Addiction Pathway

Dopamine

Opioid Peptides

Glutamate

Courtesy of Dr. John Hart, Portland, Oregon

1. Stress activates

hypothalamus

release of corti-

cotropin Releasing

factor (CRF)

2. CRF activates

pituitary release of

adrenocortico-

tropic hormone

(ACTH)

3.ACTH activates

kidney adrenal

glands to release

cortisol

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Fish Cat Chimpanzee Human fr. 5Ma

Old Brain = Survival (5X faster and more powerful) than Neocortex = Control,

Planning and Decision Making

Addiction is a battle between the

old primal brain and the new brain

Dr. James Olds, McGill University

Toronto, Canada 1954

Operant Conditioning

Dr. Terry Robinson

U of Mchg. 2004

Incentive Sensitization Research Confirmation

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Dr. Robert Heath,

Tulane University, 1959

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• is a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors.

– (ASAM definition, Short Version)

ADDICTION DEFINITON American Society of Addiction Medicine

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Courtesy, Takeichi Laboratory, Nagoya, Japan

Courtesy of UC, San Diego, Goda, Y., Sailor, M., Collins, B.

Cell Body

Myelin Sheath

of Axon

Dendrite

Synapse

Dendritic Spine

By Age 6 100 Billion Neurons and then

Development of a Quadrillion Syapses

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Professor Terry Wiseth, Northland College

Courtesy of Thomas Deerinck, NCMIR/Photo

Researchers, Inc.

Professor Terry Wiseth,

Northland College

Courtesy of Thomas Deerinck, NCMIR/Photo Researchers, Inc.

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All Addictive Substance

Involve Dopamine Activity

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0

50

100

150

200

0 60 120 180

Time (min)

% o

f B

asal

DA

Ou

tpu

t

NAc shell

Empty

Box Feeding

Di Chiara et al., Neuroscience, 1999.

FOOD

Mounts Intromissions Ejaculations

Fiorino and Phillips, J. Neuroscience, 1997.

Natural Rewards Elevate Dopamine Levels

100

150

200

DA

Co

ncen

trati

on

(%

Baselin

e)

15

0

5

10

Co

pu

latio

n F

req

ue

nc

y

Sample

Number

1 2 3 4 5 6 7 8

SEX

Female Present

Natural and Drug Reinforcers

Increase Dopamine in NAc

VTA/SN

nucleus accumbens

frontal cortex

Drugs of abuse increase DA in the Nucleus Accumbens, which is believed

to trigger the neuroadaptions that result in addiction

0 100 200 300 400 500 600 700 800 900

1000 1100

0 1 2 3 4 5 hr

AMPHETAMINE

% o

f B

asa

l Re

lea

se

0

50

100

150

200

0 60 120 180 Time (min)

% o

f B

asa

l Re

lea

se

Empty

Box Feeding

Di Chiara et al., 1997

FOOD

150 125 100

0 20 40 60 80

MARIJUANA

% o

f B

asa

l Re

lea

se

Tanda, et al, Scienceb 1997

Di Chiara et al., 1997

0

100

200

300

400

500

600

700

800

900

1000

1100

0 1 2 3 4 5 hr

Time After Amphetamine

% o

f B

as

al R

ele

as

e

DA DOPAC HVA

Accumbens AMPHETAMINE

0

100

200

300

400

0 1 2 3 4 5 hr Time After Cocaine

% o

f B

as

al R

ele

as

e

DA DOPAC HVA

Accumbens COCAINE

0

100

150

200

250

0 1 2 3 4 5hr Time After Morphine

% o

f B

as

al R

ele

as

e Accumbens

0.5 1.0 2.5 10

Dose (mg/kg)

MORPHINE

0

100

150

200

250

0 1 2 3 hr

Time After Nicotine

% o

f B

as

al R

ele

as

e

Accumbens Caudate

NICOTINE

Di Chiara and Imperato, PNAS, 1988

Effects of Drugs on Dopamine Release Addiction: About 9% of Pot users may become dependent,

1 in 6 who start in adolescence and 25-50% of daily users

32

15

9

17

118

5

23

0

5

10

15

20

25

30

35

Per

cen

t

* Nonmedical Use Source: Anthony JC et al., 1994

Estimated Prevalence of Dependence Among Users

* *

American Psychiatric Association’s Diagnostic Manual (DSM) has included marijuana use disorders since

1980. DSM-5 added Marijuana Withdrawal as a diagnosis.

2012 UCSF Research Confirms Role of Endogenous Opioid

Neurotransmitters in Reward Circuitry as well as Dopamine

Beta Endorphin Met-Enkephalin

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Inhibitory Excitatory Labeled neurons in rodent reward circuitry that starts in dorsal raphe with

glutamate stimulation releasing dopamine to the VTA (pictured — ventral

tegmental area). Image courtesy Dr. Marisela Morales, NIDA IRP

Brain Imaging

//upload.wikimedia.org/wikipedia/commons/1/17/L-Glutamic-acid-zwitterion-3D-balls.pnghttp://en.wikipedia.org/wiki/File:Serotonin-Spartan-HF-based-on-xtal-3D-sf-web.png

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Multiple Brain Imaging Techniques

Normal Normal Normal Normal

Courtesy of Volkow, Wang, & Begleiter, et al.) Courtesy of Wang,Volkow, Panayotis & Fowler (2004)

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Control 1 Puff 3 Puffs 1 Cigarette 3 Cigarettes MRI

3.1 hour after smoking these amounts calculated PET

Brody,Al, et al (2008) Intl J Neuropsychopharm.

Courtesy of Daniel Amen, M.D.

Courtesy of Daniel Amen, M.D.

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http://1.bp.blogspot.com/_IA5nokOFh84/SxAA_9hHXGI/AAAAAAAAD0Y/3yHUqHbI_6M/s1600/internet+addiction.jpghttp://www.socioaffectiveneuroscipsychol.net/index.php/snp/article/viewFile/11814/19312/50652

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Brain scans of newly in love viewing photos of love vs. others show VTA

activity to NAcS to Frontal Cortex same as drug addiction. Major Symptoms of

Romantic Love: Craving for Emotional Union, Intense Thinking / Compulsion,

and Motivation to win the person that are involuntary and hard to control

Questions?

Expanding Sciences of Pain and Recovery

CNS Productions, InCNS Productions, Inc.

Medford, Oregon Eighth Edition

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