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Eighth Edition Congratulations and Thank You All for
Attending
Part IV: Slipping Up: Neuroscience
Basis of Relapse & Recovery July 31, 2015 8 am – 12:30 pm
with Break 10-10:15am
Preventing Recrudescence
Promoting Long-Term Recovery
Neurochemistry of
Relapse & Recovery
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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
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All Addiction Memories are processed as emotional
memories via the amygdala, these are faster and
have a more powerful influence on Behavior than
hippocampal regular memories
Courtesy of Max Planck Institute of Neurobiology
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Stop Switch
Go
Switch
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
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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Multiple Brain Imaging Techniques
Courtesy of Daniel Amen, M.D.
Courtesy of Daniel Amen, M.D.
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Brody,Al, et al (2008) Intl J Neuropsychopharm.
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
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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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
Neuron Homeostasis: Brain in Dynamic
Equilibrium
Axon Terminal
Secondary Terminal
Auto Receptors on Axon
Synaptic Vesicles
Axonal Transport
Dendrite Receptors
Neurotransmitters
Dendrite
Courtesy, Takeichi Laboratory, Nagoya, Japan
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Cell Body
Myelin Sheath
of Axon
Dendrite
Synapse
Dendritic Spine
By Age 6 100 Billion Neurons and
Development of a Quadrillion Synapses
Professor Terry Wiseth, Northland College
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Courtesy of Thomas Deerinck, NCMIR/Photo Researchers, Inc..
Courtesy of Thomas Deerinck, NCMIR/Photo
Researchers, Inc.
Professor Terry Wiseth,
Northland College
All Addictive Substance Involve
Dopamine Activity
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2012 UCSF Research Confirms Role of Endogenous Opioid
Neurotransmitters in Reward Circuitry as well as Dopamine
Beta Endorphin Met-Enkephalin
Inhibitory Excitatory
Normal Normal Normal Normal
Courtesy of Volkow, Wang, & Begleiter, et al.) Courtesy of
Volkow, Wang, & Begleiter, et al.)
//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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Craving can be caused
by the sight, smell,
and taste of
a using partner
* a using place
* a dealer
* cash
* the drug itself
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Courtesy of Anna Rose Childress, Ph.D.
© Magal Mondin and Daniel Choquet, CNRS, Universite Bordeaux
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Courtesy of Max Planck Institute of Neurobiology
Stop Switch
Go
Switch Prefrontal
Cortex
Nucleus
Accumbens
Arcuate
Nucleus Ventral
Tegmental
Area
Brain Reward Pathways
Dopamine
Opioid Peptides
Glutamate
Courtesy of Dr. John Hart, Portland, Oregon
Courtesy of Anna Rose Childress, Ph.D.
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Myrick et al. (2004). Neuropsychopharmacology, 29: 393.
Brain regions activated while viewing alcohol-related cues
Courtesy of Dr. John Hart, Portland, Oregon
Cingulate
Nucleus
Accumbens
Ventral
Tegmental
Area (VTA)
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Prefrontal
Cortex
Nucleus
Accumbens
Arcuate
Nucleus Ventral
Tegmental
Area
Brain Reward Pathways
Dopamine
Opioid Peptides
Glutamate
Courtesy of Dr. John Hart, Portland, Oregon
Limbic Area
• Role: Drive Generation (SURVIVAL)
• Intervention: Pharmacotherapy
Prefrontal Cortex
• Role: Executive Function
• Intervention: Counseling
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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Inhibitory Excitatory
//upload.wikimedia.org/wikipedia/commons/1/17/L-Glutamic-acid-zwitterion-3D-balls.png
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I.Preexisting Mental
Illness
II.Substance-Induced
Mental Illness
Need for Rule-Out Diagnosis, Provisional Diagnosis,
Working Diagnosis, Preliminary Diagnosis , or Decision
Making Diagnosis
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Note: in DSM-5 2013 the 5 axis assessment was discontinued and
replaced with
Severity Spectrums of Mild, Moderate or Severe for S-R and
Addictive Disorders
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Same combination of elements that
cause addictions
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Uppers Uppers & Psychedelics
All Addictive substances
Continued Conflicts with Treatment of
Co-Occurring Disorders
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Hope! Though the challenges
to maintaining sobriety are
daunting, developments in
treatment continue to
improve outcomes.
Remember, the qualities in
those that makes one
vulnerable to addiction are
also qualities we look for in
our charismatic leaders.
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Courtesy of Nora Volkow (Volkow, Hitzmann, Wong, et al 1992
Courtesy of Nora Volkow, et al. Journal of Neuroscience, 21,
9414-9418, 2001 Volkow et al. J. of Neuroscience 2001
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Intoxication Sober: 30 days
Neuronutrient complex “normalization” of caudate, accumbens
and putamen regions of heroin addicts demonstrated by fMRI
Scan
Co-Occurring Disorders:
Mental Health & Drugs
Eighth Edition
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Fantasy Reality! Vs. Stand Up!
Speak Up!
