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Lecture 6

Lecture 6 - Addiction movie.docx

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University of Toronto Scarborough
Suzanne Erb

Lecture 6 – Drugs and Brain – Addiction Movie Saturday Night in a Dallas ER - Alcohol/drug abuse are a large portion for ER trauma cases (almost half) - Usually pts don’t receive counselling concerning their drug/alcohol abuse, they are only fixed of their injury - 95% of all adults dependent on or abusing alcohol started drinking before age 21 - Many young deaths occur due to intoxication A Mother’s Desperation - Mother gets addict daughter arrested - Saw her overdose twice, last one she almost didn’t make it - Wants her to get through detox so she can think clearly - Daughter eventually turns herself in - Aubrey (daughter) realizes that she needs to occupy herself with a job, friends - Mother wants a contract with daughter “you help me, and I’ll help you, and maybe we’ll make it” The Science of Relapse - Addiction is unpleasant to both patient and family - Addiction is a disease of the brain that translates into abnormal behavior - When they are exposed to cues that remind/associate with drug, there is an uncontrollable reflex that they can not even stop, may happen even before they are conscious of it - Tendency to relapse is very strong, it is part of the disorder, it is not a failure of treatment, no matter how long they have been substance free - It isn’t just about moral fiber, or how willing you are, there is the “GO” system (helping us survive on reward system) and then the “STOP” system in the frontal lobe that is telling us to not act on the pull of the reward and has evolved to help us weigh the consequences of our impulses - Brain’s reward/”go” system is basic to all humans, it has evolved to help us pursue things necessary for survival - These 2 systems are interlinked at all times, for pts it has become that the “GO” system is running off on its own and is not interacting in a regular with the “STOP” system - Using CAT scan – they want to see how little it takes to get the reward system to get activated? Pictures shown for very short times, the GO system is so sensitive, it does not take multiple seconds, the craving begins - Backlofen (med) can reduce activity in the GO system, bringing it to more manageable range - With treatment, the frontal lobe has a chance to make decisions, hopefully treatment can rese the brain The Adolescent Addict - Liked “bud” (marijuana) because it chilled him out/calmed - Adolescent brain has even less override from their impulsivity vs. adults - Became “cutter”, started burning himself and using needles - There may not just be one problem (suicidal ideation, anger, depression) - Easily angered- extreme violent acts - Drugs are their one coping skill - Parents become very angry and kids act out (negative atmosphere) - Effective interventions: family engagement - Abnormal patterns of communication between family and kid, can lead to relapse - If you want to break the pattern
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