Your Brain on Drugs Presentation 81308

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Your Brain on Drugs Presentation 8/13/08

• This is your Brain, this is your Brain on
  DRUGS, any Questions? YES LOTS!
• or
• Q Why do Youth Take Drugs?
• A BECAUSE THEY WORK !
• So what can we do?
• Ira Sachnoff
• Tobacco and Alcohol Consultant, SFSUD

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Highlights

• Whats the teen environment
• The adolescent brain
• Reward System
• Alcohol/Marijuana/Tobacco
• Influencing our children

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SFUSD Youth

• Had a drink in the last 30 days
• HS MS
• 26 10
• Used Marijuana in the past 30 days
• HS MS
• 15 6
• Past 30 days Binged on Alcohol in the HSs 18

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SFUSD Headlines 2008

• Did you know that according to a survey taken
  with over 12,000 SFUSD High School Students last
  year that
• 74 reported to HAVE NOT had a drink of alcohol
  in the past month.
• 85 reported that they HAVE NOT used Marijuana in
  the past month.
• 82 reported that they HAVE NOT Binged on Alcohol
  in the last month.
• 91 reported that they believe that almost daily
  use or daily use of Alcohol is harmful.
• Did you know that the use of Alcohol and
  Marijuana in the SFUSD is lower then the state
  averages?
• While we are proud of these facts, we still are
  concerned and will always attempt thru education
  and outreach to lower these numbers every single
  year.

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Adolescent Brain
Adult Brain
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Pruning

• USE IT OR LOSE IT Reading, sports, music,
  video games, x-box, hanging outwhatever a
  child/teen is doingthese are the neural synapses
  that will be retained
• How children/teens spend their time is CRUCIAL to
  brain development since their activities guide
  the structure of the brain

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Neuroadaptation HypofrontalityMemory Loss

• Neuroadaptivity Dulling of the pleasure center
  of the brain
• Hypofrontality Interference with the decision
  making area of brain
• Memory loss Damage to the hippocampus

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Reward System

• The reward system is responsible for seeking
  natural rewards that have survival value
• seeking food, water, sex, and nurturing
• Dopamine is this systems primary neurotransmitter

reward
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Drugs Hijack the Brains Reward Circuitry

• Immediate effect of drug use is an increase in
  dopamine
• Continued use of drugs reduces the brains
  dopamine production.
• Because dopamine is part of the reward system,
  the brain is fooled that the drug has survival
  value for the organism.
• The reward system responds with drug seeking
  behaviors
• Craving occurs and, eventually, dependence.

reward
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Dopamine vs. SerotoninPleasure vs. Happiness

• Dopamine produces a feeling of pleasure
• Serotonin produces a feeling of well being
• Difference between pleasure and happiness (short
  lived vs big picture)
• Developing skills, interest, relationships,
  meaning (getting a life)

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Pleasure Scale
NORMAL RANGE
Dysphoria
Euphoria
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The Pre Frontal Cortex Disease

• Adolescent dilemma
• . . . want to be adults and theyre exposed to
  a semi-adult culture, but they dont have the
  prefrontal cortex to regulate those adult
  behaviors . . . . They cant apply emotional
  brakes.
• They have the passion and the strength but no
  brakes and they may not get good brakes until
  they are twenty-five. (Giedd)

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PreFrontal Cortex

• Parents, therapists and our task
• Sometimes need to act as though they are their
  teenagers frontal cortex . . . talking through
  possibilities and options. They have to function
  like a surrogate set of frontal lobes, an
  auxiliary problem solver.

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Are adolescents more susceptible to alcohol than
adults?
Most certainly YES

• Reduced sensitivity to intoxication
• Increased sensitivity to social disinhibitions
• Greater adverse effects to cognitive functioning

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Whats the big deal about kids drinking anyways???

• Have you ever seen a group of drunk teenagers?
• Demeaning behaviors
• Risk taking behaviors
• Accidents
• Teenage brain effects before 18 yrs old

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Are you at Risk? Apply the bio-psycho-social
model to yourself Family history of
addiction? Do you have a tendency to boredom or
ADHD? Are you anxious or depressed? Have you
suffered sexual trauma?
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ADD and Drugs
Prospective four-year study of 15 year-old
boys. 75 Un-medicated ADD boys started
abusing alcohol/drugs (N19) 25 Medicated ADD
boys started abusing alcohol/drugs (N56)
18 (Controls) Non-ADD boys started abusing
alcohol/drugs (N137) 84 Risk Reduction when
ADD treated with medications
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Alcohol and Teenagers

• Date Rape one to two-thirds of teen sexual
  assaults involve alcohol
• 18 of Females/ 39 Males say it is acceptable
  for a boy to force sex if the girl is stoned or
  drunk
• 40 of children who start drinking before age 15
  will become alcoholics
• In television 9 out of 10 drinkers are portrayed
  as having no effects or only positive outcomes
  from their alcohol consumption

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Notes for alcohol

• The alcohol industry
• Extent of binge drinking in our culture
• Integrated in society
• Alternatives to shifting gears, events, stress
• Modeling
• Power of delaying usage through age 18
• Do we want to continue the level of pain and
  suffering alcohol has caused look what we have
  done with cigarette smoking

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For parents

• I care, I see, I feel, Listen
• Clear expectations and consequences
• Communication Monitoring
• Integrity Self Assessment Modeling
• Teen-proof your home

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Prevention Factors

• Supportive family (tuned in, time together,
  supervision, fair rules/boundaries)
• Non using peers and role models are we
  interested in really changing the culture?
• Youth are connected (school, activities)
• Social Skills (e.g. dancing)
• Resiliency (coping with stress, celebration)

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Our Own Self Assessment

• Andrew Weil Unhealthy relationship
• Ignorance that the substance is a drug and what
  it does to the body
• Loss of desired effect w/increasing frequency
• Difficulty separating from the drug
• Impairment of health or social function

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Are you at Risk?

• Apply the bio-psycho-social model to yourself
• Family history of addiction?
• Do you have a tendency to boredom or ADHD?
• Are you anxious or depressed?
• Have you suffered sexual trauma?
• Do you have an effective way to manage stress?

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Are you in trouble?

• How can you tell if you are getting into trouble?
• Are you compulsive?
• Is use causing adverse consequences?
• Do you crave the drug?
• If so, when you crave the drug, can you talk
  yourself into using it, even when you had
  resolved to not use?
• When you have resolved not to use, do you find
  yourself using under known craving conditions
  environment, withdrawal (bored, irritable, sleep
  disordered), anxiety or blue, or when you are
  stressed?

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Are You an Addict?

• TRY THE EXPERIMENT
• Resolve not to use for 5 weeks.
• Go about your usual daily acivities.
• Put yourself around the drug and people using it.

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Are You an Addict?

• AFTER 5 WEEKS
• Were you able to not use?
• Did you find your mind talking you into using?
  Did you struggle not to use?
• Were you able to have pleasure without using?
• Did you have problems with boredom, depression or
  anxiety?

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Are you in trouble?

• How can you tell if you are getting into trouble?
• Are you compulsive?
• Is use causing adverse consequences?
• Do you crave the drug?
• If so, when you crave the drug, can you talk
  yourself into using it, even when you had
  resolved to not use?
• When you have resolved not to use, do you find
  yourself using under known craving conditions
  environment, withdrawal (bored, irritable, sleep
  disordered), anxiety or blue, or when you are
  stressed?

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What to do

• Get out of the using environment.
• Find alternative sources of pleasure.
• Work on balancing stress.
• Seek help for mental health issues and other
  personal stresses.

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Process

• Present a non-judgmental approach
• Establish credibility (Honesty, Knowledge,
  Authenticity)
• Stimulate discussion and serious thought
• Art of weaving information (stealing of
  knowledge)

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Strategies and ApproachesTalking with children
in the classroom or individually

• Credibility Believability plus influence
• Kids will listen, but even more, kids will
  consider and self reflect look into what they
  already know and compare with new information.
• Example THC Content

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Strategies and ApproachesTalking with children
in the classroom or individually

• Brains are different
• Not personal
• Science based
• Marshas experiment and the use of motivational
  interviewing
• Not trying to convince
• Teaching true decision making with a
  predetermined conclusion
• Kids are sensitive to being manipulated
• Use of their knowledge and past experience
• Give balanced answers

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Strategies and ApproachesTalking with children
in the classroom or individually

• Honesty They ask you if you ever used mostly to
  see if you are going to be honest be real
  because the reality of the situation is that is
  what works.

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Process

• Present a non-judgmental approach
• Establish credibility (Honesty, Knowledge,
  Authenticity)
• Stimulate discussion and serious thought
• Art of weaving information (stealing of
  knowledge)

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Reaching Teenagers

• Dont shove this kind of information down their
  throat
• No propaganda
• Non-judgmental/ Fair and Balanced
• Honest with integrity
• Interactive
• Honoring where they are and what they know
• Let them steal the information
• Authenticity

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More to think about

• Various approaches for age and circumstance
• Whats worked for you
• Classroom settings, individuals, groups, SAP
• Marijuana-Tobacco connection
• Stages of change and Motivational Interviewing
• Summation and conclusions

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The Message

• Non-Use is as Normal as Experimental Use
• Use Risk
• Risk is not Evenly Distributed
• Addiction is Real
• Quality of Life can be diminished even without
  developing addiction i.e., Seduction Vs
  Addiction
• Motivations for Initial Vs Continuing Use are
  always different
• DELAY, DELAY, DELAY