Biology and Functioning of The Teenage Brain: Implications of Drug Use Municipal Alliance Presentation 4/16/08

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(No Transcript)
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Biology and Functioning of The Teenage Brain
Implications of Drug Use Municipal Alliance
Presentation4/16/08

• Doug Leonard, D.O.
• Chair of Psychiatry Our Lady of Lourdes
• Assistant Professor of Psychiatry UMDNJ-SOM

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Overview

• We will briefly describe some of the new
  Neuroscience findings about the Adolescent Brain
• Look at basic Neuroanatomy and Neurotransmitters
  that are essential to understanding of the very
  deleterious effects of drugs of abuse
• Known for long time its a bad idea. We are now
  developing a neuroscience facts showing why it is
  so bad
• Trends in Teenage Substance Abuse
• Offer resources for further information

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Biopsychosocial Model
Biology Dramatic physical changes Neurodevelopmen
tal changes
Social Dating separation or divorce
of parents school demands and frustrations
problems with friends unsafe
living environment/neighborhood death of a loved
one changing schools
Psychological Separation-Individuation high
expectations negative thoughts and feelings about
themselves Coping Style past experiences with
stress taking on too many activities or having
too
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Biopsychosocial Model Psychological

• Separation-Individuation
• Increased risk-taking and exploration
• Increase in conflicts with authority, including
  parents
• Extreme changes in mood and attitude from
  pleasant and loving and lovable child
• Could pick up our DSM and make a number of
  diagnoses based on behaviors and symptoms
  presented
• Taking on too many activities or having too many
  demands

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Biopsychosocial Model Social

• An increase in time spent with peers and a
  decrease in time spent with one's family 
• Dating
• Separation or divorce of parents
• School demands and frustrations
• Problems with friends
• Unsafe living environment/neighborhood
• Death of a loved one
• Changing schools

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Biopsychosocial Model Biology

• Dramatic physical changes
• Puberty (sexual maturation)
• Changes in sleep patterns, including a tendency
  to go to sleep later and wake up later
• Neurodevelopmental changes-topic for tonight

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Brain Overview

• The brain is an amazingly complex, still poorly
  understood, organ.  Hundreds of billions of cells
  bathe one another in chemical messengers that
  influence moment to moment changes in brain
  function, behavior, and experience. 
• Some chemical messengers can also trigger changes
  in gene expression in other cells, leading to
  long-term changes in how they look and operate,
  and how the individual thinks and acts. 
• The current chemical milieu of your brain governs
  how you feel at this very moment -- how attentive
  you are, whether you are deeply satisfied with
  your life, whether your foot itches, you name
  it. 

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http//www.pbs.org/wgbh/pages/frontline/shows/teen
brain/
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Frontline Inside the Teenage Brain

• The period of Adolescence is another key
  neurodevelopmental stage for brain growth that is
  as important as the growth that occurred during
  the first three years of life.
• Dr. Jay Giedd of NIMH speaks of a second wave of
  overproduction of brain neurons, esp. in
  Prefrontal Cortex
• First wave of overproduction beginning in utero
  until 18 months of life
• Involves Thickening of the cortex (outer layer of
  brain essential for our cognitive abilities)

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Frontline Inside the Teenage Brain

• By 6 years of age childs brain has reached 95
  of adult size, but cortex thickening continues,
  making connections
• Overproduction of neurons followed by Pruning of
  the neural networks that is a vital part of
  development and organizing of neural pathways.
• Pruning allows us to focus attention and skills,
  it is a process that allows for tremendous
  attention and learning of skill sets.
• Principle of Use it or Lose it is especially true
  during this time of Pruning
• Unused pathways pruned out thus giving
  specificity to thinking and skills. Adolescent
  can play sports, and music OR video games on a
  couch.
• Ex) presentation

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Prefrontal Cortex

• Called the CEO of the brain
• Involved with planning, strategizing, and
  organizing, initiating attention and stopping and
  starting and shifting attention.
• Fundamental for planning, use of strategies
• Cognitive Flexibility- can you change your mind
  and think of situations in fluid manner which
  helps to solve problems.
• Helps to regulate mood swings secondary to
  hormonal changes (gas pedal)
• High risk behavior has always been part of
  Adolescence, but is always coupled with the
  Immature Frontal Cortex (brakes)

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Prefrontal Cortex

• Vital in helping us identify emotional tone of
  faces
• Adolescents will misread faces due to their
  reliance on use of limbic structures (gut feel)
  preferentially over prefrontal cortex
• As Prefrontal cortex develops identifying
  emotional tones of faces becomes more reliable
• Teens will often see emotions that are not in the
  other individual. Can lead to overreaction and
  perplexing responses in social situations.

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Cerebellum

• Part of the brain that changes the most during
  teen years, not finished until the early 20s
• Classically known for coordination but recent
  findings are seeing it as fundamental to
  coordinating thinking processes as well.

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Drug Use Stats
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Drinking Levels among Youth

• The 2003 Youth Risk Behavior Survey (5) found
  that among high school students, during the past
  month
• 1 out of 2 drink some amount of alcohol.
• 1 out of 4 binge drink.
• 1 out of 4 had their first alcoholic drink before
  age 13.
• 1 out of 10 drove after drinking alcohol.
• 1 out of 3 rode with a driver who had been
  drinking alcohol.
• Other national surveys
• In 2004, the National Survey on Drug Use and
  Health reported that 29 of youth aged 12 to 20
  years reported drinking alcohol and 20 reported
  binge drinking (6).
• Monitoring the Future Survey found that 41 of
  8th graders and 75 of 12th have tried alcohol,
  and that 17 of 8th graders and 47 of 12th
  graders drank during the past month (7).

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Percent of Students Reporting Drug Use, 20012005
  2001 2003 2005
Lifetime marijuana 42.4 40.2 38.4
Current marijuana 23.9 22.4 20.2
Lifetime cocaine 9.4 8.7 7.6
Current cocaine 4.2 4.1 3.4
Lifetime inhalant 14.7 12.1 12.4
Current inhalant 4.7 3.9 n/a
Lifetime heroin 3.1 3.3 2.4
Lifetime metham. 9.8 7.6 6.2
Lifetime MDMA n/a 11.1 6.3
Lifetime Steroid 5.0 6.1 4.0
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Juvenile Treatment Admissions, by Primary Drug,
2005
Drug Type Under 15 1517
Alcohol 8.6 7.4
Alcohol w/secondary drug 9.3 12.7
Heroin 0.3 1.0
Other opiates 0.4 1.0
Cocainesmoked 0.5 1.0
Cocaineother route 0.9 2.2
Marijuana 61.2 65.5
Meth./amphetamine 2.5 4.6
Other stimulants 0.3 0.1
Tranquilizers 0.2 0.3
Sedatives 0.2 0.2
Hallucinogens 0.1 0.2
PCP lt0.05 0.1
Inhalants 0.9 0.2
Other/none specified 14.3 3.5
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Effects of Drugs and Alcohol
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Key modulators of an Addiction Trajectory

• Aberrant learning.
• Repeated administration of psychoactive drugs
  leads significant changes in the brain at the
  molecular, cellular, and circuit organizational
  levels.
• These changes can perturb the very processes that
  support learning, decision making, and emotional
  and behavioral control, so that behaviors become
  more reflexive and consequently much less
  amenable to cognitive interference.
• To the extent that some of these changes are long
  lasting (months to years) and, in some instances,
  perhaps even irreversible, they justify the
  characterization of addiction as a chronic
  disease of the brain.

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Key modulators of an Addiction Trajectory

• Motivational shift.
• Addiction usually takes hold when vulnerable
  individuals repeatedly seek to replicate the
  originally pleasurable drug experience.
• In such cases, the gradual transition from
  recreational use to addiction is accompanied by a
  fundamental motivational shift whereby a drug is
  no longer taken for pleasure but to satiate
  intense craving and to relieve the distress of
  not having the drug.

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Role of Dopamine Multifaceted neurotransmitter

• involved in the fine-tuning of motor and
  cognitive function,
• the modulation of salience attribution and
  attention,
• and the regulation of reward and motivation,
• is implicated in the reinforcing effects of drugs
  and in the plastic changes associated with
  addiction.
• the firing rate of dopaminergic neurons in
  pleasure centers is likely to encode the saliency
  of a stimulus, as a function of current
  expectations
• and to facilitate the consolidation of memory
  traces connected to such a stimulus.

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Endocannabinoid System and Addiction

• The EC system is primary site of action for
  rewarding and pharmacological responses induced
  by cannabinoids (Pot)
• This system plays an overall modulatory effect on
  reward circuitry
• Participates in the rewarding and addictive
  properties of all prototypical drugs of abuse.

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Brain SPECTDr. Amen

• http//www.amenclinics.com/bp/spect_rotations/view
  image.php?imghealthy_CS.gif

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Chronic Substance Abuse SPECT scan

• http//www.amenclinics.com/bp/spect_rotations/view
  image.php?imgda_CS.gif

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Resources

• http//teens.drugabuse.gov/
• http//www.whitehousedrugpolicy.gov/drugfact/index
  .html ONDCP
• http//www.freevibe.com/

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Other Links

• FreevibeA Media Campaign Web site that provides
  drug-related information for youth.
• InfoFacts High School and Youth Trends This
  resource presents data on juvenile drug use,
  including trends from 19952005.
• Keeping Your Kids Drug Free A How-To Guide for
  Parents and Caregivers (PDF)The Guide is a drug
  prevention brochure that provides parents and
  caregivers with real-life tips on how to keep
  kids drug free.
• National Youth Anti-Drug Media Campaign The
  Campaign is a multi-dimensional effort designed
  to educate and empower youth to reject illicit
  drugs.
• Office of Juvenile Justice and Delinquency
  Prevention (OJJDP)OJJDP provides national
  leadership, coordination, and resources to
  prevent and respond to juvenile delinquency and
  victimization.
• What You Need to Know About Drug Testing in
  SchoolsThis guide is designed to assist
  educators, parents, and community leaders in
  determining whether student drug testing is
  appropriate for their schools.
• Youth and Drugs Publications A listing of youth
  drug abuse-related publications from various
  sources.
• Youth Substance Abuse DataThis SAMHSA site
  provides data related to youth substance abuse.

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Challenge of Teens

• We as parents put up with a lot of grief from our
  adolescents and the motivations and rewards can
  seem inconsequential. What motivates us most may
  be gleaned from the Parents Prayer
• May you blessed with a child just like you!
• So that they can know the trials and tribulations
  and joy they have put you through
• Thank you
• Questions

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Biology and Functioning of The Teenage Brain
Implications of Drug Use Municipal Alliance
Presentation4/16/08

• Doug Leonard, D.O.
• Chair of Psychiatry Our Lady of Lourdes
• Assistant Professor of Psychiatry UMDNJ-SOM