what I’d like to talk about today is the biology of people doing purses clearly
biology of people doing purses clearly
biology of people doing purses clearly as we think about building community the
as we think about building community the
as we think about building community the community is under assault from the
community is under assault from the
community is under assault from the other day I could get lots of slides
other day I could get lots of slides
other day I could get lots of slides about my participants but the bottom
about my participants but the bottom
about my participants but the bottom line to remember is that the opioid
line to remember is that the opioid
line to remember is that the opioid crisis is the number one killer of
crisis is the number one killer of
crisis is the number one killer of people under the age of 50 and last year
people under the age of 50 and last year
people under the age of 50 and last year when people die drug overdose than from
when people die drug overdose than from
when people die drug overdose than from cars or guns
cars or guns
cars or guns come on so we have a problem to address
come on so we have a problem to address
come on so we have a problem to address and one of those problems is that
and one of those problems is that
and one of those problems is that community
community
community unfortunately believes that that drug
unfortunately believes that that drug
unfortunately believes that that drug engage through the world and that’s what
engage through the world and that’s what
engage through the world and that’s what I’d like to address a bit a very simple
I’d like to address a bit a very simple
I’d like to address a bit a very simple take-home lesson addiction is a brain
take-home lesson addiction is a brain
take-home lesson addiction is a brain disease and it should be treated like a
disease and it should be treated like a
disease and it should be treated like a disease not by definition it’s a chronic
disease not by definition it’s a chronic
disease not by definition it’s a chronic relapsing disease a brain reward and
relapsing disease a brain reward and
relapsing disease a brain reward and I’ll share with you some basic ideas
I’ll share with you some basic ideas
I’ll share with you some basic ideas about the brain reward system but it’s
about the brain reward system but it’s
about the brain reward system but it’s also a defect of motivation and memory
also a defect of motivation and memory
also a defect of motivation and memory and circuitry that’s characterized by
and circuitry that’s characterized by
and circuitry that’s characterized by drug craving and seeking and useless
drug craving and seeking and useless
drug craving and seeking and useless fighting adverse outcomes in spite of
fighting adverse outcomes in spite of
fighting adverse outcomes in spite of losing primitive
losing primitive
losing primitive it’s a disease the reward pathways one
it’s a disease the reward pathways one
it’s a disease the reward pathways one of the most primitive in development all
of the most primitive in development all
of the most primitive in development all animals have a basic reward system that
animals have a basic reward system that
animals have a basic reward system that pays attention to those things in your
pays attention to those things in your
pays attention to those things in your environment and your life that are good
environment and your life that are good
environment and your life that are good for the species that we enforce our
for the species that we enforce our
for the species that we enforce our propagation so things like food and
propagation so things like food and
propagation so things like food and water and ship insects are all
water and ship insects are all
water and ship insects are all activating the same pathway in our brain
activating the same pathway in our brain
activating the same pathway in our brain we notice structure to those athletes
we notice structure to those athletes
we notice structure to those athletes we’ve characterized them they are
we’ve characterized them they are
we’ve characterized them they are involved in monitoring they’re involved
involved in monitoring they’re involved
involved in monitoring they’re involved in monitoring the environment paying
in monitoring the environment paying
in monitoring the environment paying attention to it
attention to it
attention to it remembering where we had that
remembering where we had that
remembering where we had that pleasurable feeling so that we can do it
pleasurable feeling so that we can do it
pleasurable feeling so that we can do it again and it’s involved in emotion
again and it’s involved in emotion
again and it’s involved in emotion attention savings to the event so that
attention savings to the event so that
attention savings to the event so that it has an impact for us the brain
it has an impact for us the brain
it has an impact for us the brain structures are really well characterized
structures are really well characterized
structures are really well characterized there are things like the mental
there are things like the mental
there are things like the mental mental earlier you need to let the
mental earlier you need to let the
mental earlier you need to let the nucleus accumbens the medial prefrontal
nucleus accumbens the medial prefrontal
nucleus accumbens the medial prefrontal cortex but that’s the science so that we
cortex but that’s the science so that we
cortex but that’s the science so that we understand what’s going awry and we have
understand what’s going awry and we have
understand what’s going awry and we have ways to address that and we’re trying to
ways to address that and we’re trying to
ways to address that and we’re trying to develop new ways addiction is a disease
develop new ways addiction is a disease
develop new ways addiction is a disease of the brain it’s a biological problem
of the brain it’s a biological problem
of the brain it’s a biological problem it’s not an immoral thing you don’t just
it’s not an immoral thing you don’t just
it’s not an immoral thing you don’t just tell me addict
tell me addict
tell me addict oh quit that heroin problem instead we
oh quit that heroin problem instead we
oh quit that heroin problem instead we have to help those individuals
have to help those individuals
have to help those individuals recognizing that it’s a disease we have
recognizing that it’s a disease we have
recognizing that it’s a disease we have to bring all of the tools in our
to bring all of the tools in our
to bring all of the tools in our armamentarium against helping that
armamentarium against helping that
armamentarium against helping that individual overcome a change in their
individual overcome a change in their
individual overcome a change in their brain that has set them up for continued
brain that has set them up for continued
brain that has set them up for continued abuse community doesn’t recognize that
abuse community doesn’t recognize that
abuse community doesn’t recognize that in many cases it’s a biological problem
might even I’ve been studying addiction
might even I’ve been studying addiction process now for over twenty five years
process now for over twenty five years
process now for over twenty five years we’ve done a handle on some of the
we’ve done a handle on some of the
we’ve done a handle on some of the things that are changing in the brain
things that are changing in the brain
things that are changing in the brain and the brain is changing
and the brain is changing
and the brain is changing it starts with casual use it might start
it starts with casual use it might start
it starts with casual use it might start with the prescription of a develop an
with the prescription of a develop an
with the prescription of a develop an opiate agonist for treating pain but
opiate agonist for treating pain but
opiate agonist for treating pain but then the drug becomes abused it’s not
then the drug becomes abused it’s not
then the drug becomes abused it’s not taken now to alleviate pain went away
taken now to alleviate pain went away
taken now to alleviate pain went away Connie and the brain starts changing is
Connie and the brain starts changing is
Connie and the brain starts changing is we’ll see in a minute and that leads to
we’ll see in a minute and that leads to
we’ll see in a minute and that leads to dependence where you’re physically
dependence where you’re physically
dependence where you’re physically depend
depend
depend on board this is a pharmacologically
on board this is a pharmacologically
on board this is a pharmacologically induced imprint you are changing the
induced imprint you are changing the
induced imprint you are changing the brain and then perhaps are fortunate
brain and then perhaps are fortunate
brain and then perhaps are fortunate enough for an intervention as we heard
enough for an intervention as we heard
enough for an intervention as we heard earlier and you become clean and sober
earlier and you become clean and sober
earlier and you become clean and sober and you end up in the wrong environment
and you end up in the wrong environment
and you end up in the wrong environment where you’re getting environmental cues
where you’re getting environmental cues
where you’re getting environmental cues that remind you of the problem remind
that remind you of the problem remind
that remind you of the problem remind you of the joy of taking the drug or
you of the joy of taking the drug or
you of the joy of taking the drug or stress comes into their life the loss of
stress comes into their life the loss of
stress comes into their life the loss of a loved one divorce if you remember you
a loved one divorce if you remember you
a loved one divorce if you remember you can escape that obtained by turning back
can escape that obtained by turning back
can escape that obtained by turning back to the drug and then of course our
to the drug and then of course our
to the drug and then of course our psychosocial effectiveness the flames
psychosocial effectiveness the flames
psychosocial effectiveness the flames are up privately to relapse and in our
are up privately to relapse and in our
are up privately to relapse and in our opinion that’s the main problem we can
opinion that’s the main problem we can
opinion that’s the main problem we can incarcerate somebody we can intervene
incarcerate somebody we can intervene
incarcerate somebody we can intervene with someone we can get them clean and
with someone we can get them clean and
with someone we can get them clean and sober but made any bad art and so for
sober but made any bad art and so for
sober but made any bad art and so for the last 15 or 20 years we’ve been
the last 15 or 20 years we’ve been
the last 15 or 20 years we’ve been studying this persistent molecular
studying this persistent molecular
studying this persistent molecular nutrient that occurs in the brain and
nutrient that occurs in the brain and
nutrient that occurs in the brain and sets the individual up for relapse those
sets the individual up for relapse those
sets the individual up for relapse those changes last the analogies for very long
changes last the analogies for very long
changes last the analogies for very long periods of time of abstinence and that’s
periods of time of abstinence and that’s
periods of time of abstinence and that’s why an alcoholic will frequently tell me
why an alcoholic will frequently tell me
why an alcoholic will frequently tell me I’m an alcoholic
I’m an alcoholic
I’m an alcoholic even though they’ve been clean and sober
even though they’ve been clean and sober
even though they’ve been clean and sober for a long time because they know
for a long time because they know
for a long time because they know they’re at risk for relapse falling back
they’re at risk for relapse falling back
they’re at risk for relapse falling back into the darkness that is addiction
these data come from a friend of mine at
these data come from a friend of mine at Wake Forest University Jeff Martin who
Wake Forest University Jeff Martin who
Wake Forest University Jeff Martin who has a marvelous or having marvelous
has a marvelous or having marvelous
has a marvelous or having marvelous model for getting brats to
model for getting brats to
model for getting brats to self-administer heroin through an
self-administer heroin through an
self-administer heroin through an intravenous port and they would perform
intravenous port and they would perform
intravenous port and they would perform complex tasks to get Harry but in this
complex tasks to get Harry but in this
complex tasks to get Harry but in this experiment what he did was to provide
experiment what he did was to provide
experiment what he did was to provide them with unlimited access every day in
them with unlimited access every day in
them with unlimited access every day in successive days and what you see is what
successive days and what you see is what
successive days and what you see is what we observe in humans and that’s that the
we observe in humans and that’s that the
we observe in humans and that’s that the dose escalates with time with each day’s
dose escalates with time with each day’s
dose escalates with time with each day’s opportunity to select to self administer
opportunity to select to self administer
opportunity to select to self administer of heroin but the brain is changing the
of heroin but the brain is changing the
of heroin but the brain is changing the body is changing by driving our
body is changing by driving our
body is changing by driving our attention to the y-axis
attention to the y-axis
attention to the y-axis on the left hand side of the figure
on the left hand side of the figure
on the left hand side of the figure that’s a logarithmic scale by the end of
that’s a logarithmic scale by the end of
that’s a logarithmic scale by the end of 30 days of self administration these
30 days of self administration these
30 days of self administration these rats are taking 100 times more than they
rats are taking 100 times more than they
rats are taking 100 times more than they took at the beginning in fact at 30 days
took at the beginning in fact at 30 days
took at the beginning in fact at 30 days they’re tasting and taking doses of
they’re tasting and taking doses of
they’re tasting and taking doses of drugs that would have killed that in 1
drugs that would have killed that in 1
drugs that would have killed that in 1 day 1 and hence we put the series
day 1 and hence we put the series
day 1 and hence we put the series problem that the recovering manic when
problem that the recovering manic when
problem that the recovering manic when they relapse with error or opiates and
they relapse with error or opiates and
they relapse with error or opiates and gentlemen they’ll go back to taking what
gentlemen they’ll go back to taking what
gentlemen they’ll go back to taking what they were taking
they were taking
they were taking and we end up with a lethal overdose
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