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Substance Use and the Brain

Substance Use and the Brain. Susan Tapert, Ph.D. Alcohol Medical Scholars Program. Substance Use and the Brain. How is the brain affected long-term? Alcohol Marijuana Stimulants What can we do about this?. Substance Use and the Brain. How is the brain affected long-term? Alcohol

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Substance Use and the Brain

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  1. Substance Use and the Brain Susan Tapert, Ph.D. Alcohol Medical Scholars Program

  2. Substance Use and the Brain • How is the brain affected long-term? • Alcohol • Marijuana • Stimulants • What can we do about this? Copyright AMSP

  3. Substance Use and the Brain • How is the brain affected long-term? • Alcohol • Marijuana • Stimulants • What can we do about this? Copyright AMSP

  4. Drinking & Thinking • ~50% alcoholic adults show some problems: • Spatial skills • Planning • Learning and memory • IQ and language OK • Recovery • Much in 1st month • More in 1st year if sober Copyright AMSP

  5. Problems when using and when sober Falling asleep Total sleep Sleep quality Affects memory and thinking Feeling unrested increases relapse risk Alcohol and Sleep Copyright AMSP

  6. Brain Structure • Magnetic resonance imaging (MRI) • Safe • No injections • Shows small brain parts Copyright AMSP

  7. Shrinkage: Ventricles Non-alcoholic Alcoholic Copyright AMSP

  8. Shrinkage: Cerebellum Healthy Control Alcoholic Copyright AMSP

  9. Brain Function • Functional magnetic resonance imaging (fMRI) • Safe • Movies of brain activity • Good resolution Copyright AMSP

  10. Side View Brain Function Alcoholics vs. Healthy Controls Copyright AMSP

  11. Volume Recovery 2 Years Later During Treatment Copyright AMSP

  12. Substance Use and the Brain • How is the brain affected long-term? • Alcohol • Marijuana • Stimulants • What can we do about this? Copyright AMSP

  13. Marijuana & Thinking • Modest problems in very heavy users • Learning and memory • Sustained attention • Impulsivity • Most recover after 1 month abstinent Copyright AMSP

  14. Marijuana & Brain • No evidence of brain shrinkage • Altered brain waves related to attention •  brain blood flow •  brain response while learning Copyright AMSP

  15. Substance Use and the Brain • How is the brain affected long-term? • Alcohol • Marijuana • Stimulants • What can we do about this? Copyright AMSP

  16. Stimulants &Thinking • Motor skills • Planning • Switching tasks • Decision making • Working memory • Impulsivity • Learning and memory Copyright AMSP

  17. Stimulants & Brain Structure • Volume reductions: • Cingulate • Hippocampus • No overall gray matter changes • Volume increase: • Subcortical areas Copyright AMSP

  18. High blood flow Low blood flow Stimulants & Blood Flow Cocaine-dependent Healthy Control Gottschalk, 2001, Am J Psychiatry Copyright AMSP

  19. Blood Flow Recovery High blood flow Non users Cocaine users, 10 days sober Low blood flow Cocaine Users, 100 days sober Copyright AMSP

  20. Substance Use and Brain Summary: • Thinking problems • Tissue loss • Decreased blood flow • Altered brain response to task • Much recovery with abstinence Copyright AMSP

  21. Substance Use and the Brain • How is the brain affected? • What can we do about this? Copyright AMSP

  22. Implications • Inform patients • Develop better treatments Copyright AMSP

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