Drug AddictionDrug Addiction

It’s All in Your BrainIt’s All in Your Brain

NIDA - Criteria for Substance Dependence DiagnosisNIDA - Criteria for Substance Dependence DiagnosisDiagnostic and Statistical Manual Diagnostic and Statistical Manual

A maladaptive pattern of substance use leading to clinicallyA maladaptive pattern of substance use leading to clinicallysignificant impairment or distress as manifested by three (orsignificant impairment or distress as manifested by three (ormore) of the following, occurring at any time in the same 12-more) of the following, occurring at any time in the same 12-month period:month period:

Substance is often taken in larger amounts or overSubstance is often taken in larger amounts or overlonger period than intended.longer period than intended.

Persistent desire or unsuccessful efforts to cut down orPersistent desire or unsuccessful efforts to cut down orcontrol substance use.control substance use.

A great deal of time is spent in activities necessary toA great deal of time is spent in activities necessary toobtain the substance e.g., visiting multiple doctors orobtain the substance e.g., visiting multiple doctors ordriving long distances), use the substance (e.g., chaindriving long distances), use the substance (e.g., chainsmoking), or recover from its effects.smoking), or recover from its effects.

Important social, occupational, or recreational activitiesImportant social, occupational, or recreational activitiesgiven up or reduced because of substance abuse.given up or reduced because of substance abuse.

NIDA - Criteria for Substance Dependence DiagnosisNIDA - Criteria for Substance Dependence DiagnosisDiagnostic and Statistical Manual Diagnostic and Statistical Manual

(continued)(continued)

Continued substance use despite knowledge of having aContinued substance use despite knowledge of having apersistent or recurrent psychological, or physical problempersistent or recurrent psychological, or physical problemthat is caused or exacerbated by use of the substance.that is caused or exacerbated by use of the substance.

Tolerance, as defined by either:Tolerance, as defined by either: need for increased amounts of the substance in order toneed for increased amounts of the substance in order to

achieve intoxication, desired effect; orachieve intoxication, desired effect; or markedly diminished effect with continued use of themarkedly diminished effect with continued use of the

same amountsame amount

Withdrawal, as manifested by either:Withdrawal, as manifested by either: characteristic withdrawal syndrome for the substance; orcharacteristic withdrawal syndrome for the substance; or the same (or closely related) substance is taken to relievethe same (or closely related) substance is taken to relieve

or avoid withdrawal symptomsor avoid withdrawal symptoms

Brain and Spinal CordBrain and Spinal Cord

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Image from The Virtual Hospital http://www.vh.org/Providers/Textbooks/BrainAnatomy/BrainAnatomy.html

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impulse flowimpulse flow

The Reward PathwayThe Reward Pathway

The Reward PathwayThe Reward Pathway

Morphine Binding in Reward PathwayMorphine Binding in Reward Pathway

Opiate BindingOpiate Binding

Cocaine Dependence and the Reward PathwayCocaine Dependence and the Reward Pathway

Cocaine Binding SitesCocaine Binding Sites

Serotonin, LSD and EcstasySerotonin, LSD and Ecstasy

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Other Stuff (What Are PeopleOther Stuff (What Are PeopleThinking?)Thinking?)

Camel dungCamel dung C-4 explosiveC-4 explosive Embalming fluidEmbalming fluid Gasoline (“Montana Gin”)Gasoline (“Montana Gin”) M-99 (Immobilion)M-99 (Immobilion)

The Reward PathwayThe Reward Pathway

Morphine Tolerance Morphine Tolerance

thalamus

spinal cord

Morphine DependenceMorphine Dependence

thalamus

brainstem