Embed Size (px)
Citation preview
Substance Use and the Brain
Susan Tapert, Ph.D.Alcohol Medical Scholars Program
Copyright AMSP 2
Substance Use and the Brain
1. How is the brain affected long-term?• Alcohol• Marijuana• Stimulants
2. What can we do about this?
Copyright AMSP 3
How is the brain affected long-term?
• Alcohol
• Marijuana
• Stimulants
What can we do about this?
Substance Use and the Brain
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
Alcohol and Sleep
• Problems when using and when sober– Falling asleep– Total sleep– Sleep quality
• Affects memory and thinking
• Feeling unrested increases relapse risk
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
Brain Function
Side View
Alcoholics vs. Healthy Controls
Copyright AMSP 11
Volume Recovery
During Treatment 2 Years Later
Copyright AMSP 12
How is the brain affected long-term?
• Alcohol
• Marijuana
• Stimulants
What can we do about this?
Substance Use and the Brain
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
How is the brain affected long-term?
• Alcohol
• Marijuana
• Stimulants
What can we do about this?
Substance Use and the Brain
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:Volume reductions:
– CingulateCingulate
– HippocampusHippocampus
– No overall gray matter No overall gray matter changeschanges
• Volume increase:Volume increase:
– Subcortical areasSubcortical areas
Copyright AMSP 18
Stimulants & Blood FlowHigh blood flow
Low blood flow
Healthy Control Cocaine-dependent
Gottschalk, 2001, Am J Psychiatry
Copyright AMSP 19
Blood Flow Recovery
Non users
Cocaine users, 10 days sober
Cocaine Users, 100 days sober
High High blood blood flowflow
Low Low blood blood flowflow
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
How is the brain affected?
What can we do about this?
Substance Use and the Brain
Copyright AMSP 22
Implications
• Inform patients
• Develop better treatments
