Drug Addiction

DRUG ADDICTION What is Drug Addiction? Drug addiction is a chronic, relapsing MON condition that is characterized by a NE WED FRI compulsion to use a substance, loss of control in limiting intake, and the WED emergence of a negative emotional state when access to Compulsion to use a substance the substance is denied. Loss of control The core feature of drug addiction is a loss of control over drug use. Such pathologic drug use is characterized by repeated cycles of abstinence and relapse. in limiting intake The Drug Use Cycle Emergence of a negative emotional state when access to substance is denied Did You Kow? -1.72 million 1.8 million An estimated 20.6 million (8% of the population) persons aged 821,000 12 or older are classified with 4.2 million substance abuse or addiction o 16.7 million people for alcohol o 4.2 million for marijuana o 1.8 million for prescription pain relievers • 821,000 for cocaine • 1.72 million for heroin, tranquilizers, hallucinogens, stimulants, inhalants, and sedatives combined. 16.7 million Did You Know? After alcohol, marijuana has the highest rate of abuse or addiction among all drugs. The number of current (past-month) marijuana users meeting clinical criteria for abuse or addiction of marijuana is more than double the number for abuse/addiction of prescription pain relievers and four times the number for abuse/addiction of cocaine. Did You Know? Over ~200,000 deaths each year and the loss of 7 million disability adjusted life years were attributable to illicit drug use. The major causes of drug-related death include overdose, drug-related disease, suicide and trauma. Did You Know? Opioid overdoses lead to respiratory depression, while cocaine and amphetamine toxicity is typically due to myocardial infarction or stroke. The major cause of MDMA deaths is hyperthermia. Opioids are associated with the highest risk of death as they are responsible for over 90% of all overdose-related deaths. Did You Know? Drug abuse is highly comorbid with other psychiatric illnesses including depression, bipolar disorder and schizophrenia. The rate of attempted and completed suicide among drug users is significantly higher compared to the general population. Intravenous drug users are at particular risk for HIV and HCV. Risk Factors • Individual genetics has been estimated to contribute to 25-80% of abuse risk depending on the drug. Addiction is a polygenic disorder with multiple genes contributing to vulnerability. • Environmental factors Psychiatric comorbidity including early life stress, and personality trait trauma, developmental drug (e.g.,impulsivity, novelty exposure and urban living are seeking anxiety/neuroticism) associated with addiction risk. are common factors associated with vulnerability. Neurobiology Drugs of abuse activate the brain reward circuitry, leading to a sense of euphoria. Anatomy of the Brain Dopaminergic neurons projecting from the midbrain (ventral Corpus callosum Cingulate Gyrus tegmental area) to the ventral striatum Dorsal striatum (nucleus accumbens) and the prefrontal Nucleus Accumbens cortex are crucial components of the brain reward circuitry. (mesocorticolimbic pathway). It has been hypothesized that the initial, impulsive phase of addiction is mediated by ventral striatal impairments, while the later, compulsive stages Prefrontal cortex Pituitary gland Mesocorticolimbic pathway involve the dorsal striatum that mediates Amygdala habit formation. Hippocampus The mesocorticolimbic pathway integrates reward processing, motivation, emotion and motor activity in order to regulate goal-directed behavior. The glutamatergic The amygdala, a system in mesocorticolimbic mesocorticolimbic brain structure, plays a key role in negative brain circuits has been shown to play a strong role in regulating synaptic plasticity and this dysregulation is highly implicated in drug-seeking behavior and relapse. emotional states that is prominent during abstinence and contributes to relapse. Your thoughts Treatment |свт Your Your There are no cures for behaviors emotions drug abuse disorders. Treatment of drug abuse involves a multidisciplinary approach including pharmacotherapy, psychotherapy, self-help facilitation, and ongoing relapse prevention strategies. Prescriet on Medication Information for thls Infographic has been referenced from the following sources: http:/www.drugabuse.gov Mount Sinai © 2014 The Mount Sinal Hospital, New York You are free to copy, distribute and transmit but you must attribute the work to the Mount Sinal Hospital, New York. this content, Visit: icahn.mssm.edu/Addiction or www.mountsinai.org/addiction for more information.