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Vision Session: National Institute on Drug Abuse (NIDA): Addiction Science - Building Resilience from the Brain Up, Dr. Ruben Baler

Vision Session: National Institute on Drug Abuse (NIDA): Addiction Science - Building Resilience from the Brain Up, Dr. Ruben Baler

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  • Between 1999 and 2003 a 1 point increase in the strength of the accountability index translated into a 2.3 increase in consumption. <br />

VS_NIDA_Baler VS_NIDA_Baler Presentation Transcript

  • Rx ABUSE: BUILDING RESILIENCE FROM THE BRAIN UP Ruben Baler, Ph.D. Science Policy Branch – NIDA - NIH
  • BRAIN
  • System 1 System 2 Fast Automatic Implicit Effortless Abstract Slow Conscious Explicit Effortful Rule-based Morewedge and Khaneman. Trends Cogn. Sci. 14(10):435-40. (2010)
  • System 1 System 2 Fast Slow Morewedge and Khaneman. Trends Cogn. Sci. 14(10):435-40. (2010)
  • RED BLUE GREEN RED GREEN RED BLUE GREEN BLUE GREEN RED BLUE
  • RED BLUE GREEN RED GREEN RED BLUE GREEN BLUE RED GREEN BLUE
  • intuition reasoning What is it supposed to accomplished ?
  • look around eat reproduce
  • look around eat reproduce
  • look around eat reproduce time texting while driving junk food virtual sex, bizarre porn
  • look around eat reproduce texting while driving Junk food virtual sex, bizarre porn
  • OBVIOUS
  • chronic stress heart disease mental illness addictions NOT SO OBVIOUS …
  • Thinking about this problem in evolutionary terms is important …
  • efficient flexible constant change
  • How does the brain achieve flexibility?
  • light noise hormones stress hierarchy nutrition
  • Our brains usually display high performance in spite of environmental uncertainty
  • And just like thermostats, our brains are ROBUST YET FRAGILE ■ robust to disturbances that the system is designed to handle. ■ fragile to rare events and flaws in the design.
  • Seek the fattiest meat, the sweetest fruits, the most high-energy foods
  • the rise of processed foods HighFructoseCornSyrup (gr/capita)
  • SOURCE: U.S. Department of Justice US Annual Production Quota (Kg)
  • ~ 41% Rise in ADHD Dx Over the Past Decade (children 5-17) Data collated from CDC, NSCH, and NHIS data Boys All children Girls 1997 1998 1999 2000 2001 2002 2003 2004-6 2007-9 2011-2 Year(s) Percent 16 14 12 10 8 6 4 2 0 historic rate of 3-7 %
  • Fulton et al., Psychiatric Services 60(8):1075. (2009) National Variation of ADHD Diagnostic Prevalence and Medication Use v 5 4 3 2 School Accountability Index
  • 1 2 2 1 IncreaseStimulantConsumption(%) The strength of accountability pressures (i.e., rewards + assistance + sanctions), helps explain both the variation over time and across states in the aggregate consumption of ADHD drugs. Bohhari and Schneider. School accountability laws and the consumption of psychostimulants. J. Health Econ. 30(2): 355-72 (2011). Strength of the accountability index
  • Obesity 18.5 3.5 11 2011 ADHD 6 2003 1997 1965 2008 HFCS 1972 High Fructose Corn Syrup NCLB 2001 No Child left behind= ?
  • Rx Drugs Account for 7 out of the 14 most frequently abused drugs Source: 2013 Monitoring the Future Study, University of Michigan
  • Misperceptions about their safety Why? Varied motivations for their abuse Increasing environmental availability
  • look around eat reproduce texting while driving junk food virtual sex, porn
  • ACQUIRE ROBUSTNESS TO WHATEVER DROVE SELECTION AT THE EXPENSE OF FRAGILITY TO WHATEVER IT DID NOT EVOLVED SYSTEMS
  • ROBUST YET FRAGILE
  • ROBUST YET FRAGILE
  • robust, yet fragile systems are very complex
  • 100 Billion1 Quadrillion
  • But with some important differences Connections billions quadrillions Architecture simple nested Adaptability primitive plastic
  • NEURO TRANSMITTERS Dopamine Endocannabinoids GABA Glutamate Serotonin
  • reward
  • Memory emotion reward
  • Memory emotion reward motivation
  • Memory emotion reward motivation control
  • driverewar d memory contr ol no go go cont rol reward memor y drive Volkow et al. The addicted human brain: insights from imaging studies (2003) Normal brainAddicted brain
  • Memory emotion reward motivation control
  • “As I sit to compose this plea I can’t say with any amount of certainty that my son is alive. My son discovered narcotics at the age of 13, [after] he experienced a severe orthopedic sports injury. There seems to be nothing that can induce him to stop for any appreciable length of time. I had him arrested May of 2006 for heroin possession and identity fraud, he stole 900 dollars from our checking account while I was in Connecticut burying my dad and his sister . He tells me he cannot stop. Our family is being destroyed . We have exhausted our savings and retirement. Everything seems so hopeless.” Volkow, Baler, Goldstein. Addiction: pulling at the neural threads of social behaviors. Neuron. 2011 Feb 24;69(4):599-602.
  • It’s not, it’s an operational failure Volkow et al. The addicted brain: Insights from imaging studies (2003) is a moral failure.
  • tobacco marijuana analgesics alcohol cocaine heroin 260M meth
  • genetics development epigenetics environment parental style education
  • • RESILIENCE
  • BRAIN
  • poverty
  • poor parenting
  • deviant peers
  • drug availability
  • genes and development
  • environment genes and development
  • increase risk genes and development
  • increase risk genes and development
  • Strategies to Empower System II increase risk genes and development
  • Strategies to Empower System IIincrease risk genes and development
  • Ruben’s Ten Suggestions for raising a balanced brain
  •  Sleep hygiene  Marshmallow-like games from early on  Bilingualism  Classroom-based physical activity  Foster social interaction  Grant age-appropriate control over life  Contemplative practice (e.g., meditation)  Reliable environments  Stance toward “Intellectual Struggle”  Embrace different brain architectures
  •  Sleep hygiene  Marshmallow-like games from early on  Bilingualism  Classroom-based physical activity  Foster social interaction  Grant age-appropriate control over life  Contemplative practice (e.g., meditation)  Reliable environments  Stance toward “Intellectual Struggle”  Embrace different brain architectures
  •  Sleep hygiene  Marshmallow-like games from early on  Bilingualism  Classroom-based physical activity  Foster social interaction  Grant age-appropriate control over life  Contemplative practice (e.g., meditation)  Reliable environments  Stance toward “Intellectual Struggle”  Embrace different brain architectures
  •  Sleep hygiene  Marshmallow-like games from early on  Bilingualism  Classroom-based physical activity  Foster social interaction  Grant age-appropriate control over life  Contemplative practice (e.g., meditation)  Reliable environments  Stance toward “Intellectual Struggle”  Embrace different brain architectures
  •  Sleep hygiene  Marshmallow-like games from early on  Bilingualism  Classroom-based physical activity  Foster social interaction (e.g., GBG Barrish, Saunders,&Wolf)  Grant age-appropriate control over life  Contemplative practice (e.g., meditation)  Reliable environments  Stance toward “Intellectual Struggle”  Embrace different brain architectures
  •  Sleep hygiene  Marshmallow-like games from early on  Bilingualism  Classroom-based physical activity  Foster social interaction (e.g., GBG Barrish, Saunders,&Wolf)  Grant age-appropriate control over life  Contemplative practice (e.g., meditation)  Reliable environments  Stance toward “Intellectual Struggle”  Embrace different brain architectures
  •  Sleep hygiene  Marshmallow-like games from early on  Bilingualism  Classroom-based physical activity  Foster social interaction (e.g., GBG Barrish, Saunders,&Wolf)  Grant age-appropriate control over life  Contemplative practices (e.g., meditation)  Reliable environments  Stance toward “Intellectual Struggle”  Embrace different brain architectures
  •  Sleep hygiene  Marshmallow-like games from early on  Bilingualism  Classroom-based physical activity  Foster social interaction (e.g., GBG Barrish, Saunders,&Wolf)  Grant age-appropriate control over life  Contemplative practices (e.g., meditation)  Reliable environments (Celeste Kidd)  Stance toward “Intellectual Struggle”  Embrace different brain architectures
  •  Sleep hygiene  Marshmallow-like games from early on  Bilingualism  Classroom-based physical activity  Foster social interaction (e.g., GBG Barrish, Saunders,&Wolf)  Grant age-appropriate control over life  Contemplative practices (e.g., meditation)  Reliable environments (Celeste Kidd)  Praise. Fixed vs. Growth mindsets (Carol Dweck)  Embrace different brain architectures
  •  Sleep hygiene  Marshmallow-like games from early on  Bilingualism  Classroom-based physical activity  Foster social interaction (e.g., GBG Barrish, Saunders,&Wolf)  Grant age-appropriate control over life  Contemplative practices (e.g., meditation)  Reliable environments (Celeste Kidd)  Praise. Fixed vs. Growth mindsets (Carol Dweck)  Embrace different brain architectures (Ken Robinson)
  • balerr@mail.nih.gov