HOLDING HANDS WITH    THE HOPELESS <ul><li>Substance Abuse in </li></ul><ul><li>Middle Aged-Adult </li></ul><ul><li>Since ...
Table of Contents <ul><li>Brief Introduction </li></ul><ul><li>FAQs about Addiction </li></ul><ul><li>Summary; Accepting t...
Table of Contents contd. <ul><li>Summary; The Middle-Aged Alcoholic, Who are They? </li></ul><ul><li>Article:  This is you...
FAQs Regarding Alcoholism <ul><li>Is Alcoholism a Disease? </li></ul><ul><li>Can alcoholism be treated or cured? </li></ul...
Accepting The Disease Of Addiction <ul><li>Addiction is America’s number-one public health crisis.  Last year 150,000 Amer...
Accepting The Disease Of Addiction contd. <ul><li>A some point in the progression of addiction, the brain rewires itself a...
Accepting The Disease Of Addiction contd. <ul><li>What the critics are saying </li></ul><ul><li>As a society we  must  mak...
The Importance of Imaging  Technology In The Addicted  Brain <ul><li>Pyramid Of Brain Imaging </li></ul><ul><li>PET (Posit...
Copyright ©2003 American Society for Clinical Investigation Volkow, N. D. et al. J. Clin. Invest. 2003;111:1444-1451
Copyright ©2003 American Society for Clinical Investigation Volkow, N. D. et al. J. Clin. Invest. 2003;111:1444-1451
Copyright ©2003 American Society for Clinical Investigation Volkow, N. D. et al. J. Clin. Invest. 2003;111:1444-1451
The Importance of Imaging  Technology In The Addicted Brain contd. <ul><li>PET Images showing Dopamine receptors in nonhum...
Copyright ©2003 American Society for Clinical Investigation Volkow, N. D. et al. J. Clin. Invest. 2003;111:1444-1451
The Importance of Imaging  Technology In The Addicted Brain contd. <ul><li>Model proposing a network of four circuits invo...
Copyright ©2003 American Society for Clinical Investigation Volkow, N. D. et al. J. Clin. Invest. 2003;111:1444-1451
The Importance of Imaging  Technology In The Addicted Brain contd. <ul><li>Images obtained with PET to measure the numbers...
Copyright ©2003 American Society for Clinical Investigation Volkow, N. D. et al. J. Clin. Invest. 2003;111:1444-1451
Removing the Stigma    Myths of Addictions <ul><li>Addicts are bad, crazy, or stupid. </li></ul><ul><li>Addiction is a wil...
The Middle Aged Alcoholic Who Are They? <ul><li>Addiction has many faces:  black and white and all the shades in between. ...
The Middle Aged Alcoholic Who Are They? Contd. <ul><li>21 million middle-aged binge drinkers (those downing five or more d...
  Women and Alcoholism What Do We Really Know? <ul><li>The number of female alcoholics is estimated to be between 5 and 7 ...
Women and Alcoholism   What Do We Really Know? contd. <ul><li>Women are more susceptible to liver disease (in fact women w...
Women and Alcoholism   What Do We Really Know? contd. <ul><li>Alcoholic women describe themselves as: </li></ul><ul><li>~F...
Five Distinct Subtypes of Alcohol  Dependence <ul><li>In June 2007, the National Institute on Alcohol Abuse and Alcoholism...
  Sociodemographic  Characteristics of Addiction <ul><li>Twelve-month prevalence and population estimates of DSM-IV alcoho...
Articles & References Regarding Treatment Options <ul><li>Additional Articles: </li></ul><ul><li>Alcohol Abuse and Alcohol...
Addiction, Why Can’t They Just Stop?  New Knowledge. New Treatments, New Hope <ul><li>HBO & Two NIH Institutes Share Emmy ...
Inside The Mind Of An Addict <ul><li>Quotes and thoughts from    Alcoholics and Addicts </li></ul>
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Holding Hands With The Hopeless Edps Project Final

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This was initially completed as a project in one of my courses. However, understanding substance abuse as a disease and not a moral issue or lack of willpower is vitaly important to continue to make advancements in treatments and reimbursement issues, which are a huge threat.

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  • I am looking for references that support my developing understanding of a human being in a behavioural change process. they have to stop taking substances i.e. cocaine alcohol and so forth
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Holding Hands With The Hopeless Edps Project Final

  1. 1. HOLDING HANDS WITH THE HOPELESS <ul><li>Substance Abuse in </li></ul><ul><li>Middle Aged-Adult </li></ul><ul><li>Since we cannot change reality, let us change the eyes which see reality. </li></ul><ul><li>~Nikos Kazantzakis </li></ul>
  2. 2. Table of Contents <ul><li>Brief Introduction </li></ul><ul><li>FAQs about Addiction </li></ul><ul><li>Summary; Accepting the Disease of Addiction </li></ul><ul><li>Article: Addiction Is a Brain Disease </li></ul><ul><li>Summary; The Importance of Imaging Technology in the Addicted Brain </li></ul><ul><li>Article: The Addicted Human Brain: Insights from Imaging Studies </li></ul><ul><ul><li>Examples of PET, CT and fMRI Images </li></ul></ul><ul><li>Article: Neurobiological Understanding of Addictions </li></ul><ul><li>Article: Research Highlights the Neurology of Addiction </li></ul><ul><li>Summary; Removing the Stigma, the Myths of Addiction </li></ul><ul><li>Article: Removing the Stigma; Myths of Addiction; Excerpt </li></ul><ul><li>Summary; Women and Alcoholism, What do we Really Know? </li></ul><ul><li>Article: The Process of Reconnecting: Recovery from the Perspective of Addicted Women </li></ul><ul><li>Article: Women and alcoholism: A biopsychosocial perspective and treatment approaches </li></ul><ul><li>Article's Sex, Abuse, Other Issues Complicate Female Recovery </li></ul><ul><li>Article: Female Hormone Mediate Alcohol’s Effect </li></ul>
  3. 3. Table of Contents contd. <ul><li>Summary; The Middle-Aged Alcoholic, Who are They? </li></ul><ul><li>Article: This is you (Father’s) Brain on Drugs </li></ul><ul><li>Article: Alcoholics’ Suicide Risk Increases With Age </li></ul><ul><li>Article: Older Alcoholics at Greater Risk, Study Finds </li></ul><ul><li>Article: More Adults, Few Teens Using Drugs </li></ul><ul><li>Article: Boomers Struggle With Drug Addiction </li></ul><ul><li>Summary of Information </li></ul><ul><li>Sociodemographic Characteristics of Addition </li></ul><ul><li>*NESARC Chart </li></ul><ul><li>Summary; Five Distinct Subtypes of Alcohol Dependence </li></ul><ul><li>Article: Clinical Features Point to Five Alcoholic Subtypes </li></ul><ul><li>Article: Directions New; Alcohol Dependence Subtypes </li></ul><ul><li>Article: Researchers find 5 Types of Alcohol Dependence </li></ul><ul><li>Articles: Various articles regarding treatment, reimbursement issues and questions to ask when researching treatment </li></ul><ul><li>Articles and references regarding treatment options and other resources </li></ul><ul><li>Article: HBO Documentary, “Why Can’t They Just Stop?” wins Emmy </li></ul><ul><li>Inside The Mind of An Addict </li></ul><ul><li>~Quotes gathered by alcoholics regarding how they felt about their addiction </li></ul>
  4. 4. FAQs Regarding Alcoholism <ul><li>Is Alcoholism a Disease? </li></ul><ul><li>Can alcoholism be treated or cured? </li></ul><ul><li>Why do some people react differently to alcohol than others? </li></ul><ul><li>Does alcoholism treatment work? </li></ul><ul><li>A quick guide to finding effective alcohol and drug addiction treatment. </li></ul><ul><li>Which medicines are available to treat alcohol dependence? </li></ul><ul><li>Is alcoholism inherited? </li></ul>
  5. 5. Accepting The Disease Of Addiction <ul><li>Addiction is America’s number-one public health crisis. Last year 150,000 Americans died as a direct result of chemical addiction. Treatment center doors were slammed shut on the faces of people who came in for help because they couldn’t afford to pay. In some cases they had no insurance. In many, their insurance was inadequate. </li></ul><ul><li>People see addiction as either a disease or as a failure of will. </li></ul><ul><li>Addiction is a chronic, relapsing and treatable brain disease </li></ul>
  6. 6. Accepting The Disease Of Addiction contd. <ul><li>A some point in the progression of addiction, the brain rewires itself and begins to function in a persistent change in both brain structure and function. </li></ul><ul><li>Addiction involves inseparable biological and behavioral components. It is the quintessential biobehavioral disorder. </li></ul><ul><li>Addiction is not atypical to the definition of a brain disease which cannot be simply biological in nature and expression. </li></ul><ul><ul><ul><li>Stroke </li></ul></ul></ul><ul><ul><ul><li>Alzheimer’s </li></ul></ul></ul><ul><ul><ul><li>Schizophrenia </li></ul></ul></ul><ul><ul><ul><li>Clinical Depression </li></ul></ul></ul>
  7. 7. Accepting The Disease Of Addiction contd. <ul><li>What the critics are saying </li></ul><ul><li>As a society we must make aggressive progress in dealing with the problem of addiction. </li></ul><ul><li>We must ascend the moral outrage that addicts have “done this to themselves”. </li></ul><ul><li>Addiction is a brain disease. Treatment can work. </li></ul>
  8. 8. The Importance of Imaging Technology In The Addicted Brain <ul><li>Pyramid Of Brain Imaging </li></ul><ul><li>PET (Positron Emission Tomography) Imaging </li></ul><ul><li>~Proteins </li></ul><ul><li>~Glucose Metabolism </li></ul><ul><li>~Effect on Dopamine Transports & Receptors </li></ul><ul><li>fMRI (Functional Magnetic Resonance Imaging) </li></ul><ul><li>~Areas of brain activation and deactivation during cocaine intoxification compared to those given saline administration. </li></ul><ul><li>~The complex pattern of activation and/or deactivation during intoxification hitting areas that influence dopamine and involve regions with reward, memory and motivation. </li></ul><ul><li>~The color scale indicates the level of significance of the change in activation of the bold signal. </li></ul>
  9. 9. Copyright ©2003 American Society for Clinical Investigation Volkow, N. D. et al. J. Clin. Invest. 2003;111:1444-1451
  10. 10. Copyright ©2003 American Society for Clinical Investigation Volkow, N. D. et al. J. Clin. Invest. 2003;111:1444-1451
  11. 11. Copyright ©2003 American Society for Clinical Investigation Volkow, N. D. et al. J. Clin. Invest. 2003;111:1444-1451
  12. 12. The Importance of Imaging Technology In The Addicted Brain contd. <ul><li>PET Images showing Dopamine receptors in nonhuman primates that were initially tested while housed in separate cages then retested after being housed in a group. </li></ul><ul><li>Animals that became dominant when placed in a group showed increased numbers of DA D2 receptors ( a ), whereas subordinate animals did not ( b ). </li></ul><ul><li>( c ) The levels of cocaine administration in the subordinate and the dominant animals. Note the much lower intake of cocaine by dominant animals which possessed higher numbers of DA D2 receptors. The temperature scale was used to code the PET images; images; radiotracer concentration is displayed from higher to lower as yellow > red. Asterisks indicate significant differences in drug intake between groups. </li></ul>
  13. 13. Copyright ©2003 American Society for Clinical Investigation Volkow, N. D. et al. J. Clin. Invest. 2003;111:1444-1451
  14. 14. The Importance of Imaging Technology In The Addicted Brain contd. <ul><li>Model proposing a network of four circuits involved with addiction: reward, motivation/drive, memory, and control. These circuits work together and change with experience. </li></ul><ul><li>Each is linked to an important concept: saliency (reward), internal state (motivation/drive), learned associations (memory), and conflict resolution (control). </li></ul><ul><li>During addiction, the enhanced value of the drug in the reward, motivation, and memory circuits overcomes the inhibitory control exerted by the prefrontal cortex, thereby favoring a positive-feedback loop initiated by the consumption of the drug and perpetuated by the enhanced activation of the motivation/drive and memory circuits. </li></ul>
  15. 15. Copyright ©2003 American Society for Clinical Investigation Volkow, N. D. et al. J. Clin. Invest. 2003;111:1444-1451
  16. 16. The Importance of Imaging Technology In The Addicted Brain contd. <ul><li>Images obtained with PET to measure the numbers of DA D2 receptors in subjects who reported the effects of the stimulant drug methylphenidate as pleasant versus those that reported its effects as unpleasant. </li></ul><ul><li>Subjects with high numbers of DA D2 receptors tended to report the effects of methylphenidate as unpleasant, whereas subjects with low numbers of DA D2 receptors tended to report it as pleasant. </li></ul><ul><li>The rainbow scale was used to code the PET images; radiotracer concentration is displayed from higher to lower as red > yellow > green > blue. </li></ul>
  17. 17. Copyright ©2003 American Society for Clinical Investigation Volkow, N. D. et al. J. Clin. Invest. 2003;111:1444-1451
  18. 18. Removing the Stigma Myths of Addictions <ul><li>Addicts are bad, crazy, or stupid. </li></ul><ul><li>Addiction is a willpower problem. </li></ul><ul><li>Addicts should be punished not treated, for using drugs and/or alcohol. </li></ul><ul><li>People addicted to one drug are addicted to all drugs. </li></ul><ul><li>Addicts cannot be treated with medications. </li></ul><ul><li>Addiction is treated behaviorally, so it must be a behavioral problem. </li></ul><ul><li>Alcoholics can stop drinking simply by attending AA meetings, so they can’t have a brain disease. </li></ul>
  19. 19. The Middle Aged Alcoholic Who Are They? <ul><li>Addiction has many faces: black and white and all the shades in between. It is rural and urban, rich and poor. Of it’s many faces, on thing is almost guaranteed, it is a face you know. </li></ul><ul><li>Deaths from illegal-drug overdoses among people in their forties and fifties have risen 800% since 1980 and 300% in the past decade. </li></ul><ul><li>Baby Boomers make up one the largest populations of addicts. </li></ul><ul><li>Addiction is a disease that impacts 1 in 4 families. </li></ul>
  20. 20. The Middle Aged Alcoholic Who Are They? Contd. <ul><li>21 million middle-aged binge drinkers (those downing five or more drinks on one occasion in the previous month) this is double the number among teenagers and college students combined. </li></ul><ul><li>370,000 middle-aged people treated in hospital emergency rooms for abusing illegal drugs in 2005, with overdose rates for heroin, cocaine, pharmaceuticals and drugs mixed with alcohol; again this number is far higher than those among teenagers. </li></ul><ul><li>More than half of all new HIV/AIDS diagnoses in 2005 were given to middle-aged Americans, up from less than one-third a decade ago, according to the Centers for Disease Control. </li></ul><ul><li>Alcoholics’ suicide risk increases with age. </li></ul>
  21. 21. Women and Alcoholism What Do We Really Know? <ul><li>The number of female alcoholics is estimated to be between 5 and 7 million (this does not include woman addicted to other substances). </li></ul><ul><li>The physical and psychological affects on woman are tenfold compared to those of their male counterparts. </li></ul><ul><li>The majority of women develop addictions in their middle adulthood. </li></ul><ul><li>70% of female addicts have a history of sexual abuse. </li></ul>
  22. 22. Women and Alcoholism What Do We Really Know? contd. <ul><li>Women are more susceptible to liver disease (in fact women who stopped drinking after being diagnosed with alcoholic hepatitis died or progressed to cirrhosis more rapidly then men). </li></ul><ul><li>Female hormones play a huge part in the progression of the disease. </li></ul><ul><li>There is definitely a genetic component (in male addicts as well) a child of an addict is 50-60% more likely to be predisposed to addiction. </li></ul><ul><li>Do to the later onset of the disease in women, the disease progresses rapidly. </li></ul>
  23. 23. Women and Alcoholism What Do We Really Know? contd. <ul><li>Alcoholic women describe themselves as: </li></ul><ul><li>~Feeling isolated </li></ul><ul><li>~Separated from the world </li></ul><ul><li>~Lonely </li></ul><ul><li>~Feelings of inadequacy & anxiety </li></ul><ul><li>~Have poor self-esteem </li></ul><ul><li>Woman often start to use their “drug of choice” by self-medicating. </li></ul>
  24. 24. Five Distinct Subtypes of Alcohol Dependence <ul><li>In June 2007, the National Institute on Alcohol Abuse and Alcoholism (NIAAA) announced that studies reveal five distinct subtypes of alcohol dependence. </li></ul><ul><li>The five subtypes have been universally accepted by healthcare community. </li></ul><ul><li>Utilizing this as an assessment tool will lead to more appropriate treatment options </li></ul><ul><li>See attached Chart </li></ul>
  25. 25. Sociodemographic Characteristics of Addiction <ul><li>Twelve-month prevalence and population estimates of DSM-IV alcohol abuse by age, sex, and race-ethnicity: United States 2001-2002 </li></ul><ul><li>See attached chart </li></ul><ul><li>Summary of Findings </li></ul>
  26. 26. Articles & References Regarding Treatment Options <ul><li>Additional Articles: </li></ul><ul><li>Alcohol Abuse and Alcoholism: Self-Help, Prevention, and Treatment Options </li></ul><ul><li>Addiction Treatment Benefits Fall Short of Other Health Coverage </li></ul><ul><li>High Profile Failures Do Disservice to Addiction Treatment </li></ul>
  27. 27. Addiction, Why Can’t They Just Stop? New Knowledge. New Treatments, New Hope <ul><li>HBO & Two NIH Institutes Share Emmy Award </li></ul><ul><li>HOPE! Will the acknowledgement of valid resources cause a shift in the in paradigm of thinking? </li></ul><ul><li>Inside The Mind of the Addict: </li></ul><ul><li>~Quotes & Thoughts Shared by Alcoholics and Addicts </li></ul>
  28. 28. Inside The Mind Of An Addict <ul><li>Quotes and thoughts from Alcoholics and Addicts </li></ul>

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