Addiction is a chronic brain disease that involves pathological pursuit of reward and relief through substance use and other behaviors, despite their negative consequences. The brain's reward center is activated by natural rewards like food and sex but becomes dysfunctional in addiction. Genetics and life experiences influence this. For addicts, nothing else stimulates the reward center normally. Continued substance use or behaviors cause biological, psychological, social, and spiritual problems. Prevention focuses on healthy activities with family and friends while treatment requires confronting the issue with care but also firmness when needed.

1. ADDICTION IS A BRAIN DISEASE

2. DEFINITION Per American Society of
Addiction Medicine
• A primary, chronic disease of brain reward,
motivation , memory and related circuitry.
• This leads to biological, psychological, social,
and spiritual manifestations.

3. Definition
• This is reflected in an individual pathologically
pursuing reward and/or relief by use of
substances and/or other behaviors.
• Continued use will cause negative
consequences, yet is continued at all cost
• Becomes a primary or only mechanism for
perceived pleasure.

4. The Brain Reward Center

5. Reward Center
• Exists for our survival
• Activates strongly for food and sex
• Activates any time “well being’ is felt
• THIS IS THE BRAIN SAYING----”This activity is
good and enjoyable. Recommend repeating
as soon as possible.”

6. Dysfunction in this brain mechanism
• Driving behaviors found to stimulate the
pleasure center despite negative
consequences.
• Genetic to some extent
• Social and past experiences to a large extent

7. The Key Is This
• Addicted folks are not getting stimulation of
the pleasure center normally in their lives.
• We must therefore find something else to
trigger this pleasure center response. We
must!
• When something is tried or taken and
euphoria follows, this sets the trap.

8. PET Scan in Addiction

9. PET Scans show effect of various
substances and behaviors

10. Sick but True

17. Porn, Vanity, Sex addictions

18. Back to definition
• Dysfunction in pleasure center circuitry causes
problems:
– Biologically
– Behavior (psychologically)
– Socially
– Spiritually

19. Biological Manifestations
• How quickly can someone become addicted?
• ANSWER: Very QUICKLY
• You can see it in the practice of Emergency
Medicine with Opioids-
– 10 kidney stone patients

21. CRAVINGS
• Find what pleases. It is the first priority.
• We need it now.
• Nothing will deter us as our survival depends
on it.
THIS IS WHY YOU CAN NOT LEGISLATE
ADDICTIVE BEHAVIOR.

22. Continued behavior despite negative
consequences
• Drug use—overdoses and repeated law
enforcement interactions
• Food- early type 1 and 2 diabetes. Childhood
diabetes highest rate ever and climbing. Early
death coming for 70 million people
• Nicotine- cancer, heart disease, stroke, COPD

23. So now what does the addict do?
• Continues behaving the same or using
• Isolates, lies. Uses more or intensifies
behaviors due to tolerance
• Breaks the law if needed to fulfill the reward
center. Gains 10 more pounds, gambles away
last of paycheck.

26. Prevention
• Close family and friends
• Stop unhealthy behaviors quickly
• Open communication with loved ones
• Encourage healthy activities with family,
friends
• Do not take narcotic pain meds
• Limit social media
• Dispose of all unused medications promptly

27. Prevention
• Decide today how you and your children will
cope with hardship that is sure to come.
• Avoid risky behaviors-
– Teen drinking
– Marijuana use
– Unsupervised social media
– Lax rules, curfew, etc.
– Promote spirituality of your choice in the home

28. TREATMENT
• Addiction requires treatment like any chronic
disease
• Confront, offering help but not being co-
dependent (Hard Love)
• IOP, In-patient treatment, meetings, sponsor
• Use law enforcement as last resort
• Sometimes legal enforcement is life-saving