1. Substance Use and the Brain Susan Tapert, Ph.D. Alcohol Medical Scholars Program

2. Copyright AMSP2 Substance Use and the Brain 1.How is the brain affected long-term? Alcohol Marijuana Stimulants 2.What can we do about this?

3. Copyright AMSP3  How is the brain affected long-term? Alcohol Marijuana Stimulants  What can we do about this? Substance Use and the Brain

4. Copyright AMSP4 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

5. Copyright AMSP5 Alcohol and Sleep Problems when using and when sober –Falling asleep –Total sleep –Sleep quality Affects memory and thinking Feeling unrested increases relapse risk

6. Copyright AMSP6 Brain Structure Magnetic resonance imaging (MRI) –Safe –No injections –Shows small brain parts

7. Copyright AMSP7 Shrinkage: Ventricles Non-alcoholicAlcoholic

8. Copyright AMSP8 Shrinkage: Cerebellum Healthy ControlAlcoholic

9. Copyright AMSP9 Brain Function Functional magnetic resonance imaging (fMRI) –Safe –Movies of brain activity –Good resolution

10. Copyright AMSP10 Brain Function Side View Alcoholics vs. Healthy Controls

11. Copyright AMSP11 Volume Recovery During Treatment 2 Years Later

12. Copyright AMSP12  How is the brain affected long-term? Alcohol Marijuana Stimulants  What can we do about this? Substance Use and the Brain

13. Copyright AMSP13 Marijuana & Thinking Modest problems in very heavy users –Learning and memory –Sustained attention –Impulsivity Most recover after 1 month abstinent

14. Copyright AMSP14 Marijuana & Brain No evidence of brain shrinkage Altered brain waves related to attention  brain blood flow  brain response while learning

15. Copyright AMSP15  How is the brain affected long-term? Alcohol Marijuana Stimulants  What can we do about this? Substance Use and the Brain

16. Copyright AMSP16 Stimulants &Thinking Motor skills Planning Switching tasks Decision making Working memory Impulsivity Learning and memory

17. Copyright AMSP17 Stimulants & Brain Structure Volume reductions:Volume reductions: –Cingulate –Hippocampus –No overall gray matter changes Volume increase:Volume increase: –Subcortical areas

18. Copyright AMSP18 Stimulants & Blood Flow High blood flow Low blood flow Healthy Control Cocaine-dependent Gottschalk, 2001, Am J Psychiatry

19. Copyright AMSP19 Blood Flow Recovery Non users Cocaine users, 10 days sober Cocaine Users, 100 days sober High blood flow Low blood flow

20. Copyright AMSP20 Substance Use and Brain Summary: Thinking problems Tissue loss Decreased blood flow Altered brain response to task Much recovery with abstinence

21. Copyright AMSP21  How is the brain affected?  What can we do about this? Substance Use and the Brain

22. Copyright AMSP22 Implications Inform patients Develop better treatments