1. Youth standing for freedom from chemical slavery Gilberto Gerra Chief Drug Prevention and Health Branch

2. Political Declaration 2009 Paragraph 22 Emphasize and facilitate health, productive and fulfilling alternatives to the illicit consumption of drugs, which must not become accepted as a way of life;

3. a society under medication? Benzodiazepine for math test anxiety Cannabis for dating Amphetamine for working Ecstasy for dancing Energy drinks for driving Ketamine for fantasy Cocaine and Viagra for sex Efedrine and Growth Hormone for sport Oxicodon for coping with stress Heroin for escaping reality Ritalin for behavioural control Brain enhancers for carrier Alcohol for relaxing and socializing

4. Pharmaceutical Companies $ Narco-traffickers $ Alcohol producers $ Who is gaining?

5. Health Security Mental health Youth empowerment Creativity Innovative initiatives Social-family cohesion Responsibility accountability At risk with substance use disorders

6. Who is interested in young people... Less involved/engaged Acritical Sedated / anaffective With reduced cognitive capacity With reduced memory Negativism.... Unable to dream the future Dependent / conditioned ?????

7. Lancet Adverse health effects of non-medical cannabis use. The health effects most likely to occur and to affect a large number of cannabis users: Hall and Degenhardt, 2009 a dependence syndrome increased risk of motor vehicle crashes impaired respiratory functioncardiovascular disease adverse effects on adolescent psychosocial development and mental health

8. Dunedin prospective study Regularly smoking cannabis in their teens and then stopped 8 point less in IQ scale as adults

9. Ecstasy

10. MacEwen C et al. (2008) A case of cocaine-induced basilar artery thrombosis Nat Clin Pract Neurol doi:10.1038/ncpneuro0879 Figure 1 Brain CT scan in a patient with cocaine-induced basilar artery thrombosis

11. Milton and Everitt, 2012 usurpation of emotional memory Cocaine addicts brain is not activated anymore by monetary reward

12. Before and after methamphetamines...

16. Stigma and discrimination To punish … To permit… Denial Not to share suffering To ignore responsibility To attenuate sense of guilt

20. Drug addiction is often the result of an unwholesome social atmosphere in which those who are most exposed to the danger of drug abuse live Resolution III, 1972 (amendments to 1961 Convention)

21. A social atmosphere detrimental to physical, mental and moral well-being…

22. Temperament, personality traits Insecure parent-child attachment Neglect Abuse Stressful life events Lack of bonding to family Affectionless control Excessive protection Extreme poverty Social exclusion Exposure to violence, displacement Chaotic family Lack of engagement in school Peer pressure Drug availability: exposure to drugs and alcohol Risk perception Psychobiological Vulnerability: Synaptic function Epigenetic changes Behavioural attitude Mental health disorders Pathogenesis of the disease

23. Emotional neglect Abuse Adverse childhood experiences Household dysfunction

24. Epigenetic effects of drugs

25. Epigenetic mechanisms in drug addiction Renthal and Nestler, 2009

26. ...and vulnerability Exploring resilience...

28. PBI Paternal care PBI Maternal care BDHI Direct aggression abstinent subjects 25,49  0,42 27,59  0,38 45.3  2.9 cocaine users LL-SL 5-HTT genotypes 22,56  0.9 24.61  0.5 59.3  2.9 cocaine users SS 5-HTT genotypes 18.78  0.4 18.89  0.45 63.25  2.5 Perceived parenting behaviour in the childhood of cocaine users: relationship with genotype and personality traits (Gerra et al., 2007)

29. 18 27 PARENTS CARE PERCEPTION 10% less risk 20% less risk RISK % OF DRUG DEPENDENCE IN THE ADULT PBI SCORE 90% less risk

31. Proceedings of the National Academy of Sciences of the United States of America (PNAS), 2012

32. short version (S) of the 5-HTTLPR Zimmermann et al., 2009 insecure attachment secure attachment agreeable autonomy hostile autonomy

34. Resilience Vulnerability inequality Prevention

35. Prevention of substance abuse reaching the most vulnerable Prevention of substance abuse as a pillar of development and freedom The commitment of the International Community

36. long-term neurobiological changes associated with early stress can be modified by the quality of the subsequent care-giving environment Kaufman and Charney, 2001

39. Prevention of cardiovascular diseases -Poker of Aces No smoking No salt No cholesterol Physical exercise

40. Give clear rules and appreciate your child behaviour

42. Dreaming with children about future… Rewarding their achievements Teaching to accept limits and rules Experiencing community cohesion and participation Making them aware of progressive autonomy Looking at life perspectives with hope Proposing values and believes Transmitting cultural identity

43. to change the trajectory of children at risk