WILLPOWER and NC
The slogan from the 1980's that stemmed from the belief that addiction is solely rooted in morally flawed behavior choices.
What is "Just Say No"?
The initial and early decisions to use substances reflect a person’s free or conscious choice. However, once the brain has been changed by addiction, that choice or willpower becomes impaired. Perhaps the most defining symptom of addiction is a loss of control over substance use.
About 25-50% of people with a substance use problem appear to have a severe, chronic disorder. For them, addiction is a progressive, relapsing disease that requires intensive treatments and continuing aftercare, monitoring and family or peer support to manage their recovery.
The good news is that even the most severe, chronic form of the disorder can be manageable and reversible, usually with long term treatment and continued monitoring and support for recovery.
This accounts for 50 to 75% of addiction
What is genetics?
While psychological and environmental factors appear to be more influential in determining whether an individual starts to use substances, genetic factors appear to have more of an influence in determining who progresses from substance use to addiction.
Unlike illicit drugs, it is widely available and accepted in many cultures. It’s often at the center of social situations and closely linked to celebrations and enjoyment.
What is alcohol?
More than 450,000 individuals suffer from alcohol addiction or abuse in North Carolina every year. Almost 40,000 of these people are teenagers.
Withdrawal symptoms like headache, dizziness, racing heart, palpitations occur as a result of the brain's release of this neurotransmitter during the immediate phase of withdrawal.
What is norepinephrine (noradrenaline)?
Withdrawal occurs because your brain works like a spring when it comes to addiction. Drugs and alcohol are brain depressants that push down the spring. They suppress your brain's production of neurotransmitters like noradrenaline. When you stop using drugs or alcohol it's like taking the weight off the spring, and your brain rebounds by producing a surge of adrenaline that causes withdrawal symptoms.
Every drug is different. Some drugs produce significant physical withdrawal (alcohol, opiates, and tranquilizers). Some drugs produce little physical withdrawal, but more emotional withdrawal (cocaine, marijuana, and ecstasy). Every person's physical withdrawal pattern is also different. You may experience little physical withdrawal. But that doesn't mean that you're not addicted, instead you may experience more emotional withdrawal.
Common signs and symptoms of withdrawal:
Two substances that can produce some of the following dangerous withdrawal symptoms:
Grand mal seizures, heart attacks, strokes, hallucinations and delirium tremens.
What are alcohol and tranquilizers?
These produce the most dangerous physical withdrawal. Suddenly stopping alcohol or tranquilizers can lead to seizures, strokes, or heart attacks in high risk patients. A medically supervised detox can minimize withdrawal symptoms and reduce the risk of dangerous complications.
This refers to a person needing a substance in order to not go through withdrawal symptoms. They have developed ________.
What is dependence?
Sometimes the terms tolerance, dependence and addiction are used incorrectly as interchangeable. Here is a breakdown of each.
Tolerance happens when a person no longer responds to a drug in the way they did at first. So it takes a higher dose of the drug to achieve the same effect as when the person first used it. This is why people with substance use disorders use more and more of a drug to get the “high” they seek.
Dependence means that when a person stops using a drug, their body goes through “withdrawal”: a group of physical and mental symptoms that can range from mild (if the drug is caffeine) to life-threatening (such as alcohol or opioids, including heroin and prescription pain relievers). Many people who take a prescription medicine every day over a long period of time can become dependent; when they go off the drug, they need to do it gradually, to avoid withdrawal discomfort. But people who are dependent on a drug or medicine aren’t necessarily addicted.
Unlike tolerance and dependence, addiction is a disease; but like tolerance and dependence, addiction can result from taking drugs or alcohol repeatedly. If a person keeps using a drug and can’t stop, despite negative consequences from using the drug, they have an addiction (also called a severe substance use disorder). But again, a person can be dependent on a drug, or have a high tolerance to it, without being addicted to it.
Having one or more of these addiction risk factors does not mean someone will become addicted, but it does mean the odds are greater. (Name 3)
This addiction claims more lives than any other addictive substance.
What is tobacco (nicotine)?
This may not appear as harmful as many other addictions because tobacco products are legal and easy to get, and the worst side effects of abusing them take time to develop. Many smokers cannot quit despite knowing smoking’s impact on their health. Wanting to quit but being unable to is a telltale sign of addiction.
Here are some statistics from the CDC.
Smoking leads to disease and disability and harms nearly every organ of the body
This area of the brain powers the ability to think, plan, solve problems, make decisions, and exert self-control over impulses.
What is the prefrontal cortex?
This is also the last part of the brain to mature, making teens most vulnerable to repeated illicit substance use. Shifting balance between this circuit and the reward and stress circuits.
Not only does the common use of this substance cause cancer but has also been linked to causing diabetes and heart disease.
What is smoking tobacco?
Smoking tobacco causes cancer, heart disease, stroke, lung diseases, diabetes, and chronic obstructive pulmonary disease (COPD), which includes emphysema and chronic bronchitis.
Smoking also increases risk for tuberculosis, certain eye diseases, and problems of the immune system, including rheumatoid arthritis. Also, it is a known cause of erectile dysfunction in males.
The number of people in NC that die everyday from a medication or drug overdose
What is 4 people?
(That’s a school bus full of people every month. Some of them are teenagers. Many are parents.)
Western North Carolina has higher than state and national averages of opioid-related overdose deaths and opioid prescribing rates. Our region also has higher rates of substance use, including opioid use disorder (OUD), and behavioral health disorders.
The most common issue connecting mental illness and substance abuse is the intention of patients to do this to alleviate symptoms that they find disruptive or uncomfortable.
What is self-medicate (with drugs and/or alcohol)?
Some examples include:
A stimulant drug usually used as a white, bitter-tasting powder or a pill; originally used in nasal decongestants and bronchial inhalers
What is methamphetamine?
Crystal Meth is becoming a bigger problem in North Carolina every year. The number of meth lab seizures went up from 32 in 2001 to 328 in 2005. In 2013, that number had almost doubled to 561. The National Drug Intelligence Center states that the methamphetamine problem is higher in rural western North Carolina than in other parts of the state. Although crack cocaine used to be a greater threat in these areas, it is getting replaced by methamphetamine because meth is easier and cheaper to obtain.
The neurotransmitter that is released during use of common illicit drugs or alcohol that has historically been linked to "feeling good" during substance use but recent studies suggest it has more to do with whether or not one will repeat the use of a substance.
What is dopamine?
Dopamine is a key element to why our brains are wired to repeat things that make us feel good. Whenever the reward system is activated by a healthy, pleasurable experience, a burst of dopamine signals that something important is happening that needs to be remembered. This dopamine signal causes changes in neural connectivity that make it easier to repeat the activity again and again without thinking about it, leading to the formation of habits.
Drug use is often accompanied by this illness
What is mental illness?
Many people who suffer from addiction are also battling other mental health issues. In these cases, both issues must be addressed for optimal results. However, most North Carolinians who are dependent on drugs or alcohol don’t receive treatment.
Drug use and mental illness often co-exist. In some cases, mental disorders such as anxiety, depression, or schizophrenia may come before addiction; in other cases, drug use may trigger or worsen those mental health conditions, particularly in people with specific vulnerabilities.
Some people with disorders like anxiety or depression may use drugs in an attempt to alleviate psychiatric symptoms, which may exacerbate their mental disorder in the long run, as well as increase the risk of developing addiction. Treatment for all conditions should happen concurrently.
Drug use is increasing among this age group.
Who are people in their fifties and early sixties?
This increase is, in part, due to the aging of the baby boomers, whose rates of illicit drug use have historically been higher than those of previous generations.
The study of functional, and sometimes inherited, changes in the regulation of gene activity and expression that can account for some individual's genetic predisposition to addiction.
What is Epigenetics?
When a person uses cocaine, for example, it can mark the DNA, increasing the production of proteins common in that addiction.
Also, increased levels of altered proteins in differing addictions (in genes involved in dopaminergic, glutamatergic and GABAergic transmission) can correspond with drug-seeking behaviors.
Abuse of this substance has become a crisis in the U.S. Four of the top 25 cities listed as having major problems with it are located in North Carolina.
What are opioids?
Almost 12 percent of the population of Wilmington struggles with opioid addiction. With a population of about 117,525, Wilmington is home to more than 14,000 individuals who are addicted or dependent. Hickory, Jacksonville, and Fayetteville also ranked on this list.
The area of the brain that is referred to as the "pleasure center" because of its' stimulation during substance use and pleasurable activities.
What is Nucleus Accumbens?
A cluster of nerve cells lying underneath the cerebral cortex in the forebrain
Use of this synthetic substance can cause serious mental and physical health problems including: rapid heart rate, vomiting, violent behavior, suicidal thoughts
What is synthetic cannabinoids like K2?
These are human-made mind-altering chemicals that are sprayed on dried, shredded plant material so they can be smoked or sold as liquids to be vaporized and inhaled in e-cigarettes and other devices. These products are also known as herbal or liquid incense and are marketed under a wide variety of specific brand names, including K2 and Spice and often labeled “not for human consumption.”
Several states have issued warnings about the dangerous of their use.
Percent of high school students in NC who report they have ever used marijuana one or more times in their lives
What is 41%
NC is close to, but slightly above, the national average on this which is 39%.
The neurotransmitter, that has inhibitory properities on neurons, and has been identified, in studies on addiction and genetics, as being involved in predisposing individuals to dependence on substances.
What is GABA?
GABA is the major inhibitory neurotransmitter in the human central nervous system—that is, it affects neurons in a way that reduces their activity. Several lines of evidence suggest that GABA is involved in many of the behavioral effects of alcohol, including motor incoordination, anxiety reduction, sedation, withdrawal signs, and preference for alcohol.
GABA interacts with several receptors, and much of the research on alcohol’s interactions with the GABA system has focused on the GABA-A receptor. This receptor also is the site of action for several medications that frequently are misused and have high addictive potential, such as benzodiazepines, barbiturates, opiates, α-hydroxybutyrates, and other sedative–hypnotic compounds. Accordingly, this receptor likely is involved in dependence on these drugs as well.
Rates of addiction of this substance are growing due to increases in potency (over 60 percent) over the past decade.
What is Marijuana?
The legalization of marijuana in some states has made the drug’s use more socially acceptable. This trend can distract people from marijuana’s addictive potential.
The area at the base of the brain where mu receptors link with opioid molecules and suppress the release of norepinephine.
What is the locus ceruleus?
The locus ceruleus (LC) is an area of the brain that is critically involved in the production of opioid dependence and withdrawal. Opioid drugs affect processes in the LC that control the release of norepinephrine that stimulates wakefulness, muscle tone, and respiration, among other functions.
Under normal conditions, natural opiate-like chemicals produced by the body link to mu opioid receptors on the surface of neurons. This linkage activates an enzyme that converts adenosine triphosphate (ATP) into cyclic adenosine monophosphate (cAMP), which in turn triggers the release of norepinenphrine. Prior to initiation of opioid drug abuse, the neuron produces enough norepinephrine to maintain normal levels of alertness, muscle tone, respiration, etc.
When heroin or another opioid drug links to the mu opioid receptors, it inhibits the enzyme that converts ATP to cAMP. As a result, less cAMP is produced, less norepinephrine is released. Alertness, muscle tone, and respiration drop, and the acute opioid effects of sedation, shallow breathing, etc., emerge.
A syndrome associated with substance abuse that has the following symptoms:
Mood swings, anxiety, irritability, tiredness, variable energy, low enthusiasm, variable concentration and disturbed sleep.
What is Post Acute Withdrawal Syndrome (PAWS)?
There are two stages of withdrawal. The first stage is the acute stage, which usually lasts a few weeks. During this stage, there may be physical withdrawal symptoms. But every drug is different, and every person is different.
The second stage of withdrawal is called the Post Acute Withdrawal Syndrome (PAWS). THIS TYPICALLY CAN LAST TWO YEARS. This is why relapse in that timeframe can be so common. During this stage there will be fewer physical symptoms, but more emotional and psychological withdrawal symptoms.
Post-acute withdrawal occurs because the brain chemistry is gradually returning to normal. As the brain improves, the levels of chemicals fluctuate as they approach the new equilibrium causing post-acute withdrawal symptoms.
Most people experience some post-acute withdrawal symptoms. Whereas in the acute stage of withdrawal every person is different, in post-acute withdrawal most people have the same symptoms.