Substance Abuse and Tuberculosis Springfield, IL April 27, 2011

Transcription

1 Substance Abuse and Tuberculosis Springfield, IL April 27, 2011 Kinds of Substance Abuse Karina Forrest-Perkins MHR LADC April 27, 2011 Karina Forrest-Perkins, MHR LADC has the following disclosures to make: No conflict of interest. No relevant financial relationships with any commercial companies pertaining to this educational activity. 1

2 TUBERCULOSIS AND SUBSTANCE ABUSE Karina A. Forrest-Perkins MHR LADC Tuberculosis is a leading cause of infectious morbidity and mortality worldwide. We now know that Substance Use, Abuse and Dependence are significant contributing factors to contracting TB and preventing effective TB Treatment. This presentation will assist in outlining the basics of substance use disorders; complications of coexisting conditions; and complicating factors in treating TB with persons in this population 2

3 KINDS OF SUBSTANCE ABUSE Understanding the Basics: Substances of Abuse Alcohol Illicit Drugs Abuse of Prescription Drugs Tobacco HOW ARE THEY USED? WHAT DO THEY DO? 1. Route of Administration Oral, Nasal, Smoke, Skin, IV Use Chewing, Razoring, Digestive, SNUS, Bath Salts 2. Metabolism, Oxygen Deprivation, Damaged tissue 2. Effects of ATOD on Behavior and Brain Function 3. Are other types of addictions similar? Compulsive disorders 3

4 Intended Brain Development Patterns Rear to Front and inside out Include adolescent interruption Introduction of stress hormone (cortisol) and natural opioids Areas of stimulation or depression Introduce substances Disrupted Brain development (Consider stage of growth 0-13 and 13-24) Concrete Thinking v Abstract Thinking Sometimes we think the Adolescent Brain is not very functional, but the truth is that it is experiencing frontal lobe growth at a phenomenal rate. Is this brain working??????? A side note, the command center of the brain is not formed yet! The Pre-Frontal Cortex. 4

5 The pre-frontal cortex controls advanced brain function including insight, judgment, impulse control, planning, strategizing, cognitive flexibility, and problem solving. Adolescents, however, don't have a fully developed pre-frontal cortex. The majority of adolescent brain functioning takes place in the ventral striatum, where decisions are made based on rewards and emotions without the back-up cognitive strength of the prefrontal cortex. 5

6 Adolescence is also a time of great vulnerability. Substance abuse and addiction use many of the same systems as normal learning. The adolescent brain, similar to the young child's brain, is highly susceptible to intensive learning. If the adolescent is abusing drugs or alcohol, the behavior is learned more deeply than in the adult brain, thereby creating a situation for stronger and longer addiction problems The relevance of childhood and adolescent brain development in conjunction with substance use is fundamentally significant when assessing/monitoring TB Treatment adherence. The developmental range or growth for the individual presenting with TB may appear to be 48 years of age, but in fact has only completed a 14 year brain development cycle. 6

7 To successfully treat the individual identified as at risk for TB or having already contracted TB We must combine the individual s developmental capacity with the effects of his or her drug of choice and those effects on emotional and physical dys-regulation Impact of certain chemicals on the brain tissue (Amphetamines, Depressants, Benzodiazapines, etc.) Concentration levels on brain tissue Impact of sudden withdrawal Impact of neuro-transmitter production and lack of production (S, D, Norep, M) Subsequent Impact on Behavior 7

8 RESOURCES American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorder, Revised (DSM IV-R) 4th ed. Washington, DC: APA, 2000). Lise Addario, Six Degrees from Liberation: Legal Needs of Women in Criminal and Other Matters (Research and Statistics Report) (Ottawa: Department of Justice, 2002). Dr. Bruce Perry and Please feel free to research this website and Dr. Perry s online course in trauma and brain development. Society for Neuroscience th Street, NW Suite 1010 Washington, DC