BRAIN RESEARCH THE EFFECTS OF ALCOHOL ON THE ADOLESCENT BRAIN

Ken Winters, Ph.D. Department of Psychiatry University of Minnesota winte001@umn.edu

CSAPs Western CAPT Audio Teleconference March 18, 2004

1. Developmental Issues

Alcohol Use by Youth

Youth alcohol use occurs on a continuum Most youth have used some alcohol
7 million teens binge drink at least once a month

Alcohol Use

Trends in prevalence of drugs for 12th graders: 1994 to 2001

Year 30-Day Alcohol %

1994 1995 1996 1997 1998 1999 2000 2001

50.1 51.3 50.8 52.7 52.0 51.0 50.0 49.8

MTFS, 1975-2001

Long-Term, Heavy Use of Alcohol

Significant shrinking of the brain 50% - 75% show cognitive impairment Effects remain even after detoxification & abstinence Alcohol dementia is 2nd-leading cause of adult dementia

1. Developmental Issues

2. Adolescence and the Brain

The Adolescent Brain is Still Developing

During adolescence, the brain is undergoing dramatic transformations
In some brain regions, over 50 % of neuronal connections are lost Some new connections are formed

Net effect is pruning (a loss of neurons)

Adolescent Brain Changes

These brain changes are relevant to adolescent behavior
Prefrontal cortex (PFC) is pruned; not fully developed until mid-20s Amygdala (and n.a.) show less pruning and tend to dominate the PFC
prefrontal cortex

amygdala
nucleus accumbens

judgment

reward system

PFC

I like to use drugs! !

amygdala

This imbalance leads to... planned thinking impulsiveness self-control risk-taking

more hot talking, less cool talking

In the presence of stress

PFC

I hate school; I am going to skip classes and get drunk

amygdala

GOOD NEWS!
The pruning of the PFC neurons produces a more efficient PFC by young adulthood
I am planning for the future

amygdala

PFC

1. Developmental Issues

2. Adolescence and the Brain

3. Brain and Alcohol

Is addiction a brain disorder?

From Oops to Dependence

Oops Phenomenon
First use to FEEL GOOD

Some continue to compulsively use because of the reinforcing effects (e.g., to FEEL NORMAL)
Changes occur in the reward system that promote continued use

Reward System
The reward system is responsible for seeking natural rewards that have survival value
seeking food, water, sex, and nurturing
reward

Dopamine is this systems primary neurotransmitter

Drugs Hijack the Brains Reward Circuitry

Immediate effect of drug use is an increase in dopamine Continued use of drugs reduces the brains dopamine production. Because dopamine is part of the reward system, the brain is fooled that the drug has survival value for the organism. The reward system responds with drug seeking behaviors Craving occurs and, eventually, dependence.

reward

Evidence
Animal Studies:
electrodes attached to Reward Circuit animals press lever to receive stimuli to brain they continue until collapse from exhaustion

Behavioral Genetics Studies:

heredity plays a role
identical twins: > chance of becoming alcoholics than fraternal twins

adoptive children of alcoholics: > chance of becoming alcoholic; even true when raised by non-alcoholic parents
further research needed by gender

1. Developmental Issues

2. Adolescence and the Brain 4. Youth, Brain and Alcohol 3. Brain and Alcohol
Are adolescents more susceptible to alcohol than adults? Is addiction a brain disorder?

Are adolescents more susceptible to alcohol than adults?

Adult studies suggest that the areas of the adolescent brain that are remodeled are sensitive to the effects of alcohol
Difficult scientifically and ethically to study adolescent sensitivity to alcohol
prefrontal cortex

amygdala
nucleus accumbens

Are adolescents more susceptible to alcohol than adults?

Animal models can be easily used to explore this issue

Role of psychosocial factors can not be studied

Are adolescents more susceptible to alcohol than adults?

1. Adolescent rats are less sensitive to effects of intoxication and less sensitive to the hangover that follows use

Are adolescents more susceptible to alcohol than adults? 2. Adolescent rats are more sensitive to the social disinhibition induced by alcohol use
Wanna look for some cheese with me? Sure!

Are adolescents more susceptible to alcohol than adults? 3. Adolescent drunk rats perform worse on memory tasks than adult drunk rats
Ugh? ?

converts information to memory

disrupts the hippocampus brain damage in the PRF

planne d thinkin g

Supporting Human Studies

1. Reduced sensitivity to intoxication

3. Greater adverse effects to cognitive functioning

Survey Data Suggest that Adolescents Are More Sensitive to Alcohol

Monitoring the Future, 2001
100 80 60 40 26 20 0 14 8 10th Graders 12th Graders 24
5+ drinks in row, past 2 weeks Been drunk past month

30

32

8th Graders

Alcohols Effects

(Brown, 2002; Wuethrich, 2001)

Adolescents with a history of extensive use.

converts informatio n to memory

Hippocampus (50%) brain activity during memory tasks brain activation when shown alcohol images
trigger for relapse

Are adolescents more susceptible to alcohol than adults?

4. Hyperexcitability issue

Are adolescents more susceptible to alcohol than adults?

4. Hyperexcitability issue
Alcohol relieves hyperexcitability state Relief is temporary; continued seeking of alcohol is reinforced Hyperexcitability is a key characteristic of conduct disorders, ADHD & other impulsive behaviors Found in non-alcoholic relatives - suggests inheritance of brain wave patterns

Are adolescents more susceptible to alcohol than adults?

Most certainly YES

1 Reduced sensitivity to intoxication 2 Increased sensitivity to social disinhibitions 3 Greater adverse effects to cognitive functioning 4 Medicates excitability

References
Leshner A. Oops. How casual drug use leads to addiction. National Institute on Drug Abuse web site: www.drugabuse.gov/Published_Articles/Oops.html September, 2000. National Institute on Alcohol Abuse and Alcoholism. Imaging and Alcoholism: A Window on the Brain. Alcohol Alert No. 47, April 2000. National Institute on Alcohol Abuse and Alcoholism. Tenth Special Report to the U.S. Congress on Alcohol and Health, NIH Pub. No. 001583, 2000. National Institute on drug Abuse. Principles of drug addiction treatment: A research-based guide. No. 99-4180, 1999.

Thank You!