The Observer News No. 14 - OID / CICAD / OAS

The National Institute on Drug Abuse (NIDA) of the U.S. government is working to share advanced scientific knowledge about drug use and addiction with the rest of the Americas, said Dr. Nora Volkow, the NIDA Director, speaking at the thirty-ninth regular session of CICAD in Washington, D.C. in May.

“If scientific knowledge is not put to use, it’s pointless,” Volkow said. “Scientific knowledge does not belong to any territory or country, but to humankind.” She welcomed any organization interested in information or cooperation to contact the NIDA directly.

Volkow said that the NIDA was collaborating directly with CICAD to develop two specific initiatives: the Latin American Epidemiology Work Group that would parallel the U.S. Community Epidemiology Work Group (CEWG) so that emerging trends in drug use could be detected early, and a program that offers small research grants to students and post-docs carrying out their investigative work at Latin American universities because NIDA wants them to utilize NIDA data and resources in their studies (See the joint announcement).

Dr. Volkow, a guest speaker the thirty-ninth regular session of CICAD, touched on wide range of the issues, including the latest scientific research on drug addiction and treatment, current trends in drug consumption, and avenues of collaboration between the NIDA and CICAD.

NIDA currently funds about 85 percent of all research on drug abuse in the world. Speaking fluently in her native Spanish, Volkow explained that there had been impressive advances in the scientific understanding of addiction over the past 10 years, and she considered it important to transmit this knowledge to Latin America and the Caribbean.

“Drug addiction is a disease of the brain, but it’s very difficult for us to accept that because we value our capacity to make decisions about our actions… our sense of freedom,” Volkow said.

She added, “Addiction should not be differentiated from other diseases that are treated clinically, like asthma, cancer or hypertension.”

Research approaches

The use of PET scans to assess the effect of drug abuse on the brain has opened new horizons to understanding how the brain works. To see a larger version of the graphic, click on the image.

Using positron emission tomography technology, more commonly know as PET scans, since the mid-1980s, Volkow focused her research on comparing the brain metabolism of addicts to that of healthy people and has helped rethink the brain’s functioning. The PET scans track a specific protein vital to the brain’s chemistry: dopamine.

Dopamine is a neurotransmitter that plays many roles in the central nervous system and is critical to fine motor coordination, immune function, motivation, insulin regulation, physical energy, thinking, short term memory, emotions such as sexual desire and autonomic nervous system balance. It is involved in movement, motivation, pleasure and learning. For instance, a dopamine deficiency is a causative factor of Parkinson’s Disease.

When a person takes a narcotic drug, it overloads the brain’s reward circuit by forcing a massive flood of dopamine, 10 to 100 times more potent than the simple pleasures of chocolate, sex or alcohol. To compensate for this overwhelming rush, the brain dampens the dopamine mechanism by reducing what are called dopamine D2 receptor. Volkow's research has shown that addicts have fewer dopamine D2 receptors than non-users. With fewer receptors, the dopamine system is desensitized, and the now-under-stimulated addict needs more of the drug to feel anything at all. A similar process occurs with an addiction to alcohol, heroin, cocaine, methamphetamine or marijuana, although each drug seems to work over different circuits in the brain.

Biography

Dr. Nora Volkow’s groundbreaking scientific research, enabled through brain imaging technology, has yielded important discoveries about the chemistry of the brain, including the long-term negative effects of therapeutic drugs for schizophrenia, the toxicity of cocaine, and the neurochemical mechanisms in the brain that may lead to addiction. She completed a B.A. at Modern American School (Mexico City), a Ph.D. at National University of Mexico (UNAM, Mexico City), and postdoctoral work in Psychiatry at New York University. She was formerly a senior scientist at Brookhaven National Laboratories in Upton, N.Y. She is the great-granddaughter of the Russian revolutionary, Leon Trotsky. Born in Mexico City, she became a U.S. citizen in 1993.

During the CICAD plenary, Volkow showed brain scans of addicts and non-drug consumers, side-by-side, highlighting the colorful patterns indicating a healthy brain metabolism and the mostly monochromatic schemes that indicate dysfunctional dopamine activity. “Addiction affects and damages the neural centers that control actions and emotions in our brain,” she said.

Developmental disease

Addiction is a developmental disease because it tends to affect disproportionately adolescents between the ages of 18 and 21, “although experimentation can start much earlier” Volkow said. “A general assumption back in my medical school days was that the brain stops developing at birth,” Volkow said. “That’s not true. The brain continues to mature into the early 20s.”

Adolescents are more vulnerable to drug addiction than adults because their brains are different, with specific areas smaller in size and underdeveloped. Adolescents also are more prone to engage in risky behavior and acquire an addiction more quickly than adults because they tend to remember pleasant sensations more intensely than adults do.

“When developing programs for young people, we have to recognize that they will have more emotional responses,” Volkow said.

Volkow also stated that there were other factors, aside from brain chemistry, that determine prevalence, including biology, genetics, and the social environment. Among the social factors that influence addiction is stress, which can come in many forms – peer pressure, poverty, a sense of subordination and powerlessness.

Volkow said, however, that there was good news in these scientific breakthroughs – the brain damage caused by addiction is not irreversible. Showing PET scans of recovering addicts, she demonstrated that brains recovered normal dopamine functions within 10 months of getting off the drugs.

The most dangerous drug

“Not all drugs are the same,” Volkow warned. Methamphetamine is an extremely dangerous drug, perhaps the most toxic and addictive of any available. Research has determined that methamphetamine produces a rush of dopamine that is 10 times more potent that cocaine, she said. It also produces more brain damage than any other drug.

According to U.S. surveys of school-age adolescents, meth consumption has been dropping substantially between 1999 and 2004, but Volkow cautioned that meth consumption may be underreported because addicts tend to drop out of school once the addiction swings into full sway. Other indicators like admissions for addiction treatment show a sharp rise over a short time: a four fold increase over four years, from 10 per 100,000 18 or older in 1992 to 52 per 100,000 in 2002.

Additional Information

If you wish to find out more about the career and work of Dr. Nora Volkow, you may check out the following material:


Inter-American Observatory on Drugs: Building a Drug Information Network with and for the Americas
No. 2, Year 4 Second Quarter 2006 Spanish Version Previous Issues Who we are Statistics National Drug Control Orgs. National Observatories International Organizations OID HelpDesk Contact OID U.S. Research on Drug Abuse Made Available to CICAD Member States The National Institute on Drug Abuse (NIDA) of the U.S. government is working to share advanced scientific knowledge about drug use and addiction with the rest of the Americas, said Dr. Nora Volkow, the NIDA Director, speaking at the thirty-ninth regular session of CICAD in Washington, D.C. in May. “If scientific knowledge is not put to use, it’s pointless,” Volkow said. “Scientific knowledge does not belong to any territory or country, but to humankind.” She welcomed any organization interested in information or cooperation to contact the NIDA directly. Volkow said that the NIDA was collaborating directly with CICAD to develop two specific initiatives: the Latin American Epidemiology Work Group that would parallel the U.S. Community Epidemiology Work Group (CEWG) so that emerging trends in drug use could be detected early, and a program that offers small research grants to students and post-docs carrying out their investigative work at Latin American universities because NIDA wants them to utilize NIDA data and resources in their studies (See the joint announcement). Dr. Volkow, a guest speaker the thirty-ninth regular session of CICAD, touched on wide range of the issues, including the latest scientific research on drug addiction and treatment, current trends in drug consumption, and avenues of collaboration between the NIDA and CICAD. Dr. Volkow speaks with CICAD Executive Secretary James Mack following her presentation. NIDA currently funds about 85 percent of all research on drug abuse in the world. Speaking fluently in her native Spanish, Volkow explained that there had been impressive advances in the scientific understanding of addiction over the past 10 years, and she considered it important to transmit this knowledge to Latin America and the Caribbean. “Drug addiction is a disease of the brain, but it’s very difficult for us to accept that because we value our capacity to make decisions about our actions… our sense of freedom,” Volkow said. She added, “Addiction should not be differentiated from other diseases that are treated clinically, like asthma, cancer or hypertension.” Research approaches The use of PET scans to assess the effect of drug abuse on the brain has opened new horizons to understanding how the brain works. To see a larger version of the graphic, click on the image. Using positron emission tomography technology, more commonly know as PET scans, since the mid-1980s, Volkow focused her research on comparing the brain metabolism of addicts to that of healthy people and has helped rethink the brain’s functioning. The PET scans track a specific protein vital to the brain’s chemistry: dopamine. Dopamine is a neurotransmitter that plays many roles in the central nervous system and is critical to fine motor coordination, immune function, motivation, insulin regulation, physical energy, thinking, short term memory, emotions such as sexual desire and autonomic nervous system balance. It is involved in movement, motivation, pleasure and learning. For instance, a dopamine deficiency is a causative factor of Parkinson’s Disease. When a person takes a narcotic drug, it overloads the brain’s reward circuit by forcing a massive flood of dopamine, 10 to 100 times more potent than the simple pleasures of chocolate, sex or alcohol. To compensate for this overwhelming rush, the brain dampens the dopamine mechanism by reducing what are called dopamine D2 receptor. Volkow's research has shown that addicts have fewer dopamine D2 receptors than non-users. With fewer receptors, the dopamine system is desensitized, and the now-under-stimulated addict needs more of the drug to feel anything at all. A similar process occurs with an addiction to alcohol, heroin, cocaine, methamphetamine or marijuana, although each drug seems to work over different circuits in the brain. Biography Dr. Nora Volkow’s groundbreaking scientific research, enabled through brain imaging technology, has yielded important discoveries about the chemistry of the brain, including the long-term negative effects of therapeutic drugs for schizophrenia, the toxicity of cocaine, and the neurochemical mechanisms in the brain that may lead to addiction. She completed a B.A. at Modern American School (Mexico City), a Ph.D. at National University of Mexico (UNAM, Mexico City), and postdoctoral work in Psychiatry at New York University. She was formerly a senior scientist at Brookhaven National Laboratories in Upton, N.Y. She is the great-granddaughter of the Russian revolutionary, Leon Trotsky. Born in Mexico City, she became a U.S. citizen in 1993. During the CICAD plenary, Volkow showed brain scans of addicts and non-drug consumers, side-by-side, highlighting the colorful patterns indicating a healthy brain metabolism and the mostly monochromatic schemes that indicate dysfunctional dopamine activity. “Addiction affects and damages the neural centers that control actions and emotions in our brain,” she said. Developmental disease Addiction is a developmental disease because it tends to affect disproportionately adolescents between the ages of 18 and 21, “although experimentation can start much earlier” Volkow said. “A general assumption back in my medical school days was that the brain stops developing at birth,” Volkow said. “That’s not true. The brain continues to mature into the early 20s.” Adolescents are more vulnerable to drug addiction than adults because their brains are different, with specific areas smaller in size and underdeveloped. Adolescents also are more prone to engage in risky behavior and acquire an addiction more quickly than adults because they tend to remember pleasant sensations more intensely than adults do. “When developing programs for young people, we have to recognize that they will have more emotional responses,” Volkow said. Volkow also stated that there were other factors, aside from brain chemistry, that determine prevalence, including biology, genetics, and the social environment. Among the social factors that influence addiction is stress, which can come in many forms – peer pressure, poverty, a sense of subordination and powerlessness. Volkow said, however, that there was good news in these scientific breakthroughs – the brain damage caused by addiction is not irreversible. Showing PET scans of recovering addicts, she demonstrated that brains recovered normal dopamine functions within 10 months of getting off the drugs. The most dangerous drug “Not all drugs are the same,” Volkow warned. Methamphetamine is an extremely dangerous drug, perhaps the most toxic and addictive of any available. Research has determined that methamphetamine produces a rush of dopamine that is 10 times more potent that cocaine, she said. It also produces more brain damage than any other drug. According to U.S. surveys of school-age adolescents, meth consumption has been dropping substantially between 1999 and 2004, but Volkow cautioned that meth consumption may be underreported because addicts tend to drop out of school once the addiction swings into full sway. Other indicators like admissions for addiction treatment show a sharp rise over a short time: a four fold increase over four years, from 10 per 100,000 18 or older in 1992 to 52 per 100,000 in 2002. There are other factors that make methamphetamine exceptionally dangerous: Easily manufactured in any kitchen Neurotoxic to the point of causing brain damage Highly addictive Enables risky sexual behavior while intensifying sexual pleasure Higher risk of infection of HIV and Hepatitis C when under the influence Alters the immune function Increased infectivity (e.g., erosion of normal protective epithelial layer) due to physiological changes resulting from meth use Additional Information For an excellent, multilingual animation of how drugs affect the brain, go to Prevnet’s Drugs in the Brain. Also see the previous issue of the Observer News for additional information and resources on methamphetamine. Also see: NIDA Notes Brain Scans Open Window to View Cocaine's Effects on the Brain If you wish to find out more about the career and work of Dr. Nora Volkow, you may check out the following material: Addiction: Pay Attention, Psychology Today Magazine, Nov/Dec 2004 http://www.psychologytoday.com/articles/pto-20041111-000001.html Revolutionary Thinker: Leon Trotsky's Great-Granddaughter Is Following Her Own Path to Greatness, Washington Post, Aug. 20, 2003 http://cannabisnews.com/news/17/thread17119.shtml NIDA Chief Studies Addicts' Brains http://www.technewsworld.com/story/health/49748.html Back to Issue Index
The Observer News: No. 2, Year 4, Second Quarter 2006
This quarterly newsletter is published electronically and circulated to encourage discussion and comment. The findings, interpretations, judgments, and conclusions expressed in this newsletter are those of the author(s) and should not be attributed to CICAD/OAS. If you wish to receive an e-mail advising you about the latest issue or if you want to be removed from the mailing list, please contact msmith@oas.org
Inter-American Observatory on Drugs (OID) Inter-American Drug Abuse Control Commission (CICAD) Organization of American States (OAS)	1889 F St., N.W. , Washington, D.C. 20006 USA Phone: (202) 458-3178 or 458-3092 Fax: (202) 4548-3658 E-mail: msmith@oas.org

U.S. Research on Drug Abuse Made Available to CICAD Member States

Research approaches

Biography

Developmental disease

The most dangerous drug

Additional Information