Glen R. Hanson, Ph.D., D.D.S.

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Glen R. Hanson, Ph.D., D.D.S. Professor in
Pharmacology, University of Utah Director of the
Utah Addiction Center, University of Utah Senior
Advisor, National Institute on Drug Abuse, NIH
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Use Prescribed and clinically
appropriate Misuse Either not prescribed or
clinically inappropriate
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Drug Abuse- use of a drug in a manner not
medically or socially approved.
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Dependence
Persistent use resulting in adaptations typically
accompanied by accommodation or tolerance
(causing compensatory escalation) and
withdrawal (e.g., aches, diarrhea, depression
and cravings)
Drug addiction
Compulsive drug use that consists of repetition
to satisfy intense urges, despite severely
negative consequences
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Example for Survey Question Prescription Pain
Killers
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What is good or bad is the way we use them.
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Survey Results
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Addiction Overview
Addiction Vulnerabilities

Poor Decision Making Destructive Outcomes
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Adolescent development of Prefrontal Cortex
Differences in gray-matter density between 16
year olds (adolescents) and 23-30 year olds
(young adults)
Source Sowell, E.R. et al., Nature Neuroscience,
2(10), pp. 859-861, 1999
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We Know That Despite Their Many Differences,
Virtually All Opioid narcotics Enhance Brain
Dopamine (neurotransmitter)

• Other transmitter pathways also
• involved!

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How They Work
Attach to Opioid Receptors in the Brain and
Spinal Cord, Blocking the Transmission of Pain
Messages to the Brain and Causing An Increase in
the Activity of Dopamine (a chemical messenger
associated with pleasure pathway) in the Brain
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Addiction Cycle for Prescription Drugs
Relieve medical condition (e.g., pain, anxiety,
stress, weight gain)

• causes reinforcing effects

• induces physical dependence

• often there is a tolerance and withdrawal
• issue (usually occurs due to lengthy drug use)

• patients often have substance abuse risk
• before treatment

• patient uses various strategies to maintain
• drug supply (often illegal)

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Prolonged Drug Use Changes the Brain In
Fundamental and Long-Lasting Ways
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Narcotics decrease protein targets for dopamine
Source Wang, G-J et al., Neuropsychopharmacology,
16(2), pp. 174-182, 1997.
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Case study

• Fights withdrawals

• Tries to go on mission for LDS
• Church-but fails

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Case study-potential long-term impact

• Ex athlete- with back injury
• as an adolescent

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Prevention

• Give accurate history (any drug
• abuse problems in family or
• personally?)

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• Only use the Rx to treat the
• condition for which it was prescribed

• Recognize the symptoms of
• dependence and addiction

• Promptly dispose of the leftovers

• Rx addiction is a relapsing disorder
• and often requires professional help