Nora D. Volkow, M.D.

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Research Advances in
DRUG ABUSE ADDICTION
What Do They Mean for Recovery?
Nora D. Volkow, M.D. Director National Institute
on Drug Abuse
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1. ADDICTION INVOLVES MULTIPLE FACTORS

Biology/Genes
Environment
DRUG
Brain Mechanisms
Addiction
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2. ADDICTION IS A DEVELOPMENTAL DISEASE starts
in adolescence and childhood
1.6
1.4
1.2
in each age group who develop first-time
cannabis use disorder
1.0
0.6
0.8
0.4
0.2
0.0
5
10
15
18
25
30
35
40
45
50
55
60
65
70
Age
Age at cannabis use disorder as per DSM IV
NIAAA National Epidemiologic Survey on Alcohol
and Related Conditions, 2003
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Recent Studies Have Shown that Maturation of
the Brains Gray Matter Moves from Back to Front
Brain areas where volumes are smaller in
adolescents than young adults
Source Sowell, E.R. et al., Nature Neuroscience,
2(10), pp. 859-861, 1999
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3. ADDICTION IS A DISEASE OF THE BRAIN as other
diseases it affects the tissue function
Decreased Heart Metabolism in Heart Disease
Patient
Healthy Heart
Diseased Heart
Sources From the laboratories of Drs. N. Volkow
and H. Schelbert
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4. ADDICTION CAN BE TREATED
Partial Recovery of Brain Dopamine
Transporters in Methamphetamine (METH) Abuser
After Protracted Abstinence
3
0
ml/gm
METH Abuser (1 month detox)
Normal Control
METH Abuser (24 months detox)
Source Volkow, ND et al., Journal of
Neuroscience 21, 9414-9418, 2001.
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Relapse Rates Are Similar for Drug Dependence
And Other Chronic Illnesses
Addiction Treatment Does Work
100
90
80
70
60
Percent of Patients Who Relapse
50
40
30
20
10
0
Drug Dependence
Type I Diabetes
Hypertension
Asthma
Source McLellan, A.T. et al., JAMA, Vol 284(13),
October 4, 2000.
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Evaluation of A Hypothetical Treatment
Just Like Hypertension, Addiction Is A Chronic
Disease That Requires Continued Care
Source McLellan, AT, Addiction 97, 249-252, 2002.
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Posterior Hippocampi of London Taxi Drivers Were
Significantly Larger Than Those of Controls
Positive Correlation Between Gray Matter Volume
and Time As A Taxi Driver
Control Cocaine Abuser
Source Maguire, E.A. et al., PNAS, 97(8), pp.
4398-4403, 2000.
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Where Do We Need to Go From Here?
We Need to
Advance the SCIENCE