Benarkah Kecanduan Narkoba Adalah Penyakit Otak?: Tsaradiksi @

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BENARKAH KECANDUAN NARKOBA

ADALAH PENYAKIT OTAK?

tsaradiksi@hotmail.com
Riset mengenai Adiksi Napza
telah lebih dari setengah abad.
Riset mengenai Otak lebih dari
seperempat abad.
ISI PRESENTASI
• MANUSIA DAN OTAK
• HUBUNGAN PERILAKU DAN OTAK
• NARKOBA MASUK KEDALAM TUBUH
• NARKOBA MASUK KEDALAM OTAK
• PERUBAHAN PERILAKU AKIBAT
DISFUNGSI OTAK
OTAK BAGIAN TUBUH YANG
PALING PENTING
APA SAJA FUNGSI DARI
OTAK?
www.drugabuse.gov
PET Image
Apa yang terjadi
didalam otak
pecandu?
CT (roentgen-ray Computed
Tomography)

MRI (Magnetic Resonance Imaging)

(Keith A. Johnson, M.D., Harvard Medical School, 2006)


SPECT/PET (Single
Photon/positron Emission
Computed Tomography)

Positron emission from radioactive nuclei was


discovered in 1933 by Thibaud and Joliot

(Keith A. Johnson, M.D., Harvard Medical School, 2006)


Positron Emission Tomography (PET)
Positron emission
tomography (PET) is a
nuclear medicine
medical imaging
technique which
produces a three
dimensional image or
map of functional
processes in the body.
Editors: Peter E. Valk, Dominique Delbeke,
Dale L. Bailey, David W. Townsend &
Michael N. Maisey (Springer, 2002)
Robert L. Dupont 1997
Dr. Nora Volkow, 2003
Genetic Contribution EXPERIMENTAL
Non-specific:
• Adoption Study
• Twin Studies
Specific:
• Drug Metabolism

Environmental
Contribution:
PHARMACOLOGICAL
• stress RESPONSE
• drug availability
• physical abuse
• sexual abuse
Repeated
• peer group
Use
Developmental
Adolescence
ADDICTION
Evidence from adoption and twin studies demonstrate that addiction,
like other chronic diseases, is a heritable disorder and that genes play
a role in vulnerability to addiction. Genes can also play a role in
protecting individuals from addiction.
As with all complex diseases, environmental risk and protective factors
interact with genetics to determine the course and outcome of disease.
Numerous compounds that bind selectively to
neuroreceptors of interest in biological psychiatry have
been radiolabeled with 11C or 18F. Radioligands that
bind to dopamine receptors (D1,D2, reuptake
transporter), serotonin receptors (5HT1A, 5HT2A,
reuptake transporter) opioid receptors (mu) and other
sites have been used successfully in studies with human
subjects. Studies have been performed examining the
state of these receptors in patients compared to healthy
controls in schizophrenia, substance abuse,
mood disorders and other psychiatric
conditions.
Imaging studies have shown evidence of tissue malfunction in the
brains of those with addiction, and in the hearts of people with heart
disease.
  Sources: From the Laboratories of Drs. N. Volkow and H. Schelbert
Addiction is a developmental
states in adolescence and
childhood
Relapse is Common in Addiction and Other
Complex Chronic Diseases

Relapse Rates Are Similar for Addiction and Other Chronic Illnesses

Source: Mc Lellan et al., 2000


KOKAIN
Image yang didapat melalui PET secara
sistimatis mengukur aktivitas protein dan
otak pada individu normal dan drug
addicted individuals, laboratoriumnya
mengarah ke peran neurotransmitter
dopamine dan sistim neuron yang
menggunakan dopamine yang berperan
dalam proses adiksi napza. Sistim dopamin
dikenal krusial terhadap positive
reinforcement, motivasi, dan drive,
diantara bentuk2 perilaku lain.
Volkow’s group memilih satu reseptor
dopamin (D2 receptor) untuk studi
subjek normal dan cocaine abusers.
Image otak, berwarna sepanjang
spektrum pelangi yang menggambarkan
refleksi dari level reseptor — violet
rendah, merah tinggi — menampakkan
regio oranye dan merah pada orang
normal. Regio yang sama hanya warna
kuning (konsentrasi rendah pada
reseptor) pada cocaine abusers.
Volkow mengidentifikasi Gangguan Obsessif-
Kompulsif pada area frontal otak. Sinyal ini
menunjukkan bahwa regio frontal otak
terlibat dalam gejala2 obsesi yang dari drug
addiction, ketidak mampuan drug users
menghentikan kebiasaannya menggunakan
drugs, meskipun mereka secara sadar ingin
menghentikannya.
METAMPHETAMINE
ECSTASY
Amphetamine

Photo courtesy of NIDA from research


conducted by Melega WP, Raleigh
MJ, Stout DB, Lacan C, Huang SC,
Phelps ME. Recovery of striatal
dopamine function after acute
amphetamine- and
methamphetamine-induced
neurotoxicity in the vervet monkey.
Brain Res 1997 Aug 22;766(1-
2);113-12
Photo courtesy of Anna Rose Childress, Ph.D.
Photo courtesy of Nora Volkow, Ph.D. Mapping cocaine binding sites in human
and baboon brain in vivo. Fowler JS, Volkow ND, Wolf AP, Dewey SL, Schlyer
DJ, Macgregor, Hitzemann R, Logan J, Bendreim B, Gatley ST, et al. Synapse
1989;4(4):371-377.
Long-term frontal brain metabolic changes in cocaine abusers. Synapse 11:184-190, 1992; Volkow
ND, Fowler JS, Wang G-J, Hitzemann R, Logan J, Schlyer D, Dewey S, Wolf AP. Decreased
dopamine D2 receptor availability is associated with reduced frontal metabolism in cocaine
abusers. Synapse 14:169-177, 1993.
Non-MDMA user

These brain scans show the amount of


serotonin activity over a 40-minute
period in a non-MDMA user (top) and an
MDMA user (bottom). Dark areas in the
MDMA user's brain show damage due to
chronic MDMA use.
 

MDMA user

McCann, U.D.; Mertl, M.; Eligulashvili, V.; and Ricaurte, G.A.


Cognitive performance in (±) 3,4-methylenedioxymethamphe-
tamine (MDMA, "ecstasy") users: a controlled study.
Psychopharmacology 143:417-425, 1999
Thank You
tsaradiksi@hotmail.com

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