HARI NUGROHO, MD UPT TERAPI & REHABILITASI BADAN NARKOTIKA NASIONAL

Permasalahan Penyalahgunaan Narkoba Indonesia pasar potensial peredaran gelap narkoba Jumlah penyalahguna semakin meningkat Adiksi merupakan masalah Public Health Adiksi adalah “Brain Disease”

Homelessness Crime Violence Homelessness Crime Violence Neurotoxicity AIDS, Cancer Mental illness, Hepatitis Neurotoxicity AIDS, Cancer Mental illness, Hepatitis Health care Productivity Accidents Health care Productivity Accidents

Estimated Economic Cost to Society Due to Substance Abuse and Addiction: Illegal drugs: $181 billion/year Alcohol: $185 billion/year Tobacco: $158 billion/year Total: $524 billion/year Surgeon General’s Report, 2004; ONDCP, 2004; Harwood, 2000.

Why Do People Take Drugs in The First Place? To Feel Good To have novel: feelings sensations experiences AND to share them To Feel Better To lessen: anxiety worries fears depression hopelessness

Your Brain on Drugs in the 1980’s

Your Brain on Drugs Today YELLOW shows places in brain where cocaine binds (e.g., striatum) Fowler et al., Synapse, 1989.

Addiction is Like Other Diseases…  It is preventable  It is treatable  It changes biology  If untreated, it can last a lifetime Healthy Brain Diseased Heart Decreased Heart Metabolism in Heart Disease Patient Decreased Brain Metabolism in Drug Abuser Diseased Brain/ Cocaine Abuser Healthy Heart High Low Research supported by NIDA addresses all of these components of addiction.

Drugs can be “Imposters” of Brain Messages

Addiction Reward & well-being Motivation Movement Dopamine

dopamine transporters

But Dopamine is only Part of the Story Scientific research has shown that other neurotransmitter systems are also affected: – Serotonin Regulates mood, sleep, etc. – Glutamate Regulates learning and memory, etc.

ControlAddicted Dopamine D2 Receptors are Decreased by Addiction Functionally… DA D2 Receptor Availability Cocaine Alcohol Heroin Meth

Konsekuensi dari perubahan di otak Gangguan mental dan perilaku

DAT Recovery with prolonged abstinence from methamphetamine [C-11]d-threo-methylphenidate Volkow et al., J. Neuroscience, low high Normal Control Methamphetamine Abuser (1 month abstinent) Methamphetamine Abuser (14 months abstinent)

Pengaruh Terhadap Hati Hepatitis B Hepatitis C Sirrosis hati

Kanker hati

HIV / AIDS Terutama IDU Infeksi Oportunistik Butuh dukungan keluarga Rutin terapi ARV

4 dari 10 kematian AIDS berhubungan dengan Drug Abuse

Wajah drugs abuser

We Need to Keep Our Eye on the Real Targets! the Real Targets! Abstinence Functionality in Family, Work and Community In Treating Addiction…

TERIMA KASIH