Youth standing for freedom

from chemical slavery

Gilberto Gerra

Chief

Drug Prevention and Health Branch

Political Declaration 2009Paragraph 22

Emphasize and facilitate health, productive and fulfilling alternatives

to the illicit consumption of drugs, which must not become accepted

as a way of life;

a society under medication?a society under medication?

Benzodiazepine for math test anxietyCannabis for datingAmphetamine for workingEcstasy for dancingEnergy drinks for drivingKetamine for fantasyCocaine and Viagra for sexEfedrine and Growth Hormone for sportOxicodon for coping with stressHeroin for escaping realityRitalin for behavioural controlBrain enhancers for carrierAlcohol for relaxing and socializing

Pharmaceutical Companies $

Narco-traffickers $

Alcohol producers $

Who is gaining?

Health

Security

Mental health

Youth empowerment

Creativity

Innovative initiatives

Social-family cohesion

Responsibility accountability

At risk with substance usedisorders

Who is interested in young people...

Less involved/engaged

Acritical

Sedated / anaffective

With reduced cognitive capacity

With reduced memory

Negativism....

Unable to dream the future

Dependent / conditioned ?????

LancetAdverse health effects of non-medical cannabis use.

The health effects most likely to occur and to affect a large number of cannabis users:

Hall and Degenhardt, 2009

a dependence syndromeincreased risk of motor vehicle crashes

impaired respiratory function cardiovascular disease

adverse effects on adolescent psychosocial development and mental health

Dunedin prospective study Dunedin prospective study

Regularly smoking cannabis in their teensand then stoppedRegularly smoking cannabis in their teensand then stopped

8 point less in IQ scale as adults8 point less in IQ scale as adults

EcstasyEcstasy

MacEwen C et al. (2008) A case of cocaine-induced basilar artery thrombosisNat Clin Pract Neurol doi:10.1038/ncpneuro0879

Figure 1 Brain CT scan in a patient with cocaine-induced basilar artery thrombosis

Milton and Everitt, 2012

usurpation of emotional memory

Cocaine addicts brain is not activatedanymore by monetary rewardCocaine addicts brain is not activatedanymore by monetary reward

Before andaftermethamphetamines ...

Stigma and discrimination

To punish … To permit…

Denial

Not to share suffering

To ignore responsibility

To attenuate sense of guilt

Stigma and discrimination

To punish … To permit…

Denial

Not to share suffering

To ignore responsibility

To attenuate sense of guilt

Drug addiction is often the result of an unwholesome social atmosphere in which those who are most exposed to the danger of drug abuse live

Resolution III, 1972 (amendments to 1961 Convention)

Drug addiction is often the result of an unwholesome social atmosphere in which those who are most exposed to the danger of drug abuse live

Resolution III, 1972 (amendments to 1961 Convention)

A social atmosphere detrimental to physical, mental and moral well-being…

A social atmosphere detrimental to physical, mental and moral well-being…

Temperament,personality traits

Insecure parent-child attachment

Neglect

Abuse

Stressful life events

Lack of bonding to family Affectionless

control

Excessiveprotection

Extreme poverty

Social exclusion

Exposure toviolence,displacement

Chaotic family Lack of

engagement in school

Peer pressureDrug availability:exposure to drugsand alcohol

Risk perception

PsychobiologicalVulnerability:

Synaptic functionEpigenetic changesBehavioural attitude

Mental health disorders

Pathogenesis of the disease

EmotionalneglectEmotionalneglect AbuseAbuse

Adversechildhoodexperiences

Adversechildhoodexperiences

HouseholddysfunctionHouseholddysfunction

Epigenetic effects of drugs

Epigenetic mechanisms in drug addiction

Renthal and Nestler, 2009

...andvulnerability

Exploring resilience...Exploring resilience...

 

   PBI

Paternal care

 PBI

Maternal care

 BDHIDirect

aggression

 abstinent subjects

 

 25,490,42

 27,590,38

 45.32.9

cocaine users LL-SL 5-HTT

genotypes

 22,560.9

 24.610.5

 59.32.9

cocaine usersSS 5-HTTgenotypes

18.780.4

 18.890.45

 63.252.5

Perceived parenting behaviour in the childhood of cocaine users: relationship with genotype and personality traits

(Gerra et al., 2007)(Gerra et al., 2007)

18

27

PARENTS CARE PERCEPTION

10% less risk

20% less risk

RISK % OF DRUG DEPENDENCE IN THE ADULT

PBI SCORE

90% less risk

Proceedings of the National Academy of Sciences of the United States of America (PNAS), 2012

short version (S) of the 5-HTTLPR

Zimmermann et al., 2009

insecure attachment

secure attachment

agreeable autonomy

hostile autonomy

Resilience

Vulnerability

inequality PreventionPrevention

Prevention of substance abuse reaching the most vulnerable

Prevention of substance abuse as a pillar of development and freedom

The commitment of the International CommunityThe commitment of the International Community

long-term neurobiological changes associated with early stress can be modified by the quality of the subsequent care-giving environment

Kaufman and Charney, 2001

Prevention of cardiovascular diseases -Poker of Aces

• No smoking

• No salt

• No cholesterol

• Physical exercise

Give clearrules andappreciateyour childbehaviour

Dreaming with children about future…

Rewarding their achievements

Teaching to accept limits and rules

Experiencing community cohesion and participation

Making them aware of progressive autonomy

Looking at life perspectives with hope

Proposing values and believes

Transmitting cultural identity

Dreaming with children about future…

Rewarding their achievements

Teaching to accept limits and rules

Experiencing community cohesion and participation

Making them aware of progressive autonomy

Looking at life perspectives with hope

Proposing values and believes

Transmitting cultural identity

to change the trajectory of children at risk