In our second Educational Grand Round, we take a look at Addiction with Dr. Safdar Chaudhary, Dr. Ruthann Valentine, Peter Bregel, and Jim Ellermeyer along with the most recent students in our first Google Hangout recorded session! Note: This is being posted out of order, so "last week" and "next week" references may not apply. Want an audio version? Subscribe to our Podcast on iTunes! Want to join us for the live discussion? Check out our Social Media in the noon hour every Monday as we sit down on Google Hangout OnAir! Follow us on Twitter, Facebook, or Google+ to get updated with the link when we start! Video at http://seclairer.com/blog/addictiontalk

1. ADDICTION
A S’eclairer teaching topic

2. ADDICTION
• Alcohol
• Drugs
• Cigarettes
• Food

3. ALCOHOL
• Most commonly abused psychoactive agent in the
U.S.
-Depresses CNS
-Activates reward circuit
• Cardioprotective at low doses; damages the heart
and liver if abused; elevates blood pressure
• MEDS:
-Acamprosate (Campral) – reduces unpleasant
feelings of discontinuation
-Naltrexone – decreases craving
-Disulfiram (Antabuse) – causes unpleasant
effects

4. DRUGS OF ABUSE
• OPIOIDS (heroin, morphine)
• STIMULANTS (cocaine, adderall, ritalin)
• BARBITURATES (phenobarbital)
• BENZODIAZEPINES (xanax, ativan,
valium)
• PSYCHEDELICS (LSD, mescaline)
• DISSOCIATIVE drugs (phencyclidine,
ketamine)
• ANABOLIC STEROIDS (nandrolone,
testosterone)
• MISC. (marijuana, nitrous oxide)

5. NICOTINE
• Cigarettes are the greatest single cause of preventable
illness and death – 400,000 fatalities/year:
-lung cancer
-heart disease
-airway obstruction
• $95 billion per year
• Reaches the brain in 10 seconds
• 41% of American smokers try to quit
-5% succeed without help
-30% succeed with help
• MEDS:
-Nicotine patch, spray, inhaler
-Chantix, Zyban
-Bupropion
-Nortriptyline
-Clonidine

6. OBESITY
• Second leading preventable cause of death
• A chronic disease like hypertension and diabetes
• Contributing factors
-genetics
-metabolism
-appetite regulation
-environmental
-psychosocial
-cultural
• BMI ranges
-25 to 30 overweight
-30 to 35 Obesity 1
-35 to 40 Obesity 2
-40 plus Morbid obesity
• MEDS:
-Silbutramine (appetite suppressant)
-Orlistat (lipase inhibitor)
-Bupropion (appetite suppressant)
-Leptin (appetite modulating hormone)