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Brain Development & Addiction with Gabor Mate - part 1

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Heartspeak Productions presents... Brain Development and Addiction with Gabor Maté, M.D. My name is Gabor Maté, I work in the Downtown Eastside of Vancouver as a doctor... I've been family practicing before them for 20 years. I've xxxx on the medical world doing various... duties and engagements as my interest takes me. And for the last 10 years I've worked at a place called the Portland Hotel... which is a domicile, it's a place where a lot of people live... who otherwise would be living in the street. For the last several months I've worked at Onsite... which is the detox facility associated with Insite... the supervised injection site. So thank you all for honouring me by coming up to hear me. I just offered up the prayer that... the speaking that we do to one another this afternoon... may benefit all of humanity and... help to ease the pain and suffering in this world... of which there is a lot. And a disproportionate large share of that pain and suffering... falls upon aboriginal peoples around the world... whether in Latin America, whether in Australia, whether in the Middle East... Africa, or whether in North America. Much of that suffering is rooted in addiction... which is my subject this afternoon. There is nothing about aboriginal people that makes them more prone to addiction. There is nothing intrinsic, there is nothing innate... there is nothing in their nature or their character that drives them to addiction. So it's got nothing to do with any weakness... or flaw or predisposition from the inside. It really has to do with "what are the conditions?"... in a world that feed and drive and promote addiction. And this patients of mine die young. They get diseases from HIV... they get infections of their brains, of their heart valves, of their spines. They get crippled. They commit suicide, they are killed violently. They overdose, they get cancer... they die of liver disease. And few of them live into their 50's. And the question is why? Why do people keep doing this terribly damaging... things to themselves which have such negative consequences in their lives? They lose their health, they lose their lives, they lose their families... their children. Their dignity, their bodies, their teeth. Their earthly possessions. And still they persist. And it's not possible to answer that question... it's not possible to answer that question, if we see it as weakness of will... if we see it as moral failure... if we see it as some kind of bad decision that people make. It's much deeper than that. In fact the question you really have to ask is: "If people are using drugs, despite the negative consequences..." "what does the drug do for them?" "What makes drug so important in their lives?" It must do something. It must do something very essential, otherwise they wouldn't do it. So if we're gonna understand addiction, we first have to understand... what is it that the person gets out of it. It's clear for all of us to see what the damages. But what is the good? What is the short-term benefit... ...that the addict is looking for? Well, to answer that question, just look at the drugs, ok? So there is one major class of drugs that you all know. It's called the opiates. The opiates are drugs like heroine and morphine... ...or which come from the poppy plant. The Asian poppy. Or their man-made analogues like... ...(Propaset?) and Oxycontin and so on. These are all opiates. Well what are opiates? Why do we use them in medicine? What are they? Pain killers is the main thing. We use them as pain killers. But the xxxx in the sense that they also... ...they not only kill physical pain, they also kill emotional pain. It turns out that if you look at the brain scan of human beings... ...when they're feeling emotional pain... ...the same part of the brain lights up as when they're feeling physical pain. So whether I call you a terrible name that really hurt you and insult you... ...or whether I cut you with a knife, the same part of the brain registers it. On the emotional level. So the emotional suffering associated with physical pain... the same as the emotional suffering associated with... ...psychological pain. Is felt in the same part of the brain... ...and that's where the opiates work. So it's a xxx for relief of pain. So the first question when dealing with addiction is always... ...not "why the addiction?"... ...but "why the pain?". I don't have a single female patient in the Downtown Eastside... ...who was not sexually abused as a child. Not one, not even by accident. I talked to hundreds. Many of the men were abused, many sexually... ...if not sexually then physically or in other ways or... ...emotionally abandoned, and neglected and hurt. One guy told me that... a native guy as well actually. Or Métis. He is a Métis man. His mother... ...had a unique way of babysitting him. She was a single mum and had her own addiction and drinking problems. So she went out to the bars to meet the guys. She was in her early 20's. And the babysitter was the dryer. When this kid was 3 years old the mum would stick him in the dryer... ...put a heavy object on the top so he couldn't climb out. And that was her way of keeping him safe while she was out. And that's not untypical. So that's what people go with. So that's why the pain in them. The reason drugs work in the human brain is... ...because we have receptors for them. Now I'll tell you what receptors are. Here is a cell. Here is a brain cell, ok? This is my primitive drawing of a brain cell, with the nucleus here. Now, here is the drug, ok? Looks like this. The molecule of the drug coming into the cell. It works only if the cell has a receptor... ...that can receive it. Another question is: "why do we have receptors..." "...for molecules or drugs that come from poppies"? We're not poppies after all. Mummies and poppies I guess... Well, we don't have receptors for them but we have receptors for... ...our own substances that look just like it, ok? In our brains we have opiates. We have our own natural opiates. And those are called endorphins. Endorphins are our bodies' endogenous or inner... ...naturally occuring morphine-like substances. So the reason the opiates work... that we have endorphines which look just like the opiates... ...and so that's why we have these receptors. But why do we have opiates in our bodies? Well, yes. Pain relief. We have to have something, otherwise it would hurt too much. I mean, if I went like this... ...if I had no endorphines... ...I'd have to weight too much pain everytime I touch anything. So there has to be something to kill the pain to some degree. So, opiates are pain killers. They're also necessary for feelings of joy... ...and elation, and reward. So when you (lose any thrilling), and you're just overjoyed... ...what's happening is that you're having a lot of endorphines flooding your brain. So people when they go bumgee jumping... ...and you measure their endorphine levels... ...the higher their endorphine level the more elated they are after tey go bumgee jumping. Which by the way should tell you something about the nature of addiction. Because addiction is not just about drugs, is it? You can addict to all kinds of things. Lots of you get addicted to dangerous activities. Why? That's so they get their endorphines. So, we have endorphines as pain killers, we have endorphines... to give us joy and elation. They also work in our immune system, they do a lot of things. But the most important thing they do, and here is the key to all addiction... least the least known function of the endorphines... ...our natural opiates... they connect infant to parents. They are the love chemicals. When infant, when that little baby is looking into your eyes... Is it a he or she? He. He's got endorphines going in his brains. So do you, which is why you enjoy it so much. If you didn't have endorphines you wouldn't enjoy your babbies very much. Let's face it, the parents have to do put up with a lot of crap, don't they? You know? Literally. And one of the things that makes it enjoyable... that we have these endorphines floating in our brains. So, endorphines are necessary for their loving connections. They've been called love chemicals. The've been called molecules of love. Is what they've been called. You can have mice in the laboratory, infant mice... ...and you cannnot cut their endorphine receptors. You can actually breed them genetically so that they don't have these things. So now the opiates have nowhere to act. When these animals in the laboratory... ...are born with the endorphine receptors knocked out... ...they will not be upset when they're separated from their mother. Now what would that mean for them in a while? Their death. Because the mother's loving nurturing presence is required... protect the child, to feed the child... ...and also to bring up the child. Without that, if the child does not look into the mum... ...Because there's no endorphines... ...there is no love from the child to the mother... ...therefore no connection, therefore no life. So what I'm sayoing is that the opiates, and the opiate addiction... ...arises in the most essential brain circuit... ...that we human beings have. Which is pain relief, reward and loving connection. Which is the essential dynamic in human life. Now when you ask "why is it so powerful?" Well, because that's where it arises. In the most essential brain circuit. I'm not talking xxxx, but why it arises there. But the point is: that's why it's so powerful. Now, another chemical that's involved in addiction... called dopamine. And I just xxxx in a science to understand the basics. Dopamine is another brain chemical. It's necessary for human life also. Whay is it necessary? To make us feel curious about something. To give us the sense of vitality and excitement. To make us explore something. When you're exploring a novel environment... when you're checking up something for the first time and you're curious. When you're checking out sorts of food. When you're seeking a sexual partner... got dopamine flowing in your brain. Without dopamine, we're like zombies. We're not interested in anything. We're not curious about anything. We won't explore anything. In other words: we're not human beings. I'm mentioning dopamine because all the drugs of abuse, including the opiates... ...release dopamine in your brain as well but... ...the stimulants, particularly cocaine and nicotine... ...and caffeine and crystal meth release dopamine in a major way. Now, if you're seeking food or the expectation of beign rewarded by food... ...that will get your dopamine circuits... will give you a 50% increase in your dopamine level. That's pretty good. That's why you look for food, you know... You're hungry but also excited, right? When you're seeking a sexual partner or about to receive a sexual reward... ...your dopamine level goes up 100%. So it doubles. Now a shot of cocaine... ...will increase your dopamine levels by 300%. A shot of crystal meth will increase your dopamine level by 1.200% So you see how powerful a drug crystal meth is. By the way I'll tell you that, even though crystal meth is a very powerful drug... ...these are all powerful drugs... they don't cause the addiction. The drugs are not addictives in themselves. I mean, just like a pack of cards. You can look at a pack of cards and not become a gambler, right? You can eat food and not become a food addict. You can... Some of you can open up a store... ...but you don't necessarily need to become a shopping addict. You can try crystal meth, and most people who try don't become addicted to it. I'm not saying is a good thing to try. What I am saying is that the drug itself doesn't cause the addiction. Something else has to be there as well, and that something else... what I'll be telling you. Now, in response to your question... when you're getting shots of dopamine from the outside... ...from the cocaine, then your brain says "there's too much here". And it reduces the number of dopamine receptors. So these dopamine receptors xxxxx... ...if you have too much dopamine here your brain says "this is too much for me". And it will kill off some of its own receptors. Now when you stop the cocaine...'re not getting it from the outside, and your body stop making it from the inside. And it takes a while for the brain to regenerate itself. Sometimes it takes a long time. And why is that going on? While it's regenerating you're irritable and you're tired and you're depressed... ...and you're going to redraw. And nobody likes beign around you very much. Because you're a pretty miserable person, because you don't have dopamine. And you not even have endorphines. So that's the second circuit involved in addiction. Now you have the love, reward, pain relief chemical. Now you have the incentive, motivation, curiosity, exploration chemical. Vitality chemical, where addiction arises. And I very quickly ought to tell you about two more brain circuits that don't work in addiction. And actually Hhow do we know these things? Because you can do a brain scan of people. You do a scan, a special kind of imaging... ...with X-ray technology of somebody's brain... ...and these parts don't work. And you can see it that they don't work. Two more circuits don't work in addiction. One of them somebody mentioned, have to do with stress. The adrenalin circuitry. Now, adrenalin is a stress hormone. And we need that... ...if I was to attack you, you have to be able to fight back. And for that your body would create a lot of adrenalin. That would help you scape or to fight back..

Video Details

Duration: 16 minutes and 2 seconds
Country: Brazil
Language: English
Views: 274
Posted by: renan.ferreira on Jul 23, 2012

Gabor Maté is a Hungarian-born, Canadian physician who specializes in the study and treatment of addiction and is also widely recognized for his unique perspective on Attention Deficit Disorder and his firmly held belief in the connection between mind and body health.

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