“Addiction is not something we can simply take care of by applying the proper remedy. For it is in the very nature of addiction to feed on our attempts to master it.” – Gerald May, Author
Welcome to installment 3 of the of the science of addiction, The Dopamine Response and Neuroplasticity. Installment 2 discussed the conditioning aspects of the dopamine response, why it is there, and what happens when addiction takes something that is there to help us and turns it against us. I said that I would rely on hard science and yet much of the prior discussion was about conditioning, the subconscious and the conscious brain. That is getting close to “touchy, feely” psychology stuff but it is there to lay the ground work for the following discussion of how addiction hijacks the dopamine response.
Neuro-what?
You have probably heard the term neuroplasticity in Lumosity.com advertisements and you may have wondered what it meant or maybe you were just too busy with your life to even really listen to the commercial. Well, neuroplasticity is a real thing that has been well documented. Neuro – nervous system specifically the brain and plasticity – the ability to mold and remold. As late as the 1970s, we still believed that once your adult brain was physically formed it did not change until you got very old. I’m not sure why we decided that but since the only brains we could physically study were dead we had no reason to believe otherwise. Now that we have brain scans, specifically PET scans, we can “see” what the brain is doing and how it changes. The NIDA put a good deal of the funding into studying brain scans in differing situations. The scans have been used to define the areas of the brain that fulfill different roles and the changes that take place in the brain as a result of various behaviors and injuries.
Your Brain, Like a Muscle, Gets Bigger Where It Gets Used, Duh!
Danger science! The next paragraph explains how the physical changes to the brain occur. It’s not that you can’t understand this but feel free to skip it and take my word for the fact that it happens.
One of the things that was learned is that the brain is moldable and remoldable and that it physically changes in response to stresses and demands. Neuroplasticity was discovered when it was observed that a demand or stress placed on a certain area of the brain caused, thickening of the brain in that area and construction of new neural pathways and more interconnections between neural pathways. This occurred because in response to the demand, more blood was sent to that area of the brain carrying more oxygen and glucose. The oxygen and glucose spurred on cell generation. Getting back to what a great design we are, it makes sense that if there is a high demand on an area of the brain, it must be doing something important. If it is doing something important for survival, it is advantageous to make it stronger and better at what it does. By the way, the very colorful image at the top of every page illustrates the neural pathways in the brain, like a jumble of wires connecting and interconnecting our brain and allowing signals to pass back and forth.
Drug are Really Smart and Devious
In the previous installment in this series, we discussed that under normal circumstances dopamine is the stimulus that drives conditioning. It is also a sign to the brain that the thing (food, sex, etc.) causing the increase in dopamine is important for survival. When a drug is used, the massive flood of dopamine tells the brain that this is very important. Conditioning causes the brain to focus on the drug and the areas of the brain affected, the addictive areas of the brain. Increased bloodflow causes those areas of the brain that are affected to get thicker, to have more neural pathways and connections, and to get better at what they do. In effect the massive dopamine response caused by addictive substances/behavior causes physical changes in the brain that build a better addict. By build a better addict, I mean that it reinforces addictive behavior and it ignores areas of the brain that would get in the way of the addiction, such as, ethics, relationships, and any outside interests. The longer the individual uses, the more the addiction gets reinforced. The pathways supporting addiction then become highways and the pathways that get in the way become dirt roads.
Wow, drugs are really smart. They know how to take this wonderful system that is built into our brain to help us survive and it uses it to turn our focus to only the drug. Eventually, this drive us to believe that we must have it to survive. Sounds like job security to me. NOPE, I was wrong again, the drug is just a chemical. Drugs don’t think. Drugs aren’t capable of caring if you use them or not. It is in effect, a flaw in an otherwise brilliant system. We managed to accidentally find this particular bug in our programming while we were looking for something to make us feel good. Isn’t that what drives most addicts to start? Trying to feel better, trying to hide from physical or emotional pain, looking for something outside of themselves to fix or hide what they don’t like inside themselves. More on this later.
Okay, Let’s Ramp Down the Science a Little
If you look at the big picture of everything that we just discussed, you can clearly see the typical path of addiction. First, the drug is used to make us feel better in some way. In the case of my son, he never thought that he was smart enough, good looking enough or that anyone really liked him. That combined with some social awkwardness, probably due to his mild ADD (attention deficit disorder), made him uncomfortable in social situations. Later in life, he called alcohol a social lubricant and he first abused alcohol and then moved on to harder drugs. Second, the high from the drug causes us to want to use it again. Third, the changes in our brain that occur from using, convince our brain that we need the drug. As we know, right or wrong, what our brain believes is our reality. We called this time in my son’s life the Dark Times. He changed from someone incredibly honest and ethical to someone who rarely cared about much other than getting the next fix. He worked hard but that was to have money to get the drugs that his brain now told him he NEEDED.
The Skeptic
At this point, you are probably considering that addiction may be a disease that was allowed to start because of a poor decision then rapidly took control. If you think about it, there are other diseases that a person may have done something that allowed it to start (smoking => lung cancer or emphysema; poor diet and no exercise =>heart disease). A skeptic may say, “if you are right about the changes to the brain, then no one would ever get cured.” To this I say, you are right, no one does get cured but they can learn to manage addiction with help. Initially, you cannot overcome addiction by yourself, as I said before, you are fighting your own brain and doing it with one hand tied behind your back. But,
- If you are given support (AA and other 12-step programs) and possibly something to help with cravings such as, suboxone or methadone.
- If you are kept away from any drugs.
- If you work hard to address why you started.
- If you work hard to rebuild your ethics.
- You will SLOWLY begin to recover but the addiction will never leave you.
The neural pathways that were built to support addiction you will turn to dirt roads and the neglected dirt roads of the old you will go back to the highways that they should be. The dirt roads of addiction will never totally go away. Turn down that road of addiction and it will be reconstructed so fast that PennDOT would be impressed.
I have seen this. I have seen my son work hard at his recovery and become a great person. I have met many others like him that did the same. But the journey is so long and so arduous that they will slip sometimes. They may fall sometimes but eventually they will find their footing.
Do you have thoughts or experiences to share? Please comment, let’s work together and help each other to understand this problem.
I hope that you will join me next week for “The Limbic System And Stupid Brain Tricks”.