November 16

Addiction as a brain disease revised: why it still matters, and the need for consilience Neuropsychopharmacology

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However, as we will see below, in the case of addiction, it contributes to large, consistent probability shifts towards maladaptive behavior. Imaging studies also reveal that many substances of abuse are related to reduction in volume of specific areas of the cerebral cortex, reflecting a pruning of synapses to make the brain highly efficient in drug-seeking. The loss of synaptic density underlies a biologically https://thecaliforniadigest.com/top-5-advantages-of-staying-in-a-sober-living-house/ based inability to respond to the wide range of other, more natural rewards. Opiate drugs, such as morphine and codeine, are commonly used in the clinical setting for pain relief. However, this class of psychoactive agent can also elicit intense euphoric effects followed by feelings of well-being in the user when taken in high doses, which can lead to their abuse and ultimately may result in addiction.

Is a view of addiction as a brain disease deterministic?

After exposure to CBT, that reactivity in the brains of those with social anxiety had noticeably decreased. Your brain created a neural pathway that reinforced this cause-and-effect; speaking up means punishment. You no longer have to consciously make this connection—it is a defined course in your mind.

Box 1 What’s in a name? Differentiating hazardous use, substance use disorder, and addiction

Alcohol is an addictive substance, and the social lubricant effects so many chase can have deadly consequences when a habit turns into addiction. Binge drinking is a pattern of drinking alcohol that increases the BAC to 0.08 or higher. For adults, this is five or more drinks for men and four or more for women in two hours.

How Science Has Revolutionized the Understanding of Drug Addiction

  • As indicated above, viewing addiction as a brain disease simply states that neurobiology is an undeniable component of addiction.
  • Furthermore, efficacy of treatment approaches such as contingency management, which provides systematic incentives for abstinence [107], supports the notion that behavioral choices in patients with addictions remain sensitive to reward contingencies.
  • Unlike other organs, the brain is designed to change, because its mission is to keep us alive, and in order to safeguard us, it needs to be able to detect and respond to the ever-changing dynamics of the real world.
  • Finally, such work should ultimately be codified in both the DSM and ICD systems to demarcate clearly where the attribution of addiction belongs within the clinical nosology, and to foster greater clarity and specificity in scientific discourse.

This allows individuals to get unique treatment, physical and psychological help, and a deeper understanding of their addiction. The chemical compounds in stimulants, nicotine, opioids, alcohol, and sedatives enter the brain and bloodstream upon use. Once a chemical enters the brain, it can cause people to lose control of their impulses or crave a harmful substance. Just as drugs produce intense euphoria, they also produce much larger surges of dopamine, powerfully reinforcing the connection between consumption of the drug, the resulting pleasure, and all the external cues linked to the experience. Large surges of dopamine “teach” the brain to seek drugs at the expense of other, healthier goals and activities.

how does addiction affect the brain

Staying Social When You Quit Drinking

how does addiction affect the brain

In the course of recovery from addiction, brain gets unstuck; areas that lost connectivity—particularly the prefrontal cortex—regain their normal neural power. People recover the ability to exert control over impulses, over feelings of craving. In the nucleus accumbens, new subsets of dopamine receptors flourish at synapses to deliver the capacity to get excited by other goals and especially by connection to others. People regain the ability to respond to more natural rewards, setting the stage for psychological growth. One of the most notable findings of brain imaging studies of addiction is the degree to which, through dopamine pathways, the prefrontal cortex is consistently dysregulated, disempowered in response to activation of the nucleus accumbens by drug cues. Brain imaging studies help explain how drug cues biologically narrow focus on the substance of abuse, motivate the drive to get it, and impair rational decision-making—brain changes that make addiction a self-perpetuating condition.

  • If not from the brain, from where do the healthy and unhealthy choices people make originate?
  • One of the biggest red flags is impaired social and occupational functioning, Koob says.
  • The brain loses the capacity to respond to other potentially rewarding activities.
  • The capacity to respond to drug cues doesn’t necessarily vanish entirely, but it is deactivated; it is overridden, no longer the only goal capable of firing up the brain, and it diminishes in importance.
  • He goes on to conclude that “generally, genetic prediction of the risk of disease (even with whole-genome sequencing data) is unlikely to be informative for most people who have a so-called average risk of developing an addiction disorder” [7].

A key implication of this model is that genetic susceptibility for a complex, polygenic trait is continuously distributed in the population. This may seem antithetical to a view of addiction as a distinct disease category, but the contradiction is only apparent, and one that has long been familiar to quantitative genetics. Addictive drugs, for example, can release two to 10 times the amount of dopamine that natural rewards do, and they do it more quickly and more reliably.

Some effects of drug abuse and addiction include changes in appetite, mood, and sleep patterns. More serious health issues such as cognitive decline, major organ damage, overdose, and death are also risks. Addiction to drugs while pregnant can lead to serious Top 5 Advantages of Staying in a Sober Living House outcomes for both mother and child. • the prefrontal cortex, which is the seat of such executive functions as judgment, decision-making, impulse control; it gradually weakens in response to overactivation of the reward circuits by drugs of abuse.


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