Discussion With Psychologists on Addiction & The Brain
Addiction And The Brain: QED with Dr. B | WOSU Public Media
The episode on “QED With Dr.B” focused on addiction at a biological and psycho-social level. Dr.B interviewed many experts who study addiction in diverse ways.
Dr. Carl Hart explained that addiction on a medical level is not only a disruption in psychosocial functioning but also distress felt by an individual. Early exposure, psychosocial factors, and psychological or physical pain increase the chances and susceptibility of individuals to abuse substances or drugs. For instance, an individual with preexisting or co-occurring psychological or psychiatric disorders such as depression, schizophrenia, or anxiety disorder is more at risk of having an addiction to substances and drugs. Another example is when unrealistic expectations are put on an individual which also increases risk. In addition, Dr. Hart emphasized that the amount of a drug that is put into the body is important when looking at addiction: the correct dose of a drug can be therapeutic; however, too much of it can be fatal.
Dr. Wade Perretinini proposed an idea that stood out to me. Dr. Wade stated that addiction is not a lack of willpower but instead a “chronic relapse brain disease” or how the brain’s original wiring changes. When the brain is first exposed to a drug, an individual will feel euphoric which drives the brain to repeat that pleasurable feeling. This causes more frequent use until compulsive daily use. “Chronic relapse brain disease” is when substance use causes activation of the central reward system in the brain. Drugs—or what Dr. Wade considered “unnatural rewards” relative to food which is considered a “natural reward”—activate the group of neurons between the midbrain and frontal cortex that use and make the neurotransmitter dopamine. This relates to the construct of demand in behavioral economics or how much an individual values an activity (varying based on content and available alternatives). After an individual’s initial introduction to a certain drug, the demand for that drug—or more specifically that feeling of euphoria—rapidly increases.
Another idea that stood out to me was that Dr. Edmund Griffin proposed that addiction is a disorder of learning and memory. Dopamine, although most widely known for its pleasurable feeling in the brain, is a neurotransmitter that says “That was good for survival, do it again” according to Dr. Griffin. Drugs and substances activate this feeling of “do it again” because it feels good to the brain. Hence the brain gets addicted to drugs quickly since it wants to find that exact feeling and repeat it again. This relates to the Community Reinforcement Approach (CRA) as this type of treatment aims to decrease the relative value of negative behavior by increasing the relative value of positive alternative behavior. CRA attempts to change an individual’s lifestyle where drinking or smoking does not have a relatively large value compared to other healthy activities such as biking or cooking etc. CRA uses positive—and intermittent—reinforcement every time an individual abstains from smoking or drinking. CRA allows individuals to get the “do it again” feeling from beneficial hobbies instead of harmful activities such as substance abuse.
Watching this episode changed the way I thought about addiction. I used to isolate drug and substance addiction—especially opiates, benzodiazepines, and cannabis—as its own “issue” that existed amongst teens and adults. However, I failed to recognize that drug addiction is just like any other addiction such as gambling (which Dr. Eve Limbrick-Oldfield talked about), shopping, and food (e.g. binge eating disorder). All of these addictions have a common theme: they all biologically affect the brain by rewiring which affects the way an individual makes decisions and behaves. In simpler terms, having an addiction physically changes the brain. Drug and substance addiction should not be stigmatized and treated as an isolated case when looking at potential treatments. Instead, we should look at people struggling with addiction through the perspective that their brain has been impaired by an external factor such as alcohol or a drug. Their brain can be brought back to their optimal functioning level with treatments such as Community Reinforcement Approach (CRA), Contingency Management (CM), or Episodic Future Thinking (EFT). I believe that there is always hope that individuals who struggle with an addiction can recover and build strong relationships with their community.
