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Archive for Tuesday, August 16, 2011

Addiction a brain disorder, not just bad behavior

August 16, 2011

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— Addiction isn’t just about willpower. It’s a chronic brain disease, says a new definition aimed at helping families and their doctors better understand the challenges of treating it.

“Addiction is about a lot more than people behaving badly,” says Dr. Michael M. Miller of the American Society for Addiction Medicine.

That’s true whether it involves drugs and alcohol or gambling and compulsive eating, the doctors group said Monday. And like other chronic conditions such as heart disease or diabetes, treating addiction and preventing relapse is a long-term endeavor, the specialists concluded.

Addiction generally is described by its behavioral symptoms — the highs, the cravings, and the things people will do to achieve one and avoid the other. The new definition doesn’t disagree with the standard guide for diagnosis based on those symptoms.

But two decades of neuroscience have uncovered how addiction hijacks different parts of the brain, to explain what prompts those behaviors and why they can be so hard to overcome. The society’s policy statement, published on its website, isn’t a new direction as much as part of an effort to translate those findings to primary care doctors and the general public.

“The behavioral problem is a result of brain dysfunction,” agrees Dr. Nora Volkow, director of the National Institute on Drug Abuse.

She welcomed the statement as a way to help her own agency’s work to spur more primary care physicians to screen their patients for signs of addiction. NIDA estimates that 23 million Americans need treatment for substance abuse but only about 2 million get that help. Trying to add compassion to the brain findings, NIDA even has made readings from Eugene O’Neill’s “Long Day’s Journey into Night” a part of meetings where primary care doctors learn about addiction.

Then there’s the frustration of relapses, which doctors and families alike need to know are common for a chronic disease, Volkow says.

“You have family members that say, ‘OK, you’ve been to a detox program, how come you’re taking drugs?’” she says. “The pathology in the brain persists for years after you’ve stopped taking the drug.”

Comments

Ron Holzwarth 2 years, 8 months ago

Qualifier: I am not an expert, so most of this is no more than how I understood what I have been told:

It is difficult for me to believe that addiction is only a brain disorder. It may become that, but that is not how it first begins.

I think there is far to great of a rush to assign behavioral problems to physical disorders in brain functioning, and not enough thought put into situational reasons which might result in the beginning of mental problems or a problem with substance abuse in the first place.

There are many people who are in very difficult situations that result in a great deal of stress. When they are directly confronted with their problems, which may or may not be of their own making, their stress is quite likely to become much worse.

In that case, a person will very likely begin to avoid his problems by trying to not think about them. That is when drugs such as alcohol, nicotine, or any number of illegal drugs are likely to be ingested in an attempt to erase those thoughts from his mind. While the drugs are being used, his problems are not at the forefront of his thoughts - for a while.

Some time after that, a physical change will very likely take place in the brain. Then the substance being used becomes tolerated by the body and brain, and then larger and larger doses are required in order to effect the same level of escapism.

And then, it is at that point that the brain changes which result in physical addiction occur.

I do not understand this at all, but I have certainly heard it being discussed a lot:

The way the brain operates has to do with serotonin production, serotonin transfer, and serotonin receptors or inhibitors within the brain at the cellular level. Undesirable changes can take place that then result in mental disorders or addiction problems.

Exactly how the serotonin levels affect brain functioning is not completely understood.

There are many psychotropic drugs that are used to treat mental disorders. What most of them do is enhance or inhibit serotonin production, or block serotonin receptors at the cellular level within the brain. Altering serotonin levels or reception can help some individuals with mental disorders, and physical addiction is one of them.

Of some interest has been the discovery that one of the older and more effective antidepressants, Wellbutrin (also known as Bupropion), has been recently been found to be very effective in helping people with smoking cessation. It is sold as Zyban when used for that purpose.

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