ADDICTION:
Asking the right questions!
How much of the problem is nature
and how much is nurture?
Or is it a disease of the brain?
Why do we self-medicate?
I have asked this question to
over 1,000 offenders. The
same reasons are given!
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‘want to fit in’
‘I am different’
‘I’m a freak’
‘It makes me feel more confident’
‘I’m boring when I’m sober.’
‘I want to block out the past.’
‘I want everything to feel OK.’
‘I get bored.’
‘Life is dull if I cannot drink.’
‘I won’t have a social life without
alcohol.’
‘It hurts too much to be sober.’
‘Everyone drinks: I’ll be the odd
one out.’
‘The pain inside my head is too
much to bear.’
‘I came back from Iraq. I should
have died with my mates.’
What is normal brain
development?
‘The Scientist’: Feb 2nd 2014
‘Pruning synapses, improves brain
connections’.
What is synaptic pruning?
What happens if it doesn’t take place?
The normal brain has resident
MICROGLIA [resident immune cells that
engulf damaged cells.] Absence of
microglia may contribute to autism/OCD.
[Nature Neuroscience, Feb 3,2014.]
Three of our chief neurotransmitters,
with which we are born, are –
NORADRENALINE
DOPAMINE
SEROTONIN
Within normal people there is sometimes
less of one of these. Only when the
imbalance is greater, do we find the
emergence of problems.
Within this manual, used by psychiatrists and mental health
professionals, there are descriptions of multiple addictions, each tied to a
specific substance or activity. The consensus is emerging that these may
represent multiple expressions of a common underlying brain process.
 Addiction changes the brain, first by subverting the way it registers
pleasure, and then by corrupting other normal desires such as
learning and motivation.
 Stephen Melemis [Feb. 2014, refers to addiction as a disease of the
wiring of the brain –www.Addictions and recovery.org]
 Koob GF, describes addiction as ‘the hijacking of the brain’ 2012.
DSM 1V [DIAGNOSTIC & STATISTICAL
MANUAL OF MENTAL DISORDERS].
DEFINITION OF
ADDICTION Addiction is characterised by INABILITY
to consistently ABSTAIN;
Impairment in BEHAVIOURAL control;
CRAVING; or increased hunger for
drugs or rewarding experiences;
DIMINISHED recognition of significant
problems with one’s behaviour, and a
dysfunctional EMOTIONAL response.
The addicted brain is one where the
brain receptors become overwhelmed.
The closest concrete analogy is the
National Grid being forced to shut
down certain areas in order to meet
demand – eg Dec 25th – multiple
homes cooking Christmas dinner!
THE REWARD PATHWAY
• The reward pathway has long
been known about in the
terms of the dopamine
neurotransmitter being in
charge of pleasure. But, when
drugs are used repeatedly, the
dopaminergic pathway is
damaged, and the brain
responds to the ‘flooding’ by
producing less dopamine or
eliminating dopamine
receptors. [In concrete terms,
it is similar to turning down
the volume on a loudspeaker
when the noise becomes too
loud].
New research shows the interplay
between the regions of the brain!
• The site of action for addiction is
the interplay between the frontal
lobes and the nucleus
accumbens, and the
hippocampus, and the amygdala.
• The substances hijack the reward
system and the individual
compulsively pursues these
rewards instead of natural
rewards.
• Addictive drugs can release 2-10
times the amount of dopamine
that natural rewards do!
• Feature of the addict: When do
we want it? We want it now – and
lots of it!
Armed with this knowledge, who is
most likely to be affected?
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Genetic factors account for between 40% and 60%
of those who become addicted.
Children who have been exposed in utero to
maternal alcohol consumption are highly predisposed to becoming addicted.
Environmental influences and exposure to trauma
interact with the person’s biology.
Young people are ill- advised to partake in binge
drinking, since the brain is not fully physiologically
developed until age 24.
Those with poor supports and under- developed
resiliences as a result of poor nurture, will not have
the coping mechanisms nor the adult listening ear
to enable sound decisions.
We often hear addicts say – ‘I want to block out the
bad stuff’. The trouble is, that the brain cannot
discriminate between good and bad – it blocks out
and shuts down all emotions, resulting in an
inability to function!
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Why do different people select
different drugs?
Cocaine’s chemical formula mimics dopamine’s formula.
Cocaine blocks the re-uptake of dopamine which then
accumulates in the synapse to stimulate receptors further
and cause the person to feel extremely good. [Tomkins and
Sellers].The wanting more leads to powerful cravings –
followed by repetitive use- and long-term damage to
dopamine levels in brain.Other drugs that mimic dopamine
are methamphetamine,dexedrine,ritalin and addererol
[Kipper and Whitney].Less harmful mimics of dopamine are
caffeine and sugar. An excess of dopamine in children can
cause ADD and ADHD. FAS children can also end up with
ADHD as a result of maternal alcohol consumption.
Those people who have a lack of serotonin – the
neurotransmitter responsible for moods and emotions, are
most likely to self- medicate with with alcohol/heroin. Both of
these drugs mimic serotonin – making the person feel better.
Prozac – is a serotonin and noradrenalin re-uptake inhibitor.
They block the re-uptake of serotonin and enable it to remain
in the syntax where it can stimulate receptors. It is for this
reason, that there are some addicts who will require very
lengthy medical interventions to enable them to function
‘normally’.
The structure of neurons can be changed permanently. This
needs to be understood in order to create a programme of
recovery for those who are seeking abstinence and
maintenance of a drug free life.
Noradrenaline keeps us informed of potential threats and is
in charge of our flight/fight/freeze responses. An over
abundance of noradrenaline leads to anxiety ; a massive
amount leads to panic. High levels of noradrenaline over a
sustained period result in sleep disorders and in complex
mental health problems. In these cases, addicts will gravitate
towards Valium/Xanax/Ativan/Marijuana/nicotine.
‘I am where I am, therefore,
with God’s help, I will be the
best I can be, and I will share
my sobriety with anyone who
wants help.’
‘When you hold onto the past with
one hand and grab at the future with
the other, you have nothing with
which you can hold on to today.’
‘You cannot get ahead until you learn
to be here.’
‘Our sickness is between our ears.’
‘Alcohol was my strength, then I
learned it was my weakness.’
‘Each day I wake up and go through my
long list of reasons for being grateful,
and I know that I am truly rich.’
Tomorrow has gone…today is here…it
is the present, and in its truest sense it
is a gift!
• Recovery is more than
stopping drug use – it is a
return of the senses – a
renewal of the mind and
spirit – and an intense
awareness of beauty.
• It is a recognition that we
need to keep life simple.
Respect ourselves, and
others, and find a way to
give back to those who
are still struggling.