By: Marc Feinstein
A NEW PARADIGM FOR ADDICTION
Dr. Nora Volkow, Director of the National Institute on Drug Abuse at the National Institute of Health, recently wrote an article for Scientific American entitled, “What does it mean when we call addiction a brain disorder.” She notes that, “The term [brain disorder] acknowledges that addiction is a chronic but treatable medical condition involving changes to circuits involved in reward, stress and self-control.”
One of the key neural circuits that Dr. Volkow is referring to is the reward circuitry of the brain that includes the ventral tegmental area (VTA), the nucleus accumbens, and the prefrontal cortex. Dopamine, produced from the VTA, is involved in the processing of motivation and reward, and is the central neurotransmitter that all drugs of abuse stimulate. Dr. Volkow’s work was pivotal in revealing that the brains of people with drug addiction look very different than non-drug addicted individuals, especially in this neural reward circuitry.
Dr. Volkow emphasizes that each scientist has a specific lens with which to view addiction, but notes that as a human phenomenon, it is multifaceted including complex interactions between biological, behavioral, and environmental factors. In fact, the predominant view in addiction science today is the biopsychosocial framework, which examines addiction from this multifaceted angle. Dr. Volkow is a proponent of the brain disorder model, which views addiction as a disorder of those neural circuits described above.
Importantly, she notes that by viewing addiction as a brain disorder, it becomes a treatable medical issue. This she says, “is crucial for enabling a public-health-focused response that ensures access to effective treatments and lessens the stigma surrounding a condition that afflicts nearly 10 percent of Americans at some point in their lives.”
Let the lesson be here that addiction is a treatable disorder. For those in addiction recovery, this can be your new mantra: ADDICTION IS A TREATABLE DISORDER.
2 WAYS TO MAKE A HEALTHY CHANGE IN YOUR LIFE
Here, we outline two different ways to approach addiction recovery. The first is from current approaches towards addiction counseling and the second is from the field of behavioral neuroscience.
Motivational interviewing (MI): Motivational interviewing involves encouraging current substance abusers to think deeply about their motivations for engaging in drug abuse behaviors. Questioning is meant to be non-judgmental as any transition from one stage to the other has to come entirely from the client’s own volition. A key element of this practice is that at any stage, relapse is possible and to a certain extent expected. The counsellor’s job is to guide questions and to refocus participants on progress no matter how many attempts it takes. The key principle is that with enough continued effort and repeated attempts, addiction is able to be overcome.
Behavioral Neuroscience: Your brain and your behavior have a two-way relationship. Your brain generates your behavior, but your behavior (and especially repeated behaviors as is the case in addiction) influences the structure and function of your brain. As a metaphor, behavior change can be like rerouting a river. Behavior, like water, will follow its easiest path; in the case of a river, this is the deepest channel. If you add energy to the system (like digging another channel), you can redirect the flow. Over time, the new default flow that you have created will win. Try replacing maladaptive behaviors with healthy behaviors, and over time, your new default state will be a healthy, happy you! And as a result, your brain will begin to heal as well.
Tip 1: Think deeply about why you are engaging in addictive behaviors, and identify your triggers. What makes you crave your substance of abuse?
Tip 2: Try shifting your behaviors to healthy habits such as eating well, engaging in physical activity, or meditating. Over time, these will be your go-to behaviors!
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