Describe how alcohol and drug addiction affects the whole family. Explain how substance abuse treatment works, what family interventions can look like. Alcohol and Drug Addiction Happens in Best Families Describe how alcohol and drug addiction affects the whole family. Explains how substance abuse treatment works, how family interventions can be a first step to recovery, and how to help children from families affected by alcohol and drug abuse.
Our burgeoning knowledge of the brain is, in large part, the product of addiction research. Identifying what happens in the brain when a drug is inhaled, injected or eaten, why it leads to compulsive drug searching and learning to interrupt that process seems to be the last best hope for a permanent solution to addiction. That's why, according to Alan Leshner, director of the National Institute on Drug Abuse (NIDA), researchers know more about drugs in the brain than anything else in the brain. Imaging studies have revealed neurochemical and functional changes in the brain of subjects addicted to drugs that provide new insights into the mechanisms underlying addiction.
Neurochemical studies have shown that large and rapid increases in dopamine are associated with the reinforcing effects of drugs of abuse, but also that after chronic drug abuse and during abstinence, brain dopamine function decreases markedly and these decreases are associated with the dysfunction of prefrontal regions (including orbitofrontal cortex and cingulate gyrus). Changes in brain dopamine function are likely to result in decreased sensitivity to natural enhancers, since dopamine also mediates the reinforcing effects of natural enhancers and in altering frontal cortical functions, such as inhibitory control and attribution of prominence. Functional imaging studies have shown that during drug poisoning, or during desire, these frontal regions are activated as part of a complex pattern that includes brain circuits involved with reward (nucleus accumbens), motivation (orbitofrontal cortex), memory (amygdala and hippocampus), and control ( prefrontal cortex and cingulate gyrus). Here, we integrate these findings and propose a model that attempts to explain the loss of control and compulsive drug intake that characterize addiction.
Specifically, we propose that in drug addiction the value of drugs and drug-related stimuli be increased at the expense of other reinforcers. This is a consequence of conditioned learning and the re-establishment of reward thresholds as an adaptation to high levels of stimulation induced by drugs of abuse. In this model, during exposure to the drug or drug-related signals, the recall of the expected reward results in an overactivation of the reward and motivation circuits, while activity in the cognitive control circuit decreases. This contributes to the inability to inhibit the urge to seek and consume the drug and results in a compulsive intake of the drug.
This model has implications for therapy, as it suggests a multi-pronged approach that targets strategies to decrease the rewarding properties of drugs, improve the rewarding properties of alternative reinforcers, interfere with conditioned learned associations, and strengthen cognitive control in the drug addiction treatment. The brain is often compared to an incredibly complex and intricate computer. Instead of electrical circuits in the silicon chips that control our electronic devices, the brain is made up of billions of cells, called neurons, that are organized into circuits and networks. Each neuron acts as a switch that controls the flow of information.
If a neuron receives enough signals from other neurons to which it is connected, it activates and sends its own signal to other neurons in the circuit. Each substance has slightly different effects on the brain, but all addictive drugs, including alcohol, opioids, and cocaine, produce a pleasant surge of the neurotransmitter dopamine in a region of the brain called the basal ganglia; neurotransmitters are chemicals that transmit messages between cells nervous. This area is responsible for controlling rewards and our ability to learn based on rewards. As substance use increases, these circuits adapt.
They reduce their sensitivity to dopamine, leading to a reduction in the ability of a substance to produce euphoria or the “high” that occurs when consuming it. This is known as tolerance, and it reflects the way the brain maintains balance and adjusts to a “new normal”, the frequent presence of the substance. However, as a result, consumers often increase the amount of the substance they take in order to reach the level of high they are used to. These same circuits control our ability to enjoy ordinary rewards such as food, sex and social interaction, and when interrupted by substance use, the rest of life can become less and less pleasant for the user when they are not using the substance.
Science has come a long way to help us understand the way the brain changes in addiction. In this section, we will provide updates on current research on addiction, recovery, and the brain. New research reveals that the cerebellum, a large part of the human brain that scientists thought was primarily involved in motor control, may play a key role in reward-seeking and social behaviors. Findings may help inform future therapies to treat addiction.
Alcohol and drugs affect neurotransmitters and neural pathways in the brain. At the same time, the brain struggles to maintain balance. As a result, when drugs and alcohol change brain chemistry, the brain adapts. For example, the brain will reduce dopamine production if a drug artificially recreates the effects of dopamine.
Once adaptation becomes the norm, the brain will want to “correct an imbalance” when the drug is no longer present by taking the drug again. Over time, substance use disorder (SUD) changes both the structure of the brain and how it works. According to the current theory of addiction, dopamine interacts with another neurotransmitter, glutamate, to take over the brain's reward-related learning system. Unfortunately, the lack of radiotracers available to image glutamate function in the human brain has prevented its research in drug addicted subjects.
The reinforcing effects of drugs during intoxication create an environment that, if perpetuated, triggers neural adaptations that result in addiction. However, due to its delicate structure and chemistry, the brain is also very vulnerable to addiction. Conditioned learning helps explain why people who develop an addiction are at risk of relapse even after years of abstinence. With enough reinforcement, drug users move into the stages of addiction known as desire and dependence.
This is relevant because the involvement of the dorsal striatum, which is a region associated with habit learning, indicates that in drug addiction, the routine associated with drug use can be automatically triggered by exposure to the drug or drug-related signals (4.addictive, making it more difficult to reconfigure deep-rooted neural circuits. Drugs and addictive behaviors are a shortcut, flooding the brain with dopamine and other neurotransmitters. Although important for understanding addiction, it does not seem likely that the dopamine pathway itself will produce promising new drugs or other treatments for addiction. Since the OFC also processes the information associated with the prediction of the reward (1), its activation during the exposure of the signal could indicate the prediction of the reward, which the addicted subject could experience as desire.
At this stage, the individual may not have a total addiction; however, they may have developed tolerance or dependence. The model also highlights the need for therapeutic approaches that include pharmacological and behavioral interventions in the treatment of drug addiction (5). With the use of technologies such as magnetic resonance imaging (MRI) and positron emission tomography (PET), medical professionals can see the inner functioning of the brain, both with an addictive state and without. This is not a total loss of autonomy: addicted people are still responsible for their actions, but they are much less able to nullify the powerful urge to seek relief from abstinence provided by alcohol or drugs.
Multiple memory systems have been proposed in drug addiction, including conditioned incentive learning (mediated in part by NAc and amygdala), habit learning (mediated partly by caudate and putamen) and declarative memory (partly mediated by the hippocampus) (reviewed in ref. . .