Study offers insight into brain chemistry behind addiction
August 13, 2009
MONTREAL — Researchers at the Montreal Neurological Institute have gained fresh insight into the brain chemistry behind addiction by studying the least likely of addicts — Parkinson’s disease patients.
Typically, those suffering from the neurodegenerative disorder are the polar opposite of an addictive personality. Most patients with Parkinson’s are found to be introverted,
rigid and slow to anger — not the excitable, impulsive temperament that’s necessary for addiction, said Alain Dagher, lead author of the MNI study.
Yet paradoxically, some patients who are treated for the tremors associated with Parkinson’s disease do develop addictive behaviours. For example, the incidence of pathological gambling in treated Parkinson’s patients is eight per cent compared with one per cent in the general population.
What Dagher and his colleagues discovered is that some of these patients might have been given too much medication to stimulate dopamine, a neurotransmitter in the brain. People with the disease lack dopamine.
“In some instances, Parkinson’s disease patients become addicted to their own medication, or develop addictions such as pathological gambling, compulsive shopping or hypersexuality,” Dagher said.
So what does Parkinson’s have to do with addiction? Dagher, a neurologist, has found that people suffering from addiction have elevated levels of dopamine in their brains.
Thus, the link between some Parkinson’s patients under treatment and addicts is higher-than-normal levels of dopamine in their brains. Previously, some scientists had questioned whether too much dopamine in the brain could trigger addiction.
“People with addiction, we think, have an excess of dopamine,” Dagher explained. “And with Parkinson’s disease, you give a drug to increase dopamine in order to relieve symptoms, and some people get overdosed. One of the effects of this excessive dopamine stimulation from the drug appears to be the development of addictions — especially pathological gambling.”
The practical implications of the research means that doctors will have to be much more careful in prescribing medications to patients with Parkinson’s, Dagher said.
As for addiction, researchers will need to focus more on genes that predispose people to elevated dopamine.
Nearly 100,000 Canadians have Parkinson’s. Addiction prevalence is much higher. One out of every 10 Canadians, aged 15 and over, have symptoms consistent with alcohol or illicit drug dependence, according to the Centre for Addiction and Mental Health.
The MNI study was published Wednesday in the journal Neuron. Researchers from McGill and the University of Cambridge were also involved.
Montreal Gazette
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Testimony of God’s Overcoming Addiction Power
July 6, 2009
Hello my name is Richard, and this is my testimony of God’s overcoming addiction power:
My mother loved myself and my siblings, and as a single parent did the best she could to provide for all of our needs. Sometimes providing for us included moving; different neighborhoods, different towns, and even different states. I had changed schools at least eight times before I was thirteen. I always felt like an outsider and that I did not fit in. Having quality friendships was difficult. I had finished elementary school with exceptional grades. That changed as I entered middle school. I made friends with the wrong people, I skipped school, and ultimately began smoking marijuana and drinking. My mother moved me to my Grandparents home and I accepted Jesus Christ as my Savior for the first time. My life changed.
I missed my family and returned to Portland. I believed things would be different, but they were not. By the time I was sixteen I had experimented with hard drugs and dropped out of school. I began working full time, which afforded me to continue in the same lifestyle and at that age it was very appealing, my life was out of control. At nineteen I went through my first treatment program, passed the ASVAB test, and went into the Army. I was finally on the right track. I left all of my former life behind thinking a change of environment would solve the problem. However, I began to drink, and eventually was using cocaine again. I returned home to Oregon. In Portland the same people were still doing the same activities, nothing I wanted to be a part of, I requested a transfer to Washington to be near my family. I knew that if I just had the support of my family and church everything would turn out all right.
The problem was not the environment, or the circumstances, or the friends, it was me. Read more
Restoration and Relapse
June 25, 2009
Spiritual Transformation
In aftercare treatment planning, one must include a clear plan of restoration. This plan must include a great deal of accountability and ongoing oversight. Relapse and recidivism rates for addicts still remain relatively high after completion of treatment. One must be on guard to discern the role of spiritual transformation in the life of the addict. Addicts will say—and genuinely believe, along with many others supporting the addict—that they have committed or recommitted their lives to Christ, that God has forgiven their sin, and they have been healed from their addictive desires.
The implication is that if the therapist continues to insist on strong accountability or a need for continued treatment, they are doubting the power of God to change lives. This is very difficult bind for Christian counselors. On one hand we must seriously believe in the power of God to heal and change lives, while also being aware that healing is almost always a gradual process. Furthermore, the Christian counselor knows as well as anyone the subtle power of sin and the ways of the world to tempt the addict to use again. Even in the midst of the healing process, offenders can and do experience relapse—some relapse numerous times—but eventually establish control over the problem.
We must balance the need to affirm healing in the offender with appropriate concern for the reality of relapse and renewed addiction. The church, as a community of grace and healing, looks to the hope of the gospel for the power to change the behavior of addicted persons, to heal the wounds of the their victims, and to provide reconciliation with the body of Christ.
Behavioral Change (Part 2)
June 17, 2009
Addicts have developed strong, highly programmed, even automatic behavior patterns in order to maintain their addiction. They will go to extraordinary lengths to deny, minimize, or rationalize this addictive behavior.
1. Focus honesty and behavior change.
This requires the therapist to maintain a strong initial focus on honesty and behavior change. When the addict seeks to divert discussion to family, emotional, or relationship concerns prematurely, the therapist must redirect attention to behavior. While effective treatment may address these issues, the clinician must help the addict stop using them to escape dealing with his or her addictive behavior.
One way of doing this is to link the tangential topics the client raises with the central issue of their addiction. For example, a counselor might refocus a client’s response toward the behavior in this way: “So how is the way you approach your anger toward your wife similar to the way you acted out your anger in your sex addiction?” “How is your tendency to denigrate yourself reflected in your addiction ritual?” The assumption here is that addiction has a life of its own and operates apart from other concerns. Unlike many other clinical issues, addiction is both symptom and disease.
2. Changing ritual behavior patterns.
All addicts will need to change certain behavior patterns. Even those who engage in substance addictions need to evaluate behaviors that lead them into their use. These behaviors are usually referred to in the addiction community as “rituals.” The competent Christian counselor will help an addict assess the cycle of how he or she acts out. What behaviors always seem to lead to the addictive behaviors? Taking detailed histories of usage and behavioral patterns will be helpful.
When this information has been sorted out, addicts must establish boundaries against those behaviors. Alcoholics will need to avoid certain friends, areas of towns, or stressful situations that lead them to drink. Food addicts may even need to avoid going to the grocery store in the early days of recovery, or they may need to schedule meals at regular times and find help to eat at those times religiously. Sex addicts will need to avoid people and places that trigger them into their fantasies or “connecting” rituals. For example, those sex addicts who use the computer to connect will need to become accountable for every minute of access to it.
Has Your Tolerance Increased?
June 10, 2009
God has made us “fearfully and wonderfully” (Psalm 139: 14). One of the amazing qualities of the body is its ability to adapt. Whatever happens to the body it will always seek to return to the state of normal. Scientists and systems therapists call this homeostasis. A virus enters our body and the body works to expel it. If a person gets frightened and his heart rate increases, the body works to return it to the normal rate. What the body interprets as normal, however, can change if there is repeated challenge to the normal state of affairs. This is a powerful ability that God has created in all people, the power to adapt.
The first time an alcoholic drinks a beer, for example, he or she experiences the effects of that in the brain. Brain chemistry changes and feelings of intoxication begin. Eventually, the brain returns to normal and the person “sobers up.” If the pattern is repeated over and over again, however, the state of what normal is can change. More and more alcohol will be needed to have the same effect. This is what scientists refer to as “tolerance.”
Carrying Multiple Addictions?
June 9, 2009
Many addicts suffer from more than one addiction. It is not uncommon for them to use a variety of substances and behaviors to alter their mood. Carnes (1991), in a research project with sex addicts, found, for example that half of all sex addicts suffer from chemical dependency. Carnes also found that the more serious the wounds of childhood, the more likely there would be multiple addictions.
This dynamic has led to many speculating about “cross addictions,” or the “co-morbidity” of addictions. Carnes is currently proposing a new and broad diagnosis, “Multiple Addiction Disorder” (MAD—an appropriate acronym). Christian counselors need to evaluate a broad pattern of addiction and triage which of the addictions is the most immediately destructive.
Addictive behavior and the brain
June 8, 2009
What has long been debated is whether or not certain behaviors can affect the chemistry of the brain. As scientists have increased their ability to scan and produce images of the brain (through MRI and PET studies, for example), research projects have begun to demonstrate that behaviors can also do this.
When a person looks at another person who he or she loves or has feelings of sexual attraction for, certain opiates (catecholamines) are produced more rapidly in the brain. These neuro-chemicals have a heroin-like quality in the pleasure centers of the brain. That is why some have suggested that we can become Addicted to Love (Arterburn, 19–). At Vanderbilt University, researchers are showing the dramatic effects on the brain of looking at pornography (Carnes, 1991). Little doubt remains that all sexual thought and activity produce these same neurochemical effects.
Struggling With Addiction?
June 5, 2009
The addict represents someone who has become trapped in a web of deceit and dark forces too powerful to overcome without significant help from God and others. Romans 7:21-25 reveals the truth about it:
“So I find this law at work: When I want to do good, evil is right there with me. For in my inner being I delight in God’s law; but I see another law at work in the members of my body, waging war against the law of my mind and making me a prisoner of the law of sin at work within my members. What a wretched man I am! Who will rescue me from this body of death? Thanks be to God-through Jesus Christ our Lord!” (NIV)
These words of the apostle Paul embody the spiritual journey of those struggling with addiction. The mind of an addict knows that he or she needs to stop using certain substances or doing certain behaviors, but seemingly can’t. They know that they must start doing positive behaviors, but won’t. It is the great conflict that Bill Wilson, the co-founder of Alcoholics Anonymous, captured in step one: “I admitted that I was powerless over alcohol and that my life had become unmanageable.”
Paul’s self description also reflects the shameful nature an addict’s self-perception when he says, “What a wretched man I am!” The feeling of being a bad and worthless person is common to all addicts. It is not only that addictive behavior produces shame; shame is a basic feeling that addicts have felt most of their lives. It is that addictive behavior perpetuates and inflames shame.
Addiction: The Symptoms
June 4, 2009
Symptoms and Etiology of the Addict
The following list of 17 criteria is, in our opinion, a good set of common symptomatic behaviors and characteristics—a universal diagnostic set—that could be generalized to all substance or behavioral addictions and compulsions.
* A pattern of out of control substance usage or behavior for a year or more.
* Mood swings associated with usage or behavior.
* An increasing pattern of usage or behavior over time marked by periods of abstinence.
* The presence of major or milder forms of depression.
* The feeling of shame or self-worthlessness.
* The consistent need to be liked and find approval from others.
* Impulse control problems, especially with food, sex, drugs, or money/spending/gambling.
* Use of the substance of behavior to reward oneself or to reduce anxiety.
* Obsessing about the substance or behavior, and spending great amounts of time around it.
* Obtaining or doing the behavior becomes the central organizing principle of life.
* Failed efforts to control the behavior.
* Negative consequences due to the substance or behavior.
* Alternating pattern of out-of-control behavior with over-controlling behavior.
* A history of emotional, physical, sexual abuse, or spiritual abuse.
* A family history of addiction, rigidity, divorce, or disengagement.
* Marked feelings of loneliness or abandonment.
* Arrested developmental issues.
Substance Abuse Treatment
June 3, 2009
An estimated 3.3 million people aged 12 or older (1.4 percent of the population) received some kind of treatment for a problem related to the use of alcohol or illicit drugs in the 12 months prior to being interviewed in 2003. Of these, 1.2 million persons received treatment at a rehabilitation facility as an outpatient, 752,000 at a rehabilitation facility as an inpatient, 729,000 at a mental health center as an outpatient, 587,000 at a hospital as an inpatient, 377,000 at a private doctor’s office, 251,000 at an emergency room, and 206,000 at a prison or jail. Between 2002 and 2003, there were decreases in the number of persons treated for a substance use problem at a hospital as an inpatient, at a rehabilitation facility as an inpatient, at a mental health center as an outpatient, and at an emergency room.
In 2003, the estimated number of persons aged 12 or older needing treatment for an alcohol or illicit drug problem was 22.2 million (9.3 percent of the total population), about the same as in 2002 (22.8 million). The number needing but not receiving treatment also did not change between 2002 (20.5 million) and 2003 (20.3 million). However, a decline in the number receiving specialty treatment, from 2.3 million to 1.9 million, was statistically significant. This decline was driven by a decrease in treatment among adults aged 26 or older, from 1.7 million in 2002 to 1.2 million in 2003.
Of the 20.3 million people who needed but did not receive treatment in 2003, an estimated 1.0 million (5.1 percent) reported that they felt they needed treatment for their alcohol or drug problem. Of the 1.0 million persons who felt they needed treatment, 273,000 (26.3 percent) reported that they made an effort but were unable to get treatment and 764,000 (73.7 percent) reported making no effort to get treatment. Among the 1.0 million people who needed but did not receive treatment and felt they needed treatment, the most often reported reasons for not receiving treatment were not ready to stop using (41.2 percent), cost or insurance barriers (33.2 percent), reasons related to stigma (19.6 percent), and did not feel the need for treatment (at the time) or could handle the problem without treatment (17.2 percent).