How Science Is Unlocking the Secrets of Addiction

Scientists are working to find medications that can prevent the activation of the brain’s reward system due to drugs, in order to keep people from falling back into relapse. It has been proven that electromagnetic ways can treat drug addiction. There are medications that can help people quit their addictive habits, however, relapse is very common. Dr. Gallimberti decided to use a method, transcranial magnetic stimulation (TMS), to help stop the addiction and prevent the relapse of stimulant drugs, such as cocaine.

After decades of testing animals and human volunteers, scientists have developed a picture of the way addiction can disrupt brain anatomy, chemistry, cell signaling, and more. Addiction changes the way the brain, prioritizing the drug over health, work, family, and life itself. By stimulating the region of the brain responsible for inhibiting behavior, an addict’s urge to get high may vanish. Dr. Gallimberti thought TMS might be a practical way to do that. For years, brain stimulation has treated depression and migraines by tapping the necessary circuit, Dr. Gallimberti believed brain stimulation could also activate drug-damaged neural pathways. Placebo-controlled trials proved TMS to be more effective than traditional therapy and medications.

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Dr. Childress conducted research on addict’s brains by studying the reward system. She used magnetic resonance imaging (MRI) machines, to track blood flow in the brain. Through this, she was able to detect gray ovals, bursting with colors, pinpointing the circuits in the brain that crave attention. Scientists believe the neurotransmitter dopamine is likely to trigger brain activity. The flow of dopamine heightens the motivational pull of a stimulus, such as cocaine, or a reminder of it, such as white powder. The stimulus or reminders provoke surges of dopamine. Before a person can see or hear a reminder of the stimulant, the brain has already been triggered. By the time a person becomes conscious of the trigger, it is too late.

Dr. Goldstein used an MRI machine and neuroimaging studies to understand how addiction can change the judgement, self-control, and other cognitive functions of the brain. Her research showed that as drug cues gain importance, the field of attention narrows, like a camera zooming in on one object and pushing everything else out. Dr. Goldstein's work showed that collectively, cocaine addicts have reduced gray matter volume in their prefrontal cortex. This can lead to poor executive function, resulting in decreased psychological functioning. For example, Dr. Goldstein has shown that a group of cocaine addicts may lag on a task such as, list as many farm animals as you can in one minute, compared to a group of people who aren’t addicted. However, on a task such as, list words related to drugs, they will excel. This is because their brain has narrowed down to primarily thinking about drugs. Although Dr. Goldtein’s lab does not answer the question of nature versus nurture, it has gained evidence that frontal brain regions begin to heal when people stop using drugs.  

Drug addiction is not the only problem scientists are addressing. In 2013, the American Psychiatric Association moved problem gambling out of a chapter called “Impulse Control Disorder Not Elsewhere Classified” in the Diagnostic and Statistical Manual and into the chapter called “Substance-Related and Addictive Disorders.” Dr. Potenza did some of the first brain-imaging studies of gamblers and discovered that they looked similar to scans of drug addicts, with sluggish activity in the parts of the brain responsible for impulse control. The Surgeon General of the Public Health Service has focused the Nation's attention on important public health issues. A report has confirmed what scientists have been saying for years: "Addiction is a disease, not a moral failing." Addiction is characterized by the compulsive repetition of an activity. Often times, the activity is completed regardless of the consequences. Therefore, addiction cannot be characterized by physical dependence or withdrawal. This report has encouraged many scientists to accept that addiction is not only related to drugs, but can also pertain to shopping, food, sex, or other activities. 

It’s characterized not necessarily by physical dependence or withdrawal but by compulsive repetition of an activity despite life-damaging consequences. This view has led many scientists to accept the once heretical idea that addiction is possible without drugs. 

There are a few medications that can help people overcome certain addictions. Most medications used to treat addiction have been around for years. The latest advances in neuroscience have yet to produce a breakthrough cure. Brain stimulation for addiction treatment, an outgrowth of recent neuroscience discoveries, is still experimental. Although 12-step programs, cognitive therapy, and other psychotherapeutic approaches are transformative for many people, they don’t work for everyone, and relapse rates are high. There are two camps. One believes that a cure lies in fixing the faulty chemistry or wiring of the addicted brain through medication or techniques like TMS, with psychosocial support as an adjunct. The other sees medication as the adjunct, a way to reduce craving and the agony of withdrawal while allowing people to do the psychological work essential to addiction recovery. Both camps agree on one thing: Current treatment falls short.

If you believe neurofeedback can help you or someone you know struggling with addiction, we can help. Neurofeedback can train your brain to regulate, stabilize and focus itself so you're able to concentrate better and reduce the relapse and urges associated with addiction.

Contact us for more information on how Neurofeedback can help you and your family find the focus you need to function at your best.

~Written by Allison Parker and Tanya L. Hilber, PsyD

Reference: Williams, Ryan T. “How Science Is Unlocking the Secrets of Addiction.” National Geographic, 22 Aug. 2017.

Consistent Use of ADHD Medication May Stunt Growth by 2 Inches

As previously seen on Hilber Psychological Services, there may be a relationship between consistent use of SDHD medication and height growth. According to the article, "Consistent Use of ADHD Medication May Stunt Growth by 2 Inches, Large Study Finds", written by Dr. David Rabiner, "although the benefits of medication treatment on ADHD symptoms dissipate, the impact on adult stature persists". The Multimodal Treatment Study of ADHD (MTA Study) tested 600 7–9-year-old children with ADHD. These children were randomly assigned into one of these four groups: 
1. Carefully monitored medication treatment
2. Intensive behavior therapy
3. Medication treatment combined with behavior therapy
4. Community care (parents obtained whatever treatment they want)

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After 14 months, the study showed that those children who received carefully monitored medication treatment or medication treatment combined with behavior therapy had lower levels of overall ADHD symptoms and better overall adjustment compared to those children who received intensive behavior therapy or community care. The results stayed the same after an evaluation 10 months later. However, evaluation after 1 year and again after several groups showed no group differences based on the initial group treatment assignments. Therefore, the initial benefits of the medication had disappeared. The study continued annually through age 18 and then reduced visits to age 25. Within this group, individuals were categorized based on their medication usage:
a. Consistent, i.e,. those who had met the minimum threshold during each year;
b. Inconsistent, i.e., those meeting the minimum threshold in some but not all years; and
c. Negligible, i.e., below the minimum threshold in all years. 

At the last evaluation, age 25, participants self- and parent-reported, and doctors measured the patient's height compared to other individuals around the area that had not been diagnosed with ADHD in their childhood. Based off of the medication categorized above, only 14.3% of participants consistently used medication through age 18. After comparing the other participants, participants with ADHD maintained substantially higher ADHD symptoms over time regardless of their initial treatment. It was clear that ADHD symptoms in young adulthood are not related to patterns of medication use through adolescence. 

There was thus no indication that consistent medication treatment over a number of years had any persistent impact. However, there was a relationship found between persistent medication use and adult height. According to Dr. Rabiner, "Students in the Consistent and Inconsistent medication treatment groups had average heights — combined across these groups — that were about an inch shorter than those in the Negligible treatment group. And, participants in the Consistent Group were nearly an inch shorter on average than those in the Inconsistent group, i.e., nearly 2 inches shorter than those in the Negligible group". 

Overall, the study concluded there was substantial persistence of ADHD symptoms into adulthood and although the benefits of medication treatment on ADHD symptoms dissipate, the impact on adult stature persists. However, it is possible that some other factor that contributed to some participants taking medication more consistently, e.g., more severe symptoms, also explains the reduced height attainment in this group.

There are many take home messages:
1. Relatively few youth with ADHD use medication consistently over their development.
2. Many individuals with ADHD will continue to struggle with ADHD symptoms into adulthood. 
3. Although medication helps control symptoms in the short-term, it is not a cure.
4. It is unknown whether optimal medication treatment maintained over many years would have a greater impact.
5. Parents and clinicians need to balance the need for persistent treatment in some children with the likely consequences of reduced adult height. 

Due to the symptoms that may occur from using persistent medication, an optimal solution would be to find the lowest effective dose of medication, or combine medication treatment with other behavior therapy and/or other approaches.

If your focus still has not improved enough to meet your goals, your brain may need some training. Neurofeedback can train your brain to regulate, stabilize and focus itself so you're able to concentrate better on your tasks or follow directions that are given to you.

 Contact us for more information on how Neurofeedback can help you and your family find the focus you need to function at your best.

~Written by Allison Parker and Tanya L. Hilber, PsyD

Reference: Rabiner, David. “Consistent Use of ADHD Medication May Stunt Growth by 2 Inches, Large Study Finds.” SharpBrains, SharpBrains, 28 Mar. 2018

America’s Real Digital Divide

The biggest question being asked: How bad are electronics for children? The answer: bad. The problem is people are not aware of the consequences screen time can have on their children.

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One of the problems is that people believe that middle-class children are being harmed by too much screen time. However, minority and disadvantaged kids spend much more time in front of screens."According to a 2011 study by researchers at Northwestern University, minority children watch 50 percent more TV than their white peers, and they use computers for up to one and a half hours longer each day. White children spend eight hours and 36 minutes looking at a screen every day, according to a survey by the Kaiser Family Foundation, while black and Hispanic children spend 13 hours." This large amount of time spent staring at a screen has a negative effect on children’s ability to understand nonverbal emotional cues, and is linked to higher rates of mental illness, including depression. 

Unfortunately, low-income and less-educated parents receive the message that screen time is going to help their children. Parents are being told be teachers and other staff, that a faster computer can help raise their child's grades. However, in states, such as Maine, that supply tablets for each student, there has been no noticeable improvement on standardized testing 

No one is telling poorer parents about the dangers of screen time. This is the factor that is stopping these parents from limiting their child's screen time. The real digital divide is not between children who have access to internet or don't, it's about the parents who have been brain washed into thinking more screen time is good because they don't know any better. It's time to make a difference in the lives of all children. 

If your focus still has not improved enough to meet your goals, your brain may need some training. Neurofeedback can train your brain to regulate, stabilize and focus itself so you're able to concentrate better on your tasks or follow directions that are given to you.

 Contact us for more information on how Neurofeedback can help you and your family find the focus you need to function at your best.

~Written by Allison Parker and Tanya L. Hilber, PsyD

Reference: Schaefer Riley, Naomi. “America’s Real Digital Divide.” The New York Times , The New York Times, 11 Feb. 2018.