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.
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.
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~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.