Cindi Davis PSY205 Mrs.

Clausen

Very Rewarding

Why would a recovering alcoholic who hasnt had a single drink in ten years suddenly fall off the wagon? Why would an ex-smoker ever pick up a cigarette and start smoking again? Surely the effort and struggle they went through to quit their addiction would be reason enough not to begin again. However, studies show that over 90 percent of alcoholics are likely to experience at least one relapse over the 4-year period following treatment. The fact that alcohol, nicotine, and heroin addiction have similar dependence and relapse rates suggests that the causes for relapse in many addictive disorders are quite similar ("Alcohol relapse," 2011). Whether its roots lie in an innate genetic defect or the genes become defective through substance use, the outcome is the same; the psychological benefits received from satisfying the reward deficiency in the brain, often more prominent than physiological incentives, provoke strong addictive behaviors. When a person stimulates the reward centers in the brain, through mind-altering drugs or through a specific activity, they become inclined to repeat that behavior. Stimulation of the reward centers is an integral part of brain activity, and can be caused by several factors, including food and sex. Addictive drugs, however, stimulate the reward centers unnaturally, and take the brain to places it was never intended to go (Stanford, 2012). In fact, where a basic activity like eating can cause a forty-five percent increase in reward system activity, amphetamines and cocaine can increase the activity by 500 percent. Addictive drugs also interrupt and alter the neurotransmitter activity in the brain, and repetitive altering of neurotransmitters creates dependence in the body (Zimbardo, Johnson & McCann, 2011). After a period of modifying brain activity, the brain adjusts, and starts to need the substance to operate normally. Because the drugs produce excessive amounts of the feel-good chemical dopamine, the brain

automatically reduces its dopamine receptors, resulting in a need for more of the drug. This is called down-regulation of the brain, and tolerance to the substance builds. When the brain becomes tolerant to the substance, a greater amount is needed to achieve desired results, and a vicious cycle is created (Fiore, 2010). Usually by the time this is identified, the person is fully addicted. Although most persons experimenting with using mood-altering substances will stop when they discover any negative effects, the few that go on to become addicted seem to share a common element. The reward that these potential addicts appear to get is an existential one; a relief from deep-seated anxieties they have about themselves and their lives that they have been unable to get elsewhere (Peele, 2011). This creates the belief that the substance (or activity) provides something that nothing else can, and a type of love relationship is born. When the person tries to break the addiction, the grieving process can be similar to that of losing a loved one (Polito, 2012). Depending on the substance used, most psychological effects of addiction last considerably longer than their physical counterparts. This is perhaps because the addicts mind has been conditioned to stimulate craving in expectation of the substance at the first sign of physical discomfort. When that craving is no longer satisfied, the psychological urges and yearnings intensify and escalate, whereas physical withdrawal symptoms start to gradually decrease from the onset of abstinence (Polito, 2012). Studies show that some people may have a genetic predisposition toward addiction. For example, according to the Harvard Mental Health Letter, Twin and adoption studies show that about 50% of individual variation in susceptibility to addiction is hereditary. Mice with an extra gene for the production of a certain nerve cell protein are more vulnerable to cocaine addiction. According to a recent report, one gene variant reduces the amount of dopamine release caused by cocaine in human beings a genetic defense against at least one type of addiction. This susceptibility suggests that the reward pathways for these individuals may be more vulnerable (Harvard, 2004). Since the processes for forming addiction through overstimulation of the reward pathways in the brain have become clearer, some apparent solutions have emerged as well. One strategy therapists are utilizing is trying alternate substances to cool down the reward pathway. Medications are used to

simulate cell activity or block opiate receptors, while psychotherapy is used to increase frontal-lobe activity, which is responsible for inhibitory control and executive functioning. Interestingly, the mere discovery of the underlying psychological causes of addiction initiates brain chemical changes that diffuse the compulsion and can help regulate behavior (Fiore, 2010). According to Stephen Gilman, MD, an addiction specialist in New York City, one of the more prominent reasons that an addict chooses to use again after a period of abstinence is an underlying mental issue, such as anxiety or depression. In fact, as per James Garbutt, MD, professor of psychiatry at the University of North Carolina in Chapel Hill and a researcher at the Bowles Center for Alcohol Studies, As many as 50 percent of those with bipolar disorder also have an alcohol or drug addiction (Foster, 2009). During a relapse prevention program, addicts can learn how to effectively cope with high-risk scenarios where relapse is most likely, including care for any mental health issues. The disease model of addiction states that addiction is progressive, incurable, and potentially fatal. The academic model argues that it is the use of drugs that causes the body to adapt through physiological mechanisms such as tolerance, tissue dependence, withdrawal and psychic dependence. The behavioral and environmental model says that environmental influences such as stress, anger and abuse can create addiction (Roher). Whichever model psychotherapists chose to follow, one thing is clear: Addiction is a disorder of the brains reward system with psychological motivations, and they are often lengthier and stronger than the neurological causes. Good news for addicts who struggle with relapse is the fact that scientists are working to understand how to rewire the brain to the way it was before addiction. According to researchers at researcher at UBC's Brain Research Centre, resetting the addicted brain to a non-addicted state could help a lot of people get off destructive drugs and stay clean (Helm, 2006). As shown in the following photo from the Journal of Neuroscience, the brain has a remarkable ability to recover after a prolonged abstinence from drugs (NIDA, 2010).

Fortunately for those who want to recover from their addictions, it has been shown that with proper care and therapy many addicts go on to live happy, substance-free lives.

References

Alcohol relapse. (2011). Retrieved from http://www.alcoholmd.com/alcoholrelapse.htm Peele, S. (2011, October 27). The benefits of addiction: Why alcoholics drink. Retrieved from http://www.psychologytoday.com/blog/addiction-in-society/201110/the-benefits-addiction-whyalcoholics-drink Fiore, K. (2010, January 31). Addictions, bad habits can 'highjack' brain. Retrieved from http://abcnews.go.com/GMA/MindMoodNews/addictions-hardwired-brain/story?id=9699738 Foster, L. (2009, April 20). Understanding addiction relapse. Retrieved from http://www.everydayhealth.com/addiction/understanding-addiction-relapse.aspx Harvard. (2004, July). The addicted brain. Retrieved from http://www.health.harvard.edu/newsweek/The_addicted_brain.htm Helm, J. (2006, June 1). Rewiring the brain against addiction. Retrieved from http://thetyee.ca/News/2006/06/01/RewiringTheBrain/ Institute of Alcohol Studies. (2007, July). Alcohol and mental health. Retrieved from http://www.ias.org.uk/resources/factsheets/mentalhealth.pdf NIDA. (2010, August). Drugs, brains, and behavior: The science of addiction. Retrieved from http://www.drugabuse.gov/publications/science-addiction/treatment-recovery Polito, J. R. (2012, January 16). Why quit?. Retrieved from http://whyquit.com/whyquit/A_Symptoms.html Riss, S. (2012). Whats wrong with my brain?. Retrieved from http://www.together.us.com/2012/01/whats-wrong-with-my-brain/ Stanford, M. (2012, April 16). The dysfunctional reward..addiction. Retrieved from http://www.mentalhealthgracealliance.org/mental-illness/dysfunctional-reward-addiction/ Zimbardo, P., Johnson, R., & McCann, V. (2011).Psychology: Core Concepts. (Sixth ed.). Boston: WGBH Boston.