How The Science Of Addiction Is Working Toward A Cure – And Getting Close
An article in the September edition of National Geographic “How Science Is Unlocking The Secrets Of Addiction” details how substance use hijacks the neural pathways of the brain, and author Fran Smith says many scientists contend addiction is therefore NOT a moral failing.
After decades of research, scientists finally have a thorough understanding of how addiction works by disrupting neural pathways and the brain’s reward system. That is, addiction is responsible for changes in brain structure, chemistry, and cell signaling, and assigns “supreme value to cocaine or heroin or gin, at the expense of other interests such as health, work, family, or life itself.”
Antonello Bonci, a neurologist from the National Institute on Drug Abuse, referred to it as “a pathological form of learning.”
Smith goes on to explain the biological mechanisms behind substance dependence, and highlight new techniques that scientists are testing in the ongoing search for a cure. Moreover, how the science of addiction is rapidly evolving.
For example, In Padua, Italy, psychiatrist Luigi Gallimberti is using an experimental treatment on patients known as transcranial magnetic stimulation (TMS), with real success.
Currently, he and other researchers are planning a large-scale trial, and the technique is being implemented by other scientists around the globe.
Smith says that Gallimberti decided to try the technique due to “frustration with traditional treatments.” Moreover “relapse is common, and there’s no effective medical remedy for addiction to stimulants like cocaine.”
Gallimberti was intrigued when he read an article about experiments by Bonci and others at NIDA.
They had measured neuronal electrical activity in cocaine-dependent rats and found that an area in the brain linked to behavior inhibition was unusually quiet.
Through the use of optogenetics, researchers re-activated these cells, and according to Bonci “Their interest in cocaine basically vanished.” So researchers posited that stimulation of that region of the brain in the pre-frontal cortex could curb an addicts desire for substances.
And Gallimberti believed that TMS “might offer a practical way to do that.” Because our brains run on electrical impulses, brain stimulation can impact that circuitry. Indeed, it has been used for years to treat other conditions such as depression.
The device is essentially simple – a magnetic wand with a coiled wire inside. When current runs through it, the device produces a magnetic pulse that changes electrical activity in the brain. Gallimberti believed that multiple impulses could activate neural pathways damaged by drugs, “like a reboot on a frozen computer.”
So he and a partner collaborated with Bonci to test the technique. They sought out a group of people addicted to cocaine, and sixteen received one month of brain stimulation while thirteen others received standard care, such as medication.
At the trial’s conclusion, eleven people in stimulation group were abstinent, compared to just three in the standard care group.
Eventually, the researchers published their findings in the Journal European Neuropsychopharmacology (January 2016.) This publicity resulted in hundreds of cocaine addicts flooding into the clinic.
However, it will take large-scaled trails to determine if the treatment is consistently effective and that the benefits are long-lasting, and the team is planning future studies.
“It’s so promising. Patients tell me, ‘Cocaine used to be part of who I am. Now it’s a distant thing that no longer controls me.’”
Understanding The Reward System And Advancements In The Science Of Addiction
Smith notes that it hasn’t been long since the concept of repairing drug-damaged wiring in the brain “would have seemed far-fetched.” Advancement in neuroscience, however, have put to rest traditional ideas about addiction:
“If you’d opened a medical textbook 30 years ago, you would have read that addiction means dependence on a substance with increasing tolerance, requiring more and more to feel the effects and producing a nasty withdrawal when use stops. That explained alcohol, nicotine, and heroin reasonably well.”
However, this model did not account for all substances, she goes on to say, including cocaine and marijuana, which do not typically cause many of the withdrawal symptoms that other substances do – such as shakiness, nausea, and vomiting.
Also, the traditional model did not explain relapse. Moreover, why do people still crave substances long after they leave the body and are no longer chemically dependent?
A recent report by the Surgeon General confirmed what the scientific community contended for years – that addiction is a disease and not a moral failing. And rather than being characterized by chemical dependence and withdrawal symptoms, it is a “compulsive repetition of an activity despite life-damaging consequences.”
Looking at the science of addiction in this way, medical professionals eventually began to believe that addiction could occur without substances such as drugs or alcohol – for example, people can be addicted to sex, gambling, cell phones, etc.
Anna Rose Childress, a clinical neuroscientist at the University of Pennsylvania Center for Studies of Addiction, who has also been hard at work for years studying the brain’s reward system in an attempt to understand addiction put it this way:
“We are all exquisite reward detectors. It’s our evolutionary legacy.”
You can read the article in its entirety here.
~ G. Nathalee Serrels, M.A., Psychology
Smith, Fran. “Unlocking the Secrets of Addiction.” National Geographic, September 2017.